Information about QSEHRA & ICHRA

How to offer health insurance for remote employees

Written by Susanne | Sep 22, 2023 8:40:44 PM

The global pandemic has accelerated the adoption of remote work, with many businesses embracing the flexibility and efficiency of remote work. A significant portion of the workforce is now working remotely, either full-time or part-time, which has raised several important considerations for business owners, including health insurance for remote employees.

Health insurance for remote employees

Providing health benefits has always been crucial to an employee's compensation package. However, with the rise of remote work, employers face new hurdles in offering health insurance to their teams. Remote employees may live in various states or countries with regulations and health insurance options. Additionally, remote workers' diverse needs and preferences necessitate employers to offer more flexible and customizable health insurance options.

Navigating Health Coverage for a Local Remote Workforce

As the workforce becomes increasingly remote, understanding the options available for health insurance for remote workers is crucial. Employers must navigate various insurance structures to provide comprehensive and compliant coverage for their remote teams. Here’s a breakdown of the standard health insurance options and more in-depth answers: how does health insurance work for remote workers?

Traditional Health Insurance

Traditional health insurance plans remain a cornerstone for many companies' coverage of employees, including emote worker insurance. These plans typically offer extensive networks of healthcare providers and are well-understood by employees. However, for remote workers who may be out of state, ensuring that the plan provides coverage in their location is essential. Employers need to select plans with a broad network or consider plans specifically tailored for out-of-state coverage to effectively meet remote worker insurance needs.

Group Coverage Benefits

Group coverage plans benefit remote teams as they can leverage the buying power of the entire group to secure more favorable terms, including lower premiums and better benefits. These plans also offer the simplicity of a single policy that covers employees in various locations, which can significantly simplify the administrative burden of managing health insurance for remote workers.

HRAs

Health Reimbursement Arrangements (HRAs) provide a flexible option for employers, especially when dealing with a geographically diverse team. HRAs allow employees to purchase their health insurance and then get reimbursed for the premiums and other medical expenses up to a set limit. This model is particularly advantageous for health insurance for remote workers, as it allows them to choose local plans, ensuring they have access to the necessary healthcare providers.

HSAs

Health Savings Accounts (HSAs), often paired with high-deductible health plans, offer remote workers the ability to save money pre-tax for future medical expenses. They provide a tax-efficient way to cover out-of-pocket costs. HSAs are a practical choice for remote workers as they provide flexibility and control over health expenses, regardless of the employee's location.

PPOs (Preferred Provider Organizations) 

PPO plans offer more flexibility when choosing healthcare providers. These are particularly useful for remote workers as they allow for visits to out-of-network doctors at a higher cost, which is a significant advantage for employees who live in areas with limited in-network options.

EPOs (Exclusive Provider Organizations)

Similar to PPOs but generally more affordable, EPOs require patients to stay within a network of providers. However, they don't need referrals for specialists, which simplifies remote workers' access to various services.

Telemedicine Services

As remote work continues to rise, so does the relevance of telemedicine. Employers can offer telemedicine as a part of their health insurance benefits, providing remote workers with convenient access to medical consultations without needing to visit a doctor's office.

Direct Primary Care (DPC)

Under this model, employers pay a flat monthly or annual fee to a healthcare provider, covering most primary care services. This arrangement can ensure remote workers have continuous access to care without the typical constraints of traditional insurance models.

Supplemental Insurance

This can include specific insurance policies for critical illnesses or accidents, providing additional coverage beyond standard health insurance. Supplemental plans benefit remote workers by providing extra financial protection in case of unexpected health issues.

Navigating Health Coverage for a Multi-State Remote Workforce

In an era where remote work is becoming increasingly common, employers have the flexibility to hire talent from all over the U.S. While the approach is excellent for recruitment and business growth, it presents challenges in offering health coverage to employees in different states.

Health insurance companies don’t always have uniform network coverage across all states, and even if they do, medical care providers may not offer the most cost-effective networks for out-of-state employees. Let’s review different options to provide out-of-state remote workers health insurance.

