HRAs: ICHRA vs QSEHRA text overlaying image of a clipboard showing ichra and qsehra You’re not the only one who wants to know what the difference is between an ICHRA and a QSEHRA. This is one of the more common questions business owners ask when they’re trying to decide which benefits to offer their employees. Both plans are health reimbursement accounts (HRAs). They make it possible for you, the employer, to give your workers benefits that are both affordable and tailored to their needs. They each let your employees save money exclusively for their health care needs. While ICHRAs and QSEHRAs are similar in what they offer, they work in different ways. Understanding them is the first step in deciding if you’d like to offer one or the other depending on your budget and how you’d like your employee benefits to work.

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What are HRAs?

Before we get into these two types of HRAs let’s look at what a standard HRA is. A HRA might be the best way for a small business to help its workers get coverage at a price they can afford. HRAs are not health insurance plans. Instead, they are a way for employers to reimburse their workers for their health care costs that is allowed by the IRS. These are not accounts like HSAs or FSAs. Instead, they are agreements (hence the name), which makes them easier to use than bank accounts. 


Employers don’t have to have a pre-funded account for distributing the money, but they can if they want. They keep the money until an employee files a claim for reimbursement. So, if an employee doesn’t ask for reimbursements or doesn’t ask for the full amount, the employer gets the money. On top of that, there are no taxes on the reimbursements! 

What Are ICHRAs?

An ICHRA is a tax-free health benefit paid for by an employer that reimburses employees for their qualifying medical costs. With an ICHRA, employers give their workers a tax-free allowance each month to pay for certain medical costs. Employees then buy the health care services and things they want, like individual health insurance coverage, and the company reimburses them up to their allowance amount. Your employees can compare their options for individual coverage on the government health insurance marketplace.


There is no annual limit on how much an employer can contribute, and you can give different classes of workers different allowance amounts. There are two more things to keep in mind. First, employees and their families are only qualified for the ICHRA if they have coverage through a qualifying individual health insurance policy. If the employee or a family member who is part of the individual plan loses benefits, they can no longer get reimbursements.


Second, there are limits on the insurance tax credit in the ICHRA. Specifically, if an employee takes part in the ICHRA, they are no longer qualified for premium tax credits. Because of this, workers are free to opt out of the ICHRA as long as their allowance amount is considered “unaffordable” and wouldn’t provide minimum value under the ACA.

ICHRA Process

Here’s a step by step process for operating an ICHRA.


  • You set the allowance – The amount of tax-free money you give to an employee for qualified costs is set by you. There can be different amounts for each type of employee. Such as full-time employees, part time employees, seasonal workers, etc. In general, ICHRA allowances for each class of workers should be the same. You can, however, give different allowances within that employee class based on the age of the worker or the size of their family.
  • Employees receive healthcare – Employees pay for their own health care with their own money. They can buy the health goods and services that are right for them, such as individual health insurance.
  • Employees submit proof – When an employee has a medical expense, they must show you proof. Such as a receipt or a letter from their insurance company explaining the services they received.
  • You review – When an employee has a medical cost, they must show you proof. Like a receipt or a letter from their insurance company explaining the services they received.
  • You reimburse the employee – The company pays back the worker up to the amount of their allowance. Both the business and its workers do not have to pay taxes on these reimbursements, but once the employee’s allowance limit is hit, they can’t get any more reimbursements.

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Who Can Offer An ICHRA?

Even though ICHRAs are available to all organizations, a company can’t give both the ICHRA and a QSEHRA. You also can’t offer both an ICHRA and a group health plan to the same group of employees. For example, you could offer full-time employees a traditional group health plan and part-time employees an ICHRA, but you couldn’t give full-time employees an option between the group health plan and the ICHRA; it’s one or the other. ICHRAs are a good choice for businesses with 50 or more workers. Under the ACA’s employer mandate, you must give at least 95% of full-time employees health insurance that meets the minimum necessary coverage. Meaning they include the “10 essential benefits”.


A qualified small employer HRA (QSEHRA) is an official health benefit that has been approved by the IRS. It lets small businesses with fewer than 50 full-time employees pay their workers tax-free for their health insurance premiums and other health-related costs. With a QSEHRA, workers don’t have to sign up for a certain type of health insurance in order to be eligible. This gives them the freedom to choose any insurance plan they want. 


Payroll taxes do not have to be paid on any QSEHRA reimbursements by you or your employees. If an employee has health insurance that offers minimum essential coverage (MEC), he or she may not have to pay income tax on reimbursements. Because these reimbursements are not taxed, workers don’t have to count their QSEHRA as income at the end of the year. Unlike traditional group health insurance, the QSEHRA doesn’t have minimum employer contribution limits. This means that you can give this benefit to your employees even if you don’t have a lot of money, but there are limits on how much you can give.


Also, there are no participation requirements to offer a QSEHRA. So you don’t have to have a certain number of workers registered in the benefit in order to offer it. Employers can set monthly budget caps with a QSEHRA, which gives them full control over their costs. Once the limits have been set, they can’t be broken. Also, because a QSEHRA doesn’t need to be pre-funded, costs are only paid out when an employee has a qualifying expense. Any money that isn’t used stays with you.

