What are examples of documentation needed for subsequent months?

Once the initial claim has been set up, there is a decreased burden of proof for subsequent reimbursements. You will only need to send either a proof of payment or proof that the claims were incurred such as a letter from the insurance company showing the policy still in force, monthly statement, etc.

What are examples of initial proof to set up a recurring distribution?

When requesting a recurring claim, you must submit documentation that contains the following information: completed and signed QSEHRA claim form, date of service or term of the agreement, services rendered, recipient of the services rendered, and cost of service.

What if I have a monthly recurring expense, such as monthly health insurance premiums?

There are specific IRS rules for recurring claims, which must be followed in order to take advantage of the QSEHRA benefit. Surency must receive documentation each and every month to process the claim. However, the documentation required is relaxed after the initial set-up of the recurring claim. The claim form also provides additional instructions as to what documentation is acceptable.

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, his/her 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 $5,050 per employee or $10,250 per family. If your coverage is for less than an entire year, these limits would be prorated.