BizCare Benefits, a company that says it has backing from Bain Capital, is ramping up ICHRA operations by providing ICHRA program support for VensureHR,, a large professional employer organization. A PEO is an entity that serves as the official employer for many firms' workers.

ICHRA programs provide a way for employers of all sizes to offer cash-for-coverage programs. Federal agencies completed regulations that make the programs possible in xx.

The typical ICHRA program provides a fixed amount of cash and lets a worker use the cash to pay for any kind of individual major medical coverage that meets federal standards for major medical coverage.

The COVID-19 pandemic disrupted efforts to launch the programs, the programs are just now getting their real debut.

Results from a new survey report from Softheon, a company with an ICHRA support services subsidiary, suggest that about 6 million U.S. residents may now be using ICHRAs or similar programs to pay for coverage.

Here's a look at the eHealth, Remodel and BizCare ICHRA efforts.

EHealth, a big web broker, has set up Iris by eHealth, a unit that will help employers set up ICHRAs and help employees choose and use plans.

The firm already works with ICHRA program sponsors and participants. Early experience shows that the participants are price-conscious and use employer cash to buy cheaper coverage than the employers would have chosen. Because of that effect, an ICHRA program may reduce health benefits spending at a typical eHealth ICHRA sponsor employer by about 17%, according to eHealth.

Remodel Health began focusing on individual health coverage in 2015. Remodel and its PeopleKeep unit can provide comprehensive ICHRA support services, including integration with human resources systems and access to ancillary products, as well as plan creation, call center support, quoting and employee onboarding.

Remodel has been focusing on efforts to work with insurance brokers.

BizCare also offers comprehensive ICHRA support services, and it sees its VensureHR relationship will help it reach VensureHR clients with millions of worksite employees.

The firm says its ICHRA program can connect workers with wellness programs, mental health programs, telehealth services programs, financial education programs and retirement planning programs, in addition to connecting them with health coverage providers.

The clouds: One source of suspense about the ICHRA market is questions about how well employers and workers will take to cash-for-coverage plans.

Another source of suspense is activity in Washington.

Before the Affordable Care Act major medical insurance market rules took effect, in 2014, health insurers in most states used medical underwriting in the individual market. Older people and people with health problems had a tough time getting health coverage at an affordable price.

The ACA now prohibits plans from considering health status factors other than location, age and tobacco use when reviewing applications or pricing coverage. That has made offering cash-for-coverage programs practical, by giving older employees and employees with conditions such as obesity or diabetes access to the individual market.

Some in Congress want to eliminate the ACA "Obamacare" major medical market framework, by repealing or changing part or all of the ACA.

Any ACA changes that lead to the return of medical underwriting in the individual market could disrupt the new ICHRA programs.