A Qualified Small Employer Health Reimbursement Arrangement allows small employers who don’t offer group health insurance benefits to reimburse employees – tax-free – for some or all of the premiums they pay for coverage purchased in the individual market, on or off-exchange. The QSEHRA can also be used to reimburse employees for out-of-pocket medical expenses.
Yes. The maximum amount that an employer can reimburse through a QSEHRA in 2022 is $5,450 for a single employee’s coverage ($454.16 per month), and $11,050 for family coverage ($920.83 per month). These amounts are indexed annually by the IRS. For 2023, the limits are $5,850 for a single employee ($487.50 per month), and $11,800 for family coverage ($983.33 per month).
QSEHRAs can be used by any employer that is not considered an “applicable large employer” and that does not offer a group health plan for employees (applicable large employers are those that have at least 50 full-time equivalent employees).
Yes. Unlike ICHRAs, it is possible to have both a QSEHRA benefit and a premium tax credit in the marketplace.
But in situations like this, the marketplace premium tax credit will be reduced by the amount of the QSEHRA benefit. In other words, the total benefit won’t be more than the person would have had with the premium tax credit alone, but it is possible to receive some premium tax credit in addition to the amount the person would have received via the QSEHRA alone.
No. In order to provide a QSEHRA benefit, a small employer cannot offer a group health plan to any employees.
Employers interested in offering a group plan to some classes of employees and a reimbursement plan to other classes (assuming they are bona fide employee classifications) could use an ICHRA instead.
This SEP means you won't have to wait until the next open enrollment if you're offered reimbursement for health premiums through a QSEHRA or ICHRA.
Outside of ACA's annual open enrollment, you can still enroll or change plans if you experience a qualifying event.
Sweeping health reform legislation delivered a long list of provisions focused on health insurance affordability, consumer protections.