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.

Yes! With the right technology partner, selecting your ICHRA benefit and enrolling in an ACA plan is simple. The employee will answer just a few simple questions to be led down the right path for the best coverage.

During the pandemic, employees do not have to be notified 90 days in advance. Instead, it should just be as soon as possible. The reason is that without sufficient time to research their benefit and shop for a plan, employees might not properly explore all of their options and may enter a situation uninformed of the implications for premium tax credits. "The Departments recognize that some employers are considering offering an individual coverage HRA for the first time. The Departments encourage employers affected by the COVID-19 pandemic to consider whether they can provide the individual coverage HRA notice at least early enough in advance of the first day on which the individual coverage HRA may take effect so that eligible employees have sufficient time to read and understand the notice, make an informed decision whether or not to enroll in the individual coverage HRA, and exercise their special enrollment right to individual health insurance coverage so that the coverage would start no later than the first day of the individual coverage HRA plan year."

With ICHRA, an employee submits their receipts every month to their employer to have their premium reimbursed. If an employee is no longer with the employer who offered the ICHRA, they will not receive the benefit. However, the employee may choose to keep their ACA health coverage and, if eligible, receive the monthly PTC (premium tax credit).

The technology vendor will ask as part of the enrollment process whether an employee has been offered an ICHRA and for acknowledging/attesting that if they take the ICHRA, they understand they may not claim the PTC. Accordingly, it is ultimately the responsibility of the employee to confirm/attest if they were offered an ICHRA, what the dollar amount was, and that they will not be claiming the PTC.

Yes, the broker can assist employees. Additionally, the W3LL call center is an available resource, with licensed agents who can help employees.

ICHRA Administration is easy when you have a great partner, like W3LL! Our solution supports automated compliance and updates. We also manage all the rules and regulation compliance including:

• Legal plan document and summary plan document (SPD)
• Electronic enrollment signatures
• Verification and HIPAA privacy compliance.
• How to choose an ICHRA administration software solution.
• ERISA compliance
• Internal and external documentation appeal process
• Notice requirements

ICHRA is a reimbursable arrangement, not an account. The employer keeps the dollars allocated for reimbursement. Throughout the year, however, the employees unused allowances accrue. If the employee never submits receipts for the full reimbursable amount, the employer then keeps the funds.

Employers have the option to either carry over the funds or reset them at the end of the year. Which option employers utilize will depend on their benefits strategy.

If the plan is on-exchange, employees cannot use pre-tax payroll deductions to cover the remainder of their premiums. If the plan is off-exchange, however, employees can use the pre-tax payroll deduction to cover premium costs.

ICHRA reimbursement can be handled through the employer, the benefits administrator, or the HRA Program Manager..

Unfortunately, ICHRA is only applicable to Qualified Health Plan (QHP) premiums. Other health plans, including Non-Reimbursement Plans, would not qualify.

The HRA program manager will help you and your employers determine the affordability of the selected benefits. W3LL provides a simple tool for employers to upload their roster and receive a report of which benefits are affordable or not. All the employer needs to provide is the salary, zip code, and family size (optional) for each employee.

Yes, if the ICHRA benefit is deemed unaffordable, the employee has the option to either:

• Utilize the unaffordable ICHRA benefit with no PTC (premium tax credit) or
• Decline the unaffordable ICHRA benefit and accept up to the full amount of the PTC through the exchange for which they are eligible.

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

Employees participating in an ICHRA cannot collect the premium tax credit (PTC). With an ICHRA, employees have a choice: they can either participate in the HRA and waive their right to premium tax credits, or they can opt-out of the ICHRA and (if qualified) collect their premium tax credits.

If the ICHRA offering is deemed unaffordable to the employee, they have options. They can either participate in the ICHRA or opt-out and accept the Advanced Premium Tax Credit (APTC) from the Marketplace (if they are eligible). Some Applicable Large Employers (ALE) may be liable for ACA penalties for not providing affordable coverage.

There are numerous benefits to employers with 50 or fewer employees. For instance, there is no limit to an employer's contribution, some employees can receive a group policy while others receive the ICHRA, and there is more class flexibility.

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 employee's then the minimum class sizes apply. An employer cannot offer two people within the same class different benefit types.

ICHRA offers small employers numerous advantages over traditional group plans. These include:

• Cost Control: group policies typically increase by 5% annually, while ICHRA contributions are solely up to the employer. ACA plans decreased by 2% on average this year.
• Flexibility: ability to offer different reimbursement amounts to various employee classes.
• Participation Requirements: unlike group insurance, there are no participation requirements for ICHRA.

With ICHRA, the ER 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.

Minimum class sizes only come into play when the employer offers both a traditional group plan and ICHRA benefits. If the employer is only offering ICHRA benefits, there are no class size minimums. More information can be found on our blog.

If your business has older and younger employees in the same class and you choose to offer the oldest employees more money, the amount cannot be more than three times the allowance amount of the youngest employees in the class.

Yes, these employees count! Their class can vary based on their specific situations. Typically these individuals fall within Class 2, 3, or 9.

Yes! Reach out to us for more information and some collateral you can use to explain the benefits of ICHRA to your clients.

Yes, the broker can assist employees. Additionally, the W3LL call center is an available resource, with licensed agents who can help employees.

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.

No, unfortunately not. Sole proprietors and LLCs that are not C-Corps are not eligible for ICHRA benefits. Please see our blog for more information.

