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2023 Health Insurance Update for S Corporation Owners

By: Ernie Neve

As a more-than-2-percent S corporation owner, you are entitled to some good news when it comes to your health insurance.


To ensure that your health insurance deductions are in order and to avoid the $100-a-day penalties for violating the rules of the Affordable Care Act (ACA), we have provided the following steps:


  1. Get the cost of the health insurance on the S corporation’s books either by making the premium payments directly or through reimbursement.

  2. The S corporation must include the health insurance premiums on the owner-employee’s W-2 form, including the additional compensation in box 1 but not in boxes 3 or 5.

  3. Owner-employees with more than 2 percent ownership can claim the health insurance deduction as “self-employed health insurance” on line 17 of Schedule 1 of Form 1040, provided that they meet the two rules of not having access to employer-subsidized health insurance and having adequate salary.


For rank-and-file employees, the S corporation does not have to provide health insurance benefits, but if it does, it must use an acceptable ACA plan, such as (among others) the qualified small employer health reimbursement arrangement (QSEHRA) or the individual coverage HRA (ICHRA).


The S corporation can reimburse more-than-2-percent owners for individually purchased insurance without any penalties, but if it reimburses rank-and-file employees without using the QSEHRA or ICHRA, it faces the $100-a-day penalty per employee.


If you are looking to provide health benefits to employees through the S corporation, there are many tax-advantaged options available. If the S corporation provides group health insurance to all employees, including the shareholder-employee, the same rules apply.


We hope this information is helpful. If you have any further questions, please don’t hesitate to call me on my direct line at 610-278-8400.