Benefits Tech Provider Criticizes Aspects of Medical Care Regs 

July 27, 2020

The Honorable Steven Mnuchin
Secretary of the Treasury
U.S. Department of the Treasury
1500 Pennsylvania Avenue, NW
Washington, DC 20220

Re: Certain Medical Care Arrangements (REG-109755-19)

To Whom It May Concern:

Remodel Health appreciates the opportunity to provide comments on the proposed rules titled “Health Reimbursement Arrangements and Other Account-Based Group Health Plans” issued by the Department of the Treasury, the Department of Labor, and the Department of Health and Human Services.

Remodel Health, headquartered in Indianapolis, IN, is the leading benefits tech provider to faith-based organizations that combines HCSM's and other individual plans. Remodel Health assists hundreds of faith-based organizations in offering qualified small employer health reimbursement arrangements (“QSEHRA”) and other account-based health benefits. As such, we're closely acquainted with the needs and interests of faith-based organizations and seek to represent them in our commentary. In particular, we have industry-leading experience working with faith-based organizations that are seeking alternatives to traditional group health insurance.

We believe the proposed rules are a material step in the right direction toward providing greater parity for small faith-based organizations to offer competitive benefits and to care better for their team members.

With our comments below, we've provided recommendations we believe will advance the underlying aims of the proposed regulations even further. Overall, we encourage the Departments to approach the final rules with an aim of providing the greatest degree of flexibility for faith-based organizations and creating tax parity between smaller organizations and large corporations.

On June 10, 2020, the Internal Revenue Service and the Department of the Treasury released IRS-2020-0016, Certain Medical Care Arrangements (REG-109755-19)​. Under Section 6, it is proposed that HCSMs should be considered eligible for reimbursement via Individual Coverage HRA by defining HCSMs as health insurance.

We agree that HCSMs should be eligible for ICHRA:

• This was included in President Trump's original ​executive order​ from October 12, 2017, ​Presidential Executive Order Promoting Healthcare Choice and Competition Across the United States.

• Money shared by HCSM members goes toward medical expenses as defined by ​U.S. Code § 213​.

We do not​​ agree that HCSMs should be considered insurance:

• HCSMs are not configured as insurance, whereas there is no transfer of risk or guaranteed payment. Instead HCSM members assist in paying for other members' qualified and eligible medical expenses.

• HCSMs typically do not provide preventative coverage or provide sharing for preexisting conditions.

We do not​​ agree that membership in a HCSM should preclude an individual from contributing to an HSA:

• HCSMs should be understood as an administrative program and not insurance, as they are designed exclusively to assist individuals in the sharing of payments toward others' medical bills.

• Because they are not insurance, membership in a HCSM would neither preclude the member to purchase a separate HDHP nor contribute to an HSA respectively.

We are grateful for the opportunity to offer our comments on the proposed regulations regarding HCSMs and their interaction with ICHRA. If you have any questions regarding our comments, please contact Remodel Health's Development Manager, John Staub, at (317)224-4267 or john.staub@remodelhealth.com.

Sincerely,

Austin Lehman
Chief Operations Officer (COO)

John Staub
Development Manager

Remodel Health
Indianapolis, IN