Employee and Employer Health Benefits Glossary
HRA terms every employer and employee should know.


Coverage Start Date
Coverage start date is the day your health plan becomes active. Learn how it works for group and Marketplace plans, plus ICHRA reimbursement timing.
Read post

Copayment (Copay)
A copay is a fixed amount you pay for care (like $25 for a visit). Learn how copays work, what they apply to, and copay vs deductible/coinsurance.
Read post

Controlled Group
A controlled group treats related businesses as one employer for ACA size, COBRA, and benefit rules. Learn types, tests, and common pitfalls.
Read post

Form 1095-A
Understand IRS Form 1095-A (Marketplace Statement), how it supports Form 8962 premium tax credit reconciliation, and why it matters for ICHRA users.
Read post

COBRA Continuation Coverage
COBRA continuation coverage explained: eligibility, qualifying events, notice/election deadlines, cost rules, and alternatives like Marketplace plans or ICHRAs.
Read post
.png)
Consolidated Omnibus Budget Reconciliation Act (COBRA)
COBRA lets employees keep group health coverage after qualifying events. Learn eligibility, costs (up to 102%), timelines, notices, and duration rules.
Read post

Claims Processing
Claims processing explained: how medical claims are reviewed, approved, denied, and paid—plus how reimbursement claims work with HRAs like ICHRA.
Read post

Children’s Health Insurance Program (CHIP)
CHIP offers low-cost health coverage for kids in families who earn too much for Medicaid. Learn eligibility basics, what it covers, and how to apply.
Read post

Catastrophic Plan
Catastrophic plans have low premiums and very high deductibles. Learn who qualifies (under 30 or hardship), pros/cons, and how it works with ICHRA.
Read post

Cafeteria Plan
Cafeteria (Section 125) plans explained: pre-tax premiums, FSAs/DCFSA, key rules, nondiscrimination testing, and setup tips for SMBs.
Read post

Benefits Administration
Learn benefits administration basics—enrollment, eligibility, compliance, payroll, and reimbursements—and how SimplyHRA streamlines HRA administration.
Read post
.png)
Applicable Large Employer (ALE)
Learn what makes an employer an ALE (50+ FTEs), how to count employees, ACA coverage duties, IRS penalties, and 1094-C/1095-C reporting.
Read post

Form 1094-C
Learn what IRS Form 1094-C is, who must file (50+ FTE ALEs), deadlines, penalties, and how it works with Form 1095-C under ACA reporting.
Read post

Affordability Safe Harbors
Learn the 3 IRS affordability safe harbors—W-2 wages, Rate of Pay, and Federal Poverty Line—and how they affect ACA compliance and tax credits.
Read post

Affordability Percentage
Learn the IRS affordability percentage, how it’s calculated using safe harbors, and how ICHRA affordability affects Marketplace premium tax credits.
Read post

1099 Contractor
Learn what a 1099 contractor is, how contractor vs. employee classification affects benefits, and why ICHRA/HRAs generally apply only to W-2 employees.
Read post
.png)
Affordability (ACA)
Learn ACA affordability rules, safe harbors, and how ICHRA affordability affects premium tax credits—plus strategies to stay compliant with SimplyHRA.
Read post
.png)
Advance Premium Tax Credit (APTC)
Understand APTC, the Marketplace premium subsidy, and how an affordable ICHRA can end eligibility. Rules, examples, and tips from SimplyHRA.
Read post
Ready to provide the best health benefits experience to your employees?
Schedule a free 15-minute consultation. We’ll walk you through pricing, the virtual card, and exactly how setup works—no commitment required.
Happier employees
Easy to setup
Tax-free savings



