Financial

This Business Expanded Coverage to Specialty Care, Covering Fertility and Mental Health Treatments

This business chose to supplement its current health insurance plan with expanded coverage for IVF, abortion care, mental health treatment, and birth control.

September 14, 2022

The Problem

Fertility and reproductive care are a significant concern for many employees, with over 20% of couples where the woman is aged 30-39 having problems conceiving their first child.

Traditional insurance plans often don’t cover family planning or mental health care costs, and  employees at this business had requested expanded coverage for these necessary forms of care. After looking into the specifics of their group plan, this business wanted to provide additional coverage for IVF, abortion care, mental health treatment, and birth control.

By doing so, the company hoped to attract and retain a larger pool of top talent while building a more supportive and productive work environment for all employees.

How a Liferaft Health Reimbursement Arrangement Can Help

Through a Liferaft Health Reimbursement Arrangement, employers can reimburse employees for out-of-pocket costs associated with family planning care, including IVF, prescriptions, doctor visits, travel expenses, birth control, abortion care, and other medical expenses.

While recent court decisions have influenced some employers to expand their family planning coverage, the flexible nature of a Health Reimbursement Arrangement allows employers to choose to cover various out-of-pocket healthcare expenses. Employees can be reimbursed tax-free for costs like deductibles, co-pays, co-insurance, dental and vision premiums, and other qualified expenses not covered by their group health plan. 

Employers contribute a set amount of money to each employee's account each year, helping alleviate some of the financial burden of accessing these essential healthcare services. This sends a strong message that their employees' health and well-being are a top priority.

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Group health can be complex, restrictive, and costly. Liferaft offers something different.

Liferaft's 2023 Whitepaper on HRAs is the most comprehensive guide available, giving you what you need to determine if an HRA makes sense for your business.
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What you get in your guide:
• What is an HRA?
• HRA Requirements & Features
• Eligible HRA Expenses
• When an HRA Makes Sense
• Different HRA Types
• States Where HRA Works Best

The Plan

The employer wanted to ensure employees could afford expensive fertility treatments, including IVF. The employer is in California, where the average cost of IVF is $10,500. Therefore, the employer set its monthly available reimbursement amount at $875 per year with an annual cap of $10,500. Eligible reimbursable expenses included IVF treatment, prescription drugs, abortion care, and birth control.

Choosing Your Expense Categories

This employer chose a very limited number of eligible expenses. You can include or exclude any health-related expense that the IRS defines as a qualified health expense in Publication 502

Below are some examples of qualified health expenses. Based on your intent in setting up your Health Reimbursement Arrangement, Liferaft will recommend what to include and exclude in your plan documents.

2023 Year-End Report: 
HRA Trends & Insights

Liferaft's 2023 Year-End Report gives brokers and business owners the full breakdown of HRA market challenges, employer concerns, growth opportunities, and more, to help you can stay ahead of the curve.
You will automatically be redirected to your whitepaper download after submission.
This whitepaper includes:
2023 HRA Trends  |  Top Employer Concerns  |  Trends in HRA Account Types  |  Potential Pitfalls & Challenges  |  ICHRA Enrollment Stats & Trends  |  2024 Areas of Opportunity & Growth

How it works

A Liferaft Health Reimbursement Arrangement is fully customizable based on what makes the most sense for your organization. Our team will handle all the paperwork to properly set up your account—making it easy for you to benefit from all available tax advantages. 

  • Design your benefit: Decide how much tax-free money to offer each month, which expenses should be eligible for reimbursement, or offer various benefits to different employee groups.
  • Employees purchase qualifying expenses: Allowances can be used for qualifying medical expenses and healthcare services, including prescription glasses, healthcare premiums, physical therapy, and more.
  • Employees reimbursed: Our user-friendly 100% digital experience makes it easy for you and your employees to submit a claim and get reimbursed for eligible expenses.

Frequently Asked Questions

Are Health Reimbursement Arrangements considered income?

According to the IRS, employer-issued reimbursements are not considered income and are exempt from federal income and payroll taxes. This is one of the significant tax benefits of distributing employee benefits through a Liferaft Health Reimbursement Arrangement. 

What happened to unused funds? Do they roll over?

One of the central values of a Liferaft Health Reimbursement Arrangement is flexibility, and the answer here depends on the employer’s specific policies. Some companies may have a "use it or lose it" policy regarding account funds, meaning that any funds not used by December 31st will be forfeited and cannot be carried over into the new year. Other employers allow employees to roll over a certain amount of money from one year to the next. Put plainly—it’s up to you! 

What are some disadvantages of an HRA?

Because the funds in a Liferaft Health Reimbursement Arrangement are employer-funded, the employer owns the money in the account even though it is for the individual to use. If the person leaves the company or their job is terminated, the account funds stay behind with their former employer.  Employers can offer a retirement account that allows former employees to utilize funds after leaving the company.

Additionally, different employers often have different rules for reimbursement, which can be a problem for employees if they switch companies. Aside from mandatory requirements like COBRA continuation, ERISA and HIPAA, plans can vary widely. 

Which employees are eligible for a Liferaft Health Reimbursement Arrangement?

Liferaft Health Reimbursement Arrangements can be offered to any employee, as long as each job class is treated equally. This means you can easily provide benefits to part-time and seasonal employees. However, depending on what type of expenses you plan on reimbursing, there are specific IRS requirements. After learning about your business and goals, Liferaft will make a plan recommendation for the most tax-advantaged, affordable way to structure your account. 

Book your consult with Liferaft

Our team knows the ins and outs of the health insurance marketplace and will guide you towards the solution that make the most sense for your business and your team. Come with questions! Our experts are happy to dig into the details to get you the clarity you need.

During the call, Liferaft will run a cost-benefit analysis on your company's current healthcare spending and show you different ways you can save—without sacrificing plan quality. After your consult, Liferaft will design a unique plan for your employee's health insurance, including suggested plans and accounts, plan policy documents, and the annual budget.

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