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What’s the Buzz? Could an ICHRA or QSEHRA Plan Be Right for You?
/by The Ark Insurance TeamIndividual Coverage Health Reimbursement Arrangements, most commonly known as ICHRA plans, have become increasingly popular in some areas as a flexible alternative to group plans. And since they represent a significant shift in how businesses approach health insurance, they’re worth knowing about.
ICHRA plans are relatively new. First introduced in 2020, they’ve gained some traction among businesses looking for an affordable group health insurance option. But, like anything else, ICHRA plans also come with potential drawbacks. Depending on what state you’re in, how many employees you have, and the overall health of your group, an ICHRA plan might not be the best option for you.
If you’re a business owner looking at alternative health plans like ICHRA or QSEHRA, we recommend getting an in-depth analysis with a trusted professional. While they can be particularly advantageous in states like Alaska, they aren’t so much in Utah — the nuance of which we’ll discuss below.
What exactly is an ICHRA plan?
In a nutshell, ICHRA plans allow employers to reimburse their employees for individual health insurance premiums and qualified medical expenses, and the reimbursement is completely tax-free. Rather than selecting and managing a one-size-fits-all group health plan, businesses can provide employees with a predetermined amount of money each month. Employees then use that money to purchase an individual health insurance coverage on the marketplace that best fits their specific needs.
Think of an ICHRA as essentially creating a personal expense account for each employee’s healthcare needs. When employees incur medical expenses or pay their individual insurance premiums, they can submit receipts for reimbursement up to their allowed amount. This arrangement offers a fair amount of flexibility, while still providing the same tax advantages that are typically associated with employer-sponsored health benefits.
Where ICHRAs shine
For some companies, ICHRAs present an attractive option, because they solve some of the most common challenges among business owners in providing adequate health benefits. This kind of control is valuable for growing businesses or those operating across multiple states.
ICHRAs also get rid of the administrative burden of managing a group health plan. No more annual renewal negotiations, plan design decisions, or employee enrollment periods. Instead, companies just have to decide what the employee reimbursement amounts will be and process employee receipts — this is something they should delegate to third-party administrators.
This arrangement can work pretty well for companies that have a diverse workforce spread across several states. Rather than trying to find a single group plan that satisfies everyone, employees can select the coverage that matches their needs. A young, healthy employee might choose a high-deductible plan with lower premiums, while an employee managing a chronic condition might opt for more comprehensive coverage.
The downside of ICHRAs
Despite their advantages, ICHRAs aren’t without potential drawbacks. And much of this depends on what state your business and employees are operating in. The success of an ICHRA program directly correlates with the strength of the individual insurance market in your area. So, if you take Utah for instance, the state has a much more affordable group market with excellent benefits, which ICHRA can’t compete with. It’s likely that employees would struggle to find better coverage with their ICHRA allowance. But in Alaska, ICHRA plans often present a more beneficial choice.
ICHRA also tends to work best for employers with more than 50 full-time equivalent employees. Once a business crosses that threshold, the ACA’s employer mandate requires it to offer coverage or face steep penalties, sometimes thousands of dollars per employee, per year. That puts industries like restaurants and hotels in a tough spot — high turnover and inconsistent enrollment make it hard for them to get a traditional group plan, even though they’re required to offer something.
An ICHRA sidesteps that problem, since there’s no group underwriting or participation minimum to overcome. For a large employer that can’t get enough people to enroll in a group plan, or whose plan has been canceled by the carrier, ICHRA can present an affordable path forward. But for a small shop with only a handful of employees, it usually isn’t the right tool for the job.
“ICHRAs tend to be better for those large employer scenarios where they’re trying to be compliant because now they’re going to get penalized if they’re not offering, but they can’t find a good way to offer,” says Rebecca Yates, CEO of Ark Insurance Solutions. “They can be a good alternative for businesses that have a hard time meeting participation.”
Employee education represents another challenge to the overall effectiveness of an ICHRA plan. Many workers are familiar with traditional group health insurance but they might find the individual market confusing. They’ll need guidance on selecting appropriate coverage, understanding how reimbursements work, and managing their healthcare spending.
Some employees might also miss the simplicity of having their employer choose their health plan. While flexibility can be helpful, it also means employees must take more active roles in their healthcare decisions. This responsibility can feel overwhelming, especially for employees who have never had to shop for health insurance before.
QSEHRA: An Alternative to ICHRA
If your business has fewer than 20 employees, there’s another option worth exploring: the Qualified Small Employer Health Reimbursement Arrangement (QSEHRA). It also gives you the ability to reimburse employees tax-free for individual health insurance premiums, but QSEHRA comes with IRS-set contribution caps that are adjusted annually for inflation. For 2026, that cap is $6,450 per year for self-only coverage and $13,100 for family coverage.