 

National Group Health Insurance Plans

These plans are available to employees throughout the U.S., eliminating the need to manage different health insurance regulations in each state. All employees receive the same group health insurance, ensuring no one misses out on quality coverage. However, only a few health insurance companies offer multi-state plans, limiting the selection of plan types and potentially leading to higher premium prices.

 

State Health Insurance Plans

Another option is to offer separate state plans to employees in various locations. This approach allows employees to receive essential coverage tailored to their area, needs, and preferences. However, healthcare providers available within a particular plan network may vary. The Small Business Health Options Program (SHOP) Marketplace is a good starting point for small businesses. If your business meets all the state's SHOP requirements, you can offer comprehensive coverage even if you have only one employee in a location. However, managing multiple policies can be complicated and time-consuming for many employers.

 

Health Reimbursement Arrangements (HRAs)

HRAs allow businesses to set a fixed monthly allowance for all eligible employees to get reimbursed for qualified out-of-pocket costs, including individual health insurance premiums, regardless of their U.S. location—more on HRAs below.

For now, let’s look at the two main types of HRAs:

  • Qualified Small Employer HRA (QSEHRA): Suitable for small businesses with fewer than 50 full-time equivalent employees (FTEs). This HRA has annual maximum contribution limits but no minimum allowance requirements. It can coordinate with an employee’s premium tax credits and is flexible enough to meet every employee’s needs.
  • Individual Coverage HRA (ICHRA): Suitable for businesses of any size, this HRA can cover individual premium costs and other out-of-pocket expenses. Unlike QSEHRAs, ICHRAs have no contribution limits, and employees must choose between the benefit and premium tax credits based on affordability.

HRAs eliminate the administrative headaches of traditional health insurance while offering comprehensive health benefits. For a multi-state workforce, QSEHRA or ICHRA allows employees access to the best local network providers and policy options in their area.

Health Stipends

Health stipends are fixed amounts of money paid to an employee in addition to their basic salary. This allowance can cover additional costs like health insurance, wellness programs, and remote work expenses. Stipends are flexible, simple to administer, and not subject to compliance considerations that impact other employee health benefits.

However, businesses must pay payroll tax on the reimbursements, and employees must claim the stipend as part of their taxable household income.

 

Business Travel Insurance

Business Travel Insurance is crucial for companies with a multi-state remote workforce. This type of insurance is specifically designed to cover the health and safety needs of employees who travel for work, whether domestically or internationally. Business Travel Insurance typically includes coverage for medical emergencies, trip cancellations, lost luggage, and sometimes even support services in case of legal troubles or medical evacuations.

Integrating business Travel Insurance into your health coverage plan for remote workers assures employees that they are protected against unexpected events during business trips. This mitigates the financial risks associated with travel-related incidents and supports employee well-being by providing peace of mind while away from home. Such comprehensive coverage can significantly foster a supportive work environment and maintain high morale among remote teams.

Navigating Health Coverage for a Global Remote Workforce

As businesses expand globally, providing health coverage for a remote workforce across different countries presents unique challenges and opportunities. Employers must consider various insurance options and strategies to ensure comprehensive and compliant coverage for their out-of-state remote workers and international employees' health insurance. 

Local Partners or Global PEOs

One practical approach is partnering with local insurers or global Professional Employer Organizations (PEOs). Local partners can offer insurance products compliant with the host country's regulations and tailored to the local healthcare landscape. Global PEOs, on the other hand, specialize in managing employment and benefits for workers in multiple countries, including health insurance. These organizations help navigate the complexities of varying health laws and insurance standards, ensuring that employees receive adequate coverage wherever they are located.

Global Health Insurance

Global health insurance plans are designed specifically for employees who live and work in multiple countries. These plans provide comprehensive coverage that remains in effect across borders, eliminating the need for a new policy in each country. Global health insurance is particularly beneficial for employees who travel frequently or relocate for work, offering them continuous coverage and access to a vast network of healthcare providers internationally.

