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Individual Coverage HRA HEAT MAP

Is an individual coverage HRA a good choice in my location?

In roughly half of the country, individual health insurance rates are lower than their small group counterparts. This means benefits dollars will stretch further in those areas with an individual coverage HRA.

 

Note: If a county is green, that means it's a slam dunk for ICHRA. If it's white or light orange, it's worth having a conversation. 

 

 
*Data Courtesy of Ideon, 2024 rates based on bronze plans for 50 year olds.
 
Individual
More Expensive
Small Group
More Expensive
Small Group:
Individual:
Data courtesy of Ideon
Map graphic courtesy of MapSVG

What You Should Know About an Individual Coverage HRA 

HRAs, or health reimbursement plans, allow employees to be reimbursed tax-free by employers for healthcare fees while still retaining flexibility regarding their coverage. There are many different kinds of HRAs, and what kind you choose for your workplace will depend on a variety of factors. In this article, we will take a look at individual coverage HRAs, some of the advantages they offer, and a few general things to keep in mind when considering them for your workplace. We will also look into ICHRAs and QSEHRAs, and explain the differences to help you navigate the confusing world of health insurance.

What is an Individual Coverage HRA? 

An individual coverage health reimbursement arrangement, or individual coverage HRA (ICHRA), is an employer-sponsored health plan which reimburses employees tax-free for certain health care-relaxed expenses, usually in the form of a set dollar amount. This HRA is separate from a qualified small employer health reimbursement arrangement (or QSEHRA), which will be discussed later. 

One of the most alluring aspects of an ICHRA is that employees are free to shop for a health insurance plan or policy that works for them instead of the employer making a choice for every employee. Employees can benefit from ICHRAs because of their customizability – if an employee’s existing health insurance plan qualifies, they can retain their policy with no problem. Additionally, business owners that divide employees into certain classes can then offer different allowance amounts and health benefits based on their positions within the company. There are eleven different employee classes covered with an ICHRA. They are:

  • Full-time employees

  • Part-time employees

  • Seasonal employees

  • Hourly employees

  • Employees covered under collective bargaining agreements

  • Employees in a waiting period for their benefits

  • Employees who work abroad

  • Employees in different locations (based on rating areas)

  • Temporary employees

  • Employees who are salaried

  • A combination of two or more

A health reimbursement arrangement, otherwise known as an HRA, is a type of insurance plan that helps businesses provide health care options for employees. HRAs tend to be attractive options for employees because they allow flexibility when choosing plans. There are numerous questions people commonly ask about HRAs and health reimbursement arrangement rules, like “What happens to unused HRA funds?” There are several IRS rules for health reimbursement plans and stipulations about who qualifies, how companies can apply for tax credits, and more. Broadly speaking, the employer is the owner of the HRA. However, employees are entitled to a 90-day period after parting ways with the company, during which they are still eligible to ‘catch up on any outstanding reimbursement requests that happened while they were still covered as employees of the company.

In addition, when an employee leaves the company or is let go, they can take their HRA with them, as well as transfer it to another job. Any unused HRA money can be rolled over from year to year, so employees never have to worry about using or losing their funds.

Health reimbursement account-eligible expenses are generally things like regular doctor visits, hospital visits, lab fees, and many over-the-counter medicines and treatments. The IRS keeps an official list of all eligible expenses, which employees can reference to understand what their HRA can be used for. When in doubt, employees should always double-check to ensure all expenses they want to use the HRA for are eligible.

What is an ICHRA?

An individual coverage health reimbursement arrangement (ICHRA) is a type of group health plan which enables employers, both small and large, to provide their employees with tax-free reimbursements for expenses related to individual health insurance premiums, as well as, occasionally, other eligible medical expenses.

 

In order to better understand the attributes and capabilities of an ICHRA health plan, it can be helpful to assess the ICHRA's pros and cons.

One of the most significant pros for ICHRAs is that ICHRA funds are not required to be reported as income when employees file their taxes. One potential drawback to ICHRAs is that they are relatively new, and they can sometimes result in higher fees for employees. However, for many others, the ability to choose your own plan, as well as take it with you, is far worth any small downsides. For these reasons and others, ICHRA plans are popular among companies in the following industries: construction, food service, healthcare, hospitality, manufacturing, and landscaping, among others. 

