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ICHRA & QSEHRA: What qualifies as a recurring expense and what documentation is required

This article is for employees enrolled in an ICHRA or QSEHRA who want to set up recurring reimbursements for premiums or understand what documentation is required.

Written by Support

A recurring expense is a monthly insurance premium, and it must be supported with proof of premium such as a bill, online statement, or pay stub showing the amount owed.

What qualifies as a recurring expense?

Only monthly insurance premiums qualify.

A recurring expense is limited to monthly premiums for health insurance and certain eligible coverage types.

This includes:

  • Individual health insurance premiums (medical plans)

  • Eligible dental insurance premiums

  • Eligible vision insurance premiums

These expenses can be set up once and reimbursed automatically each month after approval.

What does NOT qualify as a recurring expense

The following are not eligible for recurring reimbursement setup:

  • One-time doctor visits

  • Pharmacy purchases or prescriptions

  • Emergency medical bills

  • Any expense without a predictable monthly structure

  • Group insurance premiums paid through an employer payroll deduction

If the expense is not tied to a monthly or structured payment schedule, it cannot be set up as recurring.

What documentation is required for recurring expenses?

To set up a recurring expense, you must provide proof of the monthly cost and coverage details.

Accepted documentation includes:

  1. A current monthly insurance bill showing premium amount

  2. Screenshot from your insurance carrier portal showing:

    • Monthly premium

    • Next due date or billing cycle

  3. Pay stub showing premium deduction (only if it clearly shows employee-paid premium portion)

  4. For orthodontic or chiropractic plans:

    • Signed contract showing total cost and payment schedule

    • Start and end dates of treatment

    • Monthly allocation breakdown

Documentation requirements (must include)

All submitted documentation must clearly show:

  • The name of the policyholder

  • The monthly premium amount

  • The coverage period or billing cycle

  • The insurance carrier or provider name

If any of these are missing, the recurring expense setup will be delayed or denied.

How often do I need to update documentation?

Recurring expense documentation is typically valid for one plan year.

However, you must update it immediately if:

  • Your premium increases or decreases

  • Your insurance carrier changes

  • Your coverage type changes

Failing to update may result in incorrect reimbursement amounts.

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