A Step-by-Step Guide to Setting Up an HRA for Businesses

Discover how setting up an HRA can benefit your business and your employees with practical steps and compliance tips Enhance your benefits package

Navigating the maze of health insurance can be daunting for any business owner. Setting up Health Reimbursement Arrangements (HRAs) offers a flexible and cost-effective way to provide health benefits that support both your business’s financial health and your employees’ healthcare needs.

A Health Reimbursement Arrangement is an employer-funded plan that reimburses employees for qualified medical expenses, including individual health insurance premiums. The primary purpose of an HRA is to provide non-taxed reimbursement for healthcare costs, making it a valuable tool for managing expenses in a business setting.

For businesses, the benefits of setting up an HRA are significant. First, HRAs offer financial flexibility. Employers can set caps on how much they contribute, helping to control costs while still offering valuable benefits. Additionally, HRAs can help attract and retain talent by enhancing the overall benefits package, crucial for competing against larger companies. By offering an HRA, employers can support their employees’ healthcare needs without the hefty price tag associated with traditional group health plans.

Understanding Different Types of HRAs

Health Reimbursement Arrangement (HRA)

The standard HRA allows employers to reimburse employees for eligible healthcare expenses, such as doctor visits and prescriptions, on a tax-free basis. This arrangement gives employees the freedom to choose their healthcare providers and services, which can be particularly appealing to those with specific medical needs.

Qualified Small Employer Health Reimbursement Arrangement (QSEHRA)

Designed specifically for small employers who do not offer a group health insurance plan, a QSEHRA allows businesses with fewer than 50 full-time employees to reimburse premiums for individual health insurance and other medical expenses tax-free. This can be a game-changer for companies seeking to provide health benefits without the complexities and costs of a group health plan.

Individual Coverage Health Reimbursement Arrangement (ICHRA)

A more flexible variation, the ICHRA can be offered by businesses of any size and allows employees to purchase their own individual health insurance coverage. Employers can set different reimbursement amounts based on criteria such as age or family size, providing a tailored benefits solution that aligns with diverse workforce needs.

Integrated Health Reimbursement Arrangement (Integrated HRA)

This type of HRA is combined with a group health plan to minimize employees’ out-of-pocket costs while maximizing cost savings for the company. The Integrated HRA serves as an additional layer of financial security for employees, covering expenses that the primary group plan does not fully reimburse.

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Legal and Regulatory Landscape

HRAs are influenced by various laws, including the Affordable Care Act (ACA) and the Employee Retirement Income Security Act (ERISA). These regulations ensure that HRAs are set up fairly and operate within the legal framework intended to protect both employers and employees.

To maintain compliance, businesses must adhere to specific requirements, such as providing written notice to employees 90 days before the start of the HRA. They must also ensure that the HRA funds are only used for eligible medical expenses, a task that can be managed efficiently with the help of an HRA administrator. Staying updated with recent changes, such as those expanding the flexibility and use of HRAs under current administration policies, is important. These updates can affect how HRAs can be used and who can benefit from them, impacting your decision on which HRA is right for your business.

Assessing Business Needs

When considering an HRA for your benefits package, start by evaluating the specific healthcare needs of your employees. Understanding what kind of health coverage or medical services your employees value most can guide your decision on the type of HRA to implement. For instance, if your employees value comprehensive coverage that minimizes out-of-pocket expenses, an Integrated Health Reimbursement Arrangement (Integrated HRA) could be the ideal solution.

Financial considerations are equally crucial; assess your business’s fiscal health to determine how much you can afford to contribute to an HRA. This involves analyzing current healthcare costs and projecting how an HRA could impact your finances. Choosing the right type of HRA depends on a balance of these employee needs and financial capacities, ensuring the chosen HRA aligns with both.

Setting Up the HRA

The first step in setting up an HRA is establishing the plan documents. These documents must clearly outline the terms of the HRA, including eligibility criteria, benefits provided, and the process for claiming reimbursements. Compliance with legal requirements is critical here, so it’s often wise to consult with a benefits specialist or legal advisor.

