ICHRAs and Special Enrollment Periods
Do you have a group that could benefit from re-evaluating their current health benefit plan? Maybe they signed up for (or renewed) a traditional group plan that is too expensive. Or they have decided to offer health benefits outside of Open Enrollment. It could be they are looking to offer seasonal help benefits in an effort to attract more qualified applicants.
Special Enrollment Resources:
It’s OK. They still have options.
Did you know that one advantage to an ICHRA is that they can be started at any time in the year? Your group can change to an ICHRA and you, along with Nexben, can help. When you set up their new ICHRA, a Special Enrollment Period is triggered, meaning they get a new enrollment period. So, you can stop the group plan and start an ICHRA. This is especially helpful if they are early in their group plan year before employees have spent a lot toward their deductibles, or you have seasonal employees starting.
The Special Enrollment Period allows your client to change from their current plan to an ICHRA at any time.
Are your clients experiencing high rate increases year after year? An ICHRA may be just the solution they need.
Changes Made Easy
Nexben’s platform makes it easy for you and your client to set up an ICHRA that works for them.
Steps to Get the Ball Rolling
Work with your client on these steps to begin the process of starting an ICHRA
Contact Nexben with any questions
- If you have any questions at all, contact us at
email@example.com or 1-855-4-NEXBEN
- Get a quote if you need one
Pick a Date
- Pick a date to start the ICHRA
- Use the first of the month
- The start date should be the day after the existing group health insurance plan ends, if applicable
Design the ICHRA
- Determine which employees will be offered the ICHRA
- Examples: Full-time employees, part-time employees, seasonal, etc
Set a Budget
- Determine the group’s budget for the ICHRA
- Find a contribution strategy that works for them, if you need it, Nexben can help
Finalize with the Employers
- Fill out and sign the ICHRA Employer Application
- Complete the Nexben Employee Census
- Communicate to employees, including sending out the ICHRA notice
- Don’t forget to notify the current carrier that the group is ending their coverage
How an ICHRA Works
An ICHRA is an employer-funded, tax-advantaged health benefit used to reimburse employees for individual health insurance premiums and other qualified medical expenses.
- Made for Employees
With a Nexben ICHRA, an employer defines a specific monthly reimbursement amount based on employee classes. The employee then chooses their individual health insurance coverage and pays for it using the employer contribution; any remaining premium balance due may be taken care of via employee payroll deduction, much like traditional group, on a pre-tax basis.
- Budgets Made Easy
Because the employer specifies a dollar amount per employee, ICHRAs make budgeting easy. There is a pre-determined upper limit that the company may pay for health insurance benefits each year. The employer has more control of their health benefit expenditures.
- Flexibility in Mind
ICHRAs also give employees flexibility in selecting their health insurance. Employees can pick a plan offered in their plan rating area that fits their budget and lifestyle—limiting the cost to the employer contributes or kicking in some of their own pre-tax dollars (if necessary) to cover the premium costs. If an employee leaves the company, the insurance coverage is portable.
How can an ICHRA control costs?
Traditional group health plans can have significant rate increases year over year. Carriers look at past claims for a company and determine the cost to cover them. If those claims were too high, they will likely raise the rates the next year.
Individual health insurance is guaranteed issue, meaning that eligibility is no longer based on medical history and applicants no longer face higher premiums or rejected applications due to a pre-existing condition. Individuals now have more options to choose from; selecting coverage that better fits their needs.
So, companies that have seen large rate increases due to past claims, may be able to save money with an ICHRA. Many times, in this situation, both the company and its employees save money with an ICHRA over the traditional group plan.
Let’s Get the Gears in Motion
Have a group or a few that can improve their bottom line by re-examining their health benefits? Fill out the form below and we’ll get moving.
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