What is an ICHRA provider?

An ICHRA provider helps employers set up and manage a CHOICE Arrangement, previously called an individual coverage health reimbursement arrangement. Depending on the provider, services may include plan design, compliance support, employee enrollment, reimbursement administration, and ongoing benefits support.

What’s the difference between Remodel Health and PeopleKeep?

Remodel Health is the largest ICHRA/CHOICE Arrangement partner by revenue and team size. It offers end-to-end ICHRA administration. Remodel Health is a great option for employers seeking a full-service ICHRA partner for hands-on benefits strategy, implementation, employee support, and ongoing administration. PeopleKeep is a product line of Remodel Health primarily for small businesses looking for straightforward, software-driven HRA administration.

How much does an ICHRA administrator cost?

ICHRA administration costs vary by provider and typically depend on factors such as the number of employees, services included, and level of support. When comparing providers, look beyond the upfront price and consider what’s included in the overall cost.

Why did CMS and the SBA rename ICHRA to the CHOICE Arrangement?

CMS and the SBA didn’t provide an official reason for the change during the announcement. However, many in the industry have long asked for a change due to how the ICHRA acronym is pronounced (it sounds like “ick”). The long, jargon-filled name didn’t clearly explain the value the benefit brings to employers and employees. CHOICE Arrangement does.

Does this change anything about my current ICHRA plan, budget, or strategy?

No. The renaming of ICHRA to the CHOICE Arrangement doesn’t impact current ICHRA benefits or the underlying regulatory framework. We’ll be communicating with customers and their employees about the name change for the sake of clarity, but there are no changes needed at this time.

As an employer offering an ICHRA, do I need to do anything right now?

No, there’s nothing that you need to do right now. PeopleKeep by Remodel Health will be sending out communications to customers about the name change, but CMS and the SBA haven’t made any changes to how the benefit functions.

Does this affect QSEHRA?

No, the rebrand of ICHRA to the CHOICE Arrangement doesn’t impact the qualified small employer HRA (QSEHRA). Congress created the QSEHRA, whereas federal regulations created ICHRA. The CMS and SBA announcement only impacts ICHRA.

Should a small business choose the CHOICE Arrangement or QSEHRA?

Both the CHOICE Arrangement and the QSEHRA are excellent fits for small businesses. The best option for your organization comes down to your business needs and employee demographics. A QSEHRA is a simple way to offer health benefits for those with fewer than 50 FTEs, but it lacks the customization options the CHOICE Arrangements provides, such as employee classes. You can learn more about the difference in our ICHRA vs. QSEHRA page.

Can an employee use a Section 125 plan and an ICHRA together?

Yes, but only if the employee purchases an individual health insurance policy on an off-exchange marketplace.

Can a Section 125 plan pay for individual health insurance premiums?

Yes. A Section 125 premium-only plan can pay for individual premiums under specific conditions. When paired with an ICHRA, only pre-tax payroll deductions can go toward premiums for eligible off-exchange individual health insurance plans. Employees who enroll in an on-exchange plan through a public exchange, like the federal Health Insurance Marketplace or a state exchange, can't use a Section 125 cafeteria plan to pay for the portion of their premium that their ICHRA allowance doesn't cover.

Why don’t on-exchange health plans work with a Section 125 plan?

Because public exchanges already offer premium tax credits and other cost-sharing subsidies, federal law prohibits employees from using pre-tax salary reductions under a Section 125 cafeteria plan to pay on-exchange health insurance premiums. This prevents "double-dipping" tax advantages.

Can an ICHRA reimburse an employee’s entire health insurance premium payment?

This depends on the cost of the plan and the employer’s ICHRA allowance. Employers choose a set monthly allowance amount. If an employee's premium exceeds that allowance, they must pay the remaining balance unless they have access to another eligible payment method. If the plan’s cost is less than their allowance, then the ICHRA is essentially reimbursing the employee’s entire premium cost.

Can employers offer different ICHRA allowance amounts to different employees?

Yes. Employers can vary reimbursement amounts using eligible employee classes — such as full-time vs. part-time workers and salaried vs. hourly employees — as long as they adhere to federal ICHRA regulations and nondiscrimination rules. Within each class, they can also vary contributions by employee age and family size.

Does PeopleKeep administer Section 125 plans with an ICHRA?

No. PeopleKeep uses a reimbursement-based ICHRA model and therefore doesn't offer Section 125 premium-only payroll deductions. However, organizations that need this capability can do so with our parent company, Remodel Health. Contact Remodel Health or us to learn more about how our ICHRA administration solutions compare.

Can you use a Section 125 premium-only plan (POP) with individual health insurance?

Generally, no. POPs are designed for employer-sponsored group health insurance premiums. However, employers can offer a POP alongside an ICHRA for employees who enroll in off-exchange individual health insurance plans.

What's the difference between a Section 125 plan and an HRA?

A Section 125 plan lets employees pay for qualified benefits with pre-tax salary reductions. An HRA is funded by the employer and provides tax-free employer contributions for eligible medical expenses and, in some cases, health insurance premiums.

Who should consider a Section 125 premium-only plan?

A POP is a good fit for employers that already offer group insurance and want employees to pay their share of premiums with pre-tax dollars. It’s also a great option for employers offering an ICHRA as long as employees enroll in off-exchange plans.