Can I pay the PCORI fee electronically?

Yes, you can pay the PCORI fee electronically. You can use the Electronic Federal Tax Payment System (EFTPS).

Do I owe a PCORI fee if I offer both an ICHRA and a group health plan?

Yes, you need to pay a PCORI fee if you offer an ICHRA. The PCORI fee for ICHRA is separate if the group plan is a fully-insured plan, as PCORI only applies to self-funded models. If you offer a self-funded plan alongside an ICHRA to different employees, and they share the same plan year, you can combine them for PCORI fee reporting purposes. Count the average number of participating employees and dependents for the self-funded plan plus the average number of participating ICHRA employees.

Is a QSEHRA worth it for small businesses?

For many small businesses, yes, a QSEHRA is worth it. A qualified small employer HRA (QSEHRA) offers a predictable way to provide health benefits without the cost and complexity of traditional group health insurance. Employers set a monthly allowance that fits their budget, while employees choose their preferred individual health insurance plan.

What are some potential drawbacks to consider when thinking about offering a QSEHRA?

The main potential downside to a QSEHRA is the IRS annual contribution limit. Unlike an individual coverage HRA (ICHRA), employers can't give employees more than the IRS-set maximum limit. QSEHRAs also have fewer customization options for varying employee contributions.

Can employees choose any health insurance plan with a QSEHRA?

Yes. Employees can generally purchase any ACA-compliant individual health insurance plan that best meets their needs through a local exchange, the federal Health Insurance Marketplace, a private insurer, or a licensed insurance broker. However, employees must have a health plan that provides minimum essential coverage (MEC) to participate in the QSEHRA.

Who is eligible to offer a QSEHRA?

A QSEHRA is available to employers with fewer than 50 full-time equivalent employees (FTEs). You can’t offer a traditional group health plan or group ancillary benefits alongside the QSEHRA. Employers must also comply with IRS rules regarding reimbursement limits and employee eligibility.

Can a QSEHRA reimburse more than individual insurance premiums?

Yes. Employers can design the benefit to allow employee reimbursements for health insurance premiums only or for premiums plus other IRS-qualified out-of-pocket medical expenses. This includes deductibles, copays, over-the-counter drugs, prescription medications, and other eligible expenses.

Can I administer a QSEHRA myself?

While employers can self-administer a QSEHRA, doing so can be time-consuming and risk compliance penalties. Many employers use an HRA administrator, like PeopleKeep, to automate plan documents, review reimbursement requests, maintain required records, and help ensure compliance with IRS and HIPAA requirements.

What is the main difference between an HDHP and an LDHP?

The primary difference is the deductible. A high deductible health plan (HDHP) requires you to pay more out of pocket before your insurance begins covering costs, while a low deductible health plan (LDHP) has a lower deductible but typically comes with higher monthly premiums.

Is a high deductible health plan better than a low deductible health plan?

It depends on the individual consumer’s needs. An HDHP may be a good choice for healthy individuals who don't expect many medical expenses and want lower premiums. An LDHP is often better for people who need frequent medical care and prefer lower out-of-pocket costs when they receive treatment.

Can you have a health savings account (HSA) with a low deductible health plan?

No. To contribute to an HSA, you must enroll in an HSA-qualified HDHP. Most low deductible health plans aren't eligible for HSA contributions.

Can employers offer both HDHP and LDHP options to employees?

Yes. Employers can offer multiple plan options through a traditional group health insurance program. Alternatively, employers can provide a QSEHRA or ICHRA, which allows employees to choose the individual health plan, including an HDHP or LDHP, that best fits their medical needs.

How can employers help employees with out-of-pocket healthcare costs?

Employers can supplement health coverage with benefits such as health savings accounts (HSAs), group coverage HRAs (GCHRAs), qualified small employer HRAs (QSEHRAs), or individual coverage HRAs (ICHRAs). These benefits can help employees pay for out-of-pocket medical expenses on a tax-free basis to make healthcare more affordable.

Personalized Employee Benefits Resources | PeopleKeep

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