Each year, employers are faced with rising health insurance renewal costs- driven by inflation, high claimants, and other market pressures. Let’s face it, offering employee health benefits is becoming more challenging to manage. Between rising premiums, evolving workforces, and tight budgets, many organizations are searching for alternatives that balance cost control with employee satisfaction.
One option gaining traction is the Individual Coverage Health Reimbursement Arrangement, or ICHRA (pronounced “Ick-Rah”). This innovative model allows employers to set predictable budgets while giving employees the flexibility to choose the health plan that works best for them.
At a very basic level, an ICHRA allows employers to reimburse employees tax-free for individual health insurance premiums. In most cases, instead of offering a traditional group health plan, you set a fixed monthly allowance, and employees use that money to shop for coverage that works for them, either through their state’s individual market or directly from a carrier. It’s an IRS-approved, budget-friendly alternative that gives both employers and employees more flexibility and control over rising costs.
In practice, tech-forward ICHRA vendors use a platform that walks employees through plan selection using an intuitive, user-friendly interface, similar to what they’d see when enrolling in benefits through your HRIS. Many also provide access to licensed enrollers who can answer questions and advise employees based on their preference.
For employers, these vendors take on much of the administrative burden, from compliance to enrollment logistics- making implementation smoother and more scalable. With the right setup, employers can enable pre-tax payroll deductions for employees’ premiums, helping reduce their taxable income and making the ICHRA model more appealing and more similar to the more common insured group model.
While ICHRAs are considered “health reimbursement arrangements”, using the right third party vendor can allow the process to look and feel more like the traditional group health plan that you and your employees are used to. You can set monthly premium contributions for employees, tailor contributions based on class (think full time vs. part time) while also reducing the stress and uncertainty that comes with traditional group health plan renewals and remaining in ACA compliance.
For many organizations, an ICHRA can offer real savings and more stable renewals year over year. Based on our experience, about 40% of employers are considered good candidates for this model based on their renewal history and outlook, employee demographic, budget, and benefits goals. Many times, employees find more affordable plan options that better match their personal needs while the employer benefits – making it a win- win.
One of the biggest advantages of an ICHRA is improved cost control. While individual market premiums can still increase over time, those adjustments are typically tied to broader medical inflation and not your organization’s specific claims experience. That means you’re no longer directly exposed to high-cost claims that are responsible for driving up your plan rates.
Budgeting becomes more predictable because you set the reimbursement amount in advance. You also gain flexibility by designing different benefit levels for different employee classes like full-time, part-time, or remote workers. This kind of segmentation can make your benefits strategy more aligned with how your organization actually operates.
ICHRA can be a fantastic option for financially conscious employers who are looking to save some money and reduce the unpredictability of traditional group plan renewal increases. While there are quite a few pros to ICHRAs, we’d be remiss to leave out the numerous challenges that employers can be faced with:
Challenge | What to Know |
Administrative Work | There’s more manual effort, especially with payroll and tracking. |
Enrollment Timing | ICHRAs run on a calendar year basis which can cause misalignment with other benefits and potentially cause you to have 2 open enrollment periods in the first year. Additionally, the flexibility with retroactive terminations and late enrollments in the group market goes away with ICHRA/individual plans. |
Employee Learning Curve | Most employees aren’t used to shopping for health plans which makes education critical |
Medicare Coordination | Different rules apply for employees turning 65 and timing is extremely important |
No Advocacy Role | You won’t be able to call the carrier on behalf of your employees anymore. Individual plans mean no more employer advocacy. |
Multiple Payroll Deductions | Each plan is unique and cost is based on location and age, so deductions won’t be one-size-fits-all. |
Winners and Losers | Premiums are age-based, so younger employees may pay less while older employees could pay more. |
Inconsistency of Carriers/Plan Options | Some states may have less carrier or plan design options than others. |
While there are many considerations and differences from a group health plan, the costs can be extremely compelling and much more sustainable than your traditional group health plan year over year. An ICHRA might make sense if you have a remote or spread-out workforce, your renewal increases are unsustainable, or your employees are asking for more control over their medical benefits. Depending on your unique situation and workforce, ICHRA can be worth exploring.
ICHRAs can be a powerful tool, but only if they’re implemented thoughtfully and with all considerations in mind. We’ve helped many organizations weigh the pros and cons, walk through financial and contribution modeling, and build communication plans that make employees feel supported.
Want to see if this model could work for your team?
Reach out to us directly at info@innovobenefits.com . We’ll help you assess your goals and figure out if an ICHRA is worth exploring now or something to keep on the radar for future years.