Health Reimbursement Arrangements (HRAs) and Health Savings Accounts (HSAs) are both great options for employees and employers who want to save money on group health insurance costs. Many employers and employees wonder if they can have both at the same time, and the answer is: yes! If you are willing to offer your employees both, a HRA and HSA, you need to have an understanding of how the two benefits interact with each other in order to get the most out of each.
The Difference Between HSAs & HRAs
HSAs are savings accounts that work alongside your employees’ health insurance plan. Employees are only eligible for a HSA if they are enrolled in a qualified high-deductible health plan. Your employees can contribute money to the account, which then acts like a bank account for medical expenses; you can also contribute to their HSAs, and receive some of the tax benefits. The money that you both contribute is pre-tax, earns tax-free interest, and will not be taxed when employees withdraw it to use for qualified medical expenses.
HRAs are not savings accounts like HSAs, they are arrangements that allow employers to reimburse employees for medical expenses. They are intended to help employees pay for out-of-pocket health-related expenses, and are often used in place of a traditional group health insurance plan. Depending on the type of HRA you offer, there may or may not be a limit on the amount that you can reimburse your employees in a given year.
The Different Types of HRAs
First, let’s take a look at the different types of HRAs you can offer your employees. There are integrated HRAs, which are offered alongside traditional group health insurance, including:
- ICHRAs (Individual Coverage Health Reimbursement Arrangements), which allow tax-free reimbursement of benefits for any size business, and for any amount.
- EBHRAs (Excepted Benefit HRAs), which are limited to paying for excepted benefits, such as premiums for vision and/or dental coverage and premiums for plans that are exempt from ACA rules (short-term plans).
Standalone HRAs do not have to be tied to a group plan. These include:
- QSEHRAs (Qualified Small Employer HRAs) – These are meant for businesses with less than 50 employees that do not offer a group insurance plan. Business owners can set up a QSEHRA for their employees to help pay for benefits tax-free.
- Spousal HRAs– These are for employees who are covered by a spouse’s group plan. They cannot be used to reimburse employees for their premium payments.
- Retiree HRA– These are for former employees. They allow you, the employer, to help pay for any retired members’ insurance premiums and medical expenses.
When Offering Both HSAs & HRAs
In order for your employees to be eligible for a HSA, they must have a high-deductible health insurance plan (HDHP) that is HSA-qualified. If you choose to offer a HRA and a HSA, then the HRA has to follow the same rules as a HDHP, and cannot begin paying out until your employee’s minimum “deductible” amount is met.
Another way to offer a HRA that is HSA-qualified is by offering a limited-purpose HRA that only reimburses employees for expenses that are exempt from the HSA deductible requirement. Expenses exempt from the HSA deductible are:
- Health insurance premiums
- Long-term care premiums
- Wellness and preventive care such as check-ups and quitting smoking or weight loss programs
You want to help your employees with their healthcare costs, but there is nothing wrong with also wanting to offset the costs of group health insurance. One way to do this is by offering both a HRA and a HSA. It can be done! As long as you follow the guidelines, then everyone can benefit from these arrangements. If you are unsure or need some help, then we can assist you. To compare plans, and to find a plan with the most coverage and savings, enter your zip code in the bar above. Or to speak directly to one of our licensed agents, call 888-998-2027.