You may submit reimbursement requests for prior eligible months if you had qualifying health coverage during those months and provide the required documentation.
Can I receive reimbursement for previous months?
Yes. Employees may receive reimbursement for prior eligible months if:
They were eligible for the QSEHRA during those months.
They had qualifying health coverage during those months.
They provide any required documentation.
Catch-up reimbursements are possible for missed months if the employee’s enrollment start date includes those months and proof of coverage is provided.
Reimbursements are only available for months in which all eligibility requirements were met.
Monthly and Annual Reimbursement Limits
Reimbursements are subject to monthly and annual limits set by the employer’s plan and IRS regulations. For example, if the monthly limit is $400, employees can only claim up to that amount per month, even if their out-of-pocket expenses exceed it.
QSEHRA allowances accrue monthly while an employee is eligible for the benefit.
If proof of coverage has not yet been submitted or approved, the available allowance may continue to accumulate.
Once qualifying coverage is verified, eligible reimbursement requests can be processed using the accumulated allowance.
If out-of-pocket payments were made before compliance approval, retroactive reimbursement is allowed once documentation is approved.
Example of a retroactive reimbursement claim
An employee becomes eligible for a QSEHRA in January but does not submit proof of coverage until March.
If the employee provides documentation showing they had qualifying coverage beginning in January, they may be eligible to receive reimbursement for:
January premiums
February premiums
March premiums
Approved reimbursements may appear together on a future reimbursement statement.
What documentation is required?
Employees must provide proof that they had qualifying health coverage during the reimbursement period.
Employees must also provide proof of payment to qualify for reimbursements.
Examples may include:
Proof of coverage documents
Insurance policy documents
Premium invoices
Carrier confirmation letters
Other documentation requested by Take Command
Receipts or invoices showing proof of payment
Documentation must support the period being reimbursed.
Employees must also adhere to their plan’s submission deadlines to ensure timely reimbursements.
Can I submit claims if my coverage was reinstated retroactively?
Yes. If your insurance carrier reinstates your coverage retroactively, you may be eligible to request reimbursement for the reinstated period.
Documentation showing the reinstated coverage dates may be required.
Changes in Coverage or Dependents
Changes in coverage details or dependents (e.g., switching from individual to family coverage) can affect reimbursement tiers. Updated proof of coverage must be submitted to adjust reimbursements accordingly. If family premiums took effect earlier but were not reflected in prior reimbursements, the system can retroactively apply the correct amounts once updated proof of coverage is approved.
When are retroactive claims not eligible?
Correcting Reimbursement Inaccuracies
If reimbursements were issued for months without coverage, the records must be corrected. This involves:
Identifying overpayments by reviewing ineligible months.
Removing ineligible claims and adjusting year-to-date reimbursements.
Settling overpayments by returning funds or withholding future reimbursements.
Ensuring payroll and platform records reflect accurate balances.
Retroactive reimbursement requests are generally not eligible if:
You did not have qualifying health coverage during the month being claimed.
You were not eligible for the QSEHRA during that month.
Required documentation cannot be provided.
The expense is not eligible under your employer's QSEHRA plan.
Coverage must have been active during the reimbursement period.
Does submitting a retroactive claim guarantee reimbursement?
No. All reimbursement requests are subject to eligibility verification, documentation review, available allowance amounts, and plan rules.
Submitting documentation does not automatically guarantee reimbursement.
Who should I contact if I need help?
If you have questions about:
Retroactive reimbursement requests
Coverage verification
Documentation requirements
Reimbursement eligibility
Contact Take Command Customer Experience (CX) team for assistance.