Other Compliance Requirements

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Compliance and administration issues

Other compliance requirements

Participants must be able to opt out of coverage and waive future reimbursement

Any individual who enrolls in an ICHRA is then ineligible for a premium tax credit (PTC) when purchasing individual health insurance through a public Exchange. This is true no matter what amount of reimbursement is available via the ICHRA. Therefore, eligible participants must be given the option to opt out of ICHRA coverage and waive any future reimbursements to preserve PTC eligibility when applicable.

An annual notice must be provided to eligible individuals

  • Employees who are eligible to participate in an ICHRA must be provided with a notice at least 90 days before the beginning of each plan year.
  • For those who become eligible later or enroll after the beginning of the plan year, the notice is required to be provided no later than the employee’s effective date of coverage. The notice is meant to help individuals understand the coverage available via the ICHRA and how the ICHRA may impact eligibility for a PTC toward coverage through a public Exchange.
 
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