Individual Coverage HRA

The Future of Employee Benefits

Reimagine group health. Employers control the budget. Employees choose the plan. Genihealth handles the compliance.

How an ICHRA Works

A tax-advantaged alternative to traditional "one-size-fits-all" group plans.

1

Employer Defines Budget

You decide how much tax-free money to contribute each month. Rates can vary by employee class (e.g., Full-time vs. Part-time).

2

Employee Chooses Plan

Employees shop the individual market for a plan that fits their specific doctors, drugs, and family needs.

3

Automated Reimbursement

Genihealth verifies the coverage and reimburses the employee for premiums and medical expenses automatically.

Traditional Group vs. ICHRA

Feature Traditional Group Plan Genihealth ICHRA
Cost Control Subject to unpredictable annual hikes ✔ Fixed Budget defined by you
Employee Choice Limited to 1-2 generic options ✔ Unlimited market options
Portability Plan ends when job ends ✔ Employee keeps their plan
Tax Advantages Tax-deductible for employer ✔ Tax-deductible & Reimbursements tax-free

Compliance & Requirements

ICHRA plans are powerful, but require strict adherence to IRS and ACA regulations. Genihealth manages this complexity for you.

Permitted Employee Classes

Employers can structure contributions differently for specific groups. Common classes include:

  • Full-time vs. Part-time employees
  • Salaried vs. Hourly workers
  • Employees in different geographic rating areas
  • Seasonal or Temporary workers

Affordability & Safe Harbors

To avoid penalties for "Applicable Large Employers" (ALEs), the ICHRA must be deemed "affordable" under IRS standards.

  • Location Safe Harbor: Calculations based on employee's primary work site.
  • Look-Back Method: Using prior year's Silver Plan data to set stable budgets.
  • Genihealth algorithms calculate this automatically to ensure compliance.

Plan Integration Rules

An ICHRA must be integrated with individual health insurance coverage to be valid.

  • Participants must be enrolled in an ACA-compliant individual plan.
  • Medicare (Parts A/B or C) is considered eligible coverage.
  • TRICARE is not eligible for integration.

Employer Responsibilities

While Genihealth handles the heavy lifting, employers must:

  • Provide a 90-day written notice before the plan year starts.
  • Ensure specific class sizes are met (e.g., 10+ employees for smaller firms).
  • Verify coverage annually and before each reimbursement.

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