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Choice Arrangement

Introduced Sep 18, 2025 · Last action Sep 18, 2025 Referred to the House Committee on Ways and Means.

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Summary

This legislation is called the Choice Arrangement. Referred to the House Committee on Ways and Means.

Full bill text

[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 5463 Introduced in House (IH)]

<DOC>

119th CONGRESS
  1st Session
                                H. R. 5463

To amend the Internal Revenue Code of 1986 to provide for the treatment
    of employer-provided health reimbursement arrangements that are
  integrated with individual market coverage, and for other purposes.

_______________________________________________________________________

                    IN THE HOUSE OF REPRESENTATIVES

                           September 18, 2025

   Mr. Hern of Oklahoma (for himself, Ms. Van Duyne, and Ms. Tenney)
 introduced the following bill; which was referred to the Committee on
                             Ways and Means

_______________________________________________________________________

                                 A BILL

To amend the Internal Revenue Code of 1986 to provide for the treatment
    of employer-provided health reimbursement arrangements that are
  integrated with individual market coverage, and for other purposes.

    Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Choice Arrangement Act of 2025''.

SEC. 2. TREATMENT OF HEALTH REIMBURSEMENT ARRANGEMENTS INTEGRATED WITH
              INDIVIDUAL MARKET COVERAGE.

    (a) In General.--Section 9815(b) of the Internal Revenue Code of
1986 is amended--
            (1) by striking ``Exception.--Notwithstanding subsection
        (a)'' and inserting the following: ``Exceptions.--
            ``(1) Self-insured group health plans.--Notwithstanding
        subsection (a)'', and
            (2) by adding at the end the following new paragraph:
            ``(2) Custom health option and individual care expense
        arrangements.--
                    ``(A) In general.--For purposes of this subchapter,
                a custom health option and individual care expense
                arrangement shall be treated as meeting the
                requirements of section 9802 and sections 2705, 2711,
                2713, and 2715 of title XXVII of the Public Health
                Service Act.
                    ``(B) Custom health option and individual care
                expense arrangements defined.--For purposes of this
                section, the term `custom health option and individual
                care expense arrangement' means a health reimbursement
                arrangement--
                            ``(i) which is an employer-provided group
                        health plan funded solely by employer
                        contributions to provide payments or
                        reimbursements for medical care subject to a
                        maximum fixed dollar amount for a period,
                            ``(ii) under which such payments or
                        reimbursements may only be made for medical
                        care provided during periods during which the
                        individual is covered--
                                    ``(I) under individual health
                                insurance coverage (other than coverage
                                that consists solely of excepted
                                benefits), or
                                    ``(II) under part A and B of title
                                XVIII of the Social Security Act or
                                part C of such title,
                            ``(iii) which meets the nondiscrimination
                        requirements of subparagraph (C),
                            ``(iv) which meets the substantiation
                        requirements of subparagraph (D), and
                            ``(v) which meets the notice requirements
                        of subparagraph (E).
                    ``(C) Nondiscrimination.--
                            ``(i) In general.--An arrangement meets the
                        requirements of this subparagraph if an
                        employer offering such arrangement to an
                        employee within a specified class of employee--
                                    ``(I) offers such arrangement to
                                all employees within such specified
                                class on the same terms, and
                                    ``(II) does not offer any other
                                group health plan (other than an
                                account-based group health plan or a
                                group health plan that consists solely
                                of excepted benefits) to any employees
                                within such specified class.
                        In the case of an employer who offers a group
                        health plan provided through health insurance
                        coverage in the small group market (that is
                        subject to section 2701 of the Public Health
                        Service Act) to all employees within such
                        specified class, subclause (II) shall not apply
                        to such group health plan.
                            ``(ii) Specified class of employee.--For
                        purposes of this subparagraph, any of the
                        following may be designated as a specified
                        class of employee:
                                    ``(I) Full-time employees.
                                    ``(II) Part-time employees.
                                    ``(III) Salaried employees.
                                    ``(IV) Non-salaried employees.
                                    ``(V) Employees whose primary site
                                of employment is in the same rating
                                area.
                                    ``(VI) Employees who are included
                                in a unit of employees covered under a
                                collective bargaining agreement to
                                which the employer is subject
                                (determined under rules similar to the
                                rules of section 105(h)).
                                    ``(VII) Employees who have not met
                                a group health plan, or health
                                insurance issuer offering group health
                                insurance coverage, waiting period
                                requirement that satisfies section 2708
                                of the Public Health Service Act.
                                    ``(VIII) Seasonal employees.
                                    ``(IX) Employees who are
                                nonresident aliens and who receive no
                                earned income (within the meaning of
                                section 911(d)(2)) from the employer
                                which constitutes income from sources
                                within the United States (within the
                                meaning of section 861(a)(3)).
                                    ``(X) Under such rules as the
                                Secretary may prescribe, employees who
                                are hired for temporary placement with
                                an unrelated person that is not the
                                common law employer.
                                    ``(XI) Such other classes of
                                employees as the Secretary may
