
The Qsehra is a unique and fascinating cultural phenomenon, but it does come with a significant financial burden. Typically, the source of funding for a Qsehra is the community itself, with contributions from local residents and businesses.
The costs of building and maintaining a Qsehra can be substantial, with estimates ranging from thousands to tens of thousands of dollars. This is often a significant investment for a small community.
In many cases, the Qsehra is seen as a valuable resource for the community, providing a central gathering space and a sense of identity.
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QSEHRA Setup
To set up a QSEHRA, you'll need to confirm your eligibility as an employer. This is the first step in the process.
You can exclude certain employees, such as part-time and seasonal workers, from participating in the QSEHRA. This is a common practice among employers.
Deciding on the inclusion of dependents is also crucial. You'll need to examine what constitutes a dependent for QSEHRA purposes to ensure you're making the right decision.
Consider reading: Qsehra Providers
Employers can contribute up to $6,150 per month for individual employees and up to $12,450 for family coverage in 2024. This is a significant amount of money that can help offset medical expenses.
In 2025, the contribution limits will rise to $6,350 for individual employees and up to $12,800 for family coverage. It's essential to plan ahead and factor in these changes.
Here are the key steps to set up a QSEHRA:
- Confirm your eligibility as an employer.
- Determine employee eligibility.
- Decide on the inclusion of dependents.
- Establish your monthly contribution amount.
- Choose the medical expenses to reimburse.
- Prepare necessary documents.
- Select a commencement date.
- Inform employees about the QSEHRA benefit.
- Direct employees to relevant resources.
You can choose to manage the QSEHRA in-house or through a third-party administrator, also known as a TPA. This will depend on your specific needs and preferences.
Benefits and Funding
A QSEHRA can be funded by setting aside money each month that employees can use to cover their health insurance and qualified medical expenses.
The amount set aside is tax-free, benefiting both the employee and employer. This allows employers to let their employees decide what health insurance plan works best for them and their families.
Employers can set aside a fixed reimbursement amount, which can be used to cover premiums for individual health insurance policies, and other expenses that constitute medical care expenses under Section 213 of the Internal Revenue Code.
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On-Ramp to Benefits

80% of our small business clients are net new to benefits, making it a great time to explore affordable solutions.
The Qualified Small Employer Health Reimbursement Arrangement is an affordable, simple way to offer scalable benefits to your team on your budget.
This benefits solution is perfect for small businesses looking to provide HRAs, and Take Command has made it simple to set up and administer the small business HRA for StreamCare and other small businesses.
The Qualified Small Employer Health Reimbursement Arrangement was signed into law on December 13, 2016, via the 21st Century Cures Act, and took effect on January 1, 2017.
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Who Funds a?
Who Funds a QSEHRA?
The employer funds the cost of reimbursements for medical expenses under a QSEHRA. This means no reimbursements can be funded via employee salary reduction contributions.
To be specific, the employer must fund the QSEHRA without any employee contributions, unlike a flexible spending arrangement (FSA) that is part of a Section 125 cafeteria plan.
QSEHRA Reimbursable Medical Expenses
QSEHRA reimbursable medical expenses include premiums for individual health insurance policies and other expenses that constitute medical care expenses under Section 213 of the Internal Revenue Code.
Expenses incurred before an employee becomes a participant in the QSEHRA cannot be reimbursed.
Insurance premiums that can be reimbursed include those for Medicare or Medicare supplement (Medigap) policies.
If a QSEHRA permits, premiums related to an employee's family member can be reimbursed even if the policy covering the family member is not the same policy that covers the employee.
Over-the-counter drugs purchased without a prescription can be reimbursed by a QSEHRA, if the terms of the QSEHRA so provide.
Here's a list of eligible medical expenses that can be reimbursed under a QSEHRA:
- Premiums for individual health insurance policies
- Medicare or Medicare supplement (Medigap) policies
- Over-the-counter drugs purchased without a prescription
- Other expenses that constitute medical care expenses under Section 213 of the Internal Revenue Code
Note that the QSEHRA need not cover all eligible expenses, and can be designed to cover only certain types of expenses, such as premiums for individual health insurance policies only.
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Rules and Limits
Funding for a QSEHRA can come from the employer, but there are rules to follow.
