10 Rules for ICHRA (Individual Coverage HRA Rules)

Looking for ICHRA rules? The tax-advantaged benefits of the Individual Coverage HRA (ICHRA) have been available since January 1, 2020. Our team sees this HRA option as a game changer for companies that traditionally offer group plans to their employees. It gives employers flexibility to scale benefits, control costs, and make the design work for their unique staffing situation. Here’s what to know about ICHRA rules. 

What is an Individual Coverage HRA?

Before we dive in, let’s all take a moment to go over what an ICHRA actually is. An Individual Coverage HRA is a tax-advantaged solution that allows a company of any size to reimburse employees for individual health plan premiums and qualified medical expenses.

It works like this: the employer designs their HRA and determines the amount to reimburse on a monthly basis to different classes of employees, say $200 a month for a their part-time team, $400 a month for remote employees, and a traditional group plan for the full-time team.  Employees would then submit proof of an expense for reimbursement and get paid back.

This transaction is tax-free, meaning that employers don’t get dinged for payroll tax on the amount and the employees don’t have to recognize the reimbursements as income.

The biggest benefit of all is that with ICHRA plan, employers can scale their benefits based on employee classes and employees can choose the best plan that works for them.

A quick recap of all the ICHRA benefits:

Tax-free
Streamlined and simple from an administrative standpoint
Optimized for benefits savings and budget control
Scalable for growing companies 
Portable benefits for employees
Personalized and flexible to fit a diverse workforce 

This is the opposite of one-size-fits-all. And it’s positioned to completely rewrite the way companies offer health benefits to their staff.

Where are the ICHRA rules coming from? 

The final rules for the Individual Coverage HRA were announced June 13, 2019 from the U.S. Departments of Treasury, Health and Human Services, and Labor. The rules expand upon the executive order from President Trump last fall which instructed the U.S. Departments of the Treasury, Health and Human Services, and Labor to expand the usability of HRAs. This was the third step the President has used to reform healthcare policy through regulatory changes. ICHRA rules can change so it’s always important to have a well-informed ICHRA administrator on your side (like us!). 

Recent HRA research has shown that sine its inception, ICHRA has seen triple digit growth, according to the HRA Council.

See if your location is prime to save with ICHRA with our HRA Heatmap!

ICHRA Rules

Here’s the complete list of ICHRA rules.

Any size of company is eligible to offer an ICHRA.
Employees must maintain Minimum Essential Coverage (MEC), aka coverage that meets PHS 2711 & 2713 with a qualified health plan. 
Employees in different classes (think geographic location, seasonal, part-time, abroad) can be offered different levels of benefits. (We think THIS IS HUGE in terms of giving more flexibility and affordability to employers). 
There are no maximum or minimum limits for monthly reimbursement rates. 
Employers can choose to offer an ICHRA any time throughout the year (not just during open enrollment!). Switching from a group plan to an ICHRA is super easy. 
Employees have a 60 day window to enroll in an individual health plan once the ICHRA becomes available, as it triggers a special enrollment period). This makes finding an individual plan that meets MEC outside of open enrollment much easier for employees.
ICHRAs can meet the employer mandate for employers with greater than 50 full-time Applicable Large Employers (ALEs) if the offer is “affordable” and meets minimum value (MV)
An ICHRA can be offered with a traditional group plan as long as both options aren’t being offered to the same class of employees. Note: this does not preclude group dental and vision like QSEHRA.) 
If ICHRA is deemed “unaffordable,” employees can choose between using Premium Tax Credits or the ICHRA. If it is deemed affordable, they cannot opt out and receive a premium tax credit. (Confused? We built an Affordability Calculator to help. 
ICHRA can be used to reimburse for premiums and qualified medical expenses, including excepted benefits like dental, vision.

→ Learn more about how ICHRA affects premium tax credits. 

→ Learn more about ICHRA eligibility rules.

→ Check out our ICHRA plan document template!

About Take Command

Take Command is a recognized leader in HRA administration and small business HRA tax strategy. We were at the forefront of the new ICHRA administration regulations and  responded with our own comprehensive and exclusive research to the proposed regulations. We are also a founding member of the HRA Council. 

We were the only HRA provider invited to Washington when the new regulations were passed and are the only HRA administrator to offer personalized, hands-on enrollment support for employees.

Our team is passionate about HRAs and the impact they can have on a business. 

Chat with our team of HRA administrators with any questions you may have about these new, tax-friendly benefits or check out our ICHRA Guide for more information on its background, setup process, requirements, and rules. 

Additional resources →

This was post was originally published in 2019 and has been updated in 2023 to reflect the latest policy and regulatory updates.