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More and more employers are switching over to Individual Coverage Health Reimbursement Arrangements (ICHRAs) to offer affordable and comprehensible health insurance to their employees. However, ICHRA is still relatively the new kid on the market. Many employees have never heard of ICHRA or don’t understand how to make the most out of it. W3ll is here to help you understand how to utilize your ICHRA to its full potential. Here are the three things you should do once your employer makes the smart decision of switching to an ICHRA from more traditional and limiting health insurance offerings.

1. Find Out What Coverage You Qualify For

Decisions made by both businesses and employers can determine what kind of coverage your ICHRA reimburses. Because the HRAs are owned and facilitated by the employer, there are some nuances to expect across the different benefits allowances. Make sure to speak to your employer and have a full understanding about what your specific company covers before utilizing your ICHRA. This information should be readily accessible and transparent to you during the transition. However, in general, and with the ICHRA model, there are some costs you can bank on being covered.

An ICHRA can cover more than just health insurance premiums. The following can also be covered under your employer’s ICHRA setup:

  • Out-of-Pocket Medical Costs

Any costs you pay out of pocket directly to your healthcare providers will likely be reimbursable with the ICHRA benefits. An annual checkup with a physician might require additional lab work or scans. Your insurance may cover some of these costs, but typically after the deductible is met. So those costs that end up being your burden can, in turn, be submitted and reimbursed to you via the ICHRA your employer offers.

  • Dental Costs

Dental charges are also under the general umbrella of reimbursable costs. These bills can get lofty, especially if you have several covered members in your family getting routine checkups. Office visits, cleanings, x-rays, and fillings will all present invoices that can be reimbursed under the benefits of the ICHRA.

  • Vision Costs

If you or other family members covered under your health insurance plan have glasses or contacts, you’ll be glad to know that most ICHRA reimbursement platforms include out of pocket costs for vision care. Routine visits may not be a huge burden. But when you or others need contacts, replacement lenses, or prescription sunglasses, the bills can add up fast.

2. Enroll in a Health Insurance Plan that Meets Your Needs

To qualify and take advantage of your company’s ICHRA benefits, you must subscribe and enroll in a health insurance plan. You can browse the Marketplace and select a plan or with private sector companies, if necessary. The Marketplace only allows enrollment during the open enrollment period at the end of each year. But there are circumstances that will enable you to take advantage of a special enrollment period. This greatly expands the accessibility of affordable healthcare plans to you.

One of the great benefits of an ICHRA is that you are no longer restricted to the limiting plans offered through traditional group health insurance that are not guaranteed to meet your needs. Rather, you now have access to thousands of plans available on the Marketplace at affordable prices. Recent and upcoming legislation from the Biden Administration reduced the amount individuals are paying for their health insurance through the ACA marketplace. This increased stability and affordability will now be available to you due to your employers’ transition to an ICHRA. Take advantage of this newfound freedom, explore all your options for health insurance, and find the plan the best suits you. W3LL’s user-friendly platform will pair you with a health insurance plan based on what you qualify for and the aspects of coverage that you deem to be important. No longer be stuck in the dark ages of health insurance; Expand your horizons with an ICHRA.

3. Submit Required Expense Receipts

As we have mentioned before, each business has the ability to customize their ICHRA to best suit the needs of both the employees and employers. For the most reliable information regarding how to submit required expense receipts to ensure you get your reimbursement for qualifying medical costs, talk to the team responsible for facilitating your employee health coverage. While there are general practices for ICHRAs, your company may have a unique process for submitting and qualifying expenses. Typically, most companies accept an actual invoice from a provider or an explanation of benefits from the health insurance company as proof. Your timeline to reimbursement may vary and will often be paid along with a regular pay schedule. To ensure you cover all your bases, keep any receipts and invoices from any qualifying medical procedures or coverage while you are enrolled in an ICHRA.

If you have received a notice or communication from your employer about a company-sponsored ICHRA benefits platform, you will want to be sure to understand the precise setup, enrollment, and submission terms. But for most of those who already leverage the many reimbursement benefits of an ICHRA plan, it’s a great option to help control healthcare-related costs out of pocket. And most employees learn to appreciate only having to pay for what services they render and receiving reimbursements for those exact costs. This prevents you from praying high premiums for group plans that cover more than what you need. Rather, you can pick but coverage and visits that you want without worried about being charged for what you don’t.

If you find yourself looking on the Marketplace for healthcare coverage options, browse with W3LL. If you’re a business looking to explore your ICHRA options or perhaps need a third-party partner to help implement your benefits plan, W3LL can help you, as well.


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