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sharing ministries and qsehra qualified small employer HRA
Small Business

How to use a sharing ministry plan with QSEHRA

Can I use a sharing ministry plan with a QSEHRA? Healthcare sharing ministries are exploding in popularity due to their lower costs and shared values they promote. Medi-Share, Liberty HealthShare, Christian Healthcare Ministries, Aliera, Altrua Health Share, Shared Health Alliance, and Samaritan Ministries are just a few of the many sharing ministries out there.

Can I use a sharing ministry with QSEHRA?

Are Sharing Ministries considered insurance?

Sharing ministry members have a special exemption under the Affordable Care Act from maintaining Minimum Essential Coverage (MEC); however sharing ministry plans themselves are not considered insurance. 

This is a bit of a conundrum for sharing ministry members who wish to participate in their employer sponsored QSEHRA. The IRS has established that in order to receive the tax-free reimbursements of QSEHRA, the participants must enroll in a plan that meets MEC. Since the inception of QSEHRA in December of 2016, the IRS has failed to provide guidance on how sharing ministries work with QSEHRA. We explored this circular reference in detail in this blog post. 

→ More on what the IRS has to say about Sharing Ministries 

What should employees do?

Employees who want to maximize the tax-free reimbursements of QSEHRA have two options.

  • Purchase a major medical plan (Open Enrollment runs from Nov 1 to Dec 15 each year). 
  • Purchase an additional MEC supplement plan alongside their sharing ministry plan to participate in QSEHRA

Reimbursing medical expenses for sharing ministry members

When a QSEHRA plan includes reimbursements of medical expenses, employees on sharing ministry plans will need to take an extra step to be able to claim medical expenses tax free.

In order to have your medical expenses reimbursed you will need to enroll in a plan that meets MEC. This is the only way to receive tax-free reimbursements.

Sharing ministry plans may be reimbursed on a taxable basis outside of QSEHRA if allowed by employer. 

Have questions about sharing ministries and QSEHRA?

We realize the world of MEC and QSEHRA is confusing. We wrote  the QSEHRA Reimbursement Guide to help you gain a better understanding of how different plan types interact with QSEHRA. If you still have questions, hop on our chat or send us an email and one of our friendly QSEHRA experts will be happy to help you. 

Ask our experts how to get started today (it's easy!)

This post was originally published in 2018 and has been updated in 2023 to reflect the most recent changes.

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