Qualified Small Employer Health Reimbursement Arrangement (QSEHRA)

Small business employers with fewer than 50 employees that don’t offer group health coverage can offer a Qualified Small Employer Health Reimbursement Arrangement (QSEHRA), which qualifies as employer health coverage. Under the Affordable Care Act, most employers must offer health coverage to their employees.

If you are employed by a small business, you might receive a QSEHRA as a tax-free benefit to help you cover the costs of your health insurance premium and other medical expenses.

If you receive a QSEHRA, review your options carefully to ensure you use your benefits to your advantage. Keep these important things in mind:

  • The availability of this benefit, whether you use it or not, means that you have access to employer coverage.
  • In accordance with federal law, any Advance Premium Tax Credit (APTC) for which you might qualify will be reduced or replaced by the QSEHRA.
  • If your coverage is considered unaffordable under the Affordable Care Act, however, you might be eligible for APTC to help pay the remaining premium cost.
  • The difference between the QSEHRA and tax credit is reconciled when you file your taxes with a federal formula.

Your employer provides a written notice about the QSEHRA if it’s available to you. Keep this notice for your records. It contains important information such as the dollar amount available to you for health coverage expenses. You need this notice to file taxes and you might need it as validating documentation for other benefits or programs.

How to Use Your QSEHRA

Apply with the Idaho Department of Health and Welfare for Health Coverage Assistance if you haven’t already. If your employer health coverage is considered unaffordable after the QSEHRA, under the Affordable Care Act you might be eligible for APTC to help cover the remaining premium cost.

Apply at Your Health Idaho if you haven’t already and shop for a plan. All Your Health Idaho plans meet requirements to provide minimum essential coverage (MEC). You can choose to apply all, some, or none of your APTC to lower your monthly premium.

Estimate how much APTC you can use with the QSEHRA. Consult with a tax professional for help, if needed, to determine how to best apply your benefits.

Log into YourHealthIdaho.org and adjust the APTC applied to your monthly premium. Be sure to apply your APTC at the correct level or lower to avoid owing the difference when you reconcile your taxes.

To adjust your APTC:

  1. Open your secure Your Health Idaho account.
  2. Open the APTC slider tool:
  • If you are already enrolled in a plan:
    • Select My Applications > Plan Summary > Adjust Tax Credit.
    • If you are selecting a new plan:
    • Before you sign your application at the bottom of the Confirm Your Plan Selection page, click Adjust next to Advanced Premium Tax Credit.
  1. On the Adjust Your Premium Tax Credit window, click Adjust Tax Credit.
  2. Right-click the slider or press arrow buttons to move it to the correct amount.
  3. Click Confirm.

The new APTC amount is applied monthly starting the first of the next month.