Your ICHRA Questions, Answered

An ICHRA offers flexibility, predictable costs, and personal choice. Employers control their budget, and employees pick coverage that fits their needs.

Transition is generally straightforward. Once your group plan ends, employees can move to individual coverage, often using a special enrollment period tied to the termination of the group plan.

Qualifying coverage typically includes ACA marketplace plans, private individual plans, or Medicare. Short-term plans or sharing ministries are usually excluded.

There’s no set limit from the IRS. Employers can choose the amount that fits their budget and can adjust it annually if needed.

ICHRA is a federal arrangement recognized in all 50 states. However, insurance options and costs may vary based on state regulations and marketplace availability.

We use industry-standard security protocols and encryption to protect sensitive data. Only authorized individuals have access to personal and reimbursement information.

Coverage under a spouse’s employer group plan does not satisfy the individual-coverage requirement for ICHRA participation. To receive ICHRA reimbursements, the employee must be enrolled in qualifying individual health insurance or Medicare. An employee who has other coverage may decline the ICHRA.

Employees with continuous coverage typically don’t need to re-enroll in the ICHRA itself. However, it’s wise to review plan options annually—especially if your employer adjusts reimbursement amounts or if your insurance needs change.

Yes, for certain employers. If you are an Applicable Large Employer (ALE), an ICHRA can be structured to meet ACA affordability requirements. SimplyHRA helps check for compliance before finalizing plan details.

We provide customer support via email, phone, and live chat to answer questions about set-up, compliance, and everyday use. Our goal is to make offering and managing an ICHRA as simple as possible.

Simply have your employer create an employer account at SimplyHRA.com and have them invite you to their team. Once invited, the platform guides you step-by-step through your healthcare plans, reimbursements, and more. If you have any other questions, please contact SimplyHRA.

ICHRA (Individual Coverage Health Reimbursement Arrangement) lets you reimburse employees for health insurance premiums (and optionally medical expenses) on a tax-free basis. It can be more cost-effective than a group plan and offers flexible coverage options for employees.

Yes. Federal final rules establishing ICHRAs were issued in 2019, and employers could first offer them for plan years beginning January 1, 2020. Compliance depends on how the ICHRA is designed and administered, including coverage substantiation, notices, plan terms, and any applicable ACA employer-mandate requirements.

You decide how much to reimburse—there’s no minimum or maximum. You can even set different reimbursement amounts for different classes of employees (e.g., part-time, full-time, or by location). SimplyHRA will help every step along the way.

Yes. You can create separate “classes” (e.g., full-time vs. part-time) and allocate reimbursement amounts accordingly, as long as you comply with the rules for defining these classes.

No. SimplyHRA automates claim submissions and reimbursements. You set your plan parameters, and our platform handles the paperwork for you.

Employer reimbursements are generally tax-deductible as a business expense. Employees receive reimbursements tax-free, provided they hold qualifying individual health insurance.

If you value budget control and want employees to pick their own coverage, an ICHRA may be a better fit. For employers who prefer a single group plan with standardized coverage, a traditional plan could be considered—but often at a higher cost.

Employees must have qualifying coverage to receive reimbursements. If they opt out or do not enroll, they won’t be reimbursed. SimplyHRA only pays for valid expenses, so there’s no cost to you for employees who remain uninsured.

Sign up at SimplyHRA.com, create your employer account, and set your reimbursement rules. The platform guides you step-by-step through defining budgets, classes, and compliance details. If you have any other questions, please contact SimplyHRA.

With ICHRA, your employer reimburses you for health insurance premiums (and possibly medical expenses). You choose your own plan, which can be a marketplace plan or private coverage, and get reimbursed for the portion your employer sets.

You need to choose a qualifying individual health insurance plan. This can include ACA marketplace plans, private plans, or Medicare (if eligible). Short-term or health sharing ministry plans typically do not qualify.

You’ll submit proof of payment (such as receipts or statements) through the SimplyHRA platform. Once verified, your employer reimburses you up to the set allowance.

Generally, you need to enroll in a plan during the ACA’s open enrollment or a special enrollment period (e.g., loss of other coverage). However, ICHRA itself often triggers a special enrollment period, allowing you to sign up for coverage outside standard open enrollment windows.

No. As long as you have a qualifying health plan, your employer’s reimbursements for premiums and/or medical expenses are tax-free.

It depends on whether your employer’s ICHRA plan design includes family coverage. If it does, you can be reimbursed for premiums covering your spouse and dependents, provided they have qualifying coverage.

The individual insurance policy is separate from the ICHRA and may continue if you keep paying its premium. Your active-employee ICHRA coverage normally ends under the plan’s terms, but if the employer and plan are subject to federal COBRA, termination of employment or a reduction in hours that causes a loss of ICHRA coverage may give you or another qualified beneficiary the right to continue the ICHRA, generally at your own expense.

Any costs over your employer’s monthly allowance are your responsibility. You’ll pay the difference out of pocket.

While SimplyHRA doesn’t directly select a plan for you, our platform provides resources and tips to help you find the right coverage. If you need personalized advice, you can consult a licensed insurance broker or use the ACA marketplace.

You can typically change your plan during the ACA’s open enrollment period or if you experience a qualifying life event (e.g., marriage, birth of a child). However, keep an eye on enrollment deadlines to ensure you stay covered.

Simply have your employer create an employer account at SimplyHRA.com and have them invite you to their team. Once invited, the platform guides you step-by-step through your healthcare plans, reimbursements, and more. If you have any other questions, please contact SimplyHRA.