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Understanding ICHRA: Pros, Cons, and Implementation for Small Group Employers
Bret Brummitt10/9/23 1:19 PM3 min read

Understanding ICHRAs: Pros, Cons, and Implementation for Small Group Employers

In the ever-evolving landscape of employee benefits, small group employers are constantly seeking ways to provide comprehensive healthcare coverage while managing costs effectively. Enter the Individual Coverage Health Reimbursement Arrangement (ICHRA). In this blog post, we’ll delve into the world of ICHRA, exploring its benefits and potential drawbacks for small group employers. We’ll also discuss how to evaluate and make an informed decision about implementing an ICHRA for your organization.

What is IICHRA?

The Individual Coverage Health Reimbursement Arrangement (ICHRA) is a type of employer-sponsored health benefit that allows small group employers to contribute towards individually purchased health insurance plans for their employees. Instead of offering a traditional group health insurance plan, employers provide a monthly allowance to employees that they can use to purchase their own health insurance coverage.

Pros for Small Group Employers:

1. Cost Control: For small group employers, an ICHRA can offer cost control benefits as they are no longer responsible for the premiums associated with a group health insurance plan. Instead, they can provide a fixed monthly allowance that aligns with their budget while still promoting employee healthcare access.

2. Flexibility for Employees: With an ICHRA, employees have the freedom to choose a health insurance plan that best suits their individual needs. This flexibility can result in increased employee satisfaction and engagement, as they can select coverage that aligns with their personal circumstances and preferences.

3. Administrative Simplicity: Unlike traditional group health insurance plans, ICHRAs eliminates the need for extensive administration. Employers provide a monthly allowance, and employees handle the selection and management of their own plans. This can save valuable time and resources for small-group employers.

Cons for Small Group Employers:

1. Uncertainty in Premiums: With individual health insurance plans, premiums can vary significantly based on factors such as age, health status, and location. This introduces uncertainty for employers, as they cannot predict or control the precise costs associated with each employee’s coverage.

2. Lack of Group Cohesion: An ICHRA eliminates the concept of a shared group health insurance plan. Employees will have individual policies, which may result in a lack of group cohesion when it comes to benefits and overall employee experience.

3. Network limitations:  Depending on where your employees live, they may be limited to plans that are less desirable than a traditional small employer group health plan. Many of the individual and family plans available to purchase are subject to smaller EPO and HMO provider networks that can cause disruption for companies leaving a small group PPO.

Evaluating and Choosing an ICHRA:

1. Assess Employee Needs: Before considering an ICHRA, it’s crucial to understand your employees’ healthcare needs and preferences. Conduct surveys or engage in conversations to gauge their expectations and evaluate if an ICHRA aligns with their preferences.

2. Research Insurance Carriers: Explore insurance carriers and their offerings to ensure a wide range of plan options for your employees. Consider factors like coverage, provider networks, and customer service when selecting a carrier.

3. Budgetary Considerations: Calculate the potential cost savings and budgetary impact of implementing an ICHRA. Compare the cost of providing group insurance with the monthly allowances you plan to offer.

4. Communication and Education: Implementing an ICHRA requires effective communication and employee education. Clearly explain the benefits, enrollment process, and available resources to ensure employees understand the new arrangement.

While the Individual Coverage Health Reimbursement Arrangement (ICHRA) offers small-group employers an alternative approach to providing healthcare benefits, it’s important to weigh the pros and cons before making a decision. ICHRAs can provide cost control benefits, flexibility for employees, and administrative simplicity, but it also comes with uncertainties in premiums and potential challenges in maintaining group cohesion. By evaluating employee needs, researching insurance carriers, considering budgetary implications, and effectively communicating the change, small group employers can make an informed decision about implementing an ICHRA that aligns with their organization’s goals and priorities.

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Bret Brummitt

In 2019, Bret launched Generous Benefits, leveraging 20 years of experience in Employee Benefits. His mission is to transform communities through innovative benefits solutions. Bret envisions benefits beyond traditional offerings, aiming for a lasting impact by stretching, tailoring, and curating packages. He coaches insurance agencies with Q4intelligence, actively participating in communities like Health Rosetta and the Free Market Medical Association. Based in Austin, he balances his professional pursuits with running alongside Gilbert's Gazelles and playing baseball with the Austin Blue Jays.

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