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Employer Group Health Insurance Options and the ICHRA

by | Dec 29, 2024

Page Tags: 2024 | group health

Group Health Insurance

Individual Coverage Health Reimbursement Arrangement

Beginning in 2020, some employers will have the option of reimbursing employees’ health insurance premiums by using an ICHRA as an alternative to providing a group health insurance plan. This change will provide a great deal of flexibility for both employers and employees, letting employers control costs while letting employees find a health insurance plan that will fit their lifestyle.

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Employer Group Health Insurance Options and the ICHRA

What Is an ICHRA?

An individual coverage health reimbursement arrangement, or ICHRA, is an employer-funded health benefit used to reimburse employees for healthcare expenses. With an ICHRA, businesses of any size can provide their employees with a monthly allowance of tax-free money that can be used to pay for approved health care services, including individual health insurance.

 

The Pros and Cons of ICHRAs

As with traditional employer-sponsored health insurance, ICHRAs have their positives and their drawbacks. If you’ll be purchasing health insurance using an ICHRA in 2020, talk to a health insurance agent for guidance.

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Pro: ICHRAs are Tax-Free

The ICHRA is a formal IRS-approved benefit, meaning that neither the business nor its employees have to pay payroll tax on the money put into it. On top of that, the employee doesn’t pay state or federal income tax on it.

 

Con: Employees Aren’t Eligible for Premium Tax Credits

Part of what makes individual health insurance affordable, even for those with low income, is the premium tax credits that participants may be eligible for. However, if you’re an employee participating in the ICHRA, you are ineligible for those tax credits. On the flipside, if you qualify for tax credits and health insurance would be unaffordable even with the HRA allowance, you have the option of opting out of the ICHRA and using your premium tax credits.

 

Pro: It Provides More Options for Employees

When your employer is determining which health insurance plan they’ll offer to employees, chances are that your personal health needs aren’t factored in. With an ICHRA, you get to select a health care plan that provides the coverage that you and your family needs, rather than being stuck with whatever plan your employer opted for on a given year.

 

Con: It Doesn’t Provide Health Insurance Benefits to Everyone

Companies that offer health coverage through ICHRAs are unable to provide benefits to uninsured employees, those who are on their spouse’s health insurance plan or those who participate in a healthcare sharing ministry plan. Only those with individual health insurance and Medicare can participate in the ICHRA.

 

Nevada Insurance Enrollment Is Here to Help

If your employer will offer an ICHRA and you’ll be purchasing individual health insurance for the first time, you have access to free help. At Nevada Insurance Enrollment, we’ll help you find the best coverage for you and your family. Our health insurance agents help you review your health needs, determine your budget and find a plan that will fit your lifestyle. Our professional assistance comes at no cost to you, making it the simplest and most cost-effective option for finding great health insurance.

You Can Still Buy Health Insurance From a Local Agent

You Can Still Buy Health Insurance From a Local Agent

The way health insurance is being marketed may give you the wrong impression that Nevada Health Link is the ONLY place to buy health insurance these days, but that is NOT the case. You can continue to buy your health insurance from the same agents and agencies you’ve always bought your health insurance from.

Is Health Insurance Worth The Cost?

Is Health Insurance Worth The Cost?

If you experience a more extensive medical emergency and require hospitalization, hospital bills may quickly become a burden. A three-day stay, for example, could set you back about $60,000 depending on what tests are ordered and what happens during your stay.

What is Co-Insurance?

What is Co-Insurance?

Co-insurance means two parties will be paying for the bill. “Co” means joint, mutual, two, or more. The health insurance company will usually pay the larger amount (example 70%) and you as the member will usually pay the lesser amount (example 30%). This would be considered co-insurance 70/30. This (co-insurance) usually happens AFTER the deductible is met.

 

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Medical Loss Ratio

This Medical Loss Ratio states that when a family or individual buys a medical plan, 80% of every dollar collected and paid to an insurance company MUST pay medical claims/research. So that leaves the insurance company to pay ALL of their expenses with the remaining 20%. .20 cents on the dollar for their employees, buildings, broker costs, etc.

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