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The Wagner Law Group

The Wagner Law Group is a nationally recognized practice in the areas of ERISA and employee benefits, estate planning, employment, labor and human resources and investment management.

 

Established in 1996, The Wagner Law Group is dedicated to the highest standards of integrity, excellence and thought leadership and is considered to be amongst the nation's premier ERISA and employee benefits law firms. The firm has seven offices across the country, providing unparalleled legal advice to its clients, including large, small and nonprofit corporations as well as individuals and government entities worldwide. The Wagner Law Group's 29 attorneys, senior benefits consultant and four paralegals combine many years of experience in their fields of practice with a variety of backgrounds. Seven of the attorneys are AV-rated by Martindale-Hubbell and six are Fellows of the American College of Employee Benefits Counsel, an invitation-only organization of nationally recognized employee benefits lawyers.  Seven of the firm's attorneys have been named to the prestigious Super Lawyers list for 2017, which highlights outstanding lawyers based on a rigorous selection process.

 

 

 

Contact Info

The Wagner Law Group

 

  Integrity | Excellence

  

Boston 

Tel: (617) 357-5200 

Fax: (617) 357-5250 

99 Summer Street 

13th Floor

Boston, MA 02110

 

Washington, D.C.

Tel: (202) 969-2800

 

Fax: (202) 969-2568

 800 Connecticut Avenue, N.W.

Suite 810

Washington, D.C. 20006

 

Chicago

Tel: (847) 990-9034

Fax: (847) 557-1312

190 South LaSalle Street

Suite 2100

Chicago, IL 60603

 

  

Palm Beach Gardens 

Tel: (561) 293-3590
Fax: (561) 293-3591
7108 Fairway Drive
Suite 125
Palm Beach Gardens, FL 33418

   

Tampa

Tel: (813) 603-2959

Fax: (813) 603-2961

101 East Kennedy Boulevard

Suite 2140
Tampa, FL  33602 

  

San Francisco

Tel: (415) 625-0002

Fax: (415) 358-8300

300 Montgomery Street

Suite 600

San Francisco, CA 94104

  

St. Louis

Tel: (314) 236-0065

Fax: (314) 236-5743
25 W. Moody Avenue
St. Louis, MO  63119 

 

 

www.wagnerlawgroup.com

 

 

 

 

  IRS Releases Guidance on QSEHRAs

November 9, 2017

 

 

 

The IRS has released guidance on the requirements for eligible small employers to offer qualified small employer health reimbursement arrangements ("QSEHRAs") to eligible employees.  In Notice 2017- 67, the IRS presents 79 FAQs that cover various issues related to QSEHRAs.


Background.  Effective January 1, 2017, certain small employers became eligible to offer QSEHRAs to eligible employees.  (See the 3/8/2017 Alert.)  Under a QSEHRA, businesses with fewer than 50 full-time employees can reimburse their staff for individual insurance premiums and qualified out-of-pocket medical expenses. 

 

 

In general, QSEHRAs must:

 

  • be funded solely with employer contributions.
  • be offered to all eligible employees on the same terms. 
  • limit annual employer contributions (for 2017, the limit is $4,950 per year for employee-only coverage and $10,000 for family coverage).
  • provide reimbursement for health care expenses incurred by the employee (or the employee's family member), which can include premiums for individual health insurance.

 

An employer is eligible to establish a QSEHRA if:

 

  • it is not an Applicable Large Employer ("ALE") under the ACA (i.e., an employer that had 50 or more full-time employees or full-time equivalent employees during the preceding calendar year); and
  • it does not offer group health coverage to any of its employees.

 

Employees are eligible for the QSEHRA "after the employee provides proof of coverage for the payment of, or reimbursement of ... expenses for medical care."

 

 

 

However, employers may exclude the following employees from QSEHRA participation:

 

  • Part-time and seasonal employees
  • Employees who have not completed 90 days of service
  • Employees younger than 25
  • Union employees (if health care coverage was the subject of collective bargaining)
  • Nonresident aliens with no U.S.- source income

 

Notice 2017-67.  Highlights from the Notice include:

 

 

 

Employer Eligibility:  Whether an employer is ineligible to offer a QSEHRA because it offers group health coverage is determined on a monthly basis, and all entities within an employer's controlled or affiliated service group are treated as a single employer.  Thus, if one member of a group offers group health coverage, the entire group is disqualified from offering QSEHRAs.  Employers become ineligible on the date they become ALEs (even if this occurs during the QSEHRA plan year) but a run-out period is permitted for expenses incurred during the period of QSEHRA coverage.

 

  

 

Eligible Employee:  The Notice confirms that former employees and non-employee owners are ineligible to participate in a QSEHRA, and the determination of whether an employee is part-time or seasonal (and thereby excludable from coverage) is determined using Internal Revenue Code Section 105(h) nondiscrimination rules. 

 

 

 

Notice Requirements.  The Notice establishes the deadline for QSEHRA sponsors to distribute the required, initial written notice to eligible employees.  For QSEHRAs provided in 2017 or 2018, the applicable deadline is the later of February 19, 2018 or 90 days before the first day of the QSEHRA's plan year.

 

 

 

Minimum Essential Coverage Requirement.  Eligible employees must have Minimum Essential Coverage ("MEC) in order to receive tax-exempt benefits.   A QSEHRA must obtain proof that the eligible employee and the individual who incurred the expense had MEC for the month in which the expense was incurred.  Employees must submit proof of MEC annually and attest that they continue to have MEC each time they submit for reimbursement.

 

 

 

HSAs:  While a QSEHRA sponsor may contribute to an employee's HSA and allow the employee to make pre-tax HSA contributions, an employee's HSA eligibility may be lost if the QSEHRA is not HSA-compatible.

 

 

 

Premium Tax Credits:  The guidance covers the impact of QSEHRA enrollment on eligibility for ACA premium tax credits and how permitted benefits reduce those credits.

 

 

 

"Same Terms" Requirement.   QSEHRAs generally must be provided on the same terms to all employees.  However, an employer may have different maximum reimbursement amounts for individual and family coverage.  Eligible employees are not allowed to opt out of the QSEHRA, nor may the employer provide different benefit options.  Employees may not carry over unused amounts into the following year if those amounts exceed the statutory maximum.

 

 

 

Reporting Requirements.  Employers must report the amount of payments and reimbursements that an eligible employee is entitled to receive from the QSEHRA for the calendar year on the employee's Form W-2.  While no Form 1095-B is required to be provided to employees in connection with QSEHRA participation, QSEHRAs are subject to PCORI fees.

 

 

 

Notice 2017-67 is available at: https://www.irs.gov/pub/irs-drop/n-17-67.pdf

 

  

 

 

 

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This Newsletter is provided for information purposes by The Wagner Law Group to clients and others who may be interested in the subject matter, and may not be relied upon as specific legal advice.  This material is not to be construed as legal advice or legal opinions on specific facts. Under the Rules of the Supreme Judicial Court of Massachusetts, this material may be considered advertising.