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Group Coverage Health Reimbursement Arrangement (Integrated HRA)
A Group Coverage (Integrated) HRA is paired with an employer-sponsored group health plan and reimburses employees for eligible out-of-pocket medical expenses. Unlike an HSA, employers determine the reimbursement allowance and define which expenses are eligible. Employers only pay when claims are incurred, and reimbursements are tax-advantaged for both the employer and employee. A Group Coverage HRA can reduce overall plan costs while enhancing benefits by providing first-dollar coverage for eligible expenses.
Specialized Health Reimbursement Arrangements
Specialized HRAs are customizable reimbursement programs designed to cover specific IRS 213(d) eligible medical expenses. These plans can be tailored to support services that are often limited under traditional group health plans, such as behavioral health, autism support, chiropractic care, acupuncture, hearing aids, vision correction surgery, dental night guards, and more. These targeted designs allow employers to strategically enhance benefits in high-impact areas without increasing overall medical plan costs.
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Fertility, Adoption and Surrogacy Assistance Plans
Family-building benefits are increasingly important to today’s workforce. A Fertility Assistance HRA works alongside employer-sponsored health coverage to reimburse IRS-eligible fertility services. Adoption and Surrogacy Assistance programs can also be designed within IRS guidelines to support a broader range of family growth options. When self-funded, these programs allow employers to offer higher maximum benefit amounts and reimburse expenses incurred with trusted providers worldwide.
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Individual Coverage Health Reimbursement Arrangements (ICHRA)
An Individual Coverage HRA (ICHRA) allows employers to offer a defined contribution in place of traditional group health coverage. Employees use these funds to purchase individual-market health insurance and may also be reimbursed for IRS 213(d) qualified health expenses. ICHRAs can be structured by employee classes, making them a flexible solution for multi-state employers or organizations seeking cost predictability.
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Qualified Small Employer Health Reimbursement Arrangements (QSEHRA)
Employers with fewer than 50 full-time equivalent employees that do not offer group health coverage may provide a Qualified Small Employer HRA (QSEHRA). QSEHRAs have annual IRS contribution limits and allow reimbursement for individual medical, dental, and vision insurance premiums, as well as other IRS 213(d) qualified health expenses.
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Retiree Health Reimbursement Arrangements
Retiree HRAs support former employees during retirement while helping employers fulfill ongoing benefit commitments. These plans can reimburse personal health insurance premiums, including Medicare and Medicare supplemental coverage, as well as eligible out-of-pocket medical expenses.
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Limited Purpose Health Reimbursement Arrangements: Dental & Vision
A Limited Purpose HRA reimburses eligible dental and/or vision expenses. It may be paired with traditional dental and vision insurance to cover out-of-pocket costs. This design can also be combined with a Group Coverage HRA and administered on a single benefit card for a streamlined participant experience.
Lifestyle Spending Accounts (LSA)
A Lifestyle Spending Account (LSA) is an employer-funded reimbursement program designed to support employee wellbeing beyond traditional healthcare expenses. Employers define eligible categories and contribution amounts, which may include fitness, family support, financial wellness, remote work, or professional development expenses. LSAs provide a flexible, customizable way to enhance employee engagement and strengthen total rewards strategy.