Multi-state qualified health plans for employers

Offer flexible health benefits to employees across state lines using a health reimbursement arrangement or health stipend.

Need help designing a benefit that works for your organization? Book a call with a personalized benefits advisor. 

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Need to offer health insurance that’s good in all 50 states?

Given that more than half of the U.S. workforce is fully remote, today’s employees are more spread out than ever before. One company can have employees from all across the country, which makes finding health coverage options that provide in-network coverage for everyone particularly challenging. 

Luckily, employers of all sizes can implement a multi-state health benefit plan program that doesn’t require buying plans from multiple insurance companies and health insurers. 

Health reimbursement arrangements (HRAs) and health stipends are two flexible, cost-controlled and convenient ways to offer a multi-state health plan and in-network care for all your employees.


Best multi-state health plans that work across state lines

When looking into multi-state options for health coverage, it can be challenging to find an affordable national plan from traditional group health insurance issuers.

Because both HRAs and health stipends are reimbursement arrangements—not health insurance plans—coordinating their use across state lines requires no additional effort. 

These plans enable employers to reimburse employees for their medical costs by offering a set monthly allowance amount of their choosing, avoiding the hassle that comes with health insurance renewals and premium rate spikes every year. They also enable employees to select the healthcare products and services that are most accessible to them.

Health reimbursement arrangement (HRA)

An HRA is an IRS-approved, employer-funded health benefit used to reimburse employees, tax-free, for their healthcare expenses, including health insurance premiums, out-of-pocket medical expenses, or a combination of the two.

Why it’s a good multi-state plan

  • Empowers employees to choose: With an HRA, employees can shop on the individual market and select their own individual plan with a network of providers that works in their area and covers the essential health benefits that matter most to them.
  • Satisfies federal government mandates: Some HRAs, like the individual coverage HRA (ICHRA) can satisfy federal regulations for applicable large employers, including the Affordable Care Act’s employer mandate.
  • Gives your plan a competitive advantage: While most employers offer inflexible group health insurance plans, with an HRA, you’ll be able to tout to job candidates a personalized health benefit that outshines competitors.

Learn more about each HRA


For employers with 1-49 employees


A simple, controlled-cost alternative to group health insurance.




For employers of all sizes


A flexible health benefit that can be used alone or alongside group health insurance.




For employers offering group health insurance


A group health supplement to help employees with out-of-pocket expenses.



Health stipend

A health stipend is a fixed amount of money offered to employees to help pay for employees’ healthcare costs, medical care, health insurance premiums, and more. Stipends aren’t formal group health plans, so you get to decide which expenses qualify and which don’t.

Because a stipend isn’t a formal group health plan, you don’t have to worry about any compliance or regulation considerations with the federal government, like the IRS, HIPAA, or ERISA. However, you and the eligible individuals you choose to offer the benefit to will pay taxes on the stipend.

Why it’s a good multi-state plan

  • Lower administrative costs: Administering your health benefits through an employee stipend program is simple, easing the administrative burden for you or your benefits advisor. Health stipends make it easy to pay out reimbursements to all of your employees, all from the same spot.
  • Offers a level playing field: With a health stipend, each of your employees can spend their money differently, making for an equitable benefit. Employees can shop on the health insurance markets, get a private health plan, or simply spend it on out-of-pocket medical expenses.
  • Coordinates with premium tax credits: Unlike with an HRA, if your employees qualify for a premium tax credit, they’ll be able to use their health allowance and collect their full tax credit—no need to choose between the two.

Can’t decide? See how HRAs and health stipends compare in our chart


Frequently asked questions

Do all employees have to be offered the same benefits?

There is no legal requirement that says all employees need to be offered the exact same benefits. This means you can legally offer a different health benefit allowance to employees who live in a state where the cost of living or healthcare is more expensive. 

However, there are some anti-discrimination rules you’ll need to keep in mind if you’re going to be offering different benefits to employees in different groups.

Learn more about the regulations on offering different coverage for health benefits

Does an individual health insurance plan offer worse coverage than a group plan?

There’s a common misconception that an individual health insurance plan doesn’t offer the same quality of coverage as a group health plan. While many employees are already familiar with group health insurance plans, their one-size-fits all nature and strict requirements can actually make them a less attractive option. 

Reimbursing employees for individual health insurance coverage is generally more cost-effective, more flexible, and empowers employees to make their own healthcare decisions—getting them the network providers they need at a price they can afford.

Learn more about how individual health insurance compares to group health plans

What if my employees need help finding a plan on the health insurance exchange?

If your employees are new to the health insurance marketplaces, offers free help to all healthcare consumers. 

If you’re interested in an HRA or health stipend with PeopleKeep, you’ll have access to our wealth of broker partners and experts at StrideHealth to help your employees find the best plan for them no matter their health or financial requirements, or where they live.

Are there additional benefits I can offer to employees across state lines?

A health benefit isn’t the only multi-state plan program you can offer your employees. With PeopleKeep, we offer more employee stipends that business owners of all sizes can offer their employees, including wellness stipends and remote work stipends. 

Learn more about PeopleKeep’s WorkPerks products


Wondering how PeopleKeep can help you offer benefits?

Speak with a PeopleKeep personalized benefits advisor who can answer your questions and guide you toward the best benefits options for your organization.