Qualified Small Employer Health Reimbursement Arrangements and ERISA - Bim Group

Qualified Small Employer Health Reimbursement Arrangements and ERISA

Starting on January 1, 2017, certain small employers have the option to reimburse individual health coverage premiums up to a dollar limit through Qualified Small Employer Health Reimbursement Arrangements (QSE HRAs) under the 21st Century Cures Act (Cures Act).

The Cures Act amends the Employee Retirement Income Security Act of 1974 (ERISA) to exclude QSE HRAs from the ERISA definition of group health plan; however, the Cures Act does not specifically exclude QSE HRAs from the rest of ERISA.

Small employers that plan to offer QSE HRAs should be cautious before presuming that ERISA would not apply to a reimbursement arrangement. ERISA generally covers employee welfare benefit plans that are established or maintained by any employer engaged in interstate commerce or in any industry or activity affecting interstate commerce.

Under the Cures Act, QSE HRAs are excluded from one of ERISA’s two definitions of “group health plan.” QSE HRAs are excluded from the definition of group health plan that applies only to ERISA’s Title I, Part 7, that governs group health plan requirements. In summary, Part 7 includes requirements relating to portability, access, renewability, mother/newborn benefits, parity in mental health and substance use disorder benefits, reconstructive surgery, dependent student coverage, and additional market reforms.

Outside of the group health plan definition above, ERISA provides a broader definition of an employee welfare benefit plan: generally, it is any plan, fund, or program established or maintained by an employer to provide participants or their beneficiaries with medical, surgical, or hospital care or benefits, through the purchase of insurance or otherwise.

Further, in the legislative history of QSE HRA’s exclusion from ERISA’s group health plan definition, the House Committee on Ways and Means’ Report stated, as part of recommending the bill’s passage: “While these arrangements are not considered group health plans for purposes of the employer penalty, H.R. 5447 is not intended to change the extent to which these plans are employee welfare benefit plans under ERISA.”

Because QSE HRAs are new, the issue of whether the remainder of ERISA applies to QSE HRAs remains undetermined by an administrative agency or court. In consideration of the limited ERISA group health definition exclusion and the law’s legislative history, a risk-averse small employer should treat a QSE HRA as an employee welfare benefit plan covered under ERISA and comply with applicable ERISA requirements such as having a written plan document and summary plan description as well as following ERISA’s fiduciary and other rules.

A small employer who intends to offer a QSE HRA without complying with ERISA’s employee welfare benefit plan requirements should consult with its attorney before proceeding.

1/27/2017

 stars
Our access to ACA Advisor resources can help you clear up ACA questions and better craft your company’s benefit strategy for the future.

This information is general and is provided for educational purposes only. It reflects UBA’s understanding of the available guidance as of the date shown and is subject to change. It is not intended to provide legal advice. You should not act on this information without consulting legal counsel or other knowledgeable advisors.

   UBApartnerfirm

Recent Insights

November 5, 2026
News

DOL Clarifies MHPAEA Enforcement Priorities

The U.S. Department of Labor (DOL) has provided employers and group health plans with a clearer picture of how it intends to enforce the Mental Health Parity and Addiction Equity Act (MHPAEA). The DOL issued Field Assistance Bulletin 2026-03, outlining its current enforcement approach to the MHPAEA’s requirements for non-quantitative treatment limitations (NQTLs). At the same […]
Read more
October 15, 2026
News

Compliance Advisor | Agencies Issue Transparency in Coverage Final Rules

On October 5, 2026, the Department of Health and Human Services (through the Centers for Medicare & Medicaid Services), in partnership with the Departments of Labor and the Department of the Treasury (collectively, the “Agencies”) jointly finalized changes to the Transparency in Coverage (TiC) regulations issued in December 2025 (“Final Rules”). The Final Rules impact […]
Read more
October 5, 2026
News

Building a Benefits Strategy for Financial Resilience

Financial wellbeing benefits have traditionally centered on a long-term goal: retirement. But employees’ financial lives don’t begin at retirement. Many are balancing immediate priorities, including healthcare expenses, debt, emergency savings, and everyday living costs. PwC’s 2026 Employee Financial Wellness Survey found that 59% of employees were currently stressed about their finances. For many employees, the immediate concern […]
Read more
October 5, 2026
News

New Guidance Regarding Health-Contingent Wellness Programs

The Departments of Labor (DOL), Health and Human Services (HHS), and the Treasury (collectively, the Departments) issued new FAQs addressing health-contingent wellness programs, including programs that impose tobacco-related premium surcharges. The guidance provides important enforcement relief concerning when a wellness reward must be provided after an individual completes a reasonable alternative standard. Health-contingent wellness programs […]
Read more