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Health Care Accounts

The Affordable Care Act (ACA) affects cafeteria plans as well as health care accounts such as flexible spending accounts (FSAs), health savings accounts (HSAs), health reimbursement arrangements (HRAs) and Archer medical savings accounts (Archer MSAs).

Articles

What is QSEHRA? A practical guide for small employers, Take Command Health, 6/26/2018

New Guidance on Qualified Small Employer Health Reimbursement Arrangements, von Briesen & Roper, SC, 1/18/2018

Challenges of Embedded Deductibles and Out-of-Pocket Maximums, HUB International, 11/15/2017

Executive Order on Health Care Discontinuation of Cost-Sharing Subsidies in the Marketplaces, Marsh & McLennan, 10/30/2017

HRAs, AHPs, and STLDIs: What the Executive Order Means for Benefit Plans, IFEBP, 10/20/2017 Blog explains President Trump's Executive Order dated October 12, 2017, and how it could affect employers and employees

The Revolution of Employer-Sponsored Health Insurance, Trucker Huss, 10/19/2017 Article explores possible effects of 10/12/17 Executive Order on HRAs and Employer Payment Plans (EPPs).

What If Employees Could Buy Coverage with Tax-Free HRA Contributions?, Mercer, 10/12/2017

ACA Numbers & Limitations, Kaufman & Canoles, 10/1/2017 Chart including employer 4980 penalty amounts from 2015 - 2018

QSEHRA – The 21st Century Cures Act Creates a New Health Care Plan Option for Small Employers, Mintz Levin, 3/31/2017

Small Employer Standalone HRA Allowed by New Law, Dickinson Wright, 12/15/2016

IRS Proposes Additional Regulations Clarifying Handling of 'Opt-Out' or 'Cash-in-Lieu' Programs Under PPACA, Benefit Revolution, 7/23/2016

Additional Guidance on Health Reimbursement Arrangements, Segal Consulting, 2/23/2016

IRS Addresses HRA Coverage, TINs, and ACA Information Reporting, Thomson Reuters Practical Law, 8/1/2015

Implementing Health Reform: Preliminary 2015 Enrollment Numbers; Guidances, Health Affairs, 2/19/2015

What is the Future of HRAs Following Health Care Reform?, Kushner & Company, 10/7/2013

FAQs

What is a “qualified small employer health reimbursement arrangement” (QSEHRA) and is it considered a group health plan?, International Foundation, 1/23/2017

Can HMOs exclude dependents under age 26 because they live outside the service area?, International Foundation, 6/23/2016

Under the Affordable Care Act (ACA), may an employer still offer different health plan benefits to different groups of employees?, International Foundation, 3/23/2016

What is the difference between out-of-pocket limits for essential health benefits and out-of-pocket limits imposed on high deductible health plans?, International Foundation, 3/4/2016

Can we offer a stipend for employees to use to purchase their own individual health insurance policies?, International Foundation, 11/3/2015

Does the ACA require an annual open enrollment period for large, self-funded employer plans?, International Foundation, 7/22/2015

Government Resources

Fact Sheet: Proposed HHS Notice of Benefit and Payment Parameters for 2019, CMS, 10/30/2017

FAQs About ACA Implementation Part 37, EBSA, 1/12/2017 Q&A on integration of Health Reimbursement Arrangements (HRAs) with group health plans sponsored by the employer of a spouse of an employee; Qualified Small Employer Health Reimbursement Arrangements (QSEHRAs)

FAQs About ACA Implementation Part 35, EBSA, 12/20/2016 Qualified Small Employer Health Reimbursement Arrangements (QSEHRAs) and women's preventive services

Questions and Answers on Over-the-Counter Medicines and Drugs, IRS, 8/5/2016

Minimum Value of Eligible Employer-Sponsored Plans and Other Rules Regarding the Health Insurance Premium Tax Credit, IRS, 12/18/2015 Final rule on whether wellness incentives, flex credits and HRA contributions are included when calculating minimum value and affordability

Further Guidance on the Application of the Group Health Plan Market Reform Provisions of the Affordable Care Act to Employer-Provided Health Coverage, IRS, 12/16/2015 Notice 2015-87 on HRAs, FSAs and employer payment plans in which the employer directly pays employees' individual health insurance premiums

Guidance on the Application of Code � 4980D to Certain Types of Health Coverage Reimbursement Arrangements, IRS, 2/18/2015 Notice 2015-17 on failure to satisfy prohibition on annual limits. Small employers with employer payment plans get relief for 2014 and up to July 1, 2015

FAQs About ACA Implementation Part XXII, EBSA, 11/1/2014 Premium reimbursement arrangements for individual market policies

FAQs About ACA Implementation Part XIX, EBSA, 5/1/2014 Model COBRA notices, out-of-pocket (OOP) maximums, reference-based pricing, preventive coverage for tobacco cessation interventions, FSA carryovers

Application of Market Reform and Other Provisions of the ACA to HRAs, Health FSAs, and Certain other Employer Healthcare Arrangements, IRS, 9/13/2013 Notice 2013-54 on employer payment plans considered to be group health plans subject to the market reforms, including prohibition on annual limits for essential health benefits and the requirement to provide preventive care without cost sharing. Employer payment plans may be subject to a $100 per day excise tax per applicable employee

FAQs About ACA Implementation Part XI, EBSA, 1/24/2013 HRAs cannot be integrated with individual market coverage and multiemployer PCORI fee payment from plan assets

Use of Health FSA and HRA Debit Cards to Reimburse Expenses for Over-the-Counter (OTC) Medicines or Drugs, IRS, 12/23/2010 Notice 2011-5 stating after January 15, 2011, FSA and HRA debit cards may continue to be used to buy OTC drugs at drug stores and pharmacies, mail order and web-based vendors if the prescription is presented to the pharmacist and other requirements.

Payment of Reimbursement of Medicines or Drugs Restricted to Prescribed Drugs, Insulin, and Over-the-Counter (OTC) Drugs That Are Prescribed, IRS, 9/3/2010 Notice 2010-59 on revised definition of qualifying medical expenses subject to preferred tax treatment. Effective Jan. 1, 2011, distributions from health FSAs, HSAs, Archer MSAs and HRAs will be allowed to reimburse the cost of over-the-counter medicines or drugs only with a prescription