Employees manage their ICHRA health insurance by maintaining an eligible individual (or Medicare) plan, keeping proof of coverage up to date, and updating their status in HRA Hub whenever their coverage, employment, or household situation changes.
Core requirement for all employees in an ICHRA
You must have qualifying coverage to stay eligible.
To participate in an ICHRA, you must have:
An ACA-compliant individual health insurance plan, OR
Medicare (Part A and B or Medicare Advantage)
You must also:
Submit proof of coverage
Keep coverage active and current
Update changes immediately in HRA Hub
If you do not maintain qualifying coverage:
❌ You become ineligible for reimbursements
❌ Claims may be paused or denied
Common scenarios and what employees should do
Scenario 1: You enroll in a new individual health insurance plan
If you switch or start a new plan:
Enroll in an ACA-compliant individual health plan
Update your plan details in HRA Hub
Upload new proof of coverage showing:
Your name
Carrier and plan
Active coverage dates
Set up or update recurring premium reimbursement (if applicable)
Your reimbursement eligibility resumes once coverage is verified.
Scenario 2: You move to a spouse’s employer plan
If you switch to a spouse’s group health plan:
Confirm you are listed as a covered dependent
Submit proof of coverage showing your name on the plan
Update your status in HRA Hub
If required, submit a waiver for individual coverage
⚠️ Important: Some spouse plans require you to be explicitly listed as covered to remain eligible.
Scenario 3: You no longer have qualifying coverage
If you lose coverage:
Notify your status change in HRA Hub
Stop submitting reimbursement requests
Enroll in a new qualifying plan as soon as possible
Without qualifying coverage:
Reimbursements are paused
Eligibility is suspended until coverage resumes
Scenario 4: You are switching insurance plans mid-year
If changing plans:
Cancel or end your old plan with the carrier
Enroll in a new individual plan
Upload proof of new coverage
Remove or update recurring premium requests tied to the old plan
Do not overlap recurring reimbursements for multiple plans.
Scenario 5: You are on Medicare
If you have Medicare:
Ensure Medicare Part A and B (or Advantage plan) is active
Upload Medicare documentation in HRA Hub
Submit proof of coverage regularly if required
Medicare qualifies as eligible coverage under ICHRA.
Scenario 6: You choose to waive ICHRA coverage
If you do not want to participate:
Go to your HRA Hub onboarding or settings
Select “Waive Coverage” option
Confirm waiver submission
While waived:
You cannot receive reimbursements
You can re-enroll if eligible coverage is obtained later
Scenario 7: Employment ends
If your employment ends:
Your eligibility stops at the end of your employment period
You may still submit eligible expenses incurred before termination
You may have limited post-termination portal access for documentation
After termination:
No new reimbursements are allowed
Scenario 8: Your proof of coverage is under review or rejected
If your proof is not approved:
Review the rejection reason in HRA Hub
Upload corrected documentation showing:
Active coverage
Your name
Eligible plan type (individual or Medicare)
Resubmit for review
Reimbursements remain paused until approval.