Individual Coverage Health Reimbursement Arrangement (ICHRA) Rules

ICHRA is an employer-funded health reimbursement arrangement that reimburses employees for individual health insurance premiums and/or other qualified medical expenses.
Employees must be enrolled in individual health insurance (on or off the Marketplace) or Medicare to participate.
Employers set monthly allowance amounts, which employees use to purchase coverage of their choice.

Employees must provide proof of individual health insurance coverage (Marketplace, private, or Medicare).
Dependents are eligible if they are enrolled in an individual policy.
Coverage cannot be through a spouse’s group plan or health care sharing ministries.

Employees must use SureCo’s enrollment platform to select their individual health plan and utilize ICHRA funding.

Initial ICHRA Offer Period:
- Employees offered ICHRA must enroll in an individual plan through SureCo’s enrollment platform during their initial enrollment period.
Annual Open Enrollment (AKA: AEP):
- Employees must log into SureCo’s enrollment platform every year to choose or update their plan.
- SureCo's annual open enrollment period is typically November 12th – November 26th (dates may vary by year).
Special Enrollment Periods (SEPs):
- Triggered by Qualifying Life Events (QLEs).
- Employees generally have 60 days from the event to update their plan on SureCo’s platform.
- Supporting documentation should be sent to SureCo's employee experience team at employee.experience@sureco.com within 30 days of the QLE date.

Employees can enroll in or change individual coverage if they experience a QLE, including:

Loss of other health coverage
- (e.g., loss of employer coverage, COBRA expiration, divorce, aging off a parent’s plan at 26).
Change in family status
- Marriage, divorce, birth/adoption of a child, death in the family.
Change in residence
- Moving to a new area where different plans are available. (Must already be enrolled)
Gaining eligibility for Medicare or Marketplace coverage
Loss of Medicaid or CHIP eligibility
Loss of coverage through a spouse’s employer

Deadline: Must select or update a new plan through SureCo’s enrollment platform within 60 days of the QLE.

Initial ICHRA Offer: Must have individual coverage chosen through SureCo by the ICHRA start date.
Annual Open Enrollment: Nov 1 – Jan 15 (varies by state), completed through SureCo’s platform. (Dates change annually and will be communicated by employer)
QLE Special Enrollment: 60 days from the event, processed through SureCo’s platform. (Notify SureCo within 30days of event)
Proof of Coverage: Must be submitted to employer/administrator for reimbursement eligibility.

ICHRA Rules