HRA Sign-Up Form

  Employer Information:

Corporations:
Enter the company name followed by the employer/owner first and last name.  The web application will recognize the corporation and put the documents in the Company/Corporation's name.  Employer ID is not required.

Sole-Proprietors:
Company name and Employer ID is not required.  The spouse employee information will be entered on the next page.

Email:
A legitimate email is required.  We will use your email to send a unique user ID and Password. 

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  Employees:

This is basic information about each employee that will qualify for the plan.

Sole-Proprietors: 
The employee will be the spouse.

Corporations:
In a corporation, spousal employment is not necessary.  List the owner as the employee.  You do not have to enter the spouse as a second employee.

Partnerships:
The partners cannot be employees of the partnership, spousal employment is mandatory.  The spouse of each partner will be an employee and receive benefits which would include the partner.

List all employees that meet the eligibility requirements for the plan.  An additional fee of $97 applies to each additional employee (not including Spouse).  If you have more than 7 employees, please contact us.

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  Job Descriptions:

Please specify the job description for the employee(s).  The information in this section is used to create an Employer/Employee agreement which is used to solidify an employer/employee relationship between a sole proprietor and his/her spouse.  Generally, a corporation would not use this section, since the owner is typically an employee of the corporation and does not have to prove employment in order to receive benefits. 

Sole Proprietors:
Use the Job Description section to choose general duties that are performed by the spouse employee.

Corporations:
An employer/employee agreement is optional.

Partnerships:
Partners who employ their spouse will need to fill out an agreement.

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  Employer/Employee Agreement:

You may add any additional information to the Employer/Employee Agreement below.  This text box is used to create custom language in the Employer/Employee agreement.  The text entered here will not appear anywhere in the plan documentation except for the employer agreement.  Use this section to enter specific language for such items as: commodity wages, exact cash wages, hourly information, etc.

  Plan Details:

The Plan Detail section is used to establish the basic business information.

Controlling Interest:
If the employer owns controlling interest in another company, any benefit they provide for the employees of this business must be offered to the qualifying employees in the other business.

The Plan Start Date:
The plan start month by default is January.  Out of pocket expenses may only be deducted from the inception of the plan forward.

The Plan Administrator:
The plan administrator is a named individual, typically an employee of the company or the employer.

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  Eligibility Requirements:

This information is used to include or exclude employees from the plan.  The employee must meet all of the requirements above in order to qualify for participation in the HRA.

Hours Per Week - Enter the "average" hours per week the spouse/employee works in the business. Use the safe harbor rules below if needed. There is no minimum.  However, in order to have a fair and reasonable wage, the hours should rarely be below 5.

Months Per Year - This is for seasonal employees.  Those employees employed less than 7 months a year may be excluded.  See the safe harbor rules for seasonal employees below for further guidance.

Age of Employees - 25 years is the maximum age used to exclude employees.

New Employees - Use this requirement to exclude new employees after the plan has been established.

Part-time employees:
The safe harbor rule defines part-time employees as employees whose customary weekly employment is less than 25 hours per week.  Part-time can also include employees who work less than 35 hours per week if other employees in similar work or the same industry have substantially more hours (facts and circumstances).

Seasonal employees:
The safe harbor rule defines seasonal employees as employees whose customary annual employment is less than 7 months.  Seasonal can also include employees who work less than 9 months if other employees in similar work or the same industry have substantially more months (facts and circumstances).

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  Medical Expenses:

This information contains the elected benefits of the plan and is chosen by the employer.  The 'Carry Over Feature' allows the employee to utilize unused benefits in future years.

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