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Employee and Employer Health Benefits Glossary

HRA terms every employer and employee should know.

Premium

Small business guide to health insurance premiums: tax treatment, ACA rules, ICHRA strategies, compliance, and practical cost-control tips.
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Pre-Tax Contribution

Comprehensive guide to pre-tax payroll contributions, compliance, HRAs, and ACA impacts for small businesses and employees.
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Forfeiture

Learn what forfeiture means in ICHRA/HRA plans, when unused reimbursements revert to employers, and how SimplyHRA tracks deadlines and compliance.
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Flexible Spending Account (FSA)

Learn what an FSA is, how pre-tax payroll deductions work, what expenses qualify, and how carryover/grace period rules affect “use-it-or-lose-it.”
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Fiduciary

A fiduciary must act in employees’ best interest when managing ERISA-covered benefits. Learn duties, risks, and best practices for employers.
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Federally Facilitated Marketplace (FFM)

The FFM is the federal ACA marketplace on HealthCare.gov where employees enroll in qualified health plans—often alongside ICHRA reimbursements.
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Federal Poverty Line Safe Harbor

The FPL safe harbor is an ACA affordability method using federal poverty guidelines to set a max employee premium for self-only coverage.
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Explanation of Benefits (EOB)

An EOB explains how your insurer processed a claim—what was billed, allowed, paid, and what you may owe. It’s not a bill.
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Expense Documentation

Expense documentation is the receipts and proof needed to substantiate HRA/ICHRA reimbursements. Learn what to submit, store, and why it matters.
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Excepted Benefits

Excepted benefits are limited coverages like dental, vision, EAPs, and accident plans—often exempt from many ACA rules and used alongside ICHRAs.
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Excepted Benefit HRA (EBHRA)

An EBHRA reimburses employees tax-free for excepted benefits like dental, vision, COBRA, and certain premiums—alongside a group plan.
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Essential Health Benefits (EHBs)

Essential Health Benefits are 10 ACA-required coverage categories for individual and small-group plans. Learn what’s included, why it matters, and how EHBs affe
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Employee Retirement Income Security Act (ERISA)

ERISA is the federal law governing many employer benefit plans. Learn SPDs, fiduciary duties, claims rules, and how HRAs/ICHRAs fit.
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Exclusive Provider Organization (EPO)

An EPO plan covers in-network care only (except emergencies), usually without PCP referrals—often cheaper than PPOs and simpler than HMOs.
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Employer Shared Responsibility Payment (ESRP)

ESRP is the ACA penalty for employers with 50+ FTEs that don’t offer affordable, minimum-value coverage. Learn triggers, amounts, and avoidance.
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Employer Mandate

The ACA employer mandate requires 50+ FTE employers to offer affordable, minimum-value coverage or face penalties. Learn thresholds, rules, and alternatives.
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Employee Classes

Employee classes group workers (full-time, part-time, location, etc.) for benefit eligibility and ICHRA allowances. Learn rules, examples, and best practices.
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Employee Census

An employee census is a roster of workforce details (ages, status, dependents, etc.) used to set up benefits like ICHRA, estimate costs, and stay compliant.
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Eligible Expenses

Eligible expenses are medical costs an HRA/ICHRA can reimburse tax-free (like premiums, copays, Rx). Learn what’s covered, what’s not, and how to verify.
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