The basics: QSEHRA plan document template

by Keely S.

Looking for a QSEHRA plan document template? You've come to the right place. The qualified small employer health reimbursement arrangement (or QSEHRA) helps small businesses afford benefits for their teams. There are two main QSEHRA plan documents that need to be written, one for the employer (Legal Agreement) and one for the employees (Plan Summary). Here are the basics!

Getting started with QSEHRA

First things first, all you have to do as a business owner is decide:

QSEHRA plan document for employers (legal agreement)

The legal agreement establishes the small business HRA for the employer. The legal agreement should include:

  • Named fiduciaries and plan administrators and their responsibilities
  • Eligibility requirements for the small business HRA
  • Effective dates of participation
  • Description of benefits provided and excluded
  • How the small business HRA is funded and how it makes payments
  • Claims procedures
  • HIPAA privacy officers and rules relating to the use of protected health information (PHI)
  • Information on federal mandates
  • The procedure for amending the plan
  • The procedure for plan termination

QSEHRA plan document for employees

Employees must be provided a written notice in the form of a Plan Summary. The Plan Summary is a condensed, user friendly explanation (ie- not heavy on the legal-ease) of the QSEHRA benefit and how it works.

IRS Notice 2017-67 contains guidelines on the small business HRA initial written notice contents and provides an example of written notice. The QSEHRA Employee Notice must contain the following information:

  • Permitted benefit amount per employee & small business HRA start date for employee
  • A statement that the eligible employee must inform any Marketplace to which the employee applies for advance payment of the premium tax credit (APTC) of the amount of the provided benefit.
  • A statement that the amount of the provided benefit may affect the eligibility for and the amount of the premium tax credit and that the employee should retain the written notice because it may be necessary to calculate the premium tax credit on the employee’s individual income tax return.
  • A statement that if the eligible employee does not have minimum essential coverage for any month, then the employee may be liable for an individual shared responsibility payment under Section 5000A of the Affordable Care Act for that month and that reimbursements under the small business HRA for expenses incurred in that month will be included in the employee’s gross income.

The Employee Notice can be delivered electronically according to the guidelines the IRS has set forth.

Looking for help with QSEHRA plan documents?

Does this sound confusing, expensive or both? Don't worry. That's where Take Command Health's small business platform can help. This post walks you step-by-step through QSEHRA administration, and just might convince you to let Take Command Health do the heavy-lifting and paperwork for you!

We'll handle all the accounting and legal legwork, take care of onboarding each of your employees, and make tax time easy and painless. You'll never have to hassle with receipts or worry about setting up a health plan again.

Picture of Keely S.

Hi, I'm Keely S.! A wife to one and mother to four, Keely does all of the things. She’s also dabbled in personal finance blogging and social media management, contributed to MetroFamily magazine, and is passionate about good food, treasure hunting and upcycling. With a B.S. in Psychology from the University of Oklahoma and a knack for a witty punchline, it’s no surprise that Keely’s social posts are as clever as they get. In her (very little) free time, you’ll find Keely with her nose in a book or trying out a local restaurant with her family.