A properly structured QSEHRA allows employees to still claim ACA marketplace subsidies alongside their reimbursement. For a small team where most employees would qualify for subsidies anyway, that combination might make the most sense.
The ICHRA-versus-QSEHRA decision comes down to headcount, wages, and how your state’s individual insurance market compares, which is exactly the kind of analysis a knowledgeable broker can help you with before you commit to either one.
Tax advantages
These plans do have their tax advantages, with reimbursements that are tax-deductible for employers and tax-free for employees. This is a significant benefit compared to simply providing extra salary for healthcare expenses. It allows businesses to provide health benefits with the same tax advantages as traditional group coverage but with greater flexibility and often lower administrative costs.
ICHRAs and QSEHRAs can also help businesses better control their long-term healthcare costs. Unlike traditional group plans, where premium increases are the norm, employers can adjust their allowances based on their budget and business performance.
Choosing ICHRA
When it comes to implementing an ICHRA plan, you need to carefully plan and provide clear communication and assistance for your employees. This isn’t a decision to enter into lightly, and you shouldn’t do it without a broker. If your business has less than 50 employees and they aren’t making high salaries, it may be smarter to allow them to qualify for federal subsidies through the ACA marketplace instead, or explore your QSEHRA eligibility. Because there are so many caveats involved, it’s best to get help from a knowledgeable professional.
When choosing an ICHRA plan, businesses need to determine appropriate reimbursement amounts for different employee classes, making sure these amounts give employees the ability to purchase adequate coverage. They also need to establish clear policies surrounding eligible expenses and reimbursement procedures.
“Most brokers are only comfortable with group or individual plans. But at Ark, we’re well-versed in all of the options and can help you find what best fits your business,” says Yates. “It’s important to get an analysis from someone who knows what they’re doing and is established in your area.”
Whether an ICHRA or QSEHRA makes sense for your business or not depends on a variety of factors, like your workforce demographics, local insurance market conditions, and administrative capabilities. A thorough analysis from Ark will look at your current health benefit costs and challenges, and compare those against projected expenses. We consider everything, including the reimbursement amounts and administrative costs of your plan. It’s also important to think about your employees and their preferences. You may want to take into account the overall health of your group and their potential needs when it comes to healthcare. At Ark, we take every factor into consideration.
As healthcare costs continue to rise and workforce needs evolve, these alternatives represent a new approach to employee health benefits that may be helpful in certain states and/or situations. While they may not be the perfect solution for every business, they are worth taking into account.
Want to see which plans might best fit your needs? Click here to schedule an appointment with an Ark Insurance Solutions agent.
Navigating the complex world of health insurance can be daunting. The Ark Insurance Solutions team has the skill and experience to guide you. We’ll help you compare health plans to make the best decision based on your unique circumstances and budget. Give us a call at 801-901-7800 or click here to schedule an appointment with us.
A Simple Guide to Mental Health Benefits in Your Utah Group Plan
/by The Ark Insurance TeamKey Points:
Most people think of their health insurance as something to be used for doctor’s visits and the occasional urgent care run. But there are other kinds of emergencies that your health insurance is designed to help take care of—like your mental health.
This subject often feels like a separate conversation, and typically comes with considerably more friction and negative connotations. Questions about affordability, privacy, and social stigma can keep people from getting help, along with assumptions about logistics and potential bureaucratic hoops.
The reality is that accessing mental health support has become a lot easier in recent years, as coverage has evolved to include benefits that go well beyond what you’d expect—including tools that cost nothing and don’t require employer involvement.
Here at Ark, our goal is to make insurance easier to understand. So let’s break down mental health coverage in Utah and what’s available:
What the Law Already Requires
Thanks to Federal Mental Health Parity Law, group health plans are required to treat mental and physical health conditions equally. This means that if your copay for a primary care doctor is $25, your copay for a licensed clinical social worker should also be just $25. If telehealth medical visits are covered at no cost, telehealth therapy should be too, and so on. Deductibles and out-of-pocket maximums have to work the same way for mental health as they do for any other medical treatment.
“There’s this perception that there’s a barrier to access, when often there’s not,” says Rebecca Yates, Ark Founder and CEO. “It’s easy to assume that you have to meet your deductible in order to get care. And that’s just not accurate for most people on a group plan.”
Coverage denials for mental health visits that were routine a decade ago are far less frequent now. And your group plan might also include an Employee Assistance Program, which we’ll talk about next.
Employee Assistance Program
Many group health plans (but not all) now include something called an Employee Assistance Program, or EAP. This program gives employees confidential access to mental health support that can be used for a wide range of life situations; like financial stress, legal questions, grief, relationship difficulties, caregiving strain, work pressure, and more.
“It gives people a starting point when something is causing personal stress and they don’t know what to do with it,” says Yates. Most of these programs include a set of free sessions and coverage extends to everyone in the employee’s household.
