From Enrollment to Billing and Everything in Between — If You Have a Question, We Have the Answer

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Yes, ICHRAs are reimbursement accounts, so employees must save their premium payment receipts in order to receive reimbursement from ICHRA funds. Some technology vendors are working to simplify this process. Stay tuned for more!

ICHRA is a reimbursable arrangement, not an account. The employer keeps the dollars allocated for reimbursement and employees must submit receipts to be reimbursed for their qualified medical expenses.

Employers have the option to either carry over the funds into the next year or reset them at the end of each year.

ICHRAs can be offered alongside ancillary products, but the ICHRA contribution cannot be used to pay the premiums for ancillary products, such as dental or vision.

Yes, an employer can offer one class of employees a traditional group plan and an ICHRA benefit to a different class. The same class of employee’s cannot be offered both a traditional group plan and an ICHRA. Additionally, if an employer offers a traditional group benefit to any class of employees, then the minimum class sizes apply. An employer cannot offer two people within the same class different benefit types.

ICHRA and Medicare can work together. To qualify for an ICHRA, the employees eligible for Medicare must have coverage of Part A and Part B together or Part C. Part B only (not drawing Social Security) by itself does not qualify as Minimal Essential Coverage.

An ICHRA may be used to reimburse premiums for Medicare and Medicare supplemental health insurance (Med Supp or Medigap) as well as other medical care expenses. The premiums for Parts A, B, C, and D, as well as Medigap policies, are all eligible for reimbursement.

Yes, ICHRAs can be used for both health insurance premiums and qualified medical expenses.

The employer sets their contribution amount, and there is no minimum or maximum number. If the employer has 50 or more employees, they need to meet the affordability requirement when determining their contributions.

It is best to use a technology partner’s decision tool, like W3LL’s, to determine what the optimal contribution is per class so that they are deemed affordable.

The employee pays the premiums and then is reimbursed for a portion of the premium from the employer-managed ICHRA.

Once an employer has decided on the ICHRA benefit being offered to employees, W3LL does the rest. W3LL will send the compliance notice to the employees along with a link to enroll into the health plan of their choice. As long as the employee enrolls through the W3LL platform, the broker will get the credit for the enrollment, and the member is set.

W3LL is a Phase III EDE partner with CMS and has a streamlined, seamless shopping and enrollment process for all FFM (Federally Facilitated Marketplace) states. State-based Marketplaces (SBMs) do not allow for on-exchange integrations; but W3LL supports off-exchange shopping in those states.

The W3LL platform allows you and your employer to manage your entire book of business – from ICHRA benefit design to employee enrollment in one location.

While a TPA is not necessary to administer an ICHRA, engaging with a partner who meets your needs will reduce the administrative burden for your clients. W3LL offers HRA administration and an employee enrollment platform. Reach out to us and learn more.

While there are no legal requirements preventing an employer from managing an ICHRA on their own, the administrative overhead would likely prove to be overwhelming. HRA managers and TPAs like W3LL can assist in the management of both the ICHRA and employee health insurance shopping.

With ICHRA, the employer can set the contribution amount by class, ensuring that the cost will never be more than the cost of a traditional group plan. As for the employees, they can choose to decline the ICHRA contribution if the tax credit is a better option for them.

ICHRA offers small employers’ numerous advantages over traditional group plans:

  • Cost Control: group policies typically increase by 5% annually, while ICHRA contributions are solely up to the employer.
  • Flexibility: ability to offer different reimbursement amounts to various employee classes.
  • Participation Requirements: unlike group insurance, there are no participation requirements for ICHRA.

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