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Health Insurance FAQs
Health Insurance FAQs

questions and answers about health insurance and employee benefits

What’s the difference between an HRA and a MERP?

March 27, 2025March 28, 2025

A MERP (Medical Expense Reimbursement Plan) is actually a type of HRA—but the term is often used to describe a specific strategy rather than a different kind of account.

Both HRAs (Health Reimbursement Arrangements) and MERPs are employer-funded plans that reimburse employees for eligible healthcare expenses. They’re governed by the same IRS rules under Section 105 and are tax-free to employees when used properly.


đź§© So Why Use a Different Term?

The term MERP is usually used when the HRA is being implemented as a deductible-reimbursement strategy—a way for an employer to self-fund part of a higher-deductible group health plan in order to lower premiums.

Here’s how a MERP typically works:

  • The employer selects a higher-deductible health plan (to reduce premiums)

  • The employer then uses a MERP to reimburse employees for a portion of the deductible (or other out-of-pocket costs)

  • Claims are submitted and reimbursed just like with a traditional HRA

Example:
The health plan has a $5,000 deductible. The employer sets up a MERP to reimburse the first $3,000, so the employee effectively experiences only a $2,000 deductible.


đź§  Key Differences in Practice:

Feature HRA (General Term) MERP (Strategy-Specific Term)
Definition Any employer-funded plan that reimburses medical expenses A specific type of HRA used to offset high deductibles
Common Use Broad—can reimburse premiums, expenses, or both Used to self-fund part of a group health deductible
Plan Design Highly customizable Typically tied to a group plan with defined reimbursements
Communication Term IRS-compliant terminology Informal industry term to describe a plan strategy

📌 Bottom Line:

All MERPs are HRAs, but not all HRAs are MERPs.
“MERP” is just a nickname for a popular deductible-reimbursement strategy using HRA rules. It’s a flexible, cost-saving tool that allows employers to share the risk with the insurance carrier—and reduce premiums—without increasing the financial burden on employees.

Accounts HRAsMERPs

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Tax-Advantaged Accounts

  • POPs – Premium Only Plans
  • FSAs – Flexible Spending Accounts
  • DCAs – Dependent Care Accounts
  • HSAs – Health Savings Accounts
  • HRAs – Health Reimbursement Arrangements
  • MERPs – Medical Expense Reimbursement Plans
  • MPRAs – Medicare Premium Reimbursement Arrangements
  • ICHRAs – Individual Coverage HRAs
  • QSEHRAs – Qualified Small Employer HRAs
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