Major carriers lean into ICHRA

Major insurance carriers are leaning into ICHRA.

Centene Corporation named their first ICHRA President in Alan Silver https://lnkd.in/e9JRKQFW

Oscar Health Insurance’s CEO Mark Bertolini has famously called for the end of the employer group model.

They didn’t ask, but here’s my advice to make ICHRA go from a consideration when there isn’t a good group rate to a primary solution for employers:

1. Add Out of state coverage.

This is number 1 because it’s the lynchpin that will open up the ICHRA market. Without out of state coverage, individual plans are comparatively deficient for:
- Employees who live in one state and work in another (think of all the commuters in and out of NYC).
- Employees with kids at out-of-state schools
- Decision makers at employers (think owners, CFOs) who snowbird between residences.

Until individual plans mirror the out-of-state availability that group plans have, ICHRA will never be a viable option for these folks. Very frankly, if the owner of a company goes back and forth between NY and FL and can’t see a doctor in one of those states, the group will not move to ICHRA.

2. Invest in a Group Service Model.

Several carriers have made investments in ICHRA vendors/platforms. My suggestion: invest in a group service model for ICHRA-adopters. While some employers may want to wash their hands of running a health plan, many more will want to be able to assist employees with enrollment and claims issues. Figure out a way to work with those employers and remove another hurdle to ICHRA adoption.

3. Streamline Employer Compliance and Reporting Obligations

Employers are reluctant to adopt ICHRA due to perceived complexity around compliance with ACA affordability, reporting, and nondiscrimination rules. Simplifying this process could drive adoption:
• Develop automated compliance tools that integrate with payroll systems to ensure affordability thresholds are met for all employees.
• Offer streamlined reporting solutions for employers, particularly for IRS Forms 1094/1095, to reduce the administrative burden of proving compliance.

If carriers want ICHRA to be a destination and not just a last resort, they need to think about the challenges individuals and employers will face in implementing and using their plans.

What did I miss?