The idea of health reimbursements arrangements (HRAs) where employers reimburse employees for certain medical costs on a tax-advantaged basis are not new. But their use became questionable under the Affordable Care Act (ACA) when employers faced potential penalties if they offered them (see Notice 2013-54). Now, under a final rule issued jointly by the Departments of Labor, Health and Human Services, and the Treasury, employers of any size can offer a new Individual Coverage HRA starting Jan. 1, 2020, as an alternative to traditional group health coverage without running afoul of ACA. What’s more, beginning Jan. 1, 2020, employers with traditional group health coverage can offer a supplemental type of HRA, called an Excepted Benefit HRA, to help employees pay for what traditional health coverage does not (e.g., vision and dental care).

ICHRAs

Employers can adopt Individual Coverage Health Reimbursement Arrangements (ICHRAs) to enable employees to pay for individual coverage on or off a government Exchange or Medicare while retaining the tax advantages associated with traditional group health coverage (i.e., tax-free treatment for reimbursements to employees; exemption from payroll taxes on reimbursements). The ICHRA is a notational account from which employer reimburses employees according to the terms of the plan; no annual contributions by the employer are made to a trust as is the case with a qualified retirement plan.