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An individual coverage health reimbursement arrangement (ICHRA) is a new type of health reimbursement arrangement in which employers of any size can reimburse employees for some or all of the premiums that the employees pay for health insurance that they purchase on their own. ICHRAs were created under regulations issued by the Trump administration in 2019, and became available as of 2020.
ICHRAs represent a departure from previous ACA implementation rules that forbid employers from reimbursing employees for individual market premiums. QSEHRAs, which became available in 2017, allow small employers to reimburse employees for individual market premiums. ICHRAs allow this for employers of any size, and they offer more flexibility in terms of how much an employer is allowed to reimburse an employee.
As of 2022, HealthSherpa estimated that there were between 100,000 and 200,000 people with ICHRA benefits (HealthSherpa is an enhanced direct enrollment entity that processes half of all HealthCare.gov’s broker-assisted enrollments, so they have a meaningful amount of data on this topic). And HRA Council reported 64% growth from 2022 to 2023 in the number of employer offering ICHRA benefits.2
Sweeping health reform legislation delivered a long list of provisions focused on health insurance affordability, consumer protections.