Benafica helps employers design, launch, and manage Individual Coverage HRAs.
ICHRA stands for Individual Coverage Health Reimbursement Arrangement. It is an alternative to traditional group health insurance that allows employers of any size to provide more flexible and cost-effective health benefits to their employees.
Unlike a traditional group health plan, an ICHRA doesn’t require your company to select, negotiate, or manage a single insurance policy on behalf of your workforce. Instead, you set a monthly allowance, and each employee uses it toward the plan that fits their own life.
Looking for a solution for small businesses? Try QSEHRA
Employer sets the allowance
The employer defines monthly reimbursement amounts based on the plan design and eligible employee classes.
Employees choose individual coverage
Employees enroll in qualifying individual health insurance coverage that fits their needs, location, and budget.
Reimbursements are processed through the plan
Coverage is verified and eligible expenses are submitted, recurring monthly payments and any reimbursements are
processed in our platform.
Ongoing administration and support
From new hires and terminations to qualifying life events, everything is handled in our BEN360 platform with reliable support, year-round.
We support the full lifecycle of an ICHRA, from plan structure and documentation through payment and reimbursement workflows, reporting, and ongoing support.
ICHRA Eligible Expenses
The employer defines monthly reimbursement amounts based on the plan design and eligible employee classes.
ICHRA Contribution Strategies
The employer defines monthly reimbursement amounts based on the plan design and eligible employee classes.
Employee Classes & Plan Design
The employer defines monthly reimbursement amounts based on the plan design and eligible employee classes.
Affordability for ALEs
The employer defines monthly reimbursement amounts based on the plan design and eligible employee classes.
ICHRA vs QSEHRA
The employer defines monthly reimbursement amounts based on the plan design and eligible employee classes.
ICHRA Compliance
The employer defines monthly reimbursement amounts based on the plan design and eligible employee classes.
ICHRA and Medicare
The employer defines monthly reimbursement amounts based on the plan design and eligible employee classes.
ICHRA and COBRA
The employer defines monthly reimbursement amounts based on the plan design and eligible employee classes.
ICHRA and COBRA
The employer defines monthly reimbursement amounts based on the plan design and eligible employee classes.
ICHRA is available to employers of any size. You need to have at least one W-2 employee.
Employees must enroll in qualifying individual health insurance (on or off the exchange) that meet ACA minimum essential coverage. Leftover ICHRA dollars can also be used to reimburse out-of-pocket expenses.
Most employers start by looking at current benefits spend and local individual-market premiums for their employees’ ages and locations. From there, they choose an allowance strategy. With a flat-dollar strategy, you offer a flat amount to all your employees (or employees across a group). With an age-banded strategy, you offer a percentage of a targeted plan’s premium, such as 75% of a gold plan. We will help you model and adjust contribution strategies and define employee classes.
ICHRA can either be used to fully replace your traditional group health plan or you can offer it alongside a group plan for specific employee classes. For example, you might offer a group plan to full-time employees and an ICHRA to part-time employees.
ICHRA employee classes let employers offer different allowance amounts and eligibility rules to defined groups, such as full-time, part-time, salaried, hourly, different locations, etc. There are 11 different classes and they are set by IRS regulations. Employees in the same class must be treated equally. Learn more about ICHRA employee classes.
Yes, ICHRA can be offered to meet the ACA employer mandate, as long as an employee’s allowance is considered “affordable” under IRS rules. We will help you model affordability if you’re an ALE.
Get a side‑by‑side financial analysis of ICHRA compared to your current health plan.
