S-3060 : Still Just a Bill

Small Business Health Care Relief Act of 2016

This bill amends the Internal Revenue Code, the Patient Protection and Affordable Care Act (PPACA), and other laws to exempt qualified small employer health reimbursement arrangements (HRAs) from certain requirements that apply to group health plans.

A qualified small employer HRA is offered by employers that have fewer than 50 full-time employees and do not offer group health plans to any of their employees. A qualified small employer HRA must:

• be provided on the same terms to all eligible employees of the employer;
• be funded solely by the employer without salary reduction contributions;
• provide, after an employee provides proof of coverage, for the payment or reimbursement of medical expenses of the employee and family members; and
• limit annual payments and reimbursements to specified dollar amounts.

HRAs that meet these requirements are not considered group health plans and are exempt from various requirements that apply to group health plans, including coverage and cost-sharing requirements. (Under current law, employers that sponsor group health plans that do not meet specified requirements are subject to an excise tax.)

Coverage and payments under a qualified HRA are excluded from gross income, unless the employee does not have minimum essential coverage for the month in which the medical care was provided.

Employers offering a qualified HRA must notify employees in advance regarding permitted benefits and report benefit information on W-2 forms and to health exchanges.

The bill sets forth requirements for determining whether an employee covered under an HRA is also eligible for premium subsidies under PPACA.