The Individual Coverage HRA (ICHRA) requires employees and their dependents to be enrolled in a qualified health plan for each month the employee and their family members are reimbursed through ICHRA. While there are several ways to meet this requirement, not all health plans can be integrated with ICHRA. Here’s what you need to know.
What is a Qualified Health Plan?
A Qualified Health Plan for ICHRA is a major medical plan that can be purchased on or off the Exchange. It must meet the minimum requirements as outlined in Public Health Services (PHS) Act Section 2711 and Section 2713. These two provisions require no annual or lifetime limits on the dollar amount for coverage of essential health benefits and full coverage of preventative health services to be covered with no shared cost to the insured.
Essentially, ICHRA requires individuals to purchase a qualified medical plan that is MEC compliant.
What to know about Qualified Health Plans and ICHRA
The following plans can be integrated with ICHRA.
- Major medical plans purchased on the exchange (Bronze, Silver, and Gold)
- Medicare (Part A+B, or Part C)
- Catastrophic Plans (limited to those under age 30 or must qualify for hardship exemption)
- Student Health Insurance
Let us anticipate a few questions you might have...
Is Medi-Share considered a Qualified Health Plan?The final rules for ICHRA clearly state that an employee must have an individual marketplace plan to integrate with their employer-sponsored HRA. Sharing ministries do not qualify.
Can ICHRA integrate if I’m on my spouse’s insurance?Individual coverage integration unfortunately does not include coverage on a spouse's plan. Check out the this post on ICHRA and spouse's insurance for even more information and options.
Do short term plans work with ICHRA?Short term plans can not be integrated with ICHRA, but they do work with EBHRA.
Does Tricare work with ICHRA?
Under the final rules, individual coverage HRAs cannot be integrated with TRICARE.
Is it difficult to purchase an ICHRA qualified health plan?
The good news is, securing the right type of plan to participate in ICHRA is not difficult. Employees offered the Individual Coverage HRA qualify for a Special Enrollment Period upon the initial offering. This gives employees 60 days from the date that they become eligible for the ICHRA to purchase a qualifying plan outside the normal open enrollment period (open enrollment typically runs Nov 1-Dec 15 nationwide).
Next Steps: Finding the right Qualified Health Plan for your ICHRA
This individual coverage HRA option could give 11 million workers more health insurance options. Employees looking for qualified ICHRA plans can shop and compare plans directly at Take Command Health. With the ability to compare plans based on preferred doctors and prescription coverage, buying a plan has never been easier. We've also written a comprehensive guide with pretty much everything you'll ever need to know.