Dental and vision premiums and expenses can be reimbursed through a QSEHRA - but only if the employee has minimum essential coverage (MEC) first.
MEC Requirement (Must Be Met First)
Before any reimbursement can be approved, an employee must have medical insurance that qualifies as minimum essential coverage (MEC) minimum essential coverage to participate in QSEHRA at all. This is a mandatory requirement with no exceptions.
MEC can be through an individual marketplace plan
MEC can be through a spouse's employer group plan
Without MEC, QSEHRA participation is not possible—dental or vision reimbursement is not applicable
This rule applies to Health Reimbursement Arrangements (HRAs) in general, including Individual Coverage HRAs (ICHRA), in addition to QSEHRA.
Audience and Product
This guide is for QSEHRA administrators and employers managing employee reimbursements under a Qualified Health Reimbursement Arrangement (QSEHRA).
What Qualifies?
Dental premiums: Yes, reimbursable under QSEHRA as long as the employee has MEC and submits proof of coverage.
Vision premiums: Yes, reimbursable under QSEHRA as long as the employee has MEC and submits proof of coverage.
Dental and vision expenses: Yes, these can also be reimbursed if they meet the plan's eligible expense requirements.
As long as employees have MEC, they can submit dental and vision insurance premiums for reimbursement. We just need proof of the MEC coverage to approve reimbursements on other insurance plans.
What Does Not Qualify?
No MEC: An employee without minimum essential coverage cannot participate in QSEHRA. Dental or vision reimbursement is not applicable.
Missing proof of coverage: Reimbursements will not be approved without proof showing all required details (see below). Submissions missing these details may face processing delays.- Pre-coverage expenses: Expenses incurred before the effective date of your health insurance coverage are not eligible.
Premiums exceeding allowance: Premiums exceeding the employer allowance will not be reimbursed, though they may become eligible if the allowance increases later.
Proof of Coverage Requirements (Must Include All Required Items)
To approve reimbursements, your proof of coverage file must clearly show all required of the following:
Your name (must match the HRA-eligible person or indicate dependent status)
The plan name (include the plan tier and insurance company logo)
Premium amount (the cost being reimbursed)
Coverage period (start and end dates)
Current date (documentation must be dated within the last 30 days)
Backdated coverage statement (if claiming for past months, include a statement confirming coverage for those months)
Tip: Upload proof of coverage as a single file. Incomplete submissions will face delays. Acceptable documents include monthly bills, Elections of Benefits documents, or confirmation pages from your insurance provider.
How to Submit Recurring Dental or Vision Premiums
Once proof of MEC coverage is approved, you can submit additional premiums (dental, vision) for reimbursement as a recurring premium claim. Follow these steps:
Access your dashboard and select Recurring Premium +.
Choose Add a New Reimbursement.
Provide necessary details: premium amount, the individual covered, and coverage dates.
Upload proof of coverage as a single file showing all four required items (name, plan name, premium amount, coverage period).
Submit your claim. Submissions missing these details may face processing delays. Once approved, reimbursements will process automatically until the end of the plan year. If covering another person, only enter your portion of the premium based on QSEHRA eligibility.