run-a-business

QSEHRA Reimbursements — Let a Very Small Employer Reimburse Health Costs Without a Group Plan

Difficulty Hard Risk High Applies To All Potential Savings Can shift significant medical premium and expense costs into a tax-favored reimbursement structure Last Verified 2026-04-03

QSEHRA Reimbursements — Let a Very Small Employer Reimburse Health Costs Without a Group Plan

What Is It?

A Qualified Small Employer Health Reimbursement Arrangement (QSEHRA) lets an eligible small employer reimburse certain medical expenses and premiums without sponsoring a regular group health plan.

What Most People Don’t Know

  • Only employers that do not offer a group health plan can generally use it.
  • The arrangement must be provided on the same terms to eligible employees, subject to allowed variations.
  • Getting the setup wrong can turn the arrangement into a noncompliant group health plan problem.

Frequently Asked Questions

Can a company offer both a regular group health plan and a QSEHRA to current employees?


A: IRS Notice 2017-67 explains that offering another group health plan to current employees generally disqualifies QSEHRA status.

Can QSEHRA money reimburse individual-market premiums?


A: Yes, subject to the notice and substantiation rules.

Sources