What can I provide to prove my plan is qualified for ICHRA?
Here is a little more information about what to provide as proof of coverage based on your insurance plan type - scroll down to find yours!
Individual Insurance Plan (Gold/Silver/Bronze major medical plan):
A monthly bill from your insurance provider, a screenshot of the confirmation page from your enrollment, an e-mail confirmation of your enrollment, your healthcare.gov (or state exchange) confirmation page, or even a screenshot from your health insurance online portal will usually do the trick for Proof of Coverage. If you are claiming the premium for reimbursement, then we would also need to see how much you pay monthly towards that premium.
Ultimately, we’re looking for a document (or a combination of documents) that shows ALL of the following:
Your name - (the name of the HRA-eligible person- If you are not the primary insured then we will need to see that you are a covered dependent.)
The premium amount - (if you are claiming it for reimbursement)
Proof of not accepting Premium Tax Credits - normally is listed on monthly statement.
A current date - (a document dated within the last 30 days is considered current for compliance purposes.) For Open Enrollment we need to see their January 2023 premium statement.
The name of the plan + provider- (ie: Gold/Silver/Bronze 1234 with Insurance Companies Logo)
While it is our preference to have all of the above information in one document, we realize that is not always possible. Multiple documents are acceptable as long as the combination of documents provide all of the above information we are asking for.
**Important note: You cannot accept a tax credit while participating in an ICHRA. Make sure you know how ICHRA affects your tax credit.
Medicare:
Your red, white, & blue medicare ID card will show us you're enrolled! With this alone, we can approve the base rate for Medicare Part B for the current year. If you pay for Part A (this is rare) or IRMAA for Part A or B, then we will need to see that to approve those additional amounts. (Don't worry, if you have to pay IRMAA fees then you already know it!)
In order to claim reimbursement for your Medicare premiums, you can provide monthly invoices, your SS benefits statement, annual Medicare letter, or proof of your Medicare premium payments.
While Medicare Part B rates only change at year-end, many Supplemental Medicare plans (Part G, N, etc) start during the middle of the year and run for 12 months. For Example: If you had Medicare Part G and it ran from 06/01/2022 to 05/30/2023 and you were submitting it for 2023 reimbursement, we could approve through may, but for reimbursement to continue, we would need to see the June renewal,
While you can combine all of your Medicare premiums into one reimbursement request, if you have any premiums that end on different dates (like the example above), then they would need to be separate submissions.
Compliance Checks
We will ask for an updated proof of coverage for each compliance period. Check the compliance tab in your Member Portal to see when your next compliance check is!
If you were looking for info on what to provide for QSEHRA, click here.