Through your company’s ICHRA, your employer will reimburse you for your monthly insurance premiums. You must be covered by a qualifying health insurance plan in order to receive ICHRA reimbursements. As long as you are covered by a qualifying health insurance plan, you are eligible to receive reimbursements through the ICHRA for certain types of insurance premiums. Below is an outline of which plans are and are not eligible for reimbursement through the ICHRA.

Eligible Premiums

Major Medical Plans

Major medical plans are those compliant with the Affordable Care Act (ACA) that qualify as Minimum Essential Coverage. If you purchased your plan through Healthcare.gov or your state’s public marketplace, your plan is a major medical plan, and your reimbursement through ICHRA will be tax-free. All Bronze, Silver, Gold, and Platinum plans qualify.

Catastrophic Coverage

Catastrophic health plans have low monthly premiums and very high deductibles. They may be an affordable way to protect yourself from worst-case scenarios, like getting seriously sick or injured, but you pay for most routine medical expenses yourself. Catastrophic plans are only available to those under age 30 or individuals who qualify for a hardship exemption or affordability exemption. If you are eligible to buy a catastrophic plan, you will see them displayed when you compare plans on the marketplace. Please note that catastrophic health coverage is different from accident, critical illness, or short-term plans, which are not qualified health insurance plans for ICHRA reimbursement.

Medicare

In order to qualify for participation in the ICHRA, you must have Medicare Parts A and B or Medicare Part C. As long as you have either Part A+B (together) or Part C, then you can also claim reimbursement for all Medicare plans and supplements tax-free through ICHRA.

Student Health Insurance

If your school offers a student health plan it can be an easy and affordable way to get basic insurance coverage. In most cases it will count as qualifying health coverage. You may be required to provide an explanation of benefits covered under the plan. Self-funded student insurance plans are not eligible for ICHRA.

Dental Insurance & Vision Insurance Plans

 Individual vision and dental insurance plans can be reimbursed tax-free through ICHRA, as well as long as you are also enrolled in one of the qualified plans above.

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