"The Spousal Incentive Health Reimbursement Account (SIHRA) is an effective tool that self-insured health plans for larger groups can use to hedge their risks and improve their cash positions -- while keeping their plans and people whole.... [T]he SIHRA option gives financial incentives to the working spouses to enroll in their own employers' group health plans. Likewise, employees (and children) currently enrolled are also eligible to elect the SIHRA option and enroll in their spouse's employer's health plans."

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