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Health Reimbursement Arrangements (HRAs)

HRAs offer savings and money back

Earn tax deductions on an account you own

Employers fund and own HRAs, so you decide how much to contribute. You can deduct reimbursed employee health care expenses as business expenses and exclude them from your employees’ gross income.

Reimburse employees with tax-free dollars

Employees can get money back, tax-free, for out-of-pocket eligible health care expenses, up to a fixed dollar amount each year. Employers fund the account, but it doesn’t count as taxable income. That means employees use tax-free dollars to pay for certain health care expenses. And unused funds can roll over to the next year.

Make it easy with the PayFlex Card®

Want to provide extra convenience? Offer the PayFlex Card to your employees. It provides instant access to their funds for eligible expenses at qualified merchants. If they have an Apple® or Samsung® device, they can add the card to their digital wallet. Then use it for a no-touch payment. It’s a fast, easy and secure way to pay.



Understanding HRAs

Standard and limited HRAs

A standard HRA reimburses employees for eligible health care expenses.

A limited HRA reimburses certain health care expenses before meeting the deductible. Afterward, the limited HRA turns into a standard HRA.

Individual Coverage Health Reimbursement Accounts (ICHRAs)

An ICHRA is for employees who have individual health insurance or Medicare. It helps them pay for eligible health insurance premiums and medical expenses.

Retiree Reimbursement Accounts (RRAs)

RRAs are a special type of HRA. They provide reimbursement for eligible expenses of retirees.

PayFlex Specialized HRATM for mental well-being

A specialized HRA for mental well-being is a new way to support your employees’ mental health. You can put money into this account for employees to use for eligible in and out of network behavioral health services. They may use it to help pay for therapists, psychologists, psychiatrists, certain mental health apps, telehealth services and more.


Offer a PayFlex Specialized HRA for mental well-being

Behavioral and mental health is a key component of your employees’ well-being. And it can greatly affect the workplace.

61 percent of employees say their mental health affects their work

Good mental health positively impacts worker productivity and physical health. Yet 61 percent of workers say their mental health affects their productivity at work.footnote1 And less than 10 percent of employees access behavioral health services.footnote2

Even for those adults with a mental illness, over half do not get the services they need.footnote3 This is despite having access to a broad spectrum of low- and high-touch mental health services, like traditional therapists, mental health mobile apps and telehealth. PayFlex’s specialized HRA supports your employees by bridging the gap between mental health providers and those who need help. To make things easier, they can use our digital wallet-enabled debit card to pay for eligible mental health care.

Offering a PayFlex Specialized HRA means you can:

  • Increase employee access to behavioral health providers in and out of network
  • Provide money to lessen the burden of behavioral health expenses
  • Build a positive reputation among your employees by supporting their well-being

Your employees can use the specialized HRA to help pay for:

  • Applied behavioral analysis
  • General and clinical psychologists
  • Behavioral health apps
  • Licensed counselors and examiners
  • Behavioral health telemedicine
  • Nurse practitioners for behavioral health
  • Certified addictions counselors
  • Psychiatric nurses
  • Clinical social workers
  • Psychiatrists
  • Drug and alcohol counselors
  • Psychotherapists

We’re here to help you make mental health a priority. To learn more about our specialized HRA, contact a PayFlex sales executive.


Tax-free spending on eligible health care expenses

Check out the list of common eligible health care expenses. Use the search bar to find specific items and services. Or you can click on the column headers in the table to see which are eligible, eligible with a Letter of Medical Necessity (LOMN), or not eligible. 


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footnoteSHRM, Mental Illness and the Workplace 2019,
footnote2 Based on Aetna and PayFlex business analytics.
footnote3 Mental Health in the Workplace, Journal of Occupational and Environmental Medicine 2018,