What happens to the assets in my account at death?

Death benefits cannot be provided under a QSEHRA. Amounts in the account can only be used for qualified medical expenses. This is because IRC Section 105 provides an exclusion from tax only if amounts are used for qualified medical expenses. Amounts remaining in the account at death may be used to reimburse qualified medical expenses for the family members so long as the employer applies such terms uniformly to all employees. 

Can I use my QSEHRA to pay for qualified medical expenses incurred prior to becoming eligible for the QSEHRA?

No. A QSEHRA may not reimburse any qualified medical expenses that are attributable to a deduction allowed in any prior taxable year. Also, a QSEHRA may not reimburse a qualified medical expense that is incurred before the date you became eligible for the QSEHRA.

Can I get advanced reimbursements for qualified medical expenses they have not incurred yet?

No. The IRS prohibits paying claims prior to the claim being incurred. You would need to wait until a particular expense has been incurred prior to submitting a claim for reimbursement. The IRS regulations provide that the term “incurred” refers to the date you or your family member is provided with the care that the particular expense comes from. This date could be different from the date you were billed or paid for the expense.

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.