The 401(h) blog

Long-form 401(h) education.

Plain-English articles for business owners, CPAs, financial advisors, TPAs, and actuaries.

401(h) Basics12 min read

What Is a 401(h) Plan? A Plain-English Guide for Business Owners

A 401(h) account is a separate sub-account inside a qualified pension or annuity plan that may be used to fund retiree medical benefits. Here's the plain-English version every business owner should read first.

401h.com EditorialJun 15, 2026
401(h) Rules14 min read

401(h) Plan Rules: What Business Owners and Advisors Need to Know

401(h) accounts are powerful but rule-driven. Five buckets — documentation, accounting, incidental benefit, nondiscrimination, and funding — determine whether the structure stands up.

401h.com EditorialJun 15, 2026
Comparisons9 min read

401(h) vs HSA: What's the Difference?

An HSA is an individual, portable account you own. A 401(h) is a sub-account of an employer's qualified retirement plan. They are not substitutes for each other.

401h.com EditorialJun 15, 2026
Comparisons10 min read

401(h) vs HRA: How Retiree Medical Benefits Compare

HRAs and 401(h) accounts can both play a role in retiree medical strategies, but the regulatory homes, funding mechanics, and integration with retirement plans are very different.

401h.com EditorialJun 15, 2026
Cash Balance Plans11 min read

Can a Cash Balance Plan Include a 401(h) Account?

Cash balance plans look like account-based plans but are defined benefit plans for IRC purposes — which means they can also host a 401(h) sub-account.

401h.com EditorialJun 15, 2026
Retiree Healthcare12 min read

How 401(h) Plans Can Help Fund Retiree Medical Expenses

Pre-funding retiree medical benefits brings discipline to one of retirement planning's biggest unknowns. Here's how 401(h) sub-accounts contribute to that picture.

401h.com EditorialJun 15, 2026
401(h) Basics9 min read

Who Is Eligible for 401(h) Retiree Medical Benefits?

401(h) eligibility is not generic. It is set by the plan document for a defined retiree class, subject to nondiscrimination and incidental-benefit rules.

401h.com EditorialJun 15, 2026
401(h) Rules10 min read

401(h) Plan Contribution Limits and Funding Rules Explained

There is no IRA-style number that caps 401(h) funding. Funding is actuarial, ongoing, and constrained by the incidental-benefit ceiling.

401h.com EditorialJun 15, 2026
Business Owner Strategies10 min read

401(h) Plans for Small Business Owners: When Do They Make Sense?

401(h) strategies tend to land best with owners who already have — or are deliberately building — a defined benefit or cash balance plan.

401h.com EditorialJun 15, 2026
401(h) Rules11 min read

Common 401(h) Plan Mistakes to Avoid

Most 401(h) failures trace to the same handful of structural issues. Here are the ones advisors see repeatedly — and how to avoid them.

401h.com EditorialJun 15, 2026
Retiree Healthcare8 min read

Can 401(h) Plans Pay Medicare Premiums?

Medicare premiums are a frequent question. The short answer: it depends on the plan's definition of qualified medical expenses and on applicable law.

401h.com EditorialJun 15, 2026
CPA & Advisor Guides11 min read

401(h) Plans for CPAs: Questions to Ask Before Recommending One

Before any 401(h) recommendation lands in a client file, a CPA can stress-test the idea with a handful of structural and contextual questions.

401h.com EditorialJun 15, 2026
Defined Benefit Plans12 min read

Defined Benefit Plan + 401(h): How the Strategy Works

Defined benefit plans paired with 401(h) sub-accounts can help employers formalize and pre-fund a defined stream of retiree medical benefits.

401h.com EditorialJun 15, 2026
FAQs15 min read

401(h) Plan FAQ: 25 Questions Answered

A consolidated FAQ covering 25 of the most-asked 401(h) questions in one place — written for business owners, CPAs, and advisors.

