Some small-business owners are hesitant to offer health insurance because they think it will be expensive and add too much cost to their bottom line. While the tax code doesn't require small businesses with 49 or fewer employees to offer medical plans, there are many reasons why it's in your best interest to do so.
The expenses associated with offering health coverage can often be offset by tax benefits and other cost-saving measures.
If you're looking for some way to save money and reduce your tax bill, here are six Medical Plan Tax Deduction Strategies:
1. Section 105 Medical Reimbursement Plan
If you have a Section 105 plan in place and have not been reimbursing expenses monthly,
do a reimbursement now to get your 2022 deductions, and then put yourself on a monthly
reimbursement schedule in 2023.
2. Qualified Small Employer Health Reimbursement Arrangement (QSEHRA)
If your company has fewer than 50 employees and does not offer group health coverage through an employer-sponsored plan, a Qualified Small Employer Health Reimbursement Arrangement (QSEHRA) allows you to provide your employees with additional plan choices without managing group health plan coverage. allows you to provide employees with non-taxed reimbursement of certain health care expenses. These expenses include health insurance premiums and coinsurance, as well as any out-of-pocket expenses an employee may have when purchasing individual Marketplace coverage.
If you want to implement a Qualified Small Employer Health Reimbursement
Arrangement (QSEHRA) but you have not yet done so, make sure to get that done
correctly now. The tax code imposes a penalty of $50 per employee (up to a maximum of $2,500 per year) on any employer that provides a QSEHRA but fails to provide the notice in a timely manner.
3. Individual Coverage Health Reimbursement Arrangements
But if you are thinking of the QSEHRA and want to help your employees with more
money and flexibility, consider the Individual Coverage Health Reimbursement
Arrangement (ICHRA). It’s got more advantages.
4. Health Insurance Tax Deduction
If you're an S corporation and want an above-the-line tax deduction for the cost of your health insurance, make sure you take these two steps:
- Pay for or reimburse the cost of your insurance before December 31.
- Set up the reimbursement to show on your W-2.
5. Claim the tax credit for the group health insurance
If you provide your employees with group health insurance, see whether your pay structure and
number of employees put you in a position to claim a 50% tax credit for some or all
of the monies you paid for health insurance in 2022 and possibly in prior years.
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