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Some people like the idea of using an employer's cash to buy their own health coverage, many want the employer to buy the coverage, and it's possible that 2% of U.S. adults are already using employer-sponsored cash-for-coverage health plans.

Softheon, a health coverage distribution technology firm, and W3LL, a Softheon subsidiary that supports employers with individual coverage health reimbursement arrangement programs, compiled those figures in a summary of results from a recent online survey of about 1,000 U.S. adults ages 25 and older.

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The survey team found that a large majority of the participants seem to want an employer health plan to shop for the health coverage: Just 20% said they would prefer to use the employer plan's cash to shop for their own coverage, according to a set of survey results charts that Softheon made available to BenefitsPRO.

About 26% would prefer to see an employer offer just one health plan option, and 54% would prefer to see an employer do the shopping but offer two or more plans.

Comfort and discomfort: Signs of survey participants' level of ICHRA readiness depended heavily on how the survey team worded the questions.

When the survey team asked the participants directly about an employer providing a cash stipend for health coverage, 29% said they were very comfortable with the idea and 40% said they were somewhat comfortable with the idea. Only 31% said they were uncomfortable with the idea.

When the team asked about concerns that could make the survey participants nervous about buying their own coverage, 30% picked the concern that ranked first, "choosing the wrong plan (getting less or more coverage than I need), ranked first, and 29% picked the concern that ranked second, "paying too much."

Roughly 63% said they thought getting employer help with using the employer's cash to shop for health coverage would make the experience somewhat or much better.

ICHRA awareness: About 78% of the participants said they knew little or nothing about ICHRAs, and 20% said they were very or somewhat familiar with the concept without actually having ICHRA coverage themselves.

But 2% said they already are using ICHRAs to buy their coverage.
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If 2% of all Americans are using ICHRAs, that would imply that there are now about 6 million ICHRA users.

ICHRA user counts are hard to come by, but Brad O'Neill, the co-owner of the ICHRA Shop Insurance Agency, has said that he thinks there might be about 5 million ICHRA users. The new Softheon/W3LL survey appears to support the possibility that ICHRA plans are serving at least 5 million people.

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Allison Bell

Allison Bell, a senior reporter at ThinkAdvisor and BenefitsPRO, previously was an associate editor at National Underwriter Life & Health. She has a bachelor's degree in economics from Washington University in St. Louis and a master's degree in journalism from the Medill School of Journalism at Northwestern University. She can be reached through X at @Think_Allison.