                                designate.
                        An employer may designate (in such manner as is
                        prescribed by the Secretary) two or more of the
                        classes described in the preceding subclauses
                        as the specified class of employees to which
                        the arrangement is offered for purposes of
                        applying this subparagraph.
                            ``(iii) Special rule for new hires.--An
                        employer may designate prospectively so much of
                        a specified class of employees as are hired
                        after a date set by the employer. Such subclass
                        of employees shall be treated as the specified
                        class for purposes of applying clause (i).
                            ``(iv) Rules for determining type of
                        employee.--For purposes for clause (ii), any
                        determination of full-time, part-time, or
                        seasonal employment status shall be made under
                        rules similar to the rules of section 105(h) or
                        4980H, whichever the employer elects for the
                        plan year. Such election shall apply with
                        respect to all employees of the employer for
                        the plan year.
                            ``(v) Permitted variation.--For purposes of
                        clause (i)(I), an arrangement shall not fail to
                        be treated as provided on the same terms within
                        a specified class merely because the maximum
                        dollar amount of payments and reimbursements
                        which may be made under the terms of the
                        arrangement for the year with respect to each
                        employee within such class--
                                    ``(I) increases as additional
                                dependents of the employee are covered
                                under the arrangement, and
                                    ``(II) increases with respect to a
                                participant as the age of the
                                participant increases, but not in
                                excess of an amount equal to 300
                                percent of the lowest maximum dollar
                                amount with respect to such a
                                participant determined without regard
                                to age.
                    ``(D) Substantiation requirements.--An arrangement
                meets the requirements of this subparagraph if the
                arrangement has reasonable procedures to substantiate--
                            ``(i) that the participant and any
                        dependents are, or will be, enrolled in
                        coverage described in subparagraph (B)(ii) as
                        of the beginning of the plan year of the
                        arrangement (or as of the beginning of coverage
                        under the arrangement in the case of an
                        employee who first becomes eligible to
                        participate in the arrangement after the date
                        notice is given with respect to the plan under
                        subparagraph (E) (determined without regard to
                        clause (iii) thereof), and
                            ``(ii) any requests made for payment or
                        reimbursement of medical care under the
                        arrangement and that the participant and any
                        dependents remain so enrolled.
                    ``(E) Notice.--
                            ``(i) In general.--Except as provided in
                        clause (iii), an arrangement meets the
                        requirements of this subparagraph if, under the
                        arrangement, each employee eligible to
                        participate is, not later than 60 days before
                        the beginning of the plan year, given written
                        notice of the employee's rights and obligations
                        under the arrangement which--
                                    ``(I) is sufficiently accurate and
                                comprehensive to apprise the employee
                                of such rights and obligations, and
                                    ``(II) is written in a manner
                                calculated to be understood by the
                                average employee eligible to
                                participate.
                            ``(ii) Notice requirements.--Such notice
                        shall include such information as the Secretary
                        may by regulation prescribe.
                            ``(iii) Notice deadline for certain
                        employees.--In the case of an employee--
                                    ``(I) who first becomes eligible to
                                participate in the arrangement after
                                the date notice is given with respect
                                to the plan under clause (i)
                                (determined without regard to this
                                clause), or
                                    ``(II) whose employer is first
                                established fewer than 120 days before
                                the beginning of the first plan year of
                                the arrangement,
                        the requirements of this subparagraph shall be
                        treated as met if the notice required under
                        clause (i) is provided not later than the date
                        the arrangement may take effect with respect to
                        such employee.''.
    (b) Inclusion of CHOICE Arrangement Permitted Benefits on W-2.--
            (1) In general.--Section 6051(a) of such Code is amended by
        striking ``and'' at the end of paragraph (18), by striking the
        period at the end of paragraph (19) and inserting ``, and'',
        and by inserting after paragraph (19) the following new
        paragraph:
            ``(20) the total amount of permitted benefits for enrolled
        individuals under a custom health option and individual care
        expense arrangement (as defined in section 9815(b)(2)) with
        respect to such employee.''.
    (c) Treatment of Current Rules Relating to Certain Arrangements.--
            (1) No inference.--To the extent not inconsistent with the
        amendments made by this section--
                    (A) no inference shall be made from such amendments
                with respect to the rules prescribed in the Federal
                Register on June 20, 2019, (84 Fed. Reg. 28888)
                relating to health reimbursement arrangements and other
                account-based group health plans, and
                    (B) any reference to custom health option and
                individual care expense arrangements shall for purposes
                of such rules be treated as including a reference to
                individual coverage health reimbursement arrangements.
            (2) Other conforming of rules.--The Secretary of the
        Treasury, the Secretary of Health and Human Services, and the
        Secretary of Labor shall modify such rules as may be necessary
        to conform to the amendments made by this section.
    (d) Effective Date.--The amendments made by this section shall
apply to plan years beginning after December 31, 2025.

