This bill amends the Internal Revenue Code and the Employee Retirement Income Security Act of 1974 (ERISA) to allow an employer with fewer than 50 employees that does not offer group health insurance coverage to establish a health reimbursement arrangement. Under the arrangement, funds contributed by an employer are excluded from the employer's taxable income and are used to pay or reimburse employees for medical care expenses, including premiums for individual health insurance coverage or Medicare supplemental insurance.

Such a reimbursement arrangement: (1) must not pay premiums for an employee covered by a family member's coverage, (2) must be offered to all eligible employees on the same terms and may only vary based on the number of individuals covered, and (3) is not required to provide continuation coverage.

Employer contributions to a reimbursement arrangement are not included in an employee's gross income if the employee was covered by the reimbursement arrangement for more than nine months of the year. Employees covered for less than nine months have a percentage of employer contributions included in their gross income, with exceptions.

An employee offered affordable individual health insurance coverage under a reimbursement arrangement is not eligible for a premium assistance tax credit.

Employers must report contributions to a reimbursement arrangement on their employees' W-2.