By Casey Kirkeby, Strategy Consultant
Employer-sponsored health benefits have faced several threats over the past few decades, but just like hard-working employees they protect, they still endure and remain the primary method of coverage today.
One of the most impactful changes has been the introduction the Affordable Care Act (ACA). The Employee Benefits Research Institute (EBRI) recently published a report examining the ACA’s impact and other government health care solutions on employer-sponsored health plans. The study interviewed 26 benefits executives from various industries whose organizations covered over 1.2 million individuals and spent more than $6.5 billion on benefits in 2021. Their data reflected that both employers and employees still viewed employer-sponsored health benefits as an important feature of the employment relationship. Who would have though, right?! While this public option doesn’t guarantee ongoing success and stability, it will hopefully help shield employers from future challenges like legislative policy changes, economic difficulties and labor market shortages. Just like any good relationship, the employer/employee benefit relationship takes hard work, trust, and transparency.
As health care costs rise, employers are looking at any option to control costs. One arrangement that has been quite popular in the Lower 48 is the ICHRA (Individual Coverage Health Reimbursement Arrangement). Since it’s inception in January of 2022, many employers have adopted the ICHRA, directing their employees to private exchanges so that the employee is able to make plan design decisions for themselves apart from the traditional one-size-fits-all model. There are important considerations to take into account before an employer jumps to this model and the process is still clunky, but it can be a good fit for some employers. However, employers and employees have been slow to embrace the ICHRA because it lacks control over healthcare costs and creates additional administrative burdens that the employer has to absorb.
Another survey conducted by the National Business Group on Health concluded that most employers plan to continue offering health benefits to their employees as part of their overall compensation package. Specifically, the survey found that 92% of large employers offer health benefits and expect to continue doing so in the future, with an increasing focus on virtual health and digital solutions.
Employers are always exploring different ways to control costs, such as offering high-deductible health plans, Wellness Programs, Employee Assistance Programs surrounding mental health, and incentivizing employees to use cost-effective providers. But for now, employers remain confident in their ability to provide affordable health benefits to employees as an important attraction and retention tool.
This article is from RISQ Consulting’s Zywave client portal, a resource available to all RISQ Consulting clients. Please contact your Benefits Consultant or Account Executive for more information or for help setting up your own login.
You may have heard of health reimbursement arrangements (HRAs) before. These are employer-sponsored savings accounts that reimburse you for certain medical expenses.
An individual coverage HRA (ICHRA) is similar—it uses funds from your employer to help pay for certain medical expenses. However, there are some important features of ICHRAs that you should understand.
This article explains more about ICHRAs and how they may be used.
Comparing HRAs to ICHRAs
As previously stated, HRAs reimburse you for certain medical costs. Such expenses might include those associated with doctor visits, medical procedures and prescriptions, depending on the plan. To qualify for an HRA, you must be enrolled in your employer’s group health plan.
ICHRAs are a bit different. These accounts can reimburse you for certain medical expenses, your insurance premium or both. Whether your ICHRA will cover both your premium and medical expenses (or just one) will vary by employer.
To qualify for an ICHRA, you must enroll in individual health coverage using a Health Insurance Marketplace (Marketplace), a private insurer, Medicare or another method. In other words, you cannot be enrolled in an employer’s group health plan and qualify for an ICHRA.
Additionally, any dependents (e.g., a spouse or children) you have on your individual health plan would also be able to use ICHRA funds.
How ICHRAs Work
On a very basic level, here’s how an ICHRA works:
- You obtain individual health coverage through a Marketplace or another method rather than purchasing health coverage through your employer.
- Your employer contributes a set amount every month into your ICHRA so you can be reimbursed for certain expenses as they are incurred. Contributions and reimbursements are both tax-free. Your employer decides which expenses are eligible for reimbursement under the plan’s terms.
- Unused funds at the end of the plan year may go back to the employer or carry over, depending on the plan.
It’s as simple as that!
Speak with HR to learn more about the ICHRA options available to you.