ACA-compliant individual health insurance coverage is health insurance that you purchase yourself and that meets Affordable Care Act (ACA) requirements. Employees generally must maintain qualifying individual health insurance coverage to participate in an Individual Coverage HRA (ICHRA).
What qualifies as individual health insurance coverage?
Individual health insurance is coverage that you purchase directly rather than receiving through an employer-sponsored group health plan.
Qualifying individual coverage may be purchased through:
The Health Insurance Marketplace
A state-based Marketplace
An insurance carrier
A licensed insurance broker
Take Command
As long as the coverage is ACA-compliant individual health insurance, it may satisfy ICHRA requirements.
Does my plan need to provide Minimum Essential Coverage (MEC)?
Yes. To participate in an ICHRA, employees must maintain qualifying health insurance coverage that satisfies applicable ICHRA requirements.
ACA-compliant individual health insurance generally provides Minimum Essential Coverage (MEC).
Does family coverage still count as individual coverage?
Yes. "Individual coverage" refers to how the policy was obtained, not how many people are covered.
For example:
An individual policy covering only you qualifies.
An individual policy covering you and your family may also qualify.
The key requirement is that the coverage was purchased as individual health insurance and is not an employer-sponsored group health plan.
What types of coverage generally do not qualify?
Examples of coverage that generally do not satisfy ICHRA requirements include:
Employer-sponsored group health plans
Short-term health insurance
Fixed indemnity plans
Other non-compliant coverage types
Eligibility may vary based on individual circumstances.
How can I identify an ACA-compliant individual plan?
Many ACA-compliant plans include metal tier designations such as:
Bronze
Silver
Gold
Platinum
However, plan names alone should not be used to determine eligibility.
Review your plan documents or coverage information to confirm the plan is ACA-compliant individual health insurance.
What if my plan has a group number?
A group number does not automatically mean the coverage is an employer-sponsored group plan.
Some individual insurance policies use group numbers for administrative purposes.
Eligibility is determined by the type of coverage, not whether a group number appears on the policy.
How can I confirm that my plan qualifies?
Review your plan documentation to verify:
The coverage is individual health insurance
The plan is ACA-compliant
The coverage is active
The plan satisfies ICHRA requirements
If you are unsure whether your coverage qualifies, contact Take Command for assistance.
Key takeaway
To participate in an ICHRA, you generally must maintain ACA-compliant individual health insurance coverage. Coverage purchased through the Marketplace, a carrier, a broker, or Take Command may qualify if it meets applicable ACA and ICHRA requirements.