Specialized Global Insurers
  • Nomad Health: Provides comprehensive health insurance coverage in over 175 countries, including full coverage in the employee's home country. This makes it an ideal choice for digital nomads and those whose work involves frequent international travel.
  • Aetna International: Offers global medical insurance plans for individuals working and living outside their home country for extended periods. Aetna's plans are designed to meet the needs of expatriates and international professionals, providing robust health coverage wherever they are.
  • Mira: Tailored for small businesses and decentralized employers, Mira offers affordable plans that include virtual primary care, telebehavioral health, and urgent care visits. This service mainly benefits startups and small teams looking for cost-effective health solutions.

Digital Nomad Insurance

Specialized insurance plans are available for employees who work remotely while traveling as digital nomads to cater to their unique needs. Digital nomad insurance typically includes health coverage and travel insurance features such as trip interruption, gear protection, and emergency evacuation. These flexible plans can be adjusted based on the duration of travel and the countries visited, providing tailored coverage that supports the nomadic lifestyle.

Health Stipends

Another flexible option for employers is providing health stipends. This allows employees to purchase the health insurance products that best fit their needs, whether in their home country or abroad. Health stipends enable employees to choose their preferred coverage, while employers can control costs by setting fixed stipend amounts. This approach is efficient in diverse global teams, where health insurance needs and costs can vary significantly from one location to another.

Reimbursement Plans

Reimbursement plans, like HRAs (health reimbursement plans), are versatile. They allow employees to pay for their healthcare expenses and then submit receipts to their employer for reimbursement. This method can be particularly effective for remote workers where suitable insurance products are unavailable or out-of-pocket healthcare costs are more economical than insurance premiums.

Local Partner

Partnering with insurers that offer local health insurance plans can be a strategic move for covering remote employees. These plans are designed to comply with local regulations and are tailored to meet the specific healthcare needs of remote workers, ensuring that coverage is appropriate and effective for each location.

Strategies for Managing Health Insurance for a Diverse Remote Workforce

Managing health insurance for a diverse remote workforce spread across multiple locations can be challenging but is essential for attracting and retaining top talent. Here are some key considerations and strategies to manage health insurance for your remote workforce effectively:

  • Understand Your Employees’ Needs: Before providing health insurance, it is crucial to understand your remote workforce's needs. Consider surveying to gather information on:
  • Location: Where are your remote employees located? This will affect the cost and options for health insurance plans. 
  • Family Status: Do your remote employees need coverage just for themselves or for their families too?
  • Preferred Providers: Do your remote employees have favorite healthcare providers or facilities?
  • Special Needs: Do any of your remote employees have special needs, like chronic conditions or regular medications?
  • Assess Employees’ Location: If considering a group plan, assess the policy's geography and ensure it covers all employees' healthcare needs.
  • Understand the Premium: Know the monthly premium costs and how much employees will be responsible for paying.
  • Evaluate Coverage Variations: Assess how coverage changes from place to place, especially if you must comply with the Affordable Care Act (ACA)’s employer mandate.

By considering these key points and strategizing accordingly, you can manage health insurance for your diverse remote workforce effectively.

Take Command can help you navigate these options and set up a multi-state benefits package tailored to your needs. Contact us today to maximize your health benefits for remote employees.

The Role of HRAs in Simplifying Health Insurance for Remote Workers

Providing health insurance to remote employees scattered across various locations can be incredibly daunting for any employer due to the diverse state regulations and the necessity for flexible benefits. Fortunately, HRAs can significantly simplify this process.

What's a Health Reimbursement Arrangement (HRA)?

A HRA is an account funded by the employer to reimburse employees for medical expenses, which may include insurance premiums. The employer determines the contribution amount for each employee's HRA account, and the employees can request reimbursement for qualified medical expenses. HRAs are tax-advantaged, meaning that reimbursements made through an HRA are exempt from federal income and payroll taxes.

Check out our comprehensive HRA guide!

