Qualified Small Employer Health Reimbursement Arrangements (QSEHRAs) and Individual Coverage Health Reimbursement Arrangements (ICHRAs) both allow small business employers to provide tax-free reimbursement of certain health care expenses to employees who maintain qualifying coverage, including an individual Marketplace plan.


If you’re interested in offering either QSEHRA or ICHRA to your team, we recommend Take Command Health because they offer policy flexibility and a focus in HRA administration. To learn more about Take Command Health, follow this referral link to set up a new HRA or speak with an expert.

Please note: Gusto no longer administers a QSEHRA.

QSEHRA and ICHRA benefits cannot be offered alongside small-group health insurance, including small-group health insurance offered through Gusto. 

Set up payroll reimbursements

Once you offer QSEHRA or ICHRA through a third party (such as Take Command Health), you can set up tax-free payroll reimbursements in Gusto.

Tax reporting


QSEHRA contributions must be recorded on employees' end-of-year tax forms. Payroll admins should report QSEHRA totals when completing the end-of year special compensation prompt on your Home page in Gusto, then we'll add them to employee tax forms. 


ICHRA benefits do not need to be reported on employee W-2s. If you have questions about ACA reporting requirements, contact your ICHRA provider.