The Affordable Care Act creates rules that could affect special employer healthcare plans like HRAs and HSAs. It requires that health plans provide certain preventive services without imposing cost-sharing. It also prevents health plans from setting annual limits on certain benefits. However, HRAs and HSAs typically cap benefits and may not provide preventive care. Thus, it was not clear whether such HRAs and HSAs would be allowed under the Act.
The IRS has recently announced rules that resolve this issue in some cases. Specifically, the guidance provides rules on when an HRA or HSA will be “integrated” with a group health plan. If the HRA or HSA is integrated with a group health plan, it will not violate the ACA. The rules create safe harbors under which employer HRAs or HSAs will satisfy the Act. Employers offering HRAs or HSAs need to review these rules to decide whether their plans satisfy the new safe harbors. Because of the nature of most HRAs and HSAs, many employers may need to revise these plans.
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