Individual Coverage HRA

A new alternative to group health plans

The individual coverage health reimbursement arrangement (ICHRA) allows employers to reimburse employees tax-free for health plan premiums and qualified out-of-pocket expenses. Employees must be enrolled in an individual health insurance plan (on- or off-Exchange) or Medicare to be an eligible participant under the ICHRA. Flex is here to help you and your clients with the benefits administration of the plan, as well as the individual health sale.


Applicable large employers can satisfy the Employer Mandate requirements by offering an ICHRA.

However, an ICHRA may disqualify an individual for subsidy eligibility.

How Does the ICHRA Work?

3.

Employees File Claims with Flex

2.

Employees Purchase Individual Health Plans

The broker helps employees shop for and purchase their individual health plans. As a General Agency, Flex is available to provide support and assist the broker with the sale. For brokers who would prefer not to handle the individual sale directly, Flex has various partnership options available. Eligible plans include:

  • Grandfathered plans
  • Grandmothered plans
  • ACA regulated plans (on- or off-Exchange)
  • Insured student health plans
  • Medicare or Medicare Advantage plans

Once employees are enrolled in their health plans, they can get reimbursed for their premiums by filing a claim with Flex. We manage every aspect of the claims process, including:

  • Participant eligibility
  • Claim submission and tracking
  • Expense approval
  • Reimbursements via check or direct deposit
  • User-friendly member portal and mobile app

1.

Employer Sets up the ICHRA

Flex's experienced Implementation Team will guide employers through the process of setting up the ICHRA and help them determine how the plan will work. The employer can choose:

  • Eligible employee classes
  • Eligible expenses
  • Reimbursement amounts
  • Reimbursement frequency
  • Effective date of the plan

ICHRA Plan Benefits

Fixed Costs

Employers determine how much they want to reimburse employees.

Low Administrative Fees

The fees to administer an HRA are nominal

Tax Savings

Reimbursement are tax-free

Choice

Employees have the ability to select any plan available in their area

Compliance

It's an easy way to meet the offer requirements of the Employer Mandate

Options

The plan can reimburse premiums, out-of-pocket expenses, or both

Flexibility

Can offer a traditional group health plan to one class of employees and the ICHRA to another class

Ancillary

Employers can offer any type of ancillary benefit in addition to the ICHRA

Employer Requirements:

Employee Requirements:

Does not apply to employees:

At least one W-2 employee

Participating employees must have individual health insurance or Medicare

Covered by a spouse's group health insurance plan

ICHRA Plan Requirements

Participating in a health care sharing ministry

Who have short-term medical insurance

Beyond those items, employee eligibility is up to the employer. Employers determine the maximum reimbursement limits and can offer the ICHRA using the following classifications:

Full-time employees

Part-time employees

Employees working in the same geographic location

Seasonal employees

Employees in a unit covered by a collective bargaining agreement

Employees who have not satisfied the waiting period

Non-resident aliens with no U.S based income

Salaried workers

Hourly workers

Temporary employees of staffing firms

Any group of employees formed my combining two or more of these classes

Contact a Flex Sales Consultant to learn more

(866) 472-0894