Today, the Internal Revenue Service released Notice 2017-67 which provides guidance on Qualified Small Employer Health Reimbursement Arrangements (QSEHRAs). QSEHRAs were established under the 21st Century Cures Act enacted on December 13, 2016. These new employer reimbursement plans provide a means in which small employers can continue to reimburse employees for qualified medical expenses, including premiums for health insurance policies, without running afoul of some of the provisions of the Affordable Care Act (ACA). There were many open questions on the details of establishing a QSEHRA and ECFC submitted comments to the IRS on issues raised with these new arrangements.
The Notice is 59 pages and contains 79 questions and answers. It provides many details on the requirements for establishing a QSEHRA, the tax consequences of a QSHRA and the written notice requirements for a QSEHRA.
The Notice addresses issues such as:
Employers eligible to offer a QSEHRA. Employers that offer ANY group health plans are not eligible to offer a QSEHRA. In our comments to the IRS, we expressed our opinion that an employer that offered only a vision or dental benefit that qualifies as an excepted benefit should be eligible to offer a QSHRA; however, the IRS did not take that position in this notice. As a result ANY GHP coverage—including FSA, HRA, vision, dental, or excepted benefit health coverage (such as limited purpose vision or dental FSA) would disqualify an employer AND THE members of its controlled group from offering a QSEHRA
What employees are eligible to participate in the QSEHRA, which employees can be excluded and how the arrangement can meet the requirement that it be offered on the same terms to all eligible employees
How the statutory dollar limits on reimbursements from the QSEHRA operate
The written notice requirements for QSEHRAs
Operation of reimbursements from a QSEHRA
Tax reporting requirements for payments and reimbursements from a QSEHRA.
Interaction between ACA premium tax credits and QSEHRAs.
Consequences of failure to meet the requirement to be a QSEHRA
Interaction of QSEHRA and health savings accounts
Effective date of the guidance (November 20, 2017) and operation of QSEHRA prior to the effective date of the guidance.
This notice is the first step in the IRS providing proposed regulations regarding QSEHRA and they have requested comments on this Notice no later than January 19, 2018. ECFC will analyze the provisions of the notice in greater detail, incorporating the comments and concerns of membership and provide comments to the IRS. In addition, ECFC will be providing the membership a more detailed examination of the notice.