401h.com EditorialJun 15, 2026
CPA & Advisor Guides12 min read

401(h) Plan Design Checklist for Advisors

Most 401(h) work boils down to three buckets: document, design, administer. This checklist helps advisors keep all three honest.

401h.com EditorialJun 15, 2026
401(h) Basics12 min read

How to Set Up a 401(h) Plan: A Step-by-Step Overview

Setting up a 401(h) account isn't a single form — it's a coordinated amendment to a qualified pension or annuity plan with actuarial, legal, and administrative steps.

401h.com EditorialJun 15, 2026
Comparisons10 min read

401(h) vs 401(k): The Differences Owners Actually Need to Know

Same letter prefix, very different vehicles. A 401(k) is your retirement plan; a 401(h) is a medical sub-account inside a different kind of qualified plan entirely.

401h.com EditorialJun 15, 2026
Comparisons8 min read

401(h) vs 401(a): Code Sections, Vehicles, and What Each Actually Covers

401(a) is the umbrella Code section under which most qualified plans live; 401(h) is a specific sub-account feature inside certain of those plans.

401h.com EditorialJun 15, 2026
Tax Planning10 min read

401(h) Plan Tax Benefits: What Owners and CPAs Should Know

The tax story for 401(h) is unusually clean: employer-deductible going in, tax-deferred while invested, and generally tax-free coming out for qualified medical expenses.

401h.com EditorialJun 15, 2026
Comparisons11 min read

401(h) vs VEBA: Which Retiree Medical Vehicle Fits?

Both 401(h) accounts and VEBA trusts can pre-fund retiree medical benefits. Which fits depends on plan ecosystem, participant class, and funding philosophy.

401h.com EditorialJun 15, 2026
401(h) Rules11 min read

401(h) Account Funding Strategies: How Money Gets In

Funding a 401(h) is an actuarial decision, not a number you pick. Here are the strategies that drive how money flows into the sub-account over time.

401h.com EditorialJun 15, 2026
401(h) Rules9 min read

401(h) Plan Investment Options and Considerations

401(h) assets typically invest alongside the underlying qualified plan, with separate accounting and fiduciary care. Here's what design teams weigh.

401h.com EditorialJun 15, 2026
Retiree Healthcare9 min read

401(h) Plan Distributions and Claims: How Retirees Get Paid

Retirees access 401(h) benefits through a documented claims process — substantiated, eligible expenses reimbursed according to plan terms.

401h.com EditorialJun 15, 2026
Business Owner Strategies10 min read

401(h) Plans for Doctors and Dentists: Why the Specialty Fits the Vehicle

Physician and dental practices frequently sit in the structural sweet spot for 401(h): high owner income, an existing cash balance or DB plan, and real retiree medical concern.

401h.com EditorialJun 15, 2026
Business Owner Strategies10 min read

401(h) Plans for Law Firms: Partners, Associates, and Plan Design

Law firms that already run cash balance or DB plans for partners are natural candidates to evaluate 401(h) — with care around partner-vs-associate dynamics.

401h.com EditorialJun 15, 2026
Business Owner Strategies10 min read

401(h) Plans for Family Businesses: Succession, Continuity, and Retiree Medical

Family-owned businesses sometimes use 401(h) to make retiree medical commitments durable across generational and ownership changes.

401h.com EditorialJun 15, 2026
401(h) Rules10 min read

401(h) Plans and ERISA: Fiduciary, Reporting, and Plan Asset Considerations

ERISA touches 401(h) at every stage — fiduciary duty, plan-asset handling, reporting, and participant communications. None of it is optional.

401h.com EditorialJun 15, 2026
401(h) Rules9 min read

401(h) Plans and Form 5500: What Gets Reported and Where

401(h) doesn't file its own Form 5500 — it shows up inside the underlying qualified plan's filing. Here's how it typically appears.