Who Can Offer a QSEHRA?

For your company to be qualified for the QSEHRA benefit, it must have fewer than 50 full-time employees. According to the Affordable Care Act, if you have 50 or more full-time employees, your company is a large employer. This means you can give an individual coverage HRA (ICHRA), but not a QSEHRA. In addition to having to be a certain size, an eligible employer cannot give a QSEHRA and any other group plan at the same time. If an employer wants a QSEHRA and already has a group health insurance policy, they can cancel it and become qualified.

Which Is Better For My Business?

If you want to use an ICHRA or a QSEHRA, you need to think about a few different things. You should start by thinking about your workers and what they need. Benefits are used by many employers as a way to keep good workers and attract new ones. Your benefits should be as personalized as possible to the people on your team. An ICHRA is likely your best choice if you want a more flexible health benefit. Such as more customization with employee classes, no limits on yearly contributions, or meeting the employer requirement.


But a QSEHRA is the way to go if you want a health benefit that is less expensive than group health insurance, easy to set up and run, and works for qualified small employers with less than 50 workers. No matter which HRA you choose, you’ll be picking a customizable health benefit that will give your workers more control over their own healthcare decisions while saving your company money.

Working With EZ

HRAs are a great way for employers to help their workers’ pay for medical costs they have to pay for on their own. Employers can keep costs down while giving their workers a perk that lets them pay for their own medical care. There are different kinds of HRAs, so most businesses will be able to find one that works for them. This is what makes HRAs so special and why they are becoming more and more popular. We’re also here to help if you need help figuring out the complicated world of insurance.


If you want to learn more about your choices for group insurance, you can get in touch with us at EZ. We’ll put you in touch with a highly trained person who can help you decide if an HRA is right for you and your business. You’ll save time, never have to deal with trouble, and never have to pay for our services. EZ.Insure will put you in touch with a specialized agent for free, so let’s get started!  Put your zip code into the box below to get a price right away. Call 877-670-3531 to talk to your own agent.

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How To Cancel Your Group Insurance

Despite the fact that health insurance is an important and very popular employee benefit, many small business owners have been canceling their group insurance policies. For some business owners, even the tax credits that are meant to help provide coverage to employees do not offset the price of group insurance enough. For other business owners, the problem might be not enough participation in their group insurance plan, because employees are choosing to purchase individual coverage. We know that this can present a dilemma to many small business owners; after all, you want to make sure that your employees are healthy and happy. Remember you have other options to provide healthcare to your employees. So if you do decide to cancel your group insurance plan, you should first understand what other health benefits you can offer employees, as well as how to cancel your group plan.

the word cancelled written in red with a red rectangular box around it

Canceling Your Group Health Insurance Plan

The good news is that you can cancel your group health insurance plan if you really need to. Most group health insurance plans are a unilateral contract, meaning that you can cancel your plan at any time during the year. Some carriers require you to provide 30 days notice, but this is not always necessary. Be aware that some insurance carriers have penalties if you do decide to cancel early.

To get a better understanding of your carrier’s cancellation process, take a look at your contract; in fact, it is always a good idea to be fully aware of this information before you sign up for any plan. To get the cancellation process started, you will need to call a customer representative at your  insurance company. Once you’ve spoken with a representative, you will usually need to confirm your cancellation in writing, either by letter or fax; some companies will even accept an email. Be sure to confirm exactly what you need to do to cancel your coverage so you will not be billed for the following month. 

While you have every right to cancel your group insurance benefits, you should be aware that, under the Affordable Care Act, you are required to give employees at least 60 days advance notice prior to the cancellation date. This will allow them to take advantage of their 60-day Special Enrollment Period and choose a new insurance plan. 

Signing Up For A HRA

HRA written on a paper with a stethoscope and black highlighter next to it
You can offer your employees other benefits, such as a HRA, and choose from different kinds that would benefit you and them more.

Even if you choose to cancel your traditional group health plan, you still have other options for helping your employees pay for healthcare. For example, you can choose to offer them a Health Reimbursement Arrangement (HRA). HRAs have been growing in popularity among employers because of their flexibility and lower costs when compared with traditional group healthcare. With these arrangements, you give employees a set monthly amount to spend on their own health insurance policy. Your employees have the option to use this allowance to buy their own individual health insurance plan and get reimbursed for qualified health insurance premiums up to the amount of their reimbursement allowance. The are a few different types of HRAs to choose from, including:

  • QSEHRAs (Qualified Small Employer HRAs) are for businesses that have fewer than 50 employees. In order for employees to receive the tax-free reimbursement, they must have an individual health plan and submit a claim. With a QSEHRA, you can choose the monthly reimbursement amount, but you must offer the same amount to all employees, and there are set limits on how much you can reimburse them each month. 
  • ICHRAs (Individual Coverage HRAs) are for businesses of any size. With these arrangements, you can create “classes” of employees, such as part-time or full-time, and offer them different monthly reimbursement amounts. With an ICHRA you can offer as much money as you would like; there is no limit on monthly reimbursement amounts. 

