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A New Small Employer's Health Care Alternative BY LUCAS W. MURRAY, ESQ. FOR REFERRALS: .. hospicewr.org WITH NEARLY YEARS OF EXPERIENCE in hospice and palliative medicine, Hospice of the Western Reserve and HMC Hospice of Medina County share your commitment to delivering the highest quality care. Explore our professional resources: hospicewr.org/resources. Your Prtner In Cre ead the latest edition of Clinical Connections, our newsletter for medical professionals. Download our Eligibility Quick Reference Guide, for guidelines, practitioner reference materials and functional assessment tools. Share Advance Care Planning information with your patients and families using our complimentary publication, Courage in Conversation. B E G I N N I N G I N 2 0 16 , t he 21 s t Century Cures Act (the "Act") creates an exception to the A€ordable Care Act to allow certain small employers to help employees by reimbursing their individual market medical coverage premiums and certain medical expenses using a Qualified Small Employers Health Reimbursement Arrangement ("QSEHRA"). An employer may sponsor a QSEHRA if the employer does not o€er a group health plan and is not an applicable large employer under Code Section 4980H (an employer or controlled group of employers that exceeds 50 full-time equivalents). QSEHR As must be funded solely by employer contributions and can generally reimburse for major medical health insurance premiums and other expenses typically allowed in HSAs and FSAs plans. The QSEHRA cannot, however, reimburse premiums already paid by the employee with pre-tax dollars for another employer's group health plan. QSEHRA payments and reimbursements are capped at $4,950 for individual coverage and $10,000 for family coverage and all reimbursements must be reported on employees' W-2. Reimbursements are typically paid to the employee tax free, but the tax benefit may be lost on employees who have failed to purchased Minimum Essential Coverage. Since QSEHR As are not considered group health plans, they avoid the compliance requirements of the Public Health Services Act ("PHSA"). However, QSEHR As must comply with ERISA's general compliance requirements, which include, without limita- tion, plan documents, annual reporting, participant notification, and summary plan descriptions. The Act imposes additional requirements including uniformity of benefits and a 90-day notice requirement to eligible employees. Additionally, employees are required to show proof of minimum essential health coverage before participating in a QSEHR A. Q SEHR A s a re ver y attractive to sma ll employers a s a n a lternative to o€ering a group hea lth plan but they do have some significant limitations. Interested employers would be well-advised to carefully consider the QSEHR A requirements prior to implementation. NOTE: This general summary of the law should not be used to solve individual problems since slight changes in the fact situation may require a material variance in the applicable legal advice. Lucas Murray is an attorney with the law firm of Krugliak, Wilkins, Gri'ths & Dougherty Co., LPA, in Canton, Ohio. ■ M D N E W S .C O M /// M D N E W S C L E V E L A N D /A K R O N / C A N T O N 2 017 L E G A L E A S E ❰❰❰❰❰ 2 3