What You Need to Know
- The individual coverage health reimbursement arrangement program gives employers a way to let workers buy their own coverage.
- An ICHRA reporting requirement is set to become mandatory in 2025.
- CMS also held HealthCare.gov user fees steady and kept HealthCare.gov out of the ancillary benefits markets.
HealthCare.gov managers are signaling that they think individual coverage health reimbursement arrangements matter.
The regulators in charge of the federal Affordable Care Act public exchange system today gave ICHRAs official attention, by adding an ICHRA use reporting requirements for the insurers that sell coverage through HealthCare.gov.
The Centers for Medicare and Medicaid Services — the arm of the U.S. Department of Health and Human Services that oversees HealthCare.gov — put the ICHRA requirement in the HHS Notice of Benefit and Payment Parameters for 2023.
The parameters document shows how federal ACA programs and rules will work in 2023 and later years.
CMS added the ICHRA reporting requirement along with requirements that health insurers selling coverage through HealthCare.gov report the race and ethnicity of enrollees.
Reporting would be voluntary in 2023 and 2024 and mandatory in 2025.
The 660-page parameters document also includes many other provisions, including new requirements for how web brokers that plug into HealthCare.gov signup systems.
What It Means
The biggest U.S. health insurance distributor will have a stream of data that health insurance marketers could use to analyze ICHRA sales on a county-by-county, or even ZIP-code-by-ZIP-code, basis.
The data could also be of interest to life, annuity and retirement professionals. ICHRA holders could not invest HRA value the way health savings account holders invest HSA value. But, like HSA holders, ICHRA holders will have experience with managing their own benefits accounts, and they may emerge with a higher-than-average level of interest in other individual insurance, investment and income planning products.
A Health Insurance Distribution Giant
HealthCare.gov provides ACA services for the 33 states that do not operate their own locally run public exchange program.
Consumers in those 33 states can use HealthCare.gov to shop for individual and family major medical coverage, sign up for coverage and get premium tax credit subsidies from the IRS.
HealthCare.gov helped about 10 million Americans sign up for individual and family major medical coverage for 2022
Participating insurers will generate about $60 billion in premium revenue from covering HealthCare.gov users this year and pay HealthCare.gov more than $100 million in user fees.
The 2023 parameters document CMS issued today is the first document of its kind developed fully under the administration of President Joe Biden, with oversight from Chiquita Brooks-LaSure, the CMS administrator.
The Senate confirmed Brooks-LaSure in May 2021.
Consumers, employers and health insurance brokers hunted for years for a good way to let employers provide cash that workers could use to buy their own individual health coverage.
In most states, before 2014, the main obstacle was that insurers put applicants for individual major medical coverage through a medical underwriting process.