The maximum employer contribution is 50% of the premium for the employee's health coverage, and the maximum contribution for self-only coverage is $5,250.
Employers must also provide a written notice to employees explaining the QSEHRA and its terms, including how contributions will be made and how employees can enroll.
Rules

When it comes to QSEHRA rules, there are some important things to keep in mind.
All employees need to be treated fairly and offered the same benefits under your QSEHRA, also known as the Same Terms Requirements. This means an employer cannot offer different funds to different employees without qualifying them with specified criteria.
If an employee ends up not being eligible to participate in the company's QSEHRA, the funds allocated will stay with the employer. This is also the case if an employee does not make a claim in a given year.
The employer is solely responsible for funding the QSEHRA, and employees cannot contribute to it. This means they would just be paying for their health care expenses out of their own pocket.
Here are the key QSEHRA rules to keep in mind:
- Same Terms Requirements: treat all employees fairly and offer the same benefits.
- Unclaimed funds: employer keeps funds if employee is not eligible or does not make a claim.
- QSEHRA funding: employer is solely responsible for funding, employees cannot contribute.
What Are the Limits?
The limits under a QSEHRA are quite straightforward. Reimbursements to an employee are capped at $4,950 per year for single coverage, or $10,000 per year for family coverage.
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These limits are adjusted for inflation each year, so they may change from year to year. For example, the $10,000 limit for family coverage was adjusted to $10,050 for 2017.
You have some flexibility in designing your QSEHRA, as you can set your own limits that are lower than the maximums allowed by law. Some employers may choose to set a single limit that applies to all employees, regardless of whether they have single or family coverage.
For employees who aren't covered by the QSEHRA for the entire year, the annual limits must be prorated accordingly. This means that if an employee starts participating in the QSEHRA in May, they'll be subject to a lower limit for that year.
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Comparison and Cost
Funding a QSEHRA can be done through various means, but it's essential to understand the costs involved. The employer's contribution to a QSEHRA can range from 0% to 50% of the premium, depending on the plan chosen.
One of the most significant costs is the premium itself, which can vary greatly depending on the plan chosen. The premium for a QSEHRA can be higher than that of an individual plan.
Employers can also deduct the cost of the QSEHRA premiums from their taxes as a business expense. This can provide a significant tax benefit to employers.
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Qualified Small Employer HRAs
A QSEHRA is a type of Health Reimbursement Arrangement (HRA) specifically designed for small businesses with 50 or fewer full-time employees. It's a great option for businesses that want to offer their employees a tax-free way to cover their health insurance and medical expenses.
To be eligible for a QSEHRA, your business must have fewer than 50 full-time employees without offering them any group health plans, including dental or vision plans, or flexible spending accounts.
QSEHRAs have a predetermined maximum reimbursement limit for both single employees and employees with dependents. This limit is set by the IRS and must be adhered to by employers.
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Employers must also fully fund the QSEHRA without employee contributions and offer QSEHRA reimbursements only to employees who provide proof of minimum essential coverage.
Here are the key requirements for employers to provide a QSEHRA:
- Having fewer than 50 full-time employees without offering them any group health plans.
- Applying the same QSEHRA terms to all eligible employees.
- Adhering to the IRS’ annual reimbursement ceilings for QSEHRAs.
- Fully funding the QSEHRA without employee contributions.
- Offering QSEHRA reimbursements only to employees who provide proof of minimum essential coverage.
Frequently Asked Questions
How is Qsehra funded?
QSEHRA is funded through employer contributions, which are set by the employer up to an annual IRS maximum, and employee out-of-pocket payments. Employees are reimbursed by the QSEHRA after submitting proof of payment.
For which of the following can funds from a Qsehra be used?
Funds from a QSEHRA can be used to help pay household health care costs, such as monthly premiums for qualifying health coverage. This includes costs for medical expenses, prescriptions, and more.
Sources
- https://www.takecommandhealth.com/qualified-small-employer-health-reimbursement-arrangement
- https://hh-law.com/blogs/supplemental-hh-law-blogs/qsehra-frequently-asked-questions/
- https://onpay.com/insights/qsehra-vs-ichra-explained/
- https://www.takecommandhealth.com/qualified-small-employer-hra-qsehra
- https://dpath.com/qsehra-faqs/
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