Most business owners know about 401(k)s and pension plans, but few have heard of the 401(h) account — a little-known strategy that can deliver three powerful benefits in one:
This is the tax trifecta — deduction, tax-deferred growth, and tax-free distribution.
A 401(h) account is a retiree medical expense account that can be added to a Defined Benefit, Cash Balance, or Money Purchase Pension Plan. Employers fund the account, invest the assets, and later reimburse retirees for qualified medical expenses such as Medicare premiums, long-term care insurance, and out-of-pocket medical costs — all tax-free.
Who Is It For?
This strategy is ideal for:
The 401(h) account allows business owners to set aside up to 1/3% of pension contributions toward retiree medical costs, potentially creating hundreds of thousands of tax-free dollars for healthcare in retirement. Plus, vesting rules favor employers — employees only benefit if they stay until retirement, making it a strong retention tool."
Smith Manufacturing contributes $50,000 per year into its 401(h) account. After 20 years, the account grows to $500,000. When John, a key employee, retires, he uses the funds tax-free to cover his healthcare costs, saving both him and the company money while providing peace of mind. If you are a profitable business owner in your 50s or 60s, the 401(h) account may be one of the most tax-efficient, underutilized strategies available. It’s a win-win — lower taxes today, more retirement savings tomorrow, and a dedicated pool for future medical expenses.