Frequently Asked Questions

Unlike traditional group health insurance plans, an ICHRA allows employers to define a budget for each employee, which the employee can use to purchase individual health insurance coverage of their choice. ICHRAs provide employees with flexibility and portability, as they can keep their coverage even if they change jobs.  

Employers set up the ICHRA, determine the amount of contribution, and establish the eligibility criteria. The contribution amount can vary based on factors like age, family size, and geographic location. ICHRAs are available to employers of all sizes. By offering an ICHRA, employers can provide a health benefit to their employees while controlling costs and customizing the benefit to individual needs. 

ICHRAs are a relatively new form of employer-sponsored health coverage that was introduced January 1, 2020, but they are already proving to be a strong solution for many clients/companies. 

Traditionally, HRAs are commonly used with group health plans. Before the Affordable Care Act (ACA) passed in 2010, it was common for small employers to use HRAs to reimburse for individual health insurance. However, unintended regulations that spun out of the ACA put a halt to the practice of reimbursing (and even penalized employers who continued doing it). Although it took a while, congress finally addressed the problem. In December 2016, a hodge-podge bill called the 21st Century Cures Act was passed by a Republican Congress and signed by President Obama. The bill created the Qualified Small Employer Health Reimbursement Arrangement (QSEHRA), making it permissible for small employers to reimburse for individual insurance if the employers (and employees) met several strict guidelines.  

With QSEHRA gaining traction, the Trump Administration issued additional guidance to expand the use of HRAs. The team behind SureCo was instrumental in lobbying for this change, and in October 2018, the U.S. Departments of the Treasury, Health and Human Services (HHS), and Labor proposed new regulations to expand the usability of health reimbursement arrangements (HRAs). The rules were finalized in June 2019 and created two new types of HRAs: the Individual Coverage HRA (ICHRA) and the Excepted Benefit HRA.  

The HHS estimates that by the end of 2025, roughly 800,000 employers will offer ICHRAs to pay for insurance for more than 11 million employees. 

Is there a reason why a broker or benefits consultant would not support an ICHRA? 

ICHRAs are relatively new, so it might take some time for a broker to learn and adjust. And an ICHRA may not be right for every company a broker works with. But SureCo works with brokers to show how ICHRAs can be a great solution for many companies. 

We provide robust incentives for our broker partners to help them maintain their relationship with their clients. They are also encouraged to continue writing their own ancillary benefits, which we can then incorporate directly into our Enrollment Platform.  

With SureCo and your broker, you’ll have a powerhouse team behind you!  

Download our Partner Guide for more information on how SureCo works with brokers to create a winning scenario for all parties. 

ICHRAs can be utilized in companies with foreign business. One of the 11 available employee classifications is “Foreign Employees Who Work Abroad.” 

Speak with a Benefits Expert today to find out how it could work for your company.  

Businesses of any size can benefit from the cost-saving advantages of ICHRAs.  

SureCo's Enrollment Platform provides the most advanced technology for companies to administer an ICHRA at scale. Most of our customers have a minimum of 150 eligible employees, and we've onboarded organizations with more than 2,500 employees. Our customers’ average annual savings on premiums is 24%. 

Utilizing an ICHRA for remote employees only is a choice employers make quite often, and it can be a very beneficial option for those employees as they are able to access all the individual carriers and plans in their areas, giving them greater power of choice to select a plan that fits their budget and medical needs. However, there are a few compliance pieces to pay attention to: For example, the class created for those remote workers must meet the class size minimums required within the ICHRA regulation. Make sure your ICHRA administrator will check all the compliance pieces on your behalf. 

Read more about what to look for in an ICHRA administrator. 

For this type of business, an ICHRA works well because there are no participation rules. We simply work with your payroll to make the necessary changes and enrollment. 

Read more about why ICHRAs are a good solution for companies with high turnover. 

ICHRA works especially well with those customers who are ASO. The banking and administration is simplified, the plan experience sits in the individual carrier's state plan, and the costs and risk of stop loss is removed. 

There are some factors that could change the answer to this question, which mostly center around imprest balance, run-out, and claims incurred but not paid. Typically, you would just need to continue with administrative services and hold reserves for a short period of time to account for these factors. Other than that, the transition would be fairly simple.  

Schedule a call with a SureCo Benefits Expert now to dig deeper into the specifics of this. 

SureCo has a formal implementation timeline of approximately 8 weeks lead time. This allows for proper communication, integration, and education for the employees to improve the overall experience. 

Although it’s technically possible for companies to administer an ICHRA on their own, we don’t recommend it, especially for large groups and overtaxed HR teams. 

SureCo’s platform relieves the administrative burden, helps ensure compliance, and frees up HR teams to do other work. Advanced technology makes it easy to enroll hundreds of employees in individual plans in less time than it would take to enroll them in traditional group plans. Plus it simplifies the selection process, so every employee can compare the plans that are best for them, according to their individual needs. Our dedicated white-glove customer service team is there every step of the way, from implementation and open enrollment to ongoing support throughout the year.  

