Integration with Individual Coverage or Medicare

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Compliance and administration issues

Integration with Individual Coverage or Medicare

Q: What does it mean for an ICHRA to be “integrated with individual coverage?"

Flip for Answer...
A: To participate in the ICHRA, all individuals (including spouses and dependents) must be enrolled in individual health coverage or Medicare and provide proof (substantiation) of that coverage to the employer.

What Individual Health Coverage Qualifies?

Qualified

Non-Qualified

  • Coverage purchased through a public exchange
  • Coverage purchased through a private exchange
  • Coverage purchased direct from an insurance carrier (outside the exchange)
  • Student health insurance
  • Catastrophic coverage
  • Grandmothered coverage
  • Grandfathered coverage
  • Short-term, limited-duration insurance (STLDI)
  • Coverage that consists solely of excepted benefits
  • Tricare
  • Healthcare sharing ministry