ACA Affordable Care Act, also see PPACA
AD&D Plan Accidental Death and Dismemberment Plan
ADA Americans with Disabilities Act
ADAAA ADA Amendments Act of 2008
ALE Applicable Large Employer
ADEA Age Discrimination in Employment Act
APTC Advance Premium Tax Credits
ARRA American Recovery and Reinvestment Act of 2009
ASO Administrative Services Only
CARES Act Coronavirus Aid, Relief and Economic Securities Act
CCIIO Center for Consumer Information and Insurance Oversight (CCIIO), formerly known as the Office of Consumer Information and Insurance Oversight (OCIIO)
CDHC Consumer-Driven Health Care
CFR Code of Federal Regulations
CMS Centers for Medicare & Medicaid Services – formerly known as Health Care Financing Administration (HCFA)
COBRA Consolidated Omnibus Budget Reconciliation Act
DCAP Dependent Care Assistance Program
DCTC Dependent Care Tax Credit
DOL U.S. Department of Labor
EAP Employee Assistance Program
EBSA Employee Benefits Security Administration – formerly known as the Pension and Welfare Benefits Administration (PWBA)
EDI Electronic Data Interchange
EFAST ERISA Filing Acceptance System
EEOC Equal Employment Opportunity Commission
EGTRRA Economic Growth and Tax Relief Reconciliation Act
EOB Explanation of Benefits
EOI Evidence of Insurability
ERISA Employee Retirement Income Security Act
FF-SHOP Federally Facilitated Small Business Health Options Program
FFCRA Families First Coronavirus Response Act
FICA Federal Insurance Contributions Act
FLSA Fair Labor Standards Act
FMLA Family and Medical Leave Act
FSA Flexible Spending Arrangement
FUTA Federal Unemployment Tax Act
GINA Genetic Information Nondiscrimination Act
GTL Insurance Group Term Life Insurance
HCE Highly Compensated Employee
HCFA Health Care Financing Administration – now known as the Centers for Medicare & Medicaid Services (CMS)
HCTC Health Coverage Tax Credit
HDHC High Deductible Health Coverage
HDHP High Deductible Health Plan
Health FSA Health Flexible Spending Arrangement
HEART Act Heroes Earnings Assistance and Relief Tax Act of 2008
HHS U.S. Department of Health and Human Services
HIPAA Health Insurance Portability and Accountability Act
HIPAA SER Health Insurance Portability and Accountability Act Special Enrollment Rights
HIT Health Insurance Tax
HMO Health Maintenance Organization
HRA Health Reimbursement Arrangement
HSA Health Savings Account
IRC Internal Revenue Code
IRS Internal Revenue Service
LTC Long-term Care
LTD Long-term Disability
MEC Minimum Essential Coverage
MEWA Multiple Employer Welfare Arrangement
MHPAEA Mental Health Parity and Addiction Equity Act
MLR Medical Loss Ratio
MSP Medicare Secondary Payer
MSA Medical Savings Account (also known as an Archer MSA)
NAIC National Association of Insurance Commissioners
NHCE Non-highly Compensated Employee
NMHPA Newborns' and Mothers' Health Protection Act
OCR Office of Civil Rights
OCIIO Office of Consumer Information and Insurance Oversight, now known as the Center for Consumer Information and Insurance Oversight (CCIIO)
OTC Over-the-counter Item or Drug
PBM Pharmacy Benefit Manager
PCE Preexisting Condition Exclusion
PCOR Fee Patient-centered Outcomes Research Fee
PCORI Patient-centered Outcomes Research Institute
PEO Professional Employer Organization
PHI Protected Health Information
PPA Pension Protection Act of 2006
PPACA Patient Protection and Affordable Care Act- aka Health Care Reform
POP Premium Only Plan (Section 125 Cafeteria Plan)
PPO Preferred Provider Organization
PWBA Pension and Welfare Benefits Administration - now known as the Employee Benefits Security Administration (EBSA)
QDRO Qualified Domestic Relations Order
QMCSO Qualified Medical Child Support Order
SAR Summary Annual Report
SBC Summary of Benefits and Coverage
SECURE Act Setting Every Community Up for Retirement Enhancement Act of 2019
SHOP Small Business Health Options Program
SMM Summary of Material Modifications
SPD Summary Plan Description
STD Short-term Disability
TPA Third Party Administrator
USERRA Uniformed Services Employment and Reemployment Rights Act
VEBA Voluntary Employees' Beneficiary Association
VFC Voluntary Fiduciary Correction Program
WHCRA Women's Health and Cancer Rights Act

When designing their HRAs, employers have some choices about what will happen to balances remaining at termination of employment. An employer may design its HRA to forfeit unused HRA balances when employment ends, typically after a limited post‑termination opportunity to submit reimbursements for pre‑termination expenses. Employers may also choose a design that permits employees to spend down their HRA accounts after their employment terminates (i.e., to obtain reimbursement for expenses incurred after termination until the account balance is depleted). Alternatively, the HRA could be designed so that all but a nondiscriminatory class of employees forfeit unused amounts at termination; for example, retirees are entitled to spend down their HRA balance.

If the employee dies while eligible to incur reimbursable expenses, the HRA may allow the employee's accumulated balance to reimburse the substantiated qualified medical expenses of the participant's surviving spouse, children who are under age 27 as of the end of the taxable year, or tax dependents for health coverage purposes. Under no circumstance, however, may terminated employees be provided with cash or other benefits in an amount equal to some or all of the HRA balance (i.e., be "cashed out" of their HRAs). Nor may a deceased employee's balance be paid to anyone in cash or used to reimburse the medical expenses of anyone other than the individuals listed above.

The design choices should be clearly stated in the HRA plan document and explained to employees in the summary plan description and other communication materials. Finally, regardless of whether the balance is forfeited, COBRA must be offered. If COBRA coverage is purchased, the recipient will have access to the balance (notwithstanding any forfeiture rule), increased by any account credits that would be received for the coverage period by a similarly situated non‑COBRA beneficiary.