Hospitals and the Benefits of ICHRA for Their Employees

By Team Orca
Jul 20, 2023

For years, hospitals have depended on group insurance plans, whose features, benefits, and coverage are increasingly costly and limited. Hospitals can better recruit and retain talented healthcare professionals by offering health plans that work for them, making ICHRA critical.

The Individual Coverage Health ReimbursementArrangement (ICHRA) is a modern health insurance plan focusing on employees, providing them with more health coverage options. For years, hospitals have depended on group insurance plans, whose features, benefits, and coverage are increasingly costly and limited. Hospitals can better recruit and retain talented healthcare professionals by offering health plans that work for them, making ICHRA critical. Traditional group insurance policies deny employees control over their health coverage as they are designed with a larger audience in mind.Besides this, they often offer limited plan choices that lack more particular coverage for individual members.

Modern employees want more in terms of choices and benefits. However, traditional group insurance policies deny employees control over their health coverage. The freedom and flexibility offered by ICHRAs provide hospitals with a powerful recruitment tool in attracting top talent.

Understanding ICHRA

ICHRA is an employee-dependent healthcare plan through which employers provide tax-free reimbursement for insurance premiums that employees pay independently(7). Using this health reimbursement arrangement, healthcare facilities can reimburse some or all premiums paid or qualified medical expenses incurred by their employees.

Introduced in 2020, ICHRA is ideal for employers looking to offer more health coverage choices, flexibility, and customization. The purpose of this arrangement is to give employees the power to choose a plan that matches their specific healthcare needs(8).

So, how do ICHRAs work? The process is straightforward. As a hospital, develop different plan options for employees that fit your needs and budget. For instance, define employee classes, and establish reimbursement guidelines, limits, and eligibility requirements.

Once a plan is set up, employees should explore the individual market and purchase plans that perfectly fit their personal and family needs. After the purchase, an employee owns the plan and can use it even after changing jobs(9). If the employees incur a medical expense, the employer reimburses them after reviewing and approving their claims.

Advantages of ICHRA for Hospitals

ICHRA offers unique benefits to hospitals compared to group health insurance plans. First, employers of all sizes can fit their needs, abilities, and goals into the arrangement. An employer chooses who is eligible for a particular category and their contribution level without restrictions on business size.

Second, ICHRA improves retention and attraction of top talent by allowing employees to select a healthcare plan with benefits that match their specific needs(10).

Third, the health reimbursement arrangement allows hospitals and other employers to set spending amounts, giving them complete control. Employers do not have to worry about risks associated with increases in premium rates since they work with predetermined reimbursement limits.

Fourth, reimbursements for premiums and other qualified medical expenses are tax-free, thus saving money.

Lastly, ICHRA requires less time and effort to set up and run than traditional health insurance models(11). Working with an ICHRA administrator could make managing your health plan much easier, helping you manage the changing ICHRA requirements and ensure effective record keeping.

Designing An Effective ICHRA Plan

Designing an effective Individual Coverage Health Reimbursement Arrangement (ICHRA) plan requires thoughtful consideration of various factors, including employee classes, minimum class size requirements, and affordability. By carefully assessing these elements, you can design a customized health benefits package for your employees that adheres to insurance regulations. Taking the time to plan and strategize ensures that your ICHRA plan meets the specific needs of your workforce while maintaining compliance with relevant guidelines. With thoughtful deliberation, you can provide tailored and comprehensive health benefits that prioritize the well-being of your employees.

Ensuring fairness and flexibility in your ICHRA plan is of utmost importance, and one way to achieve this is by structuring reimbursements based on employee classes. This approach allows you to tailor customized plans for distinct groups, such as full-time, part-time, and seasonal workers or employees in different locations. By organizing reimbursements in this manner, you can accommodate the unique needs of each employee class, providing them with practical and personalized health benefits. This promotes equity and flexibility within your ICHRA plan, fostering employee satisfaction and ensuring that your benefits strategy aligns with the diverse workforce within your organization.

Here are a few things to consider:

  1. Full-time Employees: Provide higher reimbursements to employees who work longer hours, as they may have increased healthcare needs due to their extended work schedules. By recognizing the potential impact of longer working hours on their health, offering higher reimbursements demonstrates your commitment to supporting their well-being. This approach acknowledges the unique circumstances employees face who dedicate more time to their jobs and seeks to address any additional healthcare requirements that may arise. Through these enhanced reimbursements, you can ensure that your employees receive the necessary support to maintain their health and productivity in light of their extended working hours.
  2. Part-Time Employees: Provide  a different reimbursement amount for part-time employees who may not require as much coverage due to their reduced weekly working hours. Recognizing that part-time employees typically have different healthcare needs, offering lower reimbursements ensures a more appropriate level of coverage aligned with their work schedules. This approach allows for a fair distribution of resources while providing necessary support for part-time employees' healthcare expenses. By tailoring the reimbursement amounts to match their specific requirements, you can optimize the allocation of benefits and maintain a balanced and cost-effective approach within your overall benefits strategy.
  3. Seasonal Employees: Adjust reimbursements during busy seasons when there is an influx of temporary staff. By adapting the reimbursement structure to account for the increased number of temporary employees, you can ensure that healthcare expenses are appropriately covered during these busy periods. This approach acknowledges the unique staffing dynamics during peak seasons and aims to provide fair and sufficient reimbursement levels for temporary staff who may have short-term healthcare needs. By offering flexible reimbursement adjustments, you can effectively manage healthcare costs while ensuring that all employees, including temporary staff, receive the necessary support for their healthcare expenses during busy seasons.
  4. Different Localities: Tailor plans to reflect regional disparities in healthcare costs and the availability of services across different locations in the United States. By acknowledging and accounting for these variations, you can design plans aligning with each region's needs and conditions. This approach ensures employees access appropriate coverage and benefits relevant to their location. By considering regional differences in healthcare, you can provide comprehensive and effective plans that address the unique healthcare landscape of each area, maximizing the value and relevance of your benefits offerings.


ICHRAs allow employers to offer personalized health insurance benefits that make it easy to retain valuable professionals and attract top talent. An ICHRA empowers employees to choose healthcare services and coverage that perfectly fits their individual and family needs. It's an excellent option for hospitals of all sizes and their valued employees.

If you are concerned that group health insurance plans cannot work for your hospital, ICHRA is a valuable option. Your employees need a plan that works best for their individual healthcare needs. ICHRA will not only make you their dream employer but will also enhance the overall success of your health facility.

Venteur can help you get started with an ICHRA. Reach out to the experts at Venteur today!

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