We also provide custom integrations with every HRIS and payroll system, which makes it simple to add to your existing tech stack.  

Find out more about SureCo’s streamlined Enrollment Platform. 

SureCo provides custom integrations with all payroll systems and will assess your company's unique needs during the migration stage. 

Administrative costs can vary based on factors such as employee headcount, estimated participation, and geographic location. Typically, customers still see a cost savings north of 20% (for premium contributions and fees) when moving from a fully-insured or self-funded group to SureCo's Enrollment Platform. 

The individual market, which ICHRA utilizes, is on a calendar year. If a company opts into an ICHRA during a time that is not January 1, it will have coverage for the remainder of the year and be able to have another open enrollment in November for new plans starting the following January 1. ICHRA serves as a qualifying event, meaning a company can change/offer at any time of the year. Renewals will always have open enrollment around November for January 1 effective dates. 

ICHRA administrators should provide the  necessary raw data for the 1095 filing. SureCo provides this service to our customers. 

Read more about what to look for in an ICHRA administrator. 

SureCo integrates with most PEOs, but SureCo would be the benefits administration platform, not the PEO. Most of the time, we find it beneficial for clients to switch from a PEO to an ICHRA. 

For benefit eligibility under ICHRA, it depends on the business entity and whether the business owner is classified as an employee. 

If the business entity is an S-corp or LLC, then a business owner is a "member" and not an employee.

If the business entity is a C-corp, then a business owner is considered an employee. Learn more.

If the intent is to use ICHRA contribution from Employer A (let’s say Joe’s employer) to pay for COBRA from Employer B (say Joe’s spouse Linda’s COBRA that both are currently on), then the answer would be no. This is with the assumption that Linda’s COBRA plan is a traditional group plan, not an individual/family plan. ICHRA cannot be used to pay for a group health insurance policy. However, if Linda had an existing policy and Joe’s employer was contributing to spousal coverage through the ICHRA, then the ICHRA dollars could be extended to Linda’s policy to help pay for premiums and/or they could obtain a new family play together through the ICHRA provided from Joe’s employer. 

Read more about how ICHRA virtually eliminates COBRA. 

Companies are now able to contribute pre-tax dollars to employees' Medicare supplements with ICHRA. SureCo educates the employees on what is now available to them through our Medicare specialist. This helps to lower costs for the employee and the employer when they go to Medicare. They simply apply the ICHRA employer contribution to the Medicare cost.  

Read more about ICHRAs and Medicare. 

Most groups offer premium-only contribution (as opposed to medical expense reimbursement). If you are providing premium-only contribution/reimbursement then yes, you can still contribute. In order to use their HSA funds, they would just want to make sure that they elect in an HSA compatible health plan. 

Read more about spending-account ICHRAs vs. premium-only ICHRAs. 

Our Enrollment Platform works with 150 of the top HRIS and payroll systems. Our API calls to your existing systems make them even more  valuable by integrating an innovative digital healthcare marketplace that helps your employees find the right insurance for them and lessens the administrative burden for your HR staff. With SureCo’s Enrollment Platform you will get:  

• The ability to give your employees freedom of choice and control of their own healthcare  
• The ability to give your HR staff the time they need to engage top talent  
• Greater cost control  
• Improved employee engagement  
• Lower risk  

• A powerful recruitment tool  
• Educational materials to support your employees 

Yes, our platform and service are designed to help your team remove or reduce manual processes that can hinder productivity before, during, and after open enrollment timeframes. Throughout the year onboarding new employees is also made easier and more effective allowing your team to focus on other priorities. 

Many companies have longstanding relationships with their brokers or benefits consultants, and we understand just how valuable they can be. We are a broker-first company, meaning we prefer to get brokers involved sooner rather than later in the process.   

We provide robust incentives for our broker partners to help them maintain their relationship with your business. They are also encouraged to continue writing their own ancillary benefits, which we can then incorporate directly into our Enrollment Platform.   

With SureCo and your broker or benefits consultant, you’ll have a powerhouse team behind you!    

Download our Partner Guide for more information on how SureCo works with brokers to create a winning scenario for all parties. 

SureCo's Enrollment Platform provides the most advanced technology for companies to administer an Individual Coverage Health Reimbursement (ICHRA) at scale. Most of our customers have a minimum of 150 eligible employees, and we've onboarded organizations with more than 2,500 employees. 

Enrolling hundreds of employees in individual plans might sound daunting, but SureCo's Enrollment Platform makes the migration and onboarding process even easier on HR teams than enrolling every employee in a traditional group health insurance plan. 

Many HR professionals have longstanding relationships with their brokers, and we understand just how valuable they can be. We are a broker-first company, meaning we prefer to get brokers involved sooner rather than later in the process.  

We provide robust incentives for our broker partners to help them maintain their relationship with you. They are also encouraged to continue writing their own ancillary benefits, which we can then incorporate directly into our Enrollment Platform.  

With SureCo and your broker, you’ll have a powerhouse team behind you!  

Download our Partner Guide for more information on how SureCo works with brokers to create a winning scenario for all parties.