⚠️ Purpose: This workpaper documents the analysis, design, and implementation of a Section 105 Health Reimbursement Arrangement (HRA). Complete this workpaper once during initial HRA setup and maintain with permanent client records. This demonstrates proper due diligence and provides audit defense.
Section 1: Client & Business Information
Client Information
Business Information
Section 2: Current Tax Situation & HRA Eligibility
Tax Profile
Current Health Insurance Coverage
HRA Eligibility Check
✓ Eligibility Determination:
Section 3: HRA Plan Design & Structure
📋 Plan Design Note: The HRA must be formally established with a written plan document. This section documents the key design elements that will be incorporated into the plan.
Plan Participants
Employee Name
Relationship
Date of Birth
Job Title
Covered Under HRA?
Spouse
Child
Child
Annual Reimbursement Limits
Eligible Expenses
Select all expenses that will be eligible for reimbursement under this HRA plan:
✓ Required Records (must be maintained for audit defense):
Section 5: Tax Savings Analysis
Projected Annual Tax Savings
Item
Amount
Notes
Total Annual HRA Reimbursements
Federal Tax Rate
Federal Tax Savings
State Tax Rate
State Tax Savings
Self-Employment Tax Savings (if applicable)
TOTAL ANNUAL TAX SAVINGS
Cost-Benefit Analysis
Section 6: Implementation Checklist
HRA Setup Tasks
✓
Task
Responsible Party
Target Date
Completed
Draft written HRA plan document
Obtain board/owner resolution adopting HRA plan
Provide written notice of HRA benefits to employees
Verify all covered employees have health insurance
Create reimbursement request form template
Establish recordkeeping system for HRA documentation
Update business accounting system for HRA tracking
Process first reimbursement (test system)
Educate client on ongoing compliance requirements
Schedule annual review meeting
Section 7: Compliance & Risk Assessment
Regulatory Compliance Checklist
Risk Assessment
Risk Factor
Risk Level
Mitigation Strategy
Documentation Quality
Employee Insurance Coverage
Eligible Expense Verification
Reasonableness of Reimbursements
Client Compliance Capability
Section 8: Advisor Due Diligence & Recommendation
Suitability Analysis
Overall Advisor Recommendation
Certifications & Sign-Offs
Tax Advisor Certification
I certify that I have: (1) reviewed the client's situation and determined an HRA is appropriate, (2) verified eligibility requirements are met, (3) properly designed the HRA plan and documentation procedures, (4) documented all analysis and due diligence in this workpaper, (5) educated the client on compliance requirements and ongoing obligations, and (6) established a monitoring plan. This workpaper represents my professional analysis and recommendation.
Client Acknowledgment
I acknowledge that: (1) I have reviewed this HRA setup workpaper and understand the Health Reimbursement Arrangement strategy, (2) I commit to maintaining proper documentation for all reimbursement requests, (3) I will ensure all covered employees maintain required health insurance coverage, (4) I will follow all compliance requirements outlined by my advisor, and (5) I understand that improper implementation or documentation could result in taxable reimbursements and IRS penalties.