I have to have Individual Health Insurance to qualify for ICHRA, what does that mean?
You'll see us reference "Individual Health Insurance" or "Major Medical Individual Coverage" a lot- but what does this mean? What type of insurance do I need to have to qualify for ICHRA reimbursement?
When we reference these types of plans, we're talking about the plans you would find on Healthcare.gov. These plans must meet certain standards established by the Affordable Care Act and are also subject to certain regulations. Also, these plans legally must be the same price, regardless of where they are purchased (Healthcare.gov, state exchange, broker, Take Command Health, the insurance company itself, etc.). They are also ICHRA-compliant, regardless of where you purchased it. Additionally, these plans must provide Minimum Essential Coverage (MEC) to qualify for ICHRA reimbursement. MEC ensures that the plan covers essential health benefits and meets the baseline requirements for health insurance.
But what if my plan covers my entire family, not just me? Does it still count as Individual Coverage?
Yes! The word "Individual" simply means that the coverage was purchased by you individually, and was not provided through an employer/association, or the government (like Medicaid). Furthermore, having a group number on your individual health insurance plan does not disqualify it from ICHRA eligibility. Group numbers are often used by insurers for administrative purposes and do not indicate that the plan is part of an employer-sponsored group plan.
Any plan purchased using our shopping tool will be an individual major medical plan, so you can rest assured that you'll qualify for ICHRA reimbursement if you purchase a plan using our platform!
Another good indicator that your plan is major medical is the name- these plans will typically include a metallic tier (bronze, silver, gold, etc.). You can read more about those here! Another important factor to check is whether the plan meets Minimum Essential Coverage (MEC) requirements, as this is necessary for ICHRA reimbursement.
Please click this link to view our Window-Shopping Tool. All you will need to do is enter the age of yourself as well as any dependents, Zip code and Smoking Status. Once all the information is entered correctly you will be able to see estimated cost of your health plans as well as the carriers associated with your Zip Code
Still not sure if your plan qualifies. Reach out to us! We'll be happy to confirm for you. To verify your plan's eligibility, you can confirm that it is ACA-compliant and provides MEC, review the plan details to ensure it is not an employer-sponsored group plan, and provide documentation such as a billing statement to verify the premium amount and confirm that no tax credits are being received.