Question 1

What is ICHRA?

Accepted Answer

ICHRA (Individual Coverage Health Reimbursement Arrangement) is a health benefit that allows employers of any size to reimburse employees tax-free for individual health insurance premiums and medical expenses. It was introduced in January 2020 and is growing rapidly as an alternative to traditional group health insurance.

Question 2

Can I keep Agent of Record (AOR) with ICHRA?

Accepted Answer

It depends on the vendor. Some ICHRA platforms let brokers retain AOR on individual policies, while others require the platform to serve as AOR. Some offer a choice between models.

Question 3

How much does ICHRA cost employers?

Accepted Answer

ICHRA platform fees range from $3 to $85+ per employee per month (PEPM). Some platforms like Pro-Tier are free to employers (funded by carrier partnerships). Reach out to vendors to understand pricing.

Question 4

How do brokers get paid with ICHRA?

Accepted Answer

Broker compensation models vary widely across ICHRA vendors. Common structures include: standard carrier commissions (broker keeps existing commission), PEPM set by the broker (typically $20-40/month), commission splits, and guaranteed PEPM packages.

Question 5

What employer sizes work best with ICHRA?

Accepted Answer

ICHRA works for any employer size. Micro employers (1-10) are well served by StretchDollar, PeopleKeep, Leeway, and Thatch. Small employers (11-49) by most platforms. ALE/mid-market (50-249) by Remodel Health, Gravie, and Thatch. Large/jumbo employers (250+) by SureCo (200+ only), Remodel Health, and Bavvy/Milliman.

Question 6

Do any ICHRA vendors integrate with Direct Primary Care (DPC)?

Accepted Answer

Vitable Health is the only vendor with verified native DPC integration, every plan is paired with a $0 DPC membership. Ameriflex offers DPC-related content and webinars. Most other vendors do not publicly advertise DPC integration.

Question 7

What is the CHOICE Arrangement Act?

Accepted Answer

The CHOICE Arrangement Act passed the U.S. House of Representatives 216-211 on December 17, 2025, and is heading to the Senate. It would codify ICHRA into federal law, providing greater regulatory certainty for employers and vendors. This is seen as a major milestone for ICHRA adoption.

Question 8

How fast is ICHRA growing?

Accepted Answer

ICHRA adoption has increased over 1,000% since 2020. Enrollment tripled between 2024 and 2025, with 400,000-800,000 Americans now using ICHRAs. Major carriers like Centene/Ambetter, Wellpoint, and Anthem are building ICHRA-specific plans.

Bavvy (by Milliman)

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