Health insurance consumer news: Trump rule gives small businesses a new tool to help workers buy medical cove…
6 min read
fairly difficult
How it works is complicated. And big employers haven't rushed to embrace the new individual coverage health reimbursement arrangement — sometimes called ICHRA.
Until October, Andrea LaRew was paying $950 a month for health insurance through her job at the Northwest Douglas County Chamber & Economic Development Corp. near Denver.

Her company didn't contribute anything toward the premium. And LaRew and her husband had a steep $13,000 deductible for the plan.

But the coverage and the premium cost were in line with other plans available to the company since options for such a small work group weren't plentiful — only LaRew and another employee wanted to enroll.

Now, they're trying a new approach. Instead of a traditional plan, the chamber established what's called an individual coverage health reimbursement arrangement — sometimes referred to as ICHRA — to which it allocates $100 a month per employee that they must put toward buying comprehensive coverage on the individual insurance market. These employer contributions can be used to pay for expenses such as premiums or cost-sharing.

The reimbursements don't count as taxable income to workers.

Proponents say the plans are a good option for companies that might not feel they can afford to offer a traditional plan but want to help workers with health care expenses. But consumer advocates are concerned they can shortchange some workers.

These small businesses can't afford to offer health coverage as the premium prices rise, said Garry Manchulenko, a principal with GMBA Advisors Group in the Denver metro area, who suggested the arrangement to the chamber. "They want to help their employees, but they can't sustain these increases, particularly at the small-group level," Manchulenko said.

He said he's suggesting the new setup for some of his clients, noting that in certain places premiums on the individual market are lower than those for group plans.

LaRew, 48, bought a plan similar to the group plan but with a monthly price tag of $730 after she factors in the company's contribution — a savings of more than $2,600 a year.

"It's still super-expensive for two healthy…
Kaiser Health News
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