When you are enrolling in your company's ICHRA to receive tax-free reimbursement, we will ask you to provide proof of your health insurance coverage. You are eligible to claim reimbursements through ICHRA in any month when you have a qualified health insurance plan. When we ask for proof of coverage, we're looking to verify that your health insurance is either (1) a major medical metal tiered plan purchased on or off the Exchange, or (2) Medicare parts A+B or C, and that it is currently in effect (3) Catastrophic Coverage (limited to qualified individuals) or (4) Student health insurance.
Here is what to provide:
- If you are on Medicare: Please provide your Medicare ID card, a Medicare Statement, or Social Security statement showing your Medicare payment withheld from your benefits. We must see that you are enrolled in either Part A and B (together) or Part C.
- If you are on a major medical plan or catastrophic coverage purchased on or off the Exchange: Please provide a monthly statement from your insurance company dated within 30 days. A bill or enrollment paperwork is best- we are looking for name of insured, name of health plan, and ensuring that tax credits were not accepted. If you cannot find your bill or enrollment paperwork, a screen shot from your healthcare.gov account or insurance member portal may work, for example.
- If you are on student health insurance: Please submit a tuition bill or enrollment paperwork that includes name of insured, plan name, and plan cost.
Reminder: If you purchased a major medical plan, you CANNOT receive tax credits from the government and claim reimbursement through ICHRA.
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.
If the statement you provide shows a tax credit, our compliance team will reach out to remind you, and ask you to remove the tax credit with the Exchange, then submit a new document showing it's been removed.
We will ask for an updated proof of coverage each compliance period. Check the compliance tab in your Member Portal to see when your next compliance check is!
If you're looking for info on what to provide for a QSEHRA, click here.