Unfortunately, ICHRA is only applicable to Qualified Health Plan (QHP) premiums. Other health plans, including Non-Reimbursement Plans, would not qualify.

ICHRA benefits can be used to pay for vision and dental insurance as long as you are also enrolled in a Qualified Health Plan (QHP). For more information, please refer to our blog post on this topic. Currently, ICHRA benefits are not able to be used for life insurance.

Yes! ICHRA benefits are available in all 50 states.

HRA program managers and technology partners can work in all states. For those who will also be utilizing an enrollment engine, on-exchange enrollments can only go through the FFM at this time.

Employees who live in SBM (State-Based Marketplace) states will need to go through their state Marketplace. For off-exchange enrollments, any HRA program manager/enrollment technology partner who has arrangements with health plans can offer those plans regardless of the state.

For employers with employees in multiple states, the decision tool can be used for all employees, even those not in an FFM state.

All on-exchange plans are represented through W3LL's shopping platform, meeting ACA requirements. Additionally, the employees can select from any off-exchange carriers that are appointed and certified with the broker and or W3LL. Our agency is appointed and certified with most carriers.

Yes! Reach out to us for more information and some collateral you can use to explain the benefits of ICHRA to your clients.

Depending on the service level, there can be no or minimal costs for marketing efforts. We will work with your organization to determine the best fitting solution, ranging from the standard W3LL services to a custom-built, white-labeled platform. Ultimately the value delivered to your members will be a net gain for your organization.

There are no added service or broker fees to your members. W3LL‘s platform experience is provided at no extra cost to individuals or organizations. Upon enrollment, the insurance provider pays W3LL a commission rate. By law, these rates cannot affect how we display or recommend plans. Our mission is to help your members find the best possible plan for their needs. W3LL delivers the best unbiased expert advice for plans.

W3LL supports your members throughout the entire process from shopping to enrollment. We take pride in offering an intuitive, easy-to-use, shopping platform. For those needing extra help, we offer click-to-chat and call-in options to speak with licensed brokers. After a member enrolls in a plan, all communication is direct to the plan/service provider. If a member needs additional help, we assist in connecting them to the best resource point.

Partnering with W3LL allows you to provide one more essential need – a clear path and a simple process of obtaining health coverage. In short, you can offer your clients simple, streamlined access to healthcare.

CMS is moving away from offering technical solutions to enrollment and are, instead, focusing on the policy and partnering with third parties to provide the shopping and enrollment experience consumers have come to expect. W3LL is an approved EDE partner to CMS, which means that we have the ability to validate the user’s eligibility while streamlining the enrollment process. We reduce the process to enroll in ACA eligible coverage by over 20 minutes per user!

W3LL is an 100% US-based HIPAA, PCI, and NIST compliant e-broker platform. We are a trusted partner to solve all complex challenges regarding individual and group markets, Medicare, and ancillary products.

Depending on the partnering relationship, there can be no costs or minimal costs associated with branding and related marketing efforts. We will work with your organization to determine the most desired integration, whether it’s a fully white-labeled platform, directing members to the W3LL branded site, or a hybrid option. The value your employees gain from a partnership with us exceeds any costs that may be incurred.

W3LL will capture the required information to successfully enroll your members in the desired products. The data will be sent to relevant carriers and stored within our secure database for up to 10 years per CMS guidelines.

W3LL is there for your members through the entire shopping and enrollment process. We take pride in offering an intuitive, easy-to-use, shopping portal. For those needing little extra help, we offer click-to-chat and call-in options to speak with licensed brokers. After a member has enrolled in a plan, all communication will be conducted with the health plan (or other product/service provider). Of course, if a member does reach out to us, we will do our best to triage them to the appropriate resource.

There are no risks or downsides when working with W3LL. As a WBE and a CMS-approved EDE partner, we offer your members insurance options through the ACA along with other ancillary products. Neither W3LL nor the organization acts as the insurer and therefore does not take on any additional risk with regards to the insurance plans offered or enrolled in.

W3LL is an 100% US-based HIPAA, PCI, and NIST compliant e-broker platform. We are a trusted partner to solve all complex challenges regarding individual and group markets, Medicare, and ancillary products.

W3LL will capture the required information to successfully enroll your members in the desired products. The data will be sent to relevant carriers and stored within our secure database for up to 10 years per CMS guidelines. Member data is kept private, fully HIPAA compliant and not resold.

We’re glad you asked! We’re a secure and trusted partner of Healthcare.gov, meaning we’re able to display the exact same plans and prices as Healthcare.gov with no extra costs. The difference is that we provide you tools to empower you to find the perfect plan for your needs and budget without confusing health insurance jargon. Our streamlined, easy to use, website saves you time. With W3LL you can:

• Find out if you’re eligible for savings in 10 seconds
• See which plan will be most affordable for you
• Easily shop and compare all plans
• Get enrolled FAST!

NOTE: If you have recently lost your job due to the COVID-19 pandemic, you may be eligible for a Special Enrollment Period and can apply for health coverage. We’re here to help – shop and enroll through W3LL now! During the annual Open Enrollment Period from November 1st – December 15th, almost all Americans can enroll in health insurance through the Federal Marketplace. If you enroll by December 15th, your coverage will begin January 1st. Outside of the Open Enrollment Period, you can only enroll if you have a Qualifying Life Event, such as losing your job, losing your health insurance, adopting a baby, or getting married.

All the health insurance lingo can feel overwhelming and foreign. W3LL walks you through the shopping process in an understandable way. You can still learn more with our straight forward glossary of terms.