A Health Reimbursement Arrangement (HRA) is an employer-funded plan that reimburses employees for qualifying out-of-pocket medical expenses and, in some cases, health insurance premiums. HRAs are designed to provide tax-free reimbursements to employees, thus enhancing employee benefits while potentially reducing overall healthcare costs for both the employer and employees.
Types of HRAs
Integrated HRAs
Integrated HRAs are designed to work alongside a group health insurance plan provided by the employer. Employees can use these funds to cover costs that the primary health plan does not cover, such as copays, deductibles, and other eligible expenses.
Standalone HRAs
Standalone HRAs (also known as Excepted Benefit HRAs) are not tied to a specific health insurance plan. Employees can use the funds to pay for qualifying medical expenses and, in some instances, health insurance premiums.
Qualified Small Employer HRAs (QSEHRAs)
QSEHRAs are available to small employers who do not offer group health insurance. These plans allow small businesses to reimburse employees for medical expenses and, if applicable, health insurance premiums, up to a maximum limit set by the IRS.
Individual Coverage HRAs (ICHRAs)
ICHRAs allow employers to provide defined, non-taxed reimbursements to employees for individual health insurance policies. This type of HRA was introduced to give employees more flexibility in choosing their health insurance plans.
Special Considerations
- Employer Contributions Only: Unlike Health Savings Accounts (HSAs) and Flexible Spending Accounts (FSAs), HRAs are solely funded by employers. Employees cannot contribute to HRAs.
- Non-Taxable Benefits: Reimbursements from HRAs are generally not considered taxable income for employees unless they exceed the employee’s incurred medical expenses.
- Annual Rollover: Depending on the plan design, unused HRA funds may be carried over from year to year, providing financial flexibility for future medical expenses.
- Portability: Most HRAs are not portable, meaning that the balance typically remains with the employer if an employee leaves the company.
Historical Context
HRAs were established by the Internal Revenue Service (IRS) in 2002 to provide more flexible healthcare benefits options for employers and employees. They have evolved over time, with significant changes introduced by the Affordable Care Act (ACA) and subsequent regulatory updates to allow greater customization and applicability.
Applicability
Employers
Employers use HRAs to offer more comprehensive health benefits packages, which can aid in employee retention and satisfaction. HRAs also allow for potential cost control over health benefits spend as employers can decide the amount to allocate annually.
Employees
Employees benefit from HRAs by receiving reimbursements for eligible healthcare expenses, thereby reducing their out-of-pocket costs. This can lead to significant tax savings, as the reimbursements are generally not counted as taxable income.
Comparisons
HRA vs. HSA
- Funding: HRAs are employer-funded, while HSAs can be funded by both employers and employees.
- Portability: HSAs are portable; HRAs are usually not.
- Usage: HSA funds can be invested and used for a wider range of expenses, including long-term care and retirement healthcare costs. HRA funds are more specifically used for current medical expenses and sometimes insurance premiums.
HRA vs. FSA
- Funding: HRAs are funded solely by employers, while FSAs can be funded by both employee salary deferrals and employer contributions.
- Flexibility: FSAs have stricter use-it-or-lose-it rules, whereas HRAs can often allow unused funds to roll over to the next year.
Related Terms
- Health Savings Account (HSA): A tax-advantaged medical savings account available to taxpayers in the United States who are enrolled in a high-deductible health plan (HDHP).
- Flexible Spending Account (FSA): An account that allows employees to set aside pre-tax dollars for out-of-pocket medical expenses.
- Qualified Medical Expenses (QMEs): Expenses defined by the IRS that qualify for tax-free reimbursement from accounts like HRAs, HSAs, and FSAs.
FAQs
1. Can employees contribute to an HRA? No, HRAs are solely funded by employers. Employees cannot make contributions to an HRA.
2. Are HRA funds taxable? Reimbursements from an HRA for qualifying medical expenses are generally tax-free for employees.
3. Can unused HRA funds be rolled over? It depends on the plan design. Some HRAs allow unused funds to be carried over to the next year, while others do not.
4. What happens to my HRA if I leave my job? Most HRAs are not portable, meaning any remaining funds typically stay with the employer and do not transfer with the employee.
References
- Internal Revenue Service (IRS). Health Reimbursement Arrangements. IRS.gov.
- U.S. Department of Labor. Health Benefits Advisor. DOL.gov.
- Healthcare.gov. Health Reimbursement Arrangements (HRAs).
- National Association of Health Underwriters (NAHU). HRA Compliance and Plan Design.
Summary
Health Reimbursement Arrangements (HRAs) represent a flexible and tax-advantaged option for employers to reimburse employees for qualified medical expenses. By leveraging employer-funded contributions to provide tax-free medical expense reimbursements, HRAs enhance the benefits package for employees while offering potential cost controls for employers. Understanding the various types of HRAs and their specific applications ensures that both employers and employees can optimize their healthcare spending and benefits.
