A Health Reimbursement Account , formally a Health Reimbursement Arrangement HRA , [1] is a type of US employer-funded health benefit plan that reimburses employees for out-of-pocket medical expenses and, in limited cases, to pay for health insurance plan premiums. An HRA is not truly an account, since it does not place funds under a separate legal title. Instead, it is an agreement under which the employee can submit qualified health expenses to the employer for reimbursement. Following implementation of the Affordable Care Act , HRAs must be integrated with a qualified employer-sponsored group health insurance plan to avoid excise tax penalties. In , qualified small employer HRA QSEHRA [6] were created which allows small employers to pay for premiums, including on the individual market such as through a health insurance marketplace , although the employees may not be eligible for subsidies.

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