(920) 284-6067
For Medicare call
(920) 631-1006
We do not cover every Medicare plan available in your area. Currently, I represent 8 organizations which offers 57 products in your area. Please contact Medicare.gov. or 1-800-Medicare or your local State Health Insurance Program (SHIP) to get all of your options.
QSHERA
Which employers can offer QSEHRAs?
Small employers with fewer than 50 full-time equivalent (FTE) employees AND who do not offer a group health plan to any of their employees can offer QSEHRAs to their staff. An FTE employee is one who works 130 hours per month, or 30 or more hours per week for 120 consecutive days.
What benefits does a QSEHRA cover?
As defined in Section 213(d) of the Internal Revenue Code, a QSEHRA can cover the cost of any documented healthcare expense. In addition, employees can use their QSEHRA to help pay for individual health insurance premiums. One thing to keep in mind is that all covered costs, including medical expenses and insurance premiums, must be documented.
Who can contribute to the QSEHRA?
Like a regular HRA, a QSEHRA is funded solely (100%) by the employer. Therefore, employees cannot contribute and the employer’s contributions are not deducted from the employees’ pay.
Are there contribution limits?
Yes. For single employees, the employer may contribute a maximum of $4,950 annually. For employees with family expenses, the employer may contribute a maximum of $10,000 annually.
What are the health plan requirements for employees?
Employees must purchase a health plan that has minimum essential coverage (MEC), as stated by the ACA. Learn more about minimum essential coverage.
If an individual purchases health coverage without MEC, then they may be taxed and reimbursements from the QSEHRA may be included in their gross income.
Who can contribute to the QSEHRA?
Like a regular HRA, a QSEHRA is funded solely (100%) by the employer. Therefore, employees cannot contribute and the employer’s contributions are not deducted from the employees’ pay.
Which employees are eligible for a QSEHRA?
Full-time employees who work 130 hours per month, or 30 or more hours per week for 120 consecutive days. Generally, all employees must be offered coverage under the same terms with some exceptions.
Are individuals who purchase subsidized health insurance affected by QSEHRA?
Yes. For employees who obtain health insurance through a public exchange and qualify for subsidized coverage, they must report the amount in the QSEHRA to the exchange. Their federal subsidy amount will be reduced by the amount in the HRA benefit.
For example, if John Doe qualifies for a $2,000 annual subsidy, and he receives $1,500 in the QSEHRA, then Mr. Doe’s subsidy is reduced by $1,500.
Are there administrative requirements for QSEHRA?
Yes. Employers must provide a written notice to their workforce 90 days before the start of the plan year with the following information:
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Amount in the QSEHRA benefit
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Informing employees to notify the exchange of the QSEHRA if they apply for a subsidy
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Consequences of not getting MEC, which may result in taxes and the inclusion of reimbursements in their gross income
Health insurance can be complicated. Let us make it simple in your time of need.
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