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    Retirement & Compensation

    Medical Reimbursement Plans (HRA/ICHRA)

    Tax-Advantaged Health Benefits for Business Owners

    Health Reimbursement Arrangements (HRAs) and Individual Coverage HRAs (ICHRAs) allow businesses to reimburse employees tax-free for medical expenses and health insurance premiums. For S-Corp owner-employees, these arrangements can provide significant tax benefits on healthcare costs that would otherwise be paid with after-tax dollars or subject to employment taxes.

    See Your Potential Savings

    Based on a typical client profile for this strategy

    $5,010
    Annual Tax Savings
    $500
    Implementation Cost
    $4,510
    Net Year-1 Benefit
    $22,550
    5-Year Cash Benefit

    Real Results: Client Success Story

    Tax Before
    $55,500
    Tax After
    $50,490
    Total Savings
    $5,010
    9% Reduction

    "An S-Corp owner establishes an ICHRA reimbursing $15,000 annually for individual health insurance premiums. The reimbursement is tax-free to the owner and deductible to the corporation, avoiding FICA taxes."

    *Illustrative scenario for educational purposes. Tax savings depend on individual circumstances, income level, entity structure, and proper implementation. Consult with a tax professional to determine eligibility.

    Do You Qualify? Quick Self-Assessment

    This strategy may be right for you if:

    Formal plan document required
    Must integrate with ACA-compliant coverage (HRA)
    ICHRA must offer affordable coverage
    Cannot offer both group plan and ICHRA to same class
    Same terms for similar employee classes
    Substantiation of medical expenses

    Check 3 or more? You may be a good candidate for this strategy. Schedule a free consultation to calculate your potential savings.

    Investment Levels

    Strategy Session
    $450-$750
    per session (1-1.5 hrs)
    • Current situation analysis
    • Tax reduction opportunities
    • Action item roadmap
    • Follow-up summary
    Get Started
    Most Popular
    Comprehensive Plan
    $2,500-$6,000
    per plan
    • Full financial analysis
    • Multi-year projections
    • Entity optimization
    • Implementation support
    Get Started
    Ongoing Advisory
    $600-$1,500
    per month
    • Quarterly planning calls
    • Transaction review
    • Legislative updates
    • Priority access
    Get Started
    Implementation
    $1,500-$5,000
    per project
    • Structure analysis
    • Document preparation
    • IRS filings
    • Transition planning
    Get Started

    Related Strategies

    Deep Dive

    Explore the Details

    For those who want to understand the full picture

    Real-World Example: Before & After

    S-Corp owner with health insurance costs
    S-Corporation or C-Corporation

    An S-Corp owner establishes an ICHRA reimbursing $15,000 annually for individual health insurance premiums. The reimbursement is tax-free to the owner and deductible to the corporation, avoiding FICA taxes.

    BEFORE Strategy

    Taxable Income:$150,000
    Tax Liability:$55,500

    AFTER Strategy

    Taxable Income:$150,000
    Tax Liability:$50,490

    $15K reimbursed tax-free vs. paid with after-tax dollars. At 33.4% combined rate (income + FICA) = $5,010 savings. S-Corp owners can avoid including premiums on W-2 through proper ICHRA structure.

    IRS Authority & Professional References

    IRC § 105(b)
    Amounts Received for Medical Care
    Exclusion for employer-provided medical reimbursement
    IRC § 106
    Employer Contributions to Health Plans
    Exclusion from income for employer health contributions
    Treas. Reg. § 1.105-11
    Self-Insured Medical Reimbursement Plans
    Requirements for HRAs
    IRC § 9831
    Individual Coverage HRA
    ICHRA requirements and rules
    Notice 2013-54
    HRA Integration Requirements
    Integration with group health plan or ICHRA
    IRS Publication 15-B
    Employer's Tax Guide
    Guidance on fringe benefits including HRAs

    Key Benefits

    • Tax-free reimbursement for medical expenses
    • Corporation deducts reimbursement
    • No FICA taxes on reimbursements
    • ICHRA allows individual policy selection
    • Flexible design options
    • Works for businesses of any size

    Requirements & Risks

    Requirements:

    • •Formal plan document required
    • •Must integrate with ACA-compliant coverage (HRA)
    • •ICHRA must offer affordable coverage
    • •Cannot offer both group plan and ICHRA to same class
    • •Same terms for similar employee classes
    • •Substantiation of medical expenses

    Risks to Consider:

    • !Complex integration rules with ACA
    • !Shareholder-employees subject to special rules
    • !2% S-Corp shareholders may have different treatment
    • !Administration requirements
    • !Employee classes must be defined properly
    • !State law variations may apply

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    Last updated: September 12, 2026