Now health benefits take care of business

Employer group plan benefits don’t work the way most teams work today. ICHRA changes that. Employers set a fixed monthly allowance, and their team picks a health plan that actually fits their lives.
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ICHRA is built for everyone.

Whether you’re an employer looking for predictable costs, an employee picking a plan that suits your needs, or a broker ready to build something big, ICHRA’s the move.

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1. Employers set a budget

Employers set monthly tax-free money to deposit in employee health accounts. No extra payroll taxes for them, and no income tax for the business.

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2. Employees shop and compare options

Teams shop the individual marketplace with ACA-compliant plans in their area built for how they live and what they need. Including hundreds of options from top carriers.

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3. Everyone picks their perfect plan

Employees can pick a plan that fits their budget and includes the doctors they love. Plus, they’re never locked in—they can stick with what works or swap plans every year as life changes.

Boost that benefits strategy.

ICHRA Plan Comparison

Watch how ICHRA brings that big benefits energy.

See how ICHRA helps employers take care of their business and their people. No more what ifs.

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Take a deep dive.

    • ICHRA means Individual Coverage Health Reimbursement Arrangement. It’s a new type of Health Reimbursement Arrangement (HRA) created in 2020. It’s great because it allows businesses of any size to provide tax-free reimbursements to employees for health insurance premiums and qualified medical expenses.

    • In most cases, an employer works with a third party (broker and/or ICHRA administration platform) to design and implement their company’s ICHRA. This process typically requires the employer to determine their budget, decide which employees can and cannot participate in the ICHRA, and establish when to launch the new health benefits solution to employees. Once the ICHRA is introduced to the company, employees get to shop for an individual insurance plan on the open market and buy a plan that suits their unique needs. Then, employees seek tax-free reimbursements from their employer each month.

    • Employers of any size can offer an ICHRA so long as they have at least one employee who isn’t a self-employed owner or the spouse of a self-employed owner. If designed correctly, an ICHRA satisfies the Affordable Care Act (ACA) employer mandate for Applicable Large Employers (ALEs). To determine if ICHRA is right for your business, take a look at the official IRS ICHRA regulations or talk to a tax professional.

    • Yes. If designed correctly, an ICHRA satisfies the Affordable Care Act (ACA) employer mandate for Applicable Large Employers (ALEs). To determine if ICHRA is right for your business, take a look at the official IRS ICHRA regulations or talk to a tax professional.

    • Hmm, yes and no. Here’s why: Employers can offer an ICHRA to one segment of employees while offering a traditional group plan to a different segment of employees. However, employers are not allowed to offer both an ICHRA and a traditional group plan to the same segment of employees. To determine allowable class distinctions, just refer to official IRS ICHRA regulations or talk to a tax professional.

    • Historically, HRAs were offered as a tax-advantaged supplement to traditional group insurance as a way to cover qualified medical expenses not included in traditional insurance. However, these HRAs did not allow for tax-free reimbursements to apply towards health insurance premiums. New regulations stipulate that with an ICHRA (as well as QSEHRA), an employer can reimburse for both qualified medical expenses, and health insurance premiums.

    • There are many distinctions between these two types of HRAs, but the two primary distinctions are contribution limits and participation sizes. The Qualified Small Employer HRA (QSEHRA) has limits on how much an employer can reimburse their employees while ICHRA has no limitations on the contribution amount. 

      Additionally, only companies with less than 50 employees can offer a QSEHRA, while an ICHRA can be offered by a company of any size. To understand the complete list of differences between these two types of HRAs, just refer to official IRS regulations or talk to a tax professional.

    • No. There are no limitations here.

    • Yes. If the employer chooses to allow reimbursement for such expenses, employees can seek reimbursement. During the ICHRA design stage, employers have a choice whether or not to allow the ICHRA to cover qualified medical expenses. To see a complete list of qualified medical expenses, please refer to official IRS ICHRA regulations or talk to a tax professional.

    • If an employee is offered an ICHRA by their employer, they’re not eligible to receive federal subsidies — even if they don’t choose to participate in the ICHRA. However, in some cases — if the ICHRA allowance is deemed unaffordable — an employee may accept premium tax credits despite being offered an ICHRA. To understand the regulation around ICHRA affordability and premium tax credits, please refer to official IRS regulations or talk to a tax professional.

    • No, it’s not a legal requirement. That said, it is strongly advised to administer an ICHRA through a third party to ensure compliance with IRS regulations such as HIPAA. To learn more about ICHRA compliance, please refer to official IRS ICHRA regulations or talk to a tax professional.

Footnotes
Oscar Medical coverage is underwritten by Oscar Insurance Company and its affiliates. Administrative Services for all plans provided by Oscar Management Corporation. All insurance policies and group benefit plans contain exclusions and limitations. For availability, costs, and complete details of coverage, contact Oscar at 1-855-672-2788.