For employers, the cost for an EAP can range from zero to a small monthly fee. When it’s an add-on, the cost is usually minimal and well worth the expense. More comprehensive platforms also exist—like Nivati, a Utah-based, woman-owned company founded during COVID specifically to address workplace mental health gaps. Nivati offers unlimited therapist access, a wellness content library, and HR team support tools.
What’s included in your group plan’s EAP varies by carrier—Regence Blue Cross Blue Shield and SelectHealth offer it as an add-on. That’s why it’s a good idea to ask about this kind of coverage when you’re reviewing any group plan, especially since it can make all the difference for you or someone on your staff who’s trying to get through a rough time.
What This Means for Employers
“When your employees feel supported at work, they’re much more likely to want to be there and stay over the long term,” says Yates. “It’s such a simple thing, but it matters—especially right now, when stress levels are so high.”
Beyond staff retention, an EAP protects your team’s dynamic and encourages a healthy workplace culture. It gives people a channel that doesn’t require a detailed conversation with a manager. There is a specific resource and telephone number people can call, or they can give it to another member of their family who might also need help. Many EAPs also include learning sessions, managerial coaching, team resilience workshops, and other tools.
The Bigger Case for Mental Health Care
Part of what keeps people from using mental health benefits is an outdated idea of what it’s intended for. “Mental health does not look like what it did a couple of decades ago,” says Yates. “It’s just like any other self-care. You go out and take a walk, you get on the treadmill — you do those things because you’re taking care of yourself. Your mental health requires the same kind of upkeep. You don’t have to wait until circumstances are dire.”
Just like preventive care in your medical life, it’s important to talk to someone before things become a much larger issue. A few EAP sessions during a hard stretch, a telehealth therapy visit during a difficult family transition, or a conversation with someone trained to help can be incredibly effective in dealing with stress.
“Right now, we’re confronted with enormous amounts of stress in our lives. And we have so many more tools to take care of ourselves than any previous generation did. But how can we use them if we don’t know anything about them?”
Getting Past the Hesitation
One of the most common barriers to using mental health benefits is the assumption that doing so means telling your employer. It doesn’t. Just like with medical issues, HIPAA protections apply here.
The fastest way to find out what resources you actually have available is to call the number on the back of your insurance card, and you don’t need to ask your employer first. Once you’ve made that first call, you also have the right to find a therapist or counselor who fits you best.
“If someone doesn’t fit, keep looking,” says Yates. “Once you find your person, you stick with them.”
And if you’re on a high-deductible plan and concerned about cost, don’t be afraid to call your insurance provider and ask about free or inexpensive resources. Between EAP sessions and telehealth options covered under parity law, most people on a group plan have a path for accessing support that doesn’t require meeting a large deductible first.
What if You Don’t Have Coverage?
If you’re on an individual plan, between jobs, or without insurance, Utah has strong statewide resources available, regardless of your insurance status, income, or documentation.
988.utah.gov, which is administered and funded by the Utah Department of Health and Human Services, is a really good place to start. You do not need proof of insurance, citizenship, or a social security number. The site connects to the crisis line, the Safe UT app for text-based counselor chat, the 211 helpline for housing and social services, the Utah Domestic Violence Coalition, and mobile crisis outreach teams.
“These are all state-sponsored,” says Yates. “They’re all things our taxes pay for. It’s already paid for and here to take care of you.”
If you’re not sure what your current plan includes, or you’re interested in building a benefits package that includes mental health resources, Ark Insurance is happy to help. Give us a call at 801-901-7800 or click here to schedule an appointment with us.
Rebecca Yates Discusses Rising Costs | Ark Insurance Solutions
/by Doug BurtonArk Founder & CEO Rebecca Yates Addresses Rising Health Insurance Costs with the Wall Street Journal
When The Wall Street Journal needed an expert voice on how Americans are responding to escalating costs of health insurance premiums, they turned to our founder Rebecca Yates for the local, human side of the story.
In her conversation with WSJ reporters Alex Ossola and Rachel Ensign, Yates shared what she’s been seeing as clients face policies that have ballooned in price—forcing some to make impossible choices between coverage and basic life essentials.
“I’ve had people telling me that they are just going to go completely without insurance,” said Yates. “And these are not people that have not used the system. I mean, we’ve had people that had a heart attack in the last year that have just said, ‘I can’t,’ because their premium went from $200 to over $2,200.”
Making Change at a National Level
This isn’t Yates’s first time bringing in-depth, firsthand knowledge into national healthcare discussions. She’s participated in a Healthcare.gov working group since 2017 and serves on the Utah Rare Disease Advocacy Council. The WSJ podcast is just one of the ways she has worked to address the challenging circumstances many Americans currently face in making decisions about their health care plan.
As Congress debates whether to restore subsidies, voices like Yates’ connect policy decisions to kitchen table reality, helping lawmakers understand what happens when skyrocketing costs prevent people from accessing adequate health insurance.
To listen to the podcast, click here.