What Is A Health Reimbursement Arrangement (HRA)?

Health Reimbursement Arrangement

Chapter 54Tools & Techniques of

Estate Planning

Copyright 2011, The National Underwriter Company 1

• An HRA is an arrangement provided by an employer (including professional corporations)– To reimburse one or more employees (and covered dependents)

for medical expenses, such as dental or cosmetic surgery, not covered under a medical plan available to all employees

• The objective is to provide benefits on a tax-free basis to the employee

• A second objective is to make such payments tax deductible by the employer

What Is A Health Reimbursement Arrangement (HRA)?



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• An HRA is used– As a substitute for health insurance

– As a supplement to provide payments for medical expenses not covered under the company’s health insurance plan

– To pay medical expenses in excess of limits in the company’s health insurance plan

What Is A Health Reimbursement Arrangement (HRA)?



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• Where a corporation is closely-held and family members are the primary or only employees– An HRA makes otherwise nondeductible medical expenses

deductible

• In a professional corporation, where the only employee is a professional in a high income tax bracket, or where there are few other employees with relatively smaller salaries– An HRA makes otherwise nondeductible medical expenses

deductible

When Is Use Of An HRA Appropriate?



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• Where an employer would like to provide significant tax-favored benefits to employees beyond those provided by the basic medical coverage already in force

When Is Use Of An HRA Appropriate?



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• Must be nondiscriminatory as to both coverage and operation– If a plan is found to be discriminatory

• reimbursements to highly compensated employees will be included in their income

• rank and file employees will remain entitled to the income tax exclusion

What Are The Requirements?



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• As to “coverage,” a plan must benefit 70% or more of all employees– Alternatively, if 70% of all employees are eligible to be

covered, 80% of those individuals must in fact participate in coverage

– As a third alternative, IRS will determine on a case-by-case basis




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• “Highly compensated employees” are defined for discrimination purposes as– The five highest paid officers

– Shareholders holding more than 10% of the outstanding stock value of the corporation

– The highest paid 25% of all employees




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• If the plan discriminates in “coverage”, a fraction of payments received will be includable in income:

Amount reimbursed to Payment all participating highly received by any compensated given highlyemployees X compensatedTotal amount employeereimbursed to all employees under the plan



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• A plan would be considered discriminatory in “operation” if – Highly compensated employees are eligible to receive greater benefits

than other employees

– “Dollar-for-dollar rule,” not based on a percentage or proportion of discrimination rule

– Applicable to eligible benefits, rather than amounts actually paid

• If a plan discriminates in “operation”– The recipient highly compensated employee will have to include the

entire amount of excess reimbursement actually received in income, whether or not coverage requirements are met




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Example 1:– Corporation maintains a self insured reimbursement

arrangement covering all of its employees• Plan limits maximum benefits for officers at $5,000 and $1,000

for all other participants

– During the plan year, one of the five highest paid officers received reimbursements in the amount of $3,000

• Since the same amount of benefits for highly compensated individuals is not provided for all other participants, the plan is deemed discriminatory in “operation”

• The excess reimbursement the officer received would be includable in his gross income

How Is It Done?



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Example 2:– Corporation maintains a self insured reimbursement

arrangement covering all of its employees• Benefits subject to reimbursement are the same for all plan

participants

• Of 100 employees in the company, only 10 are eligible to participate

• The plan discriminates as to “coverage”

How Is It Done?



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Example 2 (cont’d):– During the plan year, a highly compensated individual

accrued medical expenses in the amount of $4,500 which were reimbursed to him under the plan

• During the plan year the corporation’s medical plan paid $50,000 in benefits

• $30,000 of the payments were to highly compensated individuals

• The amount of excess reimbursement that will be included in the highly compensated employee’s income is

($30,000 / $50,000) x $4,500 = $2,700

How Is It Done?



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• No significant difference exists with regard to the application of the rules regarding an HRA in community property states

Issues In Community Property States

What Is A Health Reimbursement Arrangement (HRA)?

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