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With an HRA:. The employer allocates fixed monthly allowance amounts to each employee there are no minimum contribution requirements. Employees are reimbursed on payroll for approved health insurance premium expenses, up to the amount available in their balance. And, reimbursements employees receive are tax-free. Small employers want to offer health benefits for the same reasons as larger employers, but as seen in the market analysis above, are priced out of the market more and more each year. The primary driving force for small employers adopting HRAs is affordability and cost predictability. Additionally, this approach gives eligible employees and their families access to the individual health insurance tax credits, and allows employees to have more control over their health care. Some smaller employers who do not offer health benefits consider giving employees a raise or salary bonus as an informal strategy for employer paid health insurance This could lead to expensive conditions down the line, including avoidable hospitalizations and long-term spending on chronic diseases

in CHIP or Medicaid