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QSEHRA for Small Employers

A tax-free health allowance for teams under 50

Michael Furman
Reviewed by Michael Furman, COO — 24 years in insurance · MDRT Top of the Table
NovaVida Group licensed team · Updated August 2026

A Qualified Small Employer HRA (QSEHRA) lets a business with fewer than 50 employees — and no group health plan — reimburse workers tax-free for individual health insurance and medical expenses, up to annual limits set by the IRS.

How QSEHRA Works

You set a monthly allowance; employees buy their own individual coverage and submit proof, and you reimburse them tax-free up to the IRS annual cap (with a higher cap for those covering a family). It’s simpler than a group plan, has no participation minimums, and gives you a fixed, predictable cost.

QSEHRA vs. ICHRA

Both reimburse individual coverage tax-free. QSEHRA is only for employers with fewer than 50 employees and has IRS dollar caps but no class flexibility. ICHRA works for any size, has no dollar cap, and lets you vary allowances by employee class. We’ll help you pick the right one.

Fast Facts

  • For employers with fewer than 50 full-time-equivalent employees
  • Only if you don’t offer a group health plan
  • Reimbursements are tax-free to employees
  • IRS sets annual maximums that adjust each year

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Frequently Asked

Can employees use a QSEHRA if they have a subsidy?

They can have both, but the QSEHRA allowance reduces (and may eliminate) their premium tax credit for the months it’s offered. We coordinate the two so employees come out ahead.