What kind of health insurance plan qualifies me for ICHRA Reimbursements?

In order to participate in your company's Individual Coverage HRA, you need to be enrolled in an individual health insurance plan that meets the minimum requirements as outlined in Public Health Services (PHS) Act Section 2711 and Section 2713. These two provisions require no annual or lifetime limits on the dollar amount for coverage of essential health benefits and full coverage of preventative health services to be covered with no shared cost to the insured.

In other words, your plan needs to meet Minimum Essential Coverage through an individual marketplace plan.

More specifically, your plan must either be:

  • An individual or family plan on or off the exchange (healthcare.gov or your state exchange)

  • Medicare

Plans that do not qualify as individual coverage include your spouse's employer group plan, Medicaid, TRICARE, COBRA, short-term plans, indemnity plans, sharing plans, and preventative-only MEC plans.

When can I purchase a plan?

In general, you can purchase insurance on the health insurance marketplace during Open Enrollment, which, in most states, runs from November 1-December 15.

Outside of Open Enrollment, you must have a qualifying life event to trigger a Special Enrollment Period. There are several life changes that can qualify you for a Special Enrollment Period, including becoming newly eligible for an ICHRA!

 If your ICHRA starts on a date other than January 1, or if you are a new hire being offered the ICHRA mid-year, you have 60 days from the day your HRA starts (or the date you become eligible to participate) purchase a plan.

You will need to show proof to the Exchange (either healthcare.gov or your state exchange) that you became eligible for ICHRA within the last 60 days, and we will provide a letter that you can use!

Premium Tax Credits

It's very important to remember that you cannot accept a premium tax credit if you are claiming reimbursement through ICHRA. Here is a little more about how ICHRA affects your tax credit.

I need help finding a plan!

Take Command Health is here to help! We can help you navigate your options. Reach out to our support team via chat or at support@takecommandhealth.com, let us know what state you're in, and we can help point you in the right direction!

Take a look at our blog post for more information: How to shop for an ICHRA compliant plan

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