After remaining stagnant for almost 80 years, the world of employee health benefits is finally witnessing a much-needed evolution. One of the key innovations at the forefront of this change is the ICHRA, or Individual Coverage Health Reimbursement Arrangement. An ICHRA puts the power of choice back into the employees’ hands by allowing their employer to reimburse them pre-tax for the plan of their choice from the individual market. ICHRAs can contain costs for both companies and their workforces, but technology is crucial to their success.
The Genesis of SureCo's Technology
Amir Pirnia, SureCo’s Chief Technology Officer, is acutely aware of the impact superior technology has on ICHRA administration. His ICHRA journey began long before it became a benefits buzzword. As one of the founding engineers of Hixme (whose technology SureCo acquired in 2019), Pirnia helped lay the foundation for what would become a game-changing approach to employee-sponsored health benefits. Back in those early days, the idea of ICHRA was still taking shape, and the team at Hixme was lobbying government agencies like the IRS and ACA to make this concept a reality.
The core of their vision was to leverage the flexibility and affordability of ACA plans and offer them to large organizations as an alternative to traditional group insurance. The advantages were clear: flexibility, portability, and a wide array of plan options. This meant that employees could seamlessly transition between companies without changing their health plans, even if they were unemployed for a period. Moreover, employees gained access to a variety of plans tailored to their unique needs.
The innovative aspect of Hixme's approach was its customization. Instead of the typical binary choice between expensive PPO plans and budget-friendly options, they offered up to 20-30 different plans. A comprehensive questionnaire helped users identify the plan that best suited their individual circumstances, whether they were planning surgeries, having children, or dealing with specific medical needs. This level of personalization was unprecedented at the time.
Fast forward a few years, and the regulatory landscape shifted in favor of ICHRA, and the concept of putting healthy employees on ACA plans, making them tax-deductible, and expanding the risk pool started gaining traction. By the time ICHRA went into effect in January 2020, Pirnia had already been working on a platform to enable it for the better part of a decade.
SureCo's Technological Distinction
The technology behind SureCo's Enrollment Platform is what sets it apart from competitors today. Pirnia emphasizes the importance of user-friendliness, where employees and human resource teams can effortlessly navigate the platform with minimal effort.
SureCo makes it easy to seamlessly onboard employees, eliminates the need for manual processes through custom integrations with HRIS and payroll systems, and offers automatic payments to individual carriers. The result is a user experience that is smooth, stress-free, and highly efficient, making ICHRAs accessible and manageable for both employers and employees. Additionally, the platform's scalability and flexibility mean that it can adapt to changing needs and continue to innovate.
The Power of AI and Machine Learning in ICHRA
While the early vision of ICHRA was revolutionary, Pirnia says AI and machine learning will propel SureCo’s Enrollment Platform into the future. By analyzing how people make healthcare decisions and use their plans, AI can offer personalized recommendations for the future. For instance, if an individual had a major medical event in the past, it does not mean they will experience the same situation again. AI can analyze vast datasets, including claims history, to provide better-informed suggestions.
“Imagine a world,” he explains, “where the Platform understands your unique needs, whether you're planning a surgery, having a baby, or managing a chronic condition. With AI and machine learning, the Platform can recommend the most suitable plans, considering your individual circumstances and preferences. This level of personalization, driven by data and technology, is where ICHRA's future lies.”
Pirnia even envisions a future where the Enrollment Platform leverages AI to support decision-making for a broader range of pretax, payroll-deductible benefits. This could include programs like weight loss, mental health support, exercise programs, and nutrition plans. By streamlining these offerings through a single platform, employees could access a holistic range of benefits effortlessly, improving their overall well-being.