The Advantages of Using HRA for Health Insurance of Remote Workers

Using an HRA for giving health insurance to remote workers has lots of perks:

  1. Flexibility: HRAs let employees choose the health insurance coverage that fits them best and get paid back for the premiums through the HRA.
  2. Cost Control: Employers can control costs better by setting a fixed amount to put in each employee's HRA account. This gets rid of the risk of rising premiums that come with traditional group health insurance plans.
  3. Tax Perks: Money put into an HRA is tax-deductible for the employer and tax-free for the employee, which equals big tax savings for all involved.
  4. Simplicity: HRAs simplify the administrative process of providing health insurance to remote workers. Employers are not burdened with managing multiple health insurance plans for employees in different states. Instead, they can allocate a fixed amount to each employee's HRA account and empower the employees to select their own insurance plan.

Read more about all the HRA benefits

How to Set Up an HRA for Your Remote Workers

Navigating affordable health insurance for remote workers is crucial in the modern workforce, and setting up an HRA is a great way to provide health benefits for remote workers. Setting up an HRA for your remote workers involves these steps:

  1. Pick the Type of HRA: There are several types of HRAs, including the Qualified Small Employer HRA (QSEHRA), and the Individual Coverage HRA (ICHRA). Each type of HRA has its own set of rules and regulations, so it's important to choose the one that fits your business and your employees best. At Take Command, we work with our clients to assess their specific needs and help them determine the most suitable HRA for their business.
  2. Decide on the Contribution Amount: The amount of money you decide to put into each employee's HRA account can vary based on several factors, including the employee's job role, location, and family size. It's crucial to determine an amount that is fair and helpful for your employees while also being financially sustainable for your business. Take Command assists clients in determining the most appropriate contribution amounts for their employees, taking into account all relevant factors.
  3. Set Up the HRA: With Take Command, the process of setting up the HRA is streamlined. As both the software provider and HRA administrator, we manage all aspects of the HRA, including contributions, claims, and ensuring compliance with regulations.
  4. Tell Your Employees About the HRA: It's essential to communicate clearly to your employees about the HRA, including how it works, the contribution amount, and the process for requesting reimbursements. Effective communication will help your employees understand and make the most of their HRA benefits. Take Command provides communication templates and guidance to help clients effectively communicate all necessary information about the HRA to their employees.

Handling State-Specific Rules with an HRA

Using an HRA can help handle state-specific rules by letting employees choose a health insurance plan that follows the rules in their state. For example, an employee living in a state with specific coverage rules can choose a plan that meets those rules and get paid back for the premiums through the HRA.

Also, because the HRA is funded with pre-tax dollars, it can help handle the tax stuff that comes with giving health insurance to remote workers in different states. However, it's important to note that some states have specific rules about HRAs, so it's important to talk to a legal or tax pro to make sure you're following the rules.

See how much you could save with our handy tax calculator.

Optimizing Health Benefits for Your Remote Team

The shift towards remote work has brought about new challenges for employers, one of the most crucial being managing health insurance for a diverse remote workforce. It's essential to understand the various options available, from national and state health insurance plans to Health Reimbursement Arrangements (HRAs) and health stipends.

Employers must consider their remote employees' needs and preferences, assess employees' locations, understand premium costs, and evaluate coverage variations. Additionally, it is vital to navigate legal and compliance considerations, prioritize mental health benefits, leverage telemedicine, and communicate effectively with remote employees.

Ultimately, the goal is to provide comprehensive, flexible, and customizable health insurance options that attract and retain top talent while being financially sustainable for the business. HRAs offer a flexible and cost-effective solution that can be tailored to suit the needs of both the employer and the employees.

Take Command is here to help you navigate these options and set up a multi-state benefits package tailored to your needs. Our team of experts will assist you in assessing your specific needs, determining the most suitable HRA for your business, deciding on contribution amounts, setting up the HRA, and effectively communicating with your employees.

Don't navigate the complexities of health insurance for remote employees alone. Contact Take Command today to maximize your health benefits for remote employees and ensure you are providing the best possible support for your team in these challenging times. Your employees are your most valuable asset; let's ensure they are well taken care of.