insureichra
Fit check The Desk
TOOLS · COST COMPARISON · 2026

Your renewal went up again. What are the options?

A firm with 10 to 199 workers pays an average of $9,211 a year per employee for single coverage, and the employer covers about 84 percent of it. Put your own headcount in below and see that against the other way of doing this, where you set the number instead of receiving it.

Your numbers

Every field starts on a published benchmark. Change any of them to your own.

Count the people on the plan, not total headcount.
Sets the benchmark premium. Single is $9,211 a year, family is $26,054.
$
The whole premium, before splitting it with the employee. Your renewal letter has this.
Percent. Small firms average 84 percent of single coverage and 64 percent of family.
$
This is the number that does not exist on a group plan. You choose it, and it does not change unless you change it.
$
Someone has to handle substantiation and reimbursement. Platforms in this market commonly charge in this range.
Difference over a year
$0

Group plan, your share$0
Allowance, all employees$0
Administration$0
Allowance route, total$0

Want this as a breakdown you can forward? We will email the figures above with the three things this calculator does not model, so you can put it in front of whoever signs off.

One email with your numbers. No list, no sequence, unsubscribe in one click.

The thing you are comparing against does have a name

If you have never heard it, that is not an accident. It is called an Individual Coverage HRA, usually shortened to ICHRA, and it has only existed since January 2020. Most small employers meet it for the first time when a broker mentions it, which means most never meet it at all.

The mechanism is unglamorous. You set a monthly allowance. Your employees buy their own health insurance on the individual market. You reimburse them up to the allowance, tax free to both sides. That is the whole thing.

What is genuinely different

  • You set the number instead of receiving it. On a group plan the cost arrives in a renewal letter written by somebody else. An allowance is a line in your budget that you decide, and it stays where you put it until you move it.
  • There is no participation requirement. Carriers generally will not issue a small group policy unless a minimum share of your eligible employees enrol, commonly around 70 percent. If you keep failing that threshold, the comparison is not group against allowance, it is allowance against nothing.
  • There is no minimum size and no minimum contribution. One W-2 employee is enough, and the law sets no floor on what you have to put in. Whether a low allowance is any good to your people is a separate question, and a real one.
  • Each employee buys in their own area. One group network has to cover everybody. If your people are spread across states, this is the difference between a plan that works for them and one that technically exists.

What it asks of you in return

  • Your employees have to go shopping. Some read that as freedom and some read it as being cut loose. Which one you get back depends almost entirely on how you announce it.
  • Anyone on a Marketplace subsidy needs modelling first. An employee offered an arrangement that counts as affordable loses eligibility for the premium tax credit, whether they take it or not. Get that wrong for a few people and they will do the arithmetic themselves and reach a worse answer than you did.
  • The administration does not vanish, it changes shape. You stop negotiating renewals and start handling substantiation, notices and reimbursement. That is why administrators exist and why they charge, which is the line in the calculator above.

What actually has to happen, and by when

Work out whether it fits at allHeadcount, participation, geography, workforce age and how many of your people hold a subsidy. Those five decide it, and the fit check walks through them in two minutes.
Set the allowance, then test itPick a number, then check it clears the affordability test for your lowest-paid employees using one of the three IRS safe harbours. The affordability calculator does that part.
Choose how classes work, if you use themThe rules let you set different allowances by defined classes, such as full-time against part-time, or by location and by age. You do not have to use any of them.
Send the employee noticeThis is the deadline that matters. Written notice to each participant, generally at least 90 days before the plan year starts.
Employees enrolBeing offered the arrangement opens a special enrollment period for them, so they are not stuck waiting for open enrollment.
The date almost everyone gets wrong

Marketplace open enrollment for 2027 coverage runs 1 November 2026 to 15 January 2027, so that is the date people have in their heads. It is the wrong one. If you want a plan year starting 1 January, the employee notice is due around 3 October, four weeks before open enrollment even opens. Employers who find this out in November do not rush the notice, they move the start date.

Why an employer does this at all

In the conversations behind this site the reason is almost never that somebody read about a clever tax structure. It is one of four things: the renewal came in above 15 percent again, they cannot hit participation and have no group option at all, their people are spread across states and one network cannot serve them, or they have never offered anything and want to start with a cost they can predict.

If none of those four describe you, the honest answer is that your group plan is probably doing its job and this is a conversation for your next renewal.

WHERE THIS COMES FROM

This is a federal arrangement, and you can read the rule yourself

Everything on this page rests on published regulation and published survey data. None of it rests on us. Here is each source, so you can check the claim rather than trust the publisher.

  • The regulation that created it Departments of Treasury, Labor and Health and Human Services, final rule on Health Reimbursement Arrangements, published 20 June 2019, effective for plan years from 1 January 2020. Federal Register, 2019-12571
  • The rule as it stands today 26 CFR 54.9802-4, the nondiscrimination and class rules that govern how an Individual Coverage HRA may be offered and varied. Electronic Code of Federal Regulations
  • The IRS guidance on affordability The 2019 final ICHRA rule (Federal Register 2019-12571) and the annual revenue procedure that sets the affordability percentage, which is 9.96 percent for 2026. The 2019 final ICHRA rule (Federal Register 2019-12571)
  • The government's own explainer HealthCare.gov's page for small businesses on Individual Coverage HRAs and CHOICE arrangements. HealthCare.gov
  • The cost benchmarks on this page KFF Employer Health Benefits Survey, firms with 10 to 199 workers: $9,211 single and $26,054 family, with employers covering about 84 and 64 percent respectively. KFF Employer Health Benefits Survey
What we are, plainly

InsureICHRA designs and runs Individual Coverage HRAs for employers across the United States. Employee enrollment in individual policies goes through licensed agents, and we are paid when that business is placed. We take no payment from any administrator or carrier named on this site, and no vendor on this page has paid to be here. We are not affiliated with, endorsed by, or acting on behalf of the IRS, CMS, HHS, the Department of Labor or HealthCare.gov. Where those agencies are named it is because they published the rule being described, and the link goes to their own page so you can read it in full.

Nothing here is legal, tax or benefits advice. An arrangement like this has to be set up by someone qualified to set it up, and the numbers have to be checked against your own payroll and your own ZIP codes before anybody signs anything.

Reviewed 23 September 2026 · How we check what we publish

What this looks like in your line of work

Turnover, seasonality and how many of your people are hourly change the maths more than headcount does.

CONSTRUCTIONCrews across state linesWorkers in several rating areas, and a network that covers the office but not the site. RESTAURANTS8 to 15 employeesThe participation threshold is the whole problem when half the staff decline. RETAILPart-time and seasonalClasses let you offer something real to part-timers without offering everyone the same. HEALTHCAREHigh turnover care staffOnboarding and offboarding people continuously is where the admin argument bites.

Two minutes, and you will know whether this is for you

Nine questions on your renewal, participation, geography, workforce age and timing. A score out of 100 and a straight verdict, free. Enrollment in an individual policy is handled by licensed agents, and we are paid when that business is placed.

Run the fit check Affordability calculator

Questions employers ask first

Talk to a licensed agent

(305) 901-2240

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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.