If your employer helps cover health insurance costs without a traditional group health insurance plan, you may hear your coworkers say, "Just submit your premium for reimbursement." This guide is for employees who buy their own coverage (often an individual plan) and need a clear process to follow to get reimbursed. Follow these steps:
- Step 1: Identify what type of reimbursement benefit you have
- Step 2: Confirm what expenses are eligible
- Step 3: Gather the documents you will need
- Step 4: Submit your reimbursement claim
- Step 5: Watch for follow-ups and avoid common delays
- Step 6: Confirm reimbursement and how it appears on your paystub
- Step 7: Save records for your files
Step 1: Identify what type of reimbursement benefit you have
Not all health insurance reimbursement programs work the same way.
If you are not sure which one you have, check your onboarding benefits documents, your benefits portal, and your pay stub (or ask HR). And if your employer is deciding between reimbursement options, this overview can provide context: 5 Ways to Reduce Health Insurance Costs without Reducing Benefits.
HRA (Health Reimbursement Arrangement)
If you are new to HRAs, start here: What is a Health Reimbursement Arrangement (HRA)?
With an HRA:
- Your employer reimburses you up to a set allowance.
- You typically submit claims (i.e., eligible expenses) in a portal or through a benefits administrator.
- When run correctly, reimbursements are tax-free.
Common HRA types you might see:
- ICHRA (Individual Coverage HRA)
- QSEHRA (Qualified Small Employer HRA)
Taxable health benefit stipend (or allowance)
With this approach:
- Your employer adds extra money to your paycheck.
- There may or may not be a health insurance verification process.
- This is commonly treated as taxable income.
Standard expense reimbursement (receipt-based)
With this approach:
- You submit health insurance reimbursement requests like a business expense
- Reimbursement comes through payroll, check, or direct deposit
Step 2: Confirm what expenses are eligible
Your employer's policy should list what can be reimbursed. Common categories include:
- Health insurance premiums (medical)
- Dental or vision premiums
- Out-of-pocket medical expenses
Be sure to also confirm whether you can submit for your dependents (spouse, child) and coverage through a spouse's employer plan.
Step 3: Gather the documents you will need
Most reimbursement processes require two types of proof.
Proof of coverage (you are enrolled)
Proof of coverage examples include:
- Insurance ID card
- Coverage confirmation letter from your insurer
- Marketplace enrollment confirmation
Proof of premium payment (you actually paid)
Proof of payment examples include:
- Carrier receipt or payment confirmation
- Billing statement showing premium amount, coverage month, and payment status
- Bank or credit card statement showing the payment
TIP: If you submit a bank statement, redact unrelated transactions before uploading.
Step 4: Submit your reimbursement claim
Where you submit depends on your employer:
- HRA portal or benefits administrator (e.g., the LegUp Health portal)
- Payroll platform
- Expense reimbursement tool
- HR email (less ideal, but sometimes used)
When you submit, include:
- The period (e.g., month, quarter, year, etc.) you are requesting reimbursement for
- The amount you are requesting
- The required documentation (proof of coverage and/or payment)
Email template to HR (copy and paste)
Subject: Health insurance reimbursement process
Hi [Name],
I pay my health insurance premium each month and want to make sure I submit reimbursements correctly. Can you confirm:
- Whether our benefit is an HRA (ICHRA/QSEHRA), a taxable stipend, or an expense reimbursement process
- Where I should submit premium reimbursement requests
- What documents you need and the submission deadlines
Thanks,
[Your name]
Step 5: Watch for follow-ups and avoid common delays
Approvals often get delayed because:
- The invoice does not show the coverage month
- The proof of payment does not match the invoice amount (prorated months, partial payments)
- The claim is filed under the wrong category (for example, "medical expense" instead of "premium")
If something is unclear, add a one-sentence note with your submission.
Step 6: Confirm reimbursement and how it appears on your paystub
If you buy your own coverage and want help making sense of plan documents and billing, an independent agent can often help at no added cost. (See what is an individual health insurance agent?)
Reimbursements may be paid:
- As a line item on your paycheck
- As a separate direct deposit or check
If you expected reimbursement and do not see it, ask HR:
- "Was the claim approved?"
- "When is the next reimbursement run?"
Step 7: Save records for your files
Keep a copy of:
- What you submitted
- Approval confirmation emails
- Paystubs showing reimbursement
This is helpful later if there are questions during tax season or if you change HR contacts.
FAQs
How long does reimbursement take?
Timelines vary by employer. Ask HR what the standard turnaround time is and whether reimbursements run on a set schedule.
Do I need to submit reimbursement every month?
Often yes, especially for HRAs. Some employers allow less frequent submissions.
Can I get reimbursed for dependents' premiums?
Sometimes. It depends on how the program is set up.
Is reimbursement taxable?
It depends on the benefit type and how it is administered. HRAs are often tax-free when handled correctly. Stipends are commonly taxable. If you are unsure, ask HR and consult a qualified tax professional.
Need Help?
At LegUp Health, we help small businesses and employees choose the right reimbursement program and navigate the purchase of personal health insurance plans. Whether you're looking to save money this year or build long-term financial security, we've got you covered.
