HRAs can be integrated with individual health plans

In T.D. 9867, the departments of Treasury, Labor, and Health and Human Services (the departments) jointly issued final regulations with respect to health reimbursement arrangements (HRAs) and other account-based group health plans. These final regulations:

• Allow integrating HRAs and other account-based group health plans with individual health insurance coverage or Medicare, if certain conditions are satisfied (an individual coverage HRA);
• Set forth conditions under which certain HRAs and other account-based group health plans will be recognized as limited excepted benefits;
• Provide rules under Sec. 36B regarding premium tax credit (PTC) eligibility for individuals offered an individual coverage HRA;
• Provide assurance that the individual health insurance coverage for which premiums are reimbursed by an individual coverage HRA or a qualified small employer health reimbursement arrangement (QSEHRA) does not become part of an ERISA plan, if certain safe-harbor conditions are satisfied; and
• Provide a special enrollment period (SEP) in the individual market for individuals who newly gain access to an individual coverage HRA or who are newly provided a QSEHRA.

The departments’ stated goal for the final regulations is to expand the flexibility and use of HRAs and other account-based group health plans to provide more Americans with additional options to obtain quality, affordable health care. The rules generally apply for plan years beginning after Dec. 31, 2019. The Sec. 36B rules apply to tax years beginning after that date.

In addition, the departments issued FAQs on individual coverage and excepted-benefits HRAs. The FAQs offer answers to questions about the new forms of HRAs to employers, including questions regarding their benefits, how they work, which employers can provide them, and which employees they can be provided to.