Once the plan is documented, focus on enrollment and effective employee communication. Employees need to understand how the HRA works, its benefits, and how to make claims. Clear communication ensures that employees can fully utilize the HRA benefits. Many businesses benefit from partnering with a Third-Party Administrator (TPA) who can manage the HRA, handle claims, and ensure ongoing compliance with healthcare regulations.

Funding the HRA

Deciding on contribution limits is a pivotal aspect of funding an HRA. These limits should reflect your business’s budgetary constraints but also provide meaningful benefits to employees. Additionally, you need to choose a reimbursement method—whether reimbursements will be made directly to the provider or reimbursed to the employee after they incur the expense.

Each method has its management style and impacts on workflow. It’s also essential to understand the tax implications of an HRA. Contributions made by the business are usually tax-deductible, and reimbursements received by employees are typically tax-free. This makes HRAs a tax-efficient method of offering health benefits.

Managing HRA Administration

Effective HRA administration is rooted in diligent record-keeping and accurate documentation. Ensuring that all transactions, reimbursements, and communications are properly recorded helps maintain the integrity of the plan and safeguards against compliance issues.

When handling reimbursement requests, it’s crucial to establish a clear, streamlined process so employees know how and when to submit their expenses. This can be facilitated through a digital portal provided by a TPA, which can also help reduce administrative burdens on your business.

Additionally, being responsive to employee queries and concerns is essential for maintaining a positive workplace atmosphere. Employees should have easy access to support for their questions about the HRA, whether it’s through a dedicated contact person or through regular informational sessions.

Ensuring Compliance

To ensure that your HRA adheres to health and tax laws, it is crucial to conduct regular audits. These audits verify that the HRA aligns with its plan documents and complies with federal regulations, including the Affordable Care Act (ACA) and the Internal Revenue Code. This process helps prevent legal issues and ensures that the benefits provided remain tax-free under current laws.

Additionally, keeping your plan documents up to date is essential, particularly when legislative changes affect health benefits. Compliance isn’t only about adhering to current laws; it also involves proactive adjustments in response to new regulations.

To stay informed about regulatory changes, consider subscribing to updates from reputable legal or HR resources. This proactive approach ensures that you remain knowledgeable about the latest requirements and can make necessary adjustments to your Integrated HRA, keeping it both compliant and effective for your organization and its employees.

Maximizing Employee Benefits

To maximize the benefits of an HRA for employees, start by ensuring they fully understand the advantages and how to use the plan effectively. Educational initiatives, such as workshops or detailed guides, can empower employees to make the most of their HRA benefits.

For instance, incorporating preventive care measures within the Integrated HRA can further encourage employees to maintain their health proactively. This could include reimbursements for routine screenings or vaccinations, which can prevent larger health issues down the line, thus potentially reducing overall healthcare costs and enhancing employee well-being. 

Consider also offering additional benefits such as flexible working hours or access to telehealth services. These perks not only enhance the overall benefits package but also boost employee satisfaction and loyalty, making your organization a more attractive place to work.

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Evaluating HRA Performance

To effectively measure the success of your Health Reimbursement Arrangement, it’s important to track its utilization and analyze any cost savings. Monitoring how frequently the HRA is used and which benefits are most accessed provides insights into its effectiveness and the health needs of your workforce.

Additionally, gathering feedback directly from your employees can be invaluable. It helps identify what’s working and what might need improvement in your HRA offering. Based on this data, adjustments to the HRA plan might be necessary to better meet the needs of your employees while managing the financial sustainability of the plan. Regular reviews and updates ensure that your HRA remains a robust tool in your benefits strategy.

Summary of Key Steps

Setting up a Health Reimbursement Arrangement (HRA) offers businesses a unique opportunity to provide valuable health benefits to their employees in a cost-effective way. By understanding the different types of HRAs available, staying compliant with laws, and actively managing the plan, businesses can create a supportive health benefits system that drives employee satisfaction and retention.

Evaluating the performance of your HRA regularly will ensure that it continues to meet the needs of both the business and its employees, keeping your team healthy and your operations strong. A well-implemented HRA is more than just a benefit—it’s an investment in your company’s future.

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