PeopleKeep, a software driven health benefits platform under the Remodel Health brand, has released its eighth annual report on the Qualified Small Employer Health Reimbursement Arrangement. The 2024 report analyzes how small employers across the U.S. are using QSEHRA to deliver personalized, affordable health coverage in an era where flexibility and cost control matter more than ever.
While many headlines have focused on the growth of ICHRA plans, the QSEHRA continues to be a lifeline for smaller employers particularly those offering health benefits for the first time.
QSEHRA Trends in 2024: Small Businesses Stepping Up
1. Employer Generosity on the Rise
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Since 2019, average employer contributions to QSEHRA allowances have jumped by 49%, signaling growing commitment to employee well-being.
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This growth is especially meaningful in tight labor markets, where benefits can make or break recruitment efforts.
2. More Inclusive Reimbursement Policies
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43% of employers now allow reimbursement of premiums for employees covered through a spouse’s employer-sponsored plan.
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This flexibility increases the plan’s value for families and contributes to broader coverage access.
3. A Younger Workforce Embraces QSEHRA
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The average age of QSEHRA recipients is 39, younger than the national average of 42.
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This suggests growing traction among startups, tech firms, and service-oriented employers who often serve a younger demographic.
How Employees Are Using QSEHRA Benefits
1. Premiums Are the Top Spending Category
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A full 65% of QSEHRA reimbursements went toward health, dental, and vision insurance premiums.
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The remaining funds typically covered qualified medical expenses, offering additional financial flexibility.
2. Plan Choice Reflects Practical Priorities
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Employees primarily selected bronze or gold individual plans, with HMO networks being the most common.
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This preference reflects a strategic balance between monthly costs and out-of-pocket exposure.
CEO Insight: Simple, Smart, and Scalable for Small Teams
“QSEHRA continues to be a powerful tool for small employers who want to do right by their team but can’t afford or don’t qualify for a traditional group plan,” said Austin Lehman, CEO of Remodel Health.
“This report shows that more small employers are stepping up to offer coverage often for the first time and using QSEHRA to do it on their terms.”
The findings reaffirm QSEHRA’s value as a cost-controlled, administratively simple, and employee-centric health benefit model.
Why QSEHRA Still Matters in a Post-ICHRA World
1. Ideal for First-Time Benefit Providers
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For businesses with fewer than 50 full-time equivalent employees, QSEHRA requires no group health plan, making it an excellent entry point to offering health benefits.
2. Budget-Friendly Flexibility
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Employers can cap reimbursement amounts and set eligibility rules that align with their financial strategy, all while delivering meaningful value.
3. A User-Friendly Platform from PeopleKeep
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Backed by Remodel Health, PeopleKeep offers intuitive software that simplifies the design, deployment, and day-to-day management of QSEHRAs.
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The platform’s ease-of-use enables small teams to launch compliant benefit programs with minimal lift.
A Benefit Strategy Built for Modern Small Employers
PeopleKeep’s 2024 QSEHRA Report paints a clear picture: small businesses are increasingly using flexible health reimbursement arrangements to offer real, valuable benefits even on modest budgets. With rising employer contributions, increased inclusivity, and a tech-enabled delivery model, QSEHRA continues to be a vital tool for companies that want to put their people first without sacrificing control.
As healthcare costs rise and employee expectations shift, QSEHRA offers something rare: a benefit that’s affordable, personal, and built for small business realities.
