Nowadays, Certified Public Accountants (CPAs) and some other tax specialists are requested to discuss everything about regulations and the market system on health insurance. They are also expected to make decisions on what specific plans are good for individual taxpayers and small businesses. These professionals are also requested to determine the best things and approaches that could help individuals in terms of financial stability.

The role of CPAs and other tax specialists already expanded in modern years. Way back, the ACA or Affordable Care Act has created some tax opportunities for individuals and for businesses in the United States. If you’re considering or currently using a health benefit that is a reimbursement-based system, then it could be nice! It is customizable, cost-effective, and a sustainable type of employee benefit, providing a wide range of coverage options to employees.

For you to learn more about this matter, keep in touch with the succeeding discussions. This article will know what the Certified Public Accountants must know pertaining to the reimbursements on health care benefits.

Compliance Pertaining to the Market Reform on the HealthCare Reimbursement Benefits

CPAs should know and understand the proper procedures on how the insurance plans on health are structured. If they know something about this matter, they can personally provide some advice to their clients pertaining to the specific plans based on the current rules and regulations. There’s no recent change in the regulations or tax code mentioned in Section #105: Medical Reimbursement Insurance Plans.

The Affordable Care Act has explained that these kinds of benefit plans are considered as health group plans and are subject to Market Reforms. However, not all types of plans, like stand-alone health reimbursement arrangements for employees, can meet the Market Reforms. That’s why it is important that the accountants must eloquently understand and explain how these plans are being regulated.

Reimbursements on the Health Insurance for Individuals

The reimbursement plan of the health insurance for individuals focuses on how the business company provides every employee with a fixed allowance. Employees can utilize the allowance being given to them to make reimbursement for their health insurance. So, they need to opt which policies which will be suitable for their family and individual needs.

Since this kind of healthcare reimbursement becomes prominent and used by many employees, Certified Public Accountants must familiarize themselves with the different proper procedures on how these reimbursement plans of the health insurance for individuals are being set up, reported, and administered once someone avails the service. Moreover, CPA for healthcare must be knowledgeable pertaining to the actual comparison of tax or financial benefits and advantages of traditional health insurance, which is employer-sponsored over healthcare reimbursements.

Some Rules and Regulations for the Different Business According to Its Size

The Affordable Care Act does not typically apply to all businesses in an equal manner. In fact, some rules and regulations which are being applied to every business may depend according to its size. Generally, it depends on the number of full-time employees who work in the company and the annual revenue of the business. For some business types, the actual cost of those groups that are giving health plans is higher than the surcharge or penalty for those who don’t provide it. Sometimes, it is the combination of the surcharge and the actual cost of employees’ premium of the reimbursement. With this given complex situation, the majority of the companies are requesting their Certified Public Accountants to do the calculation. CPAs can help the business company in addressing this concern.

Reimbursements of Healthcare for Tax-Related Provisions

The ACA may have a wide range of provisions that can greatly impact the income of every individual and business company. With these numerous types of provisions available, CPAs should know about these things. Some of these provisions are the following:

  • Penalties and some consequences for those individuals who are not covered in the category of a group plan and those who do not opt to buy health insurance
  • New F-720 that are utilized as prerequisites for reporting and fees on plan administrators in self-insured plans like health reimbursements
  • Deductions on taxes for those individuals who buy or avail individual plans and those who have income that does not exceed 400% on FPL or Federal Poverty Line or a Medicaid Expansion to those families below 133% of FPL in some applicable states
  • New forms for W-2 employee’s requirements for reporting are covered under the group plan by their employer
  • Penalties on taxes for those employers who meet the minimum full-time equivalent employee and those who do not provide group insurance for health
  • Changes on the threshold to the deduction of the medical expense to ten percent of adjusted total income for those who want to deduct the unreimbursed expenses for medical

These are just some of the provisions that the Certified Public Accountants of the company should know so that they can properly evaluate the documents and proper procedures being done when availing the claims for reimbursements. CPAs should also explore all updates about the changes on these provisions for them to comprehend the verdict for the healthcare reimbursements fully. Moreover, the CPAs should extensively scrutinize everything that pertains to this provision so that they can fully understand the situation.


Any Certified Public Account or tax specialist should be aware and knowledgeable enough for different types of health insurance for individuals, groups, or company business members. Since there are always some changes in the rules and regulations under the Affordable Care Act that are being implemented in the country, it is necessary that they should be updated with the new policies for them to avoid unnecessary fines and fees. It is just a matter of embracing their line of professions properly so that they can serve the people with accurate and proper procedures for the benefit of the people. With their knowledge and expertise, they can surely help everyone in terms of the healthcare reimbursement system.

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