Looking for an ICHRA plan document template? You're in the right place. Let’s look at the components required to be included in ICHRA plan documents, from employee notice to legal agreement to plan summary. Don't worry, it's not as complicated as it sounds.
The ICHRA, or individual coverage HRA, gives employers the ability to design and customize a plan for their organization. There are many rules surrounding ICHRA and other HRAs, which can change from year to year. If keeping up with changing regulations sounds overwhelming, take heart! The ICHRA platform from Take Command has built-in, automatic updates to ensure compliance. It will also ensure you have all the ICHRA plan documents you and your employees need.
ICHRA plan document template: what to include
Legal Agreement
The legal agreement establishes the ICHRA for the employer. It should include:
- Named fiduciaries and plan administrators and their responsibilities
- Eligibility requirements for the ICHRA
- Effective dates of participation
- Description of benefits provided and excluded
- How the ICHRA is funded and how it makes payments
- Claims procedures
- HIPAA privacy officers and rules relating to the use of protected health information (PHI)
- Information on federal mandates
- The procedure for amending the plan
- The procedure for plan termination
Plan Summary
Employees must be provided a written notice in the form of a Plan Summary. The Plan Summary is a condensed, user friendly explanation (psst: go easy on the legal-ease!) of the ICHRA benefit and how it works. This is a great place to include information on the different classes of benefits and a helpful link to the Take Command platform if employees need help choosing the most affordable plan based on their unique needs, doctors, prescriptions, etc. Giving employees as many resources up front will ease the transition, especially if they are shopping on the individual market for the first time.
ICHRA Employee Notice
Since the Individual Coverage HRA requires employees to purchase an ICHRA qualified plan for themselves (as opposed to picking a tier option from an employer sponsored group health plan), the employee notice is designed to guide employees in the process of purchasing health insurance from the marketplace which can be confusing if they haven't done so before. ICHRAs must provide a 90 day notice to eligible employees regarding the ICHRA and its interaction with premium tax credits and of the qualifying 60 day Special Enrollment Period (SEP) that is activated when an employee gains access to ICHRA.
Extra credit reading → ICHRA Employee Notice Guide
The ICHRA Employee Notice will need to include the following information:
- Permitted benefit amount per employee & ICHRA start date for employee.
- An opt-out provision for the employee
- An explanation of potentially utilizing a premium tax credit if the employee opts out of ICHRA and the ICHRA allowance is deemed unaffordable.
- An explanation of what happens with the premium tax credit if the employee accepts to participate in ICHRA.
- The employee will need to inform the health insurance Exchange of ICHRA if they apply for APTC.
- A statement that ICHRA is not QSEHRA.
- Contact Information for employees to contact for help regarding their ICHRA.
- Statement that new access to ICHRA qualifies employees and dependents to a Special Enrollment Period (SEP) to purchase insurance from the Exchange for 60 days.
Check out our post on the 90 day notice for the individual coverage HRA for more information. There are also special provisions being made during the COVID-19 pandemic.
We are here to help!
Does this sound confusing, expensive or both? Don't worry. We are here to make your life easier. Our ICHRA administration tool makes setup a walk in the park. We handle all the accounting and legal legwork, take care of on-boarding each of your employees (or clients), and make tax time easy and painless.
Want to learn more? Check out our ICHRA guide or chat with one of our HRA experts online. We'd be happy to help!
