Health Care Reform, Insurance and Employee Benefits

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FAQ: Can Family Members of an S-Corporation Owner Participate in a Health Reimbursement Arrangement (HRA)?

Note: None of this should be taken as legal or tax advice.

A common question about HRAs for small employers is "Can an owner participate in a HRA?" The next question is almost always "Can family members of an S-Corp owner participate in a Health Reimbursement Arrangement (HRA)?"

S-Corp owners establishing an HRA for their employees will likely want to include themselves and their family members in the HRA platform, although in some cases such owners and their family members may not receive the same amount of tax benefits as non-owner employees.

Title 26 of IRS Code states that spouses, children, grandchildren, and parents are all considered owners when one person has greater than 2% ownership of an S-Corp.

The Owners specified above may receive reimbursement from their companies for medical expenses, and they may use the HRA platform to receive and track these reimbursements. However, reimbursements made to Owners must be reported on the owners'/partners' wages (on their W-2 and 1040 forms) subject to federal income tax withholding. These reimbursements are exempt from Federal Insurance Contributions Act (FICA) and Federal Unemployment Tax Act (FUTA) taxes, similar to profits passed through to the owner. Further, the cost of the reimbursements is a deductible expense to the business, reducing the taxable income of the business and, thus, reducing the taxable income of the owners/partners (because these are flow-through tax entities).

Reimbursements paid to family members of S-Corp owners must be reported as income (on their W-2 and 1040 forms) and are subject to federal income tax withholding. IRS Notice 2008-1 (see http://www.irs.gov/pub/irs-drop/n-08-01.pdf) clarified that S-Corp owners may only take the self-employed health insurance premium tax deduction (on Form 1040) if the S-Corp pays for or reimburses the owner for the premiums.  Thus, S-Corp owners establishing an HRA for their employees will likely want to include themselves and their family members in the HRA platform, although in some cases such owners and their family members may not receive the same amount of tax benefits as non-owner employees.

Click here to read more about Health Reimbursement Arrangements (HRAs).


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IRS Releases Group Health Insurance Cost Reporting Guidelines - Voluntary Until 2013

Note: None of this should be taken as legal or tax advice.

Recently, the IRS released Notice 2011-28, which provides guidelines for employer reporting of group health insurance costs on employees' Form W-2.

Section 9002 of the Patient Protection and Affordable Care Act (PPACA) added Section 6051(a)(14), which requires the reporting for Forms W-2 issued for the 2012 calendar year.    

Section 6051(a)(14) applies to the following:
 
  • Employers with 250 or more W-2 employees  
  • Employers with self-funded insurance plans subject to COBRA.  

Employer group health insurance expenses do not become taxable under the requirement.  Contributions made to Health Reimbursement Arrangements (HRAs) are not required to be reported under Section 6051(a)(14):

"Q-18:  Is the cost of coverage under a Health Reimbursement Arrangement (HRA) 
required to be included in the aggregate reportable cost reported on Form W-2? 

A-18:  No.  An employer is not required to include the cost of coverage under an HRA in 
determining the aggregate reportable cost.  If the only applicable employer-sponsored 
coverage provided to an employee is an HRA, the employer is not required to report any 
amount under § 6051(a)(14) on the Form W-2 for that employee."

Click here to read the full notice.     


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IRS Requests Comments on Employer Provisions of Health Care Reform

Note: None of this should be taken as legal or tax advice.

On May 3rd, the Internal Revenue Service (IRS) requested comments regarding provisions included in the Affordable Care Act that will apply to certain employers starting in 2014.

Notice 2011-36 requests comments on the definitions used to calculate the employer penalty for companies with greater than 50 full-time employees.  In particular, the notice requests comment on possible approaches employers could use to determine who is a full-time employee.

Under the Affordable Care Act, employers with 50 or more full-time employees that do not offer affordable health coverage may be required to pay a penalty.  The law specifically exempts small firms that have fewer than 50 full-time employees.

Click here to read the full notice.


There are three ways to submit comments.
  1. E-mail to: Notice.Comments@irscounsel.treas.gov. Include “Notice 2011-36” in the subject line.
  2. Mail to: Internal Revenue Service, CC:PA:LPD:PR (Notice 2011-36), Room 5203, P.O. Box 7604, Ben Franklin Station, Washington, DC 20044.
  3. Hand deliver to: CC:PA:LPD:PR (Notice 2011-36), Courier’s Desk, Internal Revenue Service, 1111 Constitution Avenue NW, Washington, DC, between 8 a.m. and 4 p.m., Monday through Friday.

Comments are due June 17, 2011.

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IRS Offers New Guidance on FSA and HRA Debit Cards

Note: This should not be taken as tax or legal advice.

The Internal Revenue Service has issued new guidance allowing the continued use of health flexible spending arrangement (FSA) and health reimbursement arrangement (HRA) debit cards for the purchase of prescribed over-the-counter medicines and drugs.

The new guidance modifies previous guidance to permit taxpayers to continue using FSA and HRA debit cards to purchase over-the-counter medications for which the taxpayer has a prescription. Effective after Jan. 15, 2011, in accordance with the new guidance, this use of debit cards must comply with procedures reflecting those that pharmacies currently follow when selling prescribed medicines or drugs.

The procedures include requirements that a prescription for the medication be presented to the pharmacy or the mail-order or web-based vendor that dispenses the medication and that proper records be retained.

In accordance with the Affordable Care Act, the cost of over-the-counter medicines or drugs can be reimbursed from a health FSA or HRA if a prescription has been obtained. The requirement to obtain a prescription does not apply to insulin.

Click here to read the full notice.

Click here to read the FAQ.

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2011 Health Savings Account (HSA) Guidelines

Note: None of this should be taken as legal or tax advice


The 2011 Health Savings Account (HSA) guidelines will remain unchanged from 2010.

High Deductible Health Plan (HSA Qualified)

In 2011, a “high deductible health plan” will be defined as a health plan with an annual deductible at least $1,200 for self-only coverage or $2,400 for family coverage, and the
annual out-of-pocket expenses (deductibles, co-payments, and other amounts, but not premiums) do not exceed $5,950 for self-only coverage or $11,900 for family coverage.

2011 Annual HSA Contribution Limits
  • $3,050 for an individual with self-only coverage
  • $6,150 for an individual with family coverage

For more information, please see IRS document Rev. Proc. 2010-22.




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Clarifying Health is a blog about health insurance, health benefits, and everything else related to how Americans pay for medical expenses.

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