⚠️ 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:

Plan Year & Effective Date

Section 4: Reimbursement Procedures & Documentation

Reimbursement Request Process

Documentation & Recordkeeping Requirements

✓ 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.