Employers may contribute to a trust or similar fund out of which
employees’ medical expenses are met. As a result of
increasing reluctance of some insurance companies to write
healthcare insurance, larger employers in particular may look to
arrange equivalent benefits through the use of healthcare trusts.
An employer’s contribution to a trust to provide
healthcare benefits to its employees is an allowable deduction in
computing the taxable profits of the employer’s trade.
For employers’ contributions made to healthcare trusts:
Guidance on when, and on what amount, the employee is chargeable
to income tax, and employers’ Class 1A NICs liability arises,
on benefits from healthcare trusts is at EIM21772 and NIM02235.
If the trust is simply the vehicle through which the employer
meets employees’ medical expenses, the employee is taxable
when the medical expenses are incurred, on the cost of the medical
treatment received less anything the employee makes good. Class 1A
NICs liability arises for the employer in the same way.
In some cases income tax and NICs liability may arise earlier
when the employer makes its contribution to the healthcare trust,
not at the later date(s) on which the employees have their medical
expenses paid for them. These are cases in which the benefit to the
employee is not the medical treatment itself, but is a right
(similar to insurance cover) to have whatever medical costs arise
paid for them. The conditions which must be satisfied for such a
right to exist are explained in EIM21772 and NIM02235.
Where these conditions are satisfied the employee is
chargeable to income tax, and Class 1A NICs liability arises for
the employer, on the amount of the employer’s contribution to
the trust in respect of the employee concerned. In practice,
FA03/SCH24 will have little or no effect on the timing of
deductions for employers’ contributions in these cases.