Health insurers still have trouble connecting with ICHRAs: A benefit plan builder shares insight
Providers of ancillary benefits and services need to learn how to serve cash-for-coverage plan enrollees, according to David Millar, head of ICHRA products at Gravie.
Health insurers are still learning how to connect with ICHRA users.
David Millar, head of ICHRA products at Gravie, a benefit plan administrator that offers support services for employers’ cash-for-coverage plans, gave that assessment in a recent email interview.
“Currently, there is not a standard way for carriers to work together with the third-party administrators and brokers,” Millar said. “Every state and every carrier has its own system, its own way of working, and its own rules.”
Another challenge Millar sees is that insurers have designed their individual policy administrations to connect the insurer with the enrollee, not to connect the insurer with both an ICHRA user and the administrator of the user’s ICHRA.
“This makes for a challenging landscape,” Millar said. “Standards for handling enrollments and payments are the biggest challenges we face right now.”
What it means: Putting the finishing touches on ICHRAs could take a little more time.
Related: Why ICHRAs are the future of large-group health insurance
But that means creative brokers and benefit plan administrators still have a chance to tailor ICHRAs to fit and make their versions stand out. The ICHRA market still has room for artisans.
The history: Years ago, employers sometimes gave workers cash they could use to buy their own individual health coverage, but medical underwriting for individual health insurance made offering cash-for-coverage plans awkward: Some workers could not qualify to buy individual coverage at any price.
Starting in 2014, the Affordable Care Act changed that, by prohibiting health insurers from considering any factors other than age and, to some extent, tobacco use when issuing and pricing major medical coverage.
Federal ICHRA regulations completed in 2019 create a way for employers to provide cash that workers can use to buy their own ACA-compliant individual health coverage, either through an ACA exchange or through the off-exchange market, without violating ACA rules or other federal rules.
ICHRA promoters were getting ready to make a big ICHRA push when COVID-19 hit and sucked up all of employers’ attention.
A big year: ICHRAs began to creep in around the edges. They made a bit of a splash a year ago. This year, they’re hot, with state-based ACA public exchange systems, or supermarkets for health insurance, talking about their ICHRA strategies, and HealthCare.gov managers posting a detailed small business health options comparison chart that includes ICHRA arrangements as an option.
HealthSherpa, a company that helps many brokers process their HealthCare.gov transactions, has announced the launch of a separate HealthSherpa for ICHRA service that can help a broker work with on-exchange individual health policies and off-exchange policies through one website.
ICHRAs’ world: Millar predicted that economic pressure on small and midsize employers and the growth of the gig economy will make ICHRAs popular.
For ICHRA service providers, the focus will be less on paying the mechanics of paying the health coverage providers and more on providing support for the workers using the ICHRAs, he said.
Millar is also hoping to see providers of products like dental insurance learn how to serve ICHRA users.
Today, Gravie offers traditional group benefits customers access to Teladoc general telehealth services, Sword musculoskeletal telehealth services and FitOn virtual fitness coaching.
“In the near future, we see an opportunity to extend these benefits to our ICHRA solution, where Gravie members will have the ability to attach these benefits to their individual health plan as ancillary ‘add-on’ products,” Millar said.