ICHRAs are especially popular because you can customize them to meet your company’s needs. You can choose any monthly reimbursement amount, as well as whether to reimburse your employees for premiums only or premiums and qualified medical expenses. You can also choose whether to structure reimbursement the same for all employees or to vary the amount by family size.

Keeping Your Employees Notified

notice on a board that says "employee health insurance cancelled, meeting at 1 pm tomorrow"

As mentioned above, you will have to notify your employees once you decide you are going to cancel your group insurance policy. If you choose to offer your employees a HRA instead, make sure to keep your employees in the loop about this as well. This is especially important if you decide to offer a QSEHRA, as they will need to have their own individual health plan to participate. Your employees might feel like they are “losing” healthcare if you switch from a traditional group plan to a HRA, so make sure to thoroughly explain the HRA that you chose and its benefits. There will also be new rules for them to get used to. 

If you choose to switch to a HRA, explain to your employees:

  • How the HRA works
  • The benefits of a HRA, such as more flexibility
  • How to request reimbursement

Need Help?

If you’re looking to save some money and are ready to ditch your group health insurance plan, the first thing you should do is come to EZ.Insure. We will provide you with your own agent who will assess your business’ needs, and suggest ways to offer your employees the best health benefits possible without breaking the bank. When you use EZ.Insure, you will save time, money, and the headaches that come from trying to research and compare all the different plans out there. EZ understands how important it is to save money, which is why we will instantly compare all available plans in your area for free. To start saving, simply enter your zip code in the bar above, or to speak directly to an agent, call 888-998-2027.

Sole Proprietor Participation in HRAs

Employers who have trouble providing their employees with a traditional group health insurance plan sometimes turn to health reimbursement arrangements (HRAs) to help. HRAs are not health insurance, they are employer-funded accounts approved by the IRS that help employees pay for qualified out-of-pocket medical expenses. They can also help pay for their individual health insurance plan’s premiums. illustration of a silhouette of a man with silhuoette of many people on the other side and a hand holding dollar bills in between themHRAs work through a reimbursement system. Employers offer employees a monthly allowance of tax-free money that they can use to pay for healthcare services, including health insurance, and then the employer reimburses them up to their allowance amount. But what if you’re a sole proprietor? You can offer this arrangement to any employees you have, but can you participate in the savings from an HRA yourself?  In short, generally no, but there is a way you might be able to!

HRA Rules

Offering an HRA is a great way to help pay for your employees’ healthcare costs; these arrangements give you more control over how much you’re spending, and can help to lower your healthcare costs. HRAs only need to be funded when employees who participate in them incur expenses, and not all employees who participate will incur expenses up to the limit established by the employer. Any unused funds in the HRA stay with you, the employer. 

There are also tax advantages to HRAs: any reimbursements made to your employees are tax deductible for you and tax-free for your employees. HRAs are only available to:

  • Current and former employees, and their spouses.
  • Covered tax dependents.
  • Children who will not be 27 years old by the end of the tax year.

    caucasian man looking down at his laptop with his hand to his forehead
    Unfortunately the IRS does not separate you and your business, which makes you ineligible to participate in an HRA. 

Sole Proprietorship

As a sole proprietor, according to the IRS, there is no separation between you and your business. The Internal Revenue Code Section (IRC) 401(c) determines that owners who are self-employed individuals are not considered employees. This makes them ineligible to participate in a HRA. Ineligible owners include partners, sole proprietors, and more-than-2% shareholders in a Subchapter S corporation. 


If you are married and your spouse is listed as a W-2 employee at your business, then there is a way for you to get a HRA, and enjoy all of its tax benefits. To work around the rule set by the IRS, you can set up a HRA in your spouse’s name and list yourself as a dependent of your spouse. However, this will only work if you don’t hire any other W-2 employees who would be eligible for either an ICHRA, QSEHRA or a One-Person 105 HRA. What you can do is:

  1. Hire your spouse as a W-2 employee, and make their salary the amount you want to reimburse through the HRA.
  2. Make your spouse the primary policy holder on your family health insurance plan.
  3. Become a dependent on your spouse’s health insurance plan.
  4. Set up a One-Person 105 HRA, ICHRA, or QSEHRA for your spouse. Consider:
    • The One-Person 105 option if you have medical expenses or other employees that are excludable under the rules.
    • A QSEHRA if your health expenses are less than the reimbursement limit under the QSEHRA rules.
    • An ICHRA if the reimbursement limit of a QSEHRA is too restrictive, since there are no limits on ICHRA contributions.invoice of a medical bill
  5. Save all of your medical bills so your company can reimburse them each month from a separate account. 

Get Help

To make sure that you are following the rules laid out by the IRS properly, it would be wise to speak with an insurance agent. EZ’s agents are highly trained and knowledgeable in the group health insurance industry, and can help you determine if participating in an HRA is possible for you. To find out if you are eligible, and to compare plans in your area for free, enter your ZIP code in the bar above, or to speak directly to an agent, call 888-998-2027.