Answer up to five questions about who gets what. The checker returns one of three results: allowed as designed, allowed if you change something, or not allowed, with the paragraph of 26 CFR 54.9802-4 behind it. No email needed for the answer. Not sure an ICHRA fits your company at all? Run the two-minute fit check first.
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InsureICHRA designs and runs ICHRAs for employers nationwide. We are paid when an employer we advise puts an ICHRA in place and their people enroll through our licensed agent partners. If a class design like this is what you need built, talk to a specialist. Whether ICHRA is the right structure at all is a separate question: run the fit check.
Yes, to different classes of employees, and no, to the same employees. Under 26 CFR 54.9802-4(c)(2), a plan sponsor that offers a class of employees an ICHRA may not also offer that class a traditional group health plan, and may not give any participant or dependent a choice between the two. A group plan for one class and an ICHRA for another class is allowed when the classes come from the regulation's list and the class size test is met. HealthCare.gov states the same rule in its ICHRA guidance for employers.
Paragraph (d)(2) names ten classes and allows any combination of two or more of them. The ten are full-time, part-time, salaried, non-salaried (such as hourly), employees whose primary site of employment is in the same rating area, seasonal, employees covered by a collective bargaining agreement, employees who have not satisfied a waiting period, non-resident aliens with no U.S.-based income, and employees of a staffing entity placed at an unrelated entity. Job title, department, age, owner versus staff and health status are not on the list. A class and its definition are set before the plan year and cannot change during it.
The class offered the ICHRA needs at least 10 employees if the employer has fewer than 100, 10 percent of all employees (rounded down) if it has 100 to 200, and 20 if it has more than 200. Paragraph (d)(3) applies this only when the employer offers a group plan to one class and an ICHRA to another, and only to classes based on full-time, part-time, salaried, hourly or rating-area status, or a combination that includes one of them. Entire-state classes, collective bargaining units, seasonal employees, waiting-period classes and staffing placements are outside the test. The count is taken on the first day of the plan year among employees offered the ICHRA, not among those who enroll.
| Employer size (expected on day one of the plan year) | Minimum employees in the ICHRA class |
|---|---|
| Fewer than 100 | 10 |
| 100 to 200 | 10% of total employees, rounded down |
| More than 200 | 20 |
The checker uses exactly this formula: minimum = 10 if employees < 100; floor(employees × 0.10) if employees is 100 to 200; 20 if employees > 200. The regulation's own Example 12 shows the effect. An employer with 177 employees expected on day one has a minimum of 17, so an ICHRA offered to only 14 hourly employees fails, while the 163 salaried employees stay on the group plan.
Yes, under the special rule for new hires in paragraph (d)(5). An employer that offers a group plan to a class may prospectively offer employees in that class hired on or after a future date an ICHRA, while employees hired before that date stay on the group plan. The date must be prospective and cannot be applied back to people already hired. The ICHRA must be offered on the same terms within the new-hire subclass, no one may be offered a choice between the two, and the minimum class size does not apply to the new-hire subclass itself. Splitting the subclass later can bring the minimum back for some splits.
Related tools and guides: the ICHRA class builder checks each class and headcount, the class design playbook covers design choices, and the ICHRA versus group plan comparison compares costs. Premium questions are answered in which premiums an ICHRA can reimburse.
Talk to a licensed agent
Bring your numbers from this page. The call is to work out whether an ICHRA fits your headcount, not to put you on a plan.
InsureICHRA designs and runs the arrangement. Enrolling an employee in an individual health plan is handled by licensed agents, and InsureICHRA is not an insurance agency, an insurance carrier or a licensed producer. Calls to this number reach a licensed agent. Nothing on this page is an offer of coverage or a recommendation of any plan or carrier. Plan availability, benefits and premiums vary by state, by carrier and by the employee's rating area. We are paid when an employer we advise puts an ICHRA in place and their people enroll through our licensed agent partners.