What expenses can be set up as recurring?
The only expenses that can be set up as recurring expenses are monthly premiums on your health, dental, and vision insurance. There are times when prepaid medical expenses at a Chiropractor's office and Orthodontic payment plans are set up as recurring premiums as well.
Additionally, only individually purchased dental and vision insurance plans are eligible for reimbursement under ICHRA. Group dental and vision plans, including those obtained through an employer or a spouse’s employer, are not eligible for reimbursement. This includes group plans paid pre-tax via payroll deductions.
Additionally, standalone dental or vision plans do not qualify as MEC and therefore cannot be reimbursed through ICHRA unless they are bundled with a compliant medical plan.
This is because standalone plans do not meet the compliance requirements set by ICHRA, which necessitate enrollment in a qualifying individual health plan that meets Minimum Essential Coverage (MEC) standards.
Remember:
For QSEHRA, you must be covered by Minimum Essential Coverage (MEC) to receive reimbursements.
For ICHRA, you must be covered by a qualified individual health insurance plan purchased on or off the Exchange, or Medicare, to receive reimbursements.
As long as you maintain qualified health coverage, you may be reimbursed for your dental and vision premiums. However, standalone dental or vision plans do not qualify as Minimum Essential Coverage (MEC) and cannot be reimbursed tax-free unless bundled with compliant medical plans. Group dental and vision premiums, including those paid pre-tax via payroll deductions, are also not eligible for reimbursement under ICHRA due to IRS regulations. Only individually purchased dental and vision insurance plans are eligible for reimbursement, provided they meet ICHRA guidelines and compliance requirements. Employers may allow reimbursement for standalone dental and vision plans under certain conditions: purchasing an eligible plan, providing proof of coverage, and setting up a recurring premium claim.
What documentation can I provide for proof of my premium?
Examples of what we will accept for proof of your premium:
A recent monthly bill
Screen shot from your online portal with your insurance company showing the premium amount and when it's due next
If covered under a spouse's employer group plan, a recent pay stub will show the total amount you cover each period.*
*If you are offered a QSEHRA and covered under a spouse's employer group plan, there are a few nuances to your premium reimbursement. Check out this article for more information.
Additionally, dependent and spousal expenses may be reimbursed if they are added as dependents in your ICHRA portal, qualify as IRS-approved medical expenses, and are not reimbursed elsewhere to avoid double-dipping.
To ensure compliance, you must provide documentation showing that you are the direct policyholder of an eligible individual dental or vision plan. Once proof of coverage is uploaded and approved, reimbursements will continue according to your HRA allowance for the rest of the plan year.
How often do I need to submit an updated proof of my premium
Once you set up a recurring expense for your monthly premium, we'll only need to update once per year! We'll ask for a new proof of your premium each January. However, if your coverage or premium change at any time, you'll need to set up a new recurring expense to make sure you're receiving the correct reimbursement! You can read more about what to do if you cancel your insurance plan here.
What documentation can I provide for proof of my prepaid Chiropractic medical expense or Orthodontic payment plan?
The contract with your Chiropractic office that shows the duration that the prepayment is paying for, so that we can divide the full payment amount up into the specific months that you are being treated.
Orthodontic contract that shows your monthly payment plan, when the treatment began, and when the payment plan ends.