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ICHRAs and SEPs: An Introduction

One of the advantages of an Individual Coverage Health Reimbursement Arrangement (also called Individual Coverage HRA or ICHRA) is that health coverage can start at any time of the year. A group looking to begin these benefits does not have to wait for an Open Enrollment Period, an ICHRA can start at any time in the year.

Why is that? When an ICHRA is offered to a group that currently has traditional benefits (or no insurance at all) it triggers a Special Enrollment Period (SEP). An SEP is a period, outside of the Open Enrollment Period (OEP), where a person or group can enroll in health insurance. SEPs are defined so that people in special circumstances can sign up for insurance.

For more information on SEPs, check out:
https://www.healthcare.gov/coverage-outside-open-enrollment/special-enrollment-period/

Those circumstances that trigger an SEP are called Qualifying Life Events (QLEs). QLEs are defined as situations that happen in life where a person needs to change their health insurance coverage. Examples would be having a baby, getting married, or moving to a new area. Great news, another QLE is being offered an ICHRA.

Some good information on QLEs can be found here:
https://www.healthcare.gov/glossary/qualifying-life-event/

The bottom line to remember is that health benefits can be offered at any time using an ICHRA.

There are many reasons a group may want to begin offering health insurance benefits outside of a standard Open Enrollment Period, like:

  • They may not offer health benefits to their employees but have decided that now is the time.
  • Or they signed up for a traditional group plan only to find that the rates have skyrocketed.
  • Or maybe they are looking to offer benefits to part-time or seasonal employees in order to attract better applicants to their company.

Whatever their reason, groups can start an ICHRA at any time.

If you are looking for more information on starting an ICHRA during an SEP, go to https://www.nexben.com/changing-to-an-ichra/. That page has more information and additional resources for you.

You can also call us at 1-855-4-NEXBEN or email us at support@nexben.com to talk with someone about getting started. You can also send us a note at https://www.nexben.com/schedule-a-demo/.