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QSEHRA stands for Qualified Small Employer Health Reimbursement Arrangement. It is a health benefit plan in which small employers with fewer than 50 full-time employees can reimburse their employees for qualified medical expenses, including insurance premiums. This tax-advantaged arrangement allows employers to provide aid without offering a traditional group health insurance plan.


The phonetic pronunciation of the term QSEHRA in the International Phonetic Alphabet (IPA) is: /ˈkjuː sɛrə/

Key Takeaways

  1. QSEHRA stands for Qualified Small Employer Health Reimbursement Arrangement, which allows small employers without a group health plan to provide tax-free reimbursements to employees for their qualifying medical expenses and insurance premiums.
  2. Employers with fewer than 50 full-time employees can offer QSEHRA, and employees must provide proof of minimum essential health coverage to receive reimbursements, ensuring compliance with the Affordable Care Act.
  3. QSEHRA offers many benefits for both employers and employees, such as flexibility, cost control, and tax advantages. For example, reimbursements received by employees are typically tax-free, while employers can deduct QSEHRA expenses as a business tax deduction.


The Qualified Small Employer Health Reimbursement Arrangement (QSEHRA) is an important business and finance term as it represents a valuable health insurance benefit option for small businesses with less than 50 employees. QSEHRA allows these organizations to provide tax-free financial assistance to their employees for medical expenses, including individual health insurance premiums. This arrangement offers a cost-effective way for small employers to support and retain their workforce by contributing to their health and well-being, while also enjoying benefits such as tax deductions for their contributions. By implementing a QSEHRA, small businesses can remain competitive in the job market and ensure employee satisfaction even without offering a traditional group health insurance plan.


The Qualified Small Employer Health Reimbursement Arrangement (QSEHRA) is an innovative solution that serves to address the healthcare needs of small businesses and their employees. The primary purpose of a QSEHRA is to provide a tax-advantaged framework through which small employers can help their employees cover medical expenses. Through this arrangement, small business owners who may not be able to afford or manage traditional group health insurance plans can offer a cost-effective alternative to their workforce, enabling them to receive reimbursement for eligible healthcare costs which include insurance premiums, copays, and deductibles. Designed specifically for small businesses with fewer than 50 full-time employees, the QSEHRA plays a significant role in promoting health and well-being among the workforce, contributing to a stable and productive work environment. This employer-funded account grants flexibility to employees as they have the freedom to choose their preferred insurance plan and healthcare providers. By offering a QSEHRA, small businesses not only provide attractive benefits to recruit and retain talent, but also maintain financial control as they can determine and limit their contributions. Employees, on the other hand, benefit from the tax advantages as reimbursements from a QSEHRA are generally tax-free, provided that they have the proper minimum essential coverage. Overall, these arrangements serve as a valuable tool to assist both small employers and employees in managing healthcare expenses effectively.


A Qualified Small Employer Health Reimbursement Arrangement (QSEHRA) is an employer-sponsored reimbursement plan designed to allow small businesses to provide employees with tax-free funds to pay for eligible healthcare expenses, including insurance premiums. Here are three real-world examples of how businesses might choose to use QSEHRAs: 1. Small Law Firm: A small law firm with only a few attorneys and staff members may decide to establish a QSEHRA as a cost-effective way to offer healthcare benefits. Since the law firm is not large enough to qualify for affordable group health insurance plans, they can use the QSEHRA to reimburse their employees for individual health insurance premiums and out-of-pocket medical expenses, while maintaining tax benefits for both the firm and its employees. 2. Family-owned Retail Store: A family-owned retail store with 15 employees does not want to burden itself with the administrative responsibilities and high costs of managing a traditional group health insurance plan. Instead, they establish a QSEHRA to provide their employees with pre-set monthly allowances for health insurance costs. This allows the store to offer healthcare benefits in a simplified manner while staying within their budget. 3. Marketing Agency: A boutique marketing agency with fewer than 50 employees may choose a QSEHRA as a tool to attract and retain qualified candidates. By providing a QSEHRA, the company can compete with larger companies by offering tax-free healthcare benefits without committing to the costly group health insurance plans that larger companies can provide. The agency sets a monthly allowance based on the employees’ needs and reimburses them for purchasing individual health insurance policies, thus creating an appealing benefits package for skilled marketing professionals.

Frequently Asked Questions(FAQ)

What is QSEHRA?
QSEHRA stands for Qualified Small Employer Health Reimbursement Arrangement. It is a type of health benefit provided by small employers to their employees to reimburse them for various medical expenses, including health insurance premiums.
Who can establish a QSEHRA?
Small employers with fewer than 50 full-time equivalent (FTE) employees and who don’t offer group health plan to any of their employees are qualified to establish a QSEHRA.
What types of expenses can be reimbursed under QSEHRA?
QSEHRA covers a wide range of medical expenses, including health insurance premiums, doctor’s visits, prescription medications, dental care, vision care, and other medical treatments that are qualified under Section 213(d) of the Internal Revenue Code.
How much can an employer contribute to a QSEHRA?
The maximum annual reimbursement for an employee with self-only coverage under QSEHRA is $5,300, while the limit for an employee with family coverage is $10,700 (2021 limits). These amounts are adjusted annually for inflation.
Are the reimbursements from a QSEHRA tax-free?
Yes, reimbursements made under a QSEHRA are generally tax-free to employees as long as they maintain minimum essential coverage (MEC) as defined under the Affordable Care Act (ACA).
How do employees submit reimbursement requests to their employer?
Employees should submit proof of their eligible medical expenses (e.g., receipts, invoices) to their employer, who then reviews and processes the reimbursement accordingly. The specific reimbursement process may vary depending on the employer and their chosen reimbursement platform.
Can an employer offer both a QSEHRA and a group health plan to their employees?
No, an employer cannot offer both a QSEHRA and a group health plan to their employees. To qualify for a QSEHRA, an employer must not offer a group health plan to any of their employees.
Are there any reporting requirements for employers who offer a QSEHRA?
Yes, employers who offer a QSEHRA must report the value of the benefits on their employees’ W-2 forms. Employers must also provide a written notice to employees detailing the amount of the benefit and relevant tax implications at least 90 days before the beginning of each plan year.
Are there penalties for employers who fail to comply with QSEHRA regulations?
Yes, employers who fail to meet the requirements and regulations for QSEHRA may face penalties, including an excise tax of $100 per day per employee, up to a maximum penalty of $500,000 per year.

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