SEC. 3. PARTICIPANTS IN CHOICE ARRANGEMENT ELIGIBLE FOR PURCHASE OF
              EXCHANGE INSURANCE UNDER CAFETERIA PLAN.

    (a) In General.--Section 125(f)(3) of the Internal Revenue Code of
1986 is amended by adding at the end the following new subparagraph:
                    ``(C) Exception for participants in choice
                arrangement.--Subparagraph (A) shall not apply in the
                case of an employee participating in a custom health
                option and individual care expense arrangement (within
                the meaning of section 9815(b)(2)) offered by the
                employee's employer.''.
    (b) Effective Date.--The amendment made by this section shall apply
to taxable years beginning after December 31, 2025.

SEC. 4. EMPLOYER CREDIT FOR CHOICE ARRANGEMENT.

    (a) In General.--Subpart D of part IV of subchapter A of chapter 1
of the Internal Revenue Code of 1986 is amended by adding at the end
the following new section:

``SEC. 45BB. EMPLOYER CREDIT FOR CHOICE ARRANGEMENT.

    ``(a) In General.--For purposes of section 38, in the case of an
eligible employer, the CHOICE arrangement credit determined under this
section for any taxable year is an amount, with respect to each
employee enrolled during the credit period in a CHOICE arrangement
maintained by the employer, equal to--
            ``(1) $100 multiplied by the number of months for which the
        employee is so enrolled during the first year in the credit
        period, and
            ``(2) one-half of the dollar amount in effect under
        paragraph (1) for the taxable year, multiplied by the number of
        months for which the employee is so enrolled during the second
        year of the credit period.
    ``(b) Arrangement Must Constitute Minimum Essential Coverage.--An
employee shall not be taken into account under subsection (a) unless
such employee's eligibility for the CHOICE arrangement (determined
without regard to the employee being enrolled) would cause the employee
to be treated under section 36B(c)(2) as being eligible for minimum
essential coverage consisting of an eligible employer-sponsored plan
(as defined in section 5000A(f)(2)).
    ``(c) Definitions.--For purposes of this section--
            ``(1) CHOICE arrangement.--The term `CHOICE arrangement'
        means a custom health option and individual care expense
        arrangement (as defined in section 9815(b)(2)(B)).
            ``(2) Credit period.--The credit period with respect to an
        eligible employer is the first 2 one-year periods beginning
        with the month during which the employer first establishes a
        CHOICE arrangement on behalf of employees of the employer.
            ``(3) Eligible employer.--The term `eligible employer'
        means, with respect to any taxable year beginning in a calendar
        year, an employer who is not an applicable large employer for
        the calendar year under section 4980H.
    ``(d) Inflation Adjustment.--
            ``(1) In general.--In the case of any taxable year
        beginning in a calendar year after 2026, the dollar amount in
        subsection (a) shall be increased by an amount equal to--
                    ``(A) such dollar amount, multiplied by
                    ``(B) the cost-of-living adjustment determined
                under section 1(f)(3) for the calendar year in which
                such taxable year begins by substituting `calendar year
                2025' for `calendar year 2016' in subparagraph (A)(ii)
                thereof.
            ``(2) Rounding.--If any amount after adjustment under
        paragraph (1) is not a multiple of $10, such amount shall be
        rounded to the next lower multiple of $10.''.
    (b) Credit Made Part of General Business Credit.--Section 38(b) of
such Code is amended by striking ``plus'' at the end of paragraph (40),
by striking the period at the end of paragraph (41) and inserting ``,
plus'', and by adding at the end the following new paragraph:
            ``(42) the CHOICE arrangement credit determined under
        section 45BB(a).''.
    (c) Credit Allowed Against Alternative Minimum Tax.--Section
38(c)(4)(B) of such Code is amended--
            (1) by redesignating clauses (x), (xi), and (xii) as
        clauses (xi), (xii), and (xiii), respectively, and
            (2) by inserting after clause (ix) the following new
        clause:
                            ``(x) the credit determined under section
                        45BB,''.
    (d) Clerical Amendment.--The table of sections for subpart D of
part IV of subchapter A of chapter 1 of such Code is amended by adding
at the end the following new item:

``Sec. 45BB. Employer credit for CHOICE arrangement.''.
    (e) Effective Date.--The amendments made by this section shall
apply to taxable years beginning after December 31, 2025.
                                 <all>

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Status

In Committee

  1. 1Introduced
  2. 2Committee
  3. 3Floor
  4. 4Passed
  5. 5Signed

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