If you're running a small chorus, you're probably used to making tough budget decisions. With all the expenses required to present concerts and just keep the lights on, there's rarely money left over for what might seem like a luxury: employee health benefits.
But here's the thing: your staff members are the backbone of your organization. They're often working for below-market salaries because they believe in your mission. But even the most passionate arts professionals need to think about practical concerns like health insurance.
The good news? There's an option that could make offering some health coverage surprisingly feasible, even for the smallest chorus: Health Reimbursement Arrangements, or HRAs.
Think of an HRA as an easily controllable way to help employees with their health care costs. Instead of purchasing a group health insurance policy (which can be prohibitively expensive for small organizations), you set aside a specific amount of money each month that employees can use to reimburse their individual health insurance premiums and qualified medical expenses. Even if someone has insurance through a spouse, the HRA could cover their out-of-pocket medical expenses like co-pays, prescription drugs, dental and eye care costs—even aspirin.
Here's how it works in practice: Let's say you decide to offer $250 per month per employee through an HRA. Your music director, who purchases her own health insurance on the marketplace for $450 per month, submits her premium invoice. You reimburse her $250 tax-free. She still pays the full premium, but the reimbursement means she’s now $250 per month better off than she was before—and you've provided a meaningful benefit without breaking your budget. And for those employees who want to use the reimbursements for things other than premiums, they just build up an allowance bank each month, and use it as needed.
The beauty of HRAs is their flexibility. You determine the contribution amount. You control your budget. And unlike traditional group insurance where premiums can spike unexpectedly from year to year, you know exactly what you're spending.
Before diving into HRAs, it's worth understanding the landscape of health benefit options for small employers:
If none of these three options work for you, an HRA might be a nice solution!
There are two main types of HRAs designed specifically for small organizations:
QSEHRA (Qualified Small Employer HRA): This is available to organizations with fewer than 50 employees who don't offer group health insurance. The IRS sets annual reimbursement limits (currently around $6,450 for individual coverage and $13,100 for family coverage). These are maximum limits—you can offer any amount up to these caps. You must offer the QSEHRA to all employees on the same terms, though you can choose to exclude part-time employees entirely and only include full-timers. You can also vary contribution amounts based on family size (such as offering more for employees with families than those with individual coverage).
ICHRA (Individual Coverage HRA): This option has no contribution limits and offers more flexibility in terms of which employee classes you cover. However, it's slightly more complex administratively.
For most small choruses, the QSEHRA is the simpler starting point.
Here’s a possible scenario for a small chorus with two full-time staff members:
Scenario: You decide to offer a QSEHRA with a $250/month contribution per employee. (This is just an example – remember, you can choose any contribution level you want.)
Compare this to traditional group insurance:
The HRA approach saves you roughly $7,500-12,000 annually while still providing meaningful support to your staff. And crucially, if your funding situation changes, you have the flexibility to adjust contribution amounts for the following year.
While HRAs offer significant advantages, they're not perfect for every situation. Here are some key factors to consider:
If you're considering an HRA for your chorus, here's a practical path forward:
The HRA provider should make the logistics easy by providing detailed instructions and laying out the process for submitting reimbursements – typically an easy online interface where employees upload their receipts. The provider validates the receipts to make sure they qualify. As the employer, you won’t even see the medical expenses being submitted, which could be problematic from a privacy standpoint. The HRA provider handles all that and just notifies you about the amount of reimbursement(s) due. You can include the reimbursement payment on the next payroll as a non-taxable item, or just issue a check to the employee.
Common expenses eligible for reimbursement include health insurance premiums; medical, dental and vision expenses; prescriptions; medical equipment like hearing aids; and out-of-pocket expenses such as deductibles, copays, coinsurance, and over-the-counter medications like cold medicine and Tylenol. Some HRA providers may allow you to customize your company’s plan to reimburse only some of these expenses, but the important thing is you set the maximum monthly allowance, so it doesn’t hurt to be generous as far as what’s covered.
For some chorus managers, offering health benefits to their staff has seemed like an impossible dream—something reserved for larger organizations with deep pockets. HRAs can change that equation. They provide a practical entry point to providing meaningful health coverage without requiring a massive budget commitment or locking you into unpredictable premium increases.
Your staff members are essential to your mission. They plan your seasons, manage your donors, rehearse your singers, and handle the thousand details that make performances happen. An HRA might be the most cost-effective way to show them that their wellbeing matters—and to compete for talented arts administrators who increasingly need to balance passion with practical benefits.
In an environment where healthcare costs continue to climb and qualified arts administrators are in demand, an HRA could be the benefit that helps you recruit that perfect candidate or retain your stellar staff. And that's an investment in the long-term sustainability of your organization—one that pays dividends far beyond the monthly contribution amount.
We want to hear from you. What feels like the biggest barrier to offering employee health support? What health benefit solutions has your chorus explored — and what challenges have you run into along the way?