Benefits, explained in plain language.

Design the benefit. Review employee needs, available individual plans and the budget. Choose permitted employee classes, eligible expenses, contribution amounts and a start date. Model affordability before changing existing coverage.

Notify employees. Prepare written plan documents and give current employees notice generally at least 90 days before the plan year. Explain the allowance, coverage requirements, opt-out rights and Marketplace tax-credit effects.

Employees choose coverage. Help employees compare doctors, hospitals, prescriptions, deductibles and networks. They enroll in qualifying individual insurance on or off the Marketplace, or qualifying Medicare coverage.

Verify coverage and expenses. Confirm qualifying coverage annually and for the months being reimbursed. Review documentation for premiums and any other medical expenses allowed by the written arrangement.

Reimburse approved expenses. The employer pays tax-free reimbursements up to the allowance when requirements are met. Employees pay costs above it. Unused allowances are handled under plan terms, not automatically paid as cash.

Support and review. Provide enrollment and reimbursement support, monitor compliance, and review premiums, affordability and employee experience before renewal.