Qualified Small Employer Health Reimbursement Arrangement

(QSEHRA) Explained

QSEHRA—A result of the 2017 bipartisan 21st Century Cures Act


  • For small business with less than 50 employees
  • Reimburses premiums and qualified medical expenses
  • Contribution limits: $5,300 for single employees, $10,700 for families for 2021.
  • Employer can design reimbursements to vary based on age, family size, status
  • Participants must have MEC, otherwise they receive reimbursements as taxable income
  • All full time employees are eligible to participate
  • Cannot be offered with a group plan
  • Funds roll over year to year as long as total doesn’t exceed maximum contributions.
  • For employees eligible for premium tax credits, QSEHRA reimbursements reduce the tax credit dollar for dollar. Unfortunately, employees can’t opt-out.