Health Reimbursement Account (HRA)

A Health Reimbursement Arrangement (also known as an HRA or Health Reimbursement Plan) is an employer-funded health benefit that reimburses employees for out-of-pocket medical expenses.

Gusto doesn't offer an HRA, but if you offer one through a third party, you can set up tax-free payroll reimbursements for enrolled employees. 

Tax implications

Small businesses may provide these types of reimbursement arrangements without violating ACA mandates, but situations vary and you should consult a licensed professional or tax consultant before taking this route.