401h.com EditorialJun 15, 2026
401(h) Rules9 min read

401(h) Plan Fiduciary Duties: A Plain-English Overview

Plan fiduciaries owe the same duties for 401(h) assets as for the retirement portion. Here's how those duties show up in practice.

401h.com EditorialJun 15, 2026
401(h) Rules11 min read

401(h) Plan Actuarial Valuation: What the Actuary Actually Does

The actuary is the engine room of any 401(h) design. Here's a plain-English tour of what they're modeling and why.

401h.com EditorialJun 15, 2026
Retiree Healthcare8 min read

401(h) Plan Spouse and Dependent Coverage: How It Works

401(h) coverage frequently extends to spouses and qualifying dependents — when the plan document provides for it.

401h.com EditorialJun 15, 2026
Retiree Healthcare8 min read

Can a 401(h) Plan Pay for Long-Term Care?

Long-term care is a frequent 401(h) question. The answer hinges on plan-document definitions and applicable law.

401h.com EditorialJun 15, 2026
Comparisons9 min read

401(h) vs Section 115 Trust: Public-Sector Retiree Medical Funding

Public employers sometimes weigh Section 115 trusts for retiree medical funding. Here's how that compares to the 401(h) framework.

401h.com EditorialJun 15, 2026
401(h) Rules9 min read

Terminating a 401(h) Plan: What Sponsors Need to Know

Termination is a real possibility for any plan feature. Here's a high-level look at the steps and issues a sponsor faces when winding down a 401(h).

401h.com EditorialJun 15, 2026
401(h) Rules8 min read

401(h) and the Plan Restatement Cycle: Staying Current

Plan documents are restated on a defined cycle. Here's how 401(h) language fits the cadence and why drift is dangerous.

401h.com EditorialJun 15, 2026
Cash Balance Plans12 min read

What Is a Cash Balance Plan? A Plain-English Guide

Cash balance plans look like 401(k) accounts but are defined benefit plans under the Code. They are powerful for owner-led businesses — and can host a 401(h) sub-account.

401h.com EditorialJun 15, 2026
Cash Balance Plans10 min read

Cash Balance Plan vs 401(k): Side-by-Side for Owners

Cash balance and 401(k) plans answer different questions for owner-led businesses. They're often used together — not in place of each other.

401h.com EditorialJun 15, 2026
Cash Balance Plans11 min read

How Cash Balance Plans Work: Pay Credits, Interest Credits, and Funding

Pay credit + interest credit = hypothetical account growth. Actuarial funding fills the trust. Here's the mechanics, simply.

401h.com EditorialJun 15, 2026
Defined Benefit Plans12 min read

Defined Benefit Plan Explained: How DB Plans Work and Why Owners Use Them

Defined benefit plans promise a future benefit by formula. Owners use them to accelerate retirement savings — and to host 401(h) retiree medical sub-accounts.

401h.com EditorialJun 15, 2026
Comparisons10 min read

Defined Benefit vs Defined Contribution: Which Type Is Your Plan?

DB plans promise a benefit; DC plans accumulate an account. Different mechanics, different risks, different ability to host 401(h).

401h.com EditorialJun 15, 2026
Retiree Healthcare11 min read

Retiree Healthcare Cost Planning: Framing the Largest Unknown

Retiree healthcare can be the largest unfunded liability of a retirement. Here's a clean framing — and where each vehicle plays a role.

401h.com EditorialJun 15, 2026
Retiree Healthcare10 min read

Medicare and Employer Retiree Benefits: How They Fit Together

Medicare doesn't replace employer retiree benefits — it changes their shape. Coordination is the whole game.

401h.com EditorialJun 15, 2026
Tax Planning10 min read

Tax-Deductible Employer Retirement Contributions: The Big Picture

Employer contributions to qualified retirement plans are broadly deductible — within rules. Here's the big-picture framing, and where 401(h) fits.

401h.com EditorialJun 15, 2026