There are HRA rules for employers and HRA rules for employees, and business owners need to have a firm understanding of the laws and regulations surrounding health insurance plans for their employees. For a complete list of rules for both employers and employees regarding health reimbursement arrangements, you can visit the Internal Revenue Service (IRS) website and access informative documents like final regulations, frequently asked questions, and other important forms. 

What is an HRA?

So we’ve addressed one type of HRA but haven’t necessarily gone into the details about what an HRA is. So what is HRA insurance? And how does an HRA work? Before deciding whether or not an HRA plan would suit your business, it’s important to understand HRA account pros and cons, as well as the primary differences between programs like HRA vs. FSA – FSAs, also known as flexible spending accounts, are another type of account that can be used to help cover qualifying healthcare expenses. 

When considering an HRA vs. HSA, it’s important to remember that the employer is fully responsible for ownership and funding of the HRA account. However, an HSA (health savings account) belongs to individual employees. While ownership is the primary difference between the two, several other important distinctions can help decide which option might be best for your organization. For example, HRAs tend to be better suited for companies that seek to retain their employees. 

HRAs can be great for companies and their employees as well because of the numerous health and tax benefits they can provide. Companies and business owners that work hard to provide their employees with access to the health care that they and their families need can generally expect to see reduced employee turnover, higher levels of employee satisfaction, and even more robust productivity levels and attendance since employees have access to health care when they need it. The advantages are far-reaching beyond tax benefits and attracting talent to your organization – providing affordable healthcare options to employees can help reduce office or workplace-borne illnesses while promoting an atmosphere and company culture that values general health and wellness initiatives. 

How Does an HRA Work?

With so many HRA account pros and cons and HRA account rules, it can be a lot to comprehend. So how does an HRA work, exactly? Firstly, the HRA is owned and funded completely by the employer, and the employer decides whether or not unused HRA funds can roll over to the next calendar year. If you’re wondering, “Can I withdraw money from my HRA account?” The answer is no; employers are responsible for the reimbursement of HRAs, and money can only be withdrawn to cover qualifying medical expenses. 

There are also several different types of HRA – some of which we have discussed in this article – and some of them are better suited to certain industries and types of businesses. Generally, when an employee gets hired at a company, they find out during the onboarding process the kind of health insurance plans the organization offers and how much money the employer has decided to provide in an HRA fund. Individuals who decide not to sign up for their company’s HRA plan may have to wait until the next open enrollment period. HRAs also requires that health care payments are made upfront, and then after filing a claim, reimbursements can be disbursed. 

Employers of all sizes can offer their employees an HRA. Still, several types of HRAs have important distinctions which make them better suited for certain businesses in certain industries or businesses that have fewer than fifty full-time employees. It can be helpful to consult an HRA comparison chart when trying to understand the primary differences between an HRA vs. HSA and other plans. 

HRA vs. HSA

With an HRA, the employer decides how much money is available to employees, and they can also decide whether or not unused HRA monies can roll over and be used the following year. HRAs are gaining more and more popularity because of their greater flexibility and various tax incentives and benefits. 

HSA-eligible plans generally have higher deductibles, but contrary to HRAs, HSAs are individually owned, meaning that an employee can decide to take their HSA with them to a new job. HSAs can cover a broad range of medical expenses, including dental and eye care and the cost of over-the-counter medications. 

QSEHRA vs. ICHRA

It’s also helpful to understand the differences between a QSEHRA vs. ICHRA. The most important distinction between these two types of HRA plans is that ICHRAs can be utilized by businesses small and large and everyone in between. QSEHRAs, however, are only able to be utilized by businesses with fifty or fewer full-time employees. When deciding which is the right fit for your organization, it helps to speak with an HRA or benefits professional and consider all available options. 

At the end of the day, employees typically prefer working for an employer that also works for them in some sense. By providing adequate and easy-to-navigate health insurance plans for employees, businesses are making calculated investments in their own company’s sustainability and longevity. When deciding what option ultimately works best for your organization, comparing different HRA plans can help you decide what is right for you. Using an HRA comparison chart can help you understand your options. In general, it’s key to remember that each plan offers certain unique benefits, as well as the fact that most differences generally lie in eligibility and contributions.

ICHRAs present a wonderful option for employees who desire flexibility with their plans and tax-free reimbursement for healthcare expenses. Whatever you choose in the confusing world of health insurance, Take Command Health can help. Our user-friendly platform puts all the information you need in one place. With our hands-on support and compliance team, we can make managing health insurance stress-free.  Talk with us today to learn more.