A Health Reimbursement Arrangement must be established by whom?

A Health Reimbursement Arrangement (HRA) is a type of employer-funded plan that is designed to reimburse employees for incurred medical expenses that qualify under the tax code. The establishment of an HRA is a decision made by the employer, who sets up the plan as part of their employee benefits package. This allows employers to provide pre-tax dollars to employees for medical care expenses, thereby offering a financial benefit to help offset health care costs.

Employees cannot create or fund an HRA on their own; it is inherently linked to the employment relationship. As such, it is the employer that is responsible for defining the eligibility, contribution limits, and the specific claims process for reimbursement. Thus, the correct answer is that a Health Reimbursement Arrangement must be established by the employer.