FAQs

FAQs

What documentation is required to substantiate a claim?

Surency’s QSEHRA claim form provides detailed instructions as to what is acceptable documentation. The IRS rules require any claim to be substantiated and supported by backup documentation in order to be reimbursed. The backup documentation must include the date of service, description of services rendered, for whom the services were rendered, and the dollar amount of the services rendered. Any third-party documentation including this information will suffice. Here are some common examples of acceptable documentation:

  • Explanation of Benefits (EOB) statement from the insurance carrier (the summary of services rendered sent out by the insurance company after services are provided);
  • Co-pay receipts are covered if the eligible employee is under a managed care or prescription drug program; and
  • Itemized bill that provides the name of the provider, patient, cost, date, and description of service.

How do I obtain a claim form?

A QSEHRA claim form is available within the Forms section.  

How do I submit a claim for reimbursement?

Complete and submit to Surency a QSEHRA claim form along with the appropriate documentation for processing. The claim form can either be mailed to Surency at P.O. Box 789773, Wichita, KS 67278-9773 or faxed to 316-462-3392.  

What is the impact of QSEHRAs on subsidized coverage?

For an employee who enrolls in a qualified health plan on the Health Insurance Marketplace, their health care premium tax credit may be reduced or eliminated by the benefit available under the QSEHRA.

What can I use my QSEHRA for?

You can be reimbursed for qualified medical expenses purchased for you and your family or the funds may be used to reimburse health insurance premiums. Each expense submitted for reimbursement must include documented proof that it was a qualified medical expense before Surency can reimburse you. You can be reimbursed for expenses incurred as of the effective date of the QSEHRA or the date the eligible employee first became eligible for the QSEHRA (not before). You cannot be reimbursed for expenses that were deducted from any prior year tax returns. 

How are QSEHRAs structured?

A QSEHRA generally is funded solely through your employer’s contributions without any employee salary reduction contributions. You must provide proof of Minimal Essential Coverage (MEC) as defined by the ACA before you and your family members are reimbursed for any incurred qualified medical expenses. Annual reimbursement limits for a QSEHRA are $6,350 per employee or $12,800 per family. If your coverage is for less than an entire year, these limits would be prorated.

What is a Qualified Small Employer Health Reimbursement Arrangement (QSEHRA)?

A Qualified Small Employer Health Reimbursement Arrangement (QSEHRA) is an employer funded “health plan” that may be used to reimburse employees for qualified medical expenses, including individual health insurance premiums. 

Are there any tax implications if I use money from my HSA Advance fund?

No. Use of the HSA Advance fund has no tax implications. At year end, you will receive Form 5498-SA showing the amount contributed to your HSA during the year. If you have questions, contact your tax preparer or visit IRS.gov for tax preparation resources.

How do I pay back the HSA Advance funds?

Your HSA Advance repayment balance is automatically repaid as your payroll deductions and employer contributions are applied to your HSA until the advance is paid in full.

How do I know how much money is available through HSA Advance?

You can access HSA Advance details any time using the Accounts Page in your Member Account. It will tell you your Total Available Balance, which will include what is in your HSA currently plus any unused funds from HSA Advance. It will also show you a breakdown of your different accounts, including the Advance Balance, which is the amount available in your HSA Advance fund.

On the Account Activity page, you can select to view activity for your HSA or your HSA Advance account. There, you can see all transfers that have been made, and if you have an outstanding HSA Advance balance that needs to be repaid.

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Choose your Surency account type below to log in and access your account. Reimbursement accounts include FSA, DC FSA, LP FSA, HSA, HRA, Commuter, LSA, QSEHRA, Adoption Assistance, Travel Benefits, Direct Billing and Premium Only Plans.

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