ICHRA & benefits design
Alex's boss just cost him $2,160 a year — by trying to help
When an ICHRA offer displaces subsidies worth more.
Alex makes $32,000 a year.
At that income, he qualifies for $580/month in ACA subsidies — government support that covers most of his premium through the marketplace.
A single full bar showing the $580 a month Alex receives in ACA subsidies at an income of $32,000 a year.
Alex earns $32,000 a year
from the government, through the marketplace
Alex’s boss offers ICHRA: $400 a month.
A generous contribution. But there’s something the boss doesn’t realize.
Two bars compared: the $580 monthly ACA subsidy Alex already has, and the smaller $400 monthly ICHRA contribution his boss is offering.
from the government
well-intentioned
The $580 subsidy disappears.
The government considers an affordable ICHRA offer to be employer-sponsored coverage. That disqualifies Alex from marketplace subsidies.
The subsidy bar has emptied to zero and is marked disqualified, while the $400 ICHRA bar remains and is labelled as having replaced it.
disqualified — the ICHRA offer counts as employer coverage
replaced the subsidy rather than adding to it
Alex lost $180 a month — $2,160 a year.
“Affordable” means the employee’s required share doesn’t exceed about 9% of household income. If the ICHRA offer passes that threshold, subsidies are gone — even if the subsidy was worth more.
A tally of Alex’s monthly support before and after the offer — $580 becomes $400, a shortfall of $180 a month — followed by the annual total of $2,160.
Alex’s monthly support
- Before: ACA subsidy
- $580/mo
- After: boss’s ICHRA
- $400/mo
- Shortfall
- −$180/mo
$2,160 less support per year
There’s a way to avoid this.
ICHRA lets you define which employee classes receive the offer. For employees who qualify for large subsidies, excluding them preserves their government benefit. Sometimes not offering is the most generous option.
A three-stage sequence: define employee classes, leave the subsidy-eligible class out of the ICHRA offer, and Alex keeps his $580 a month.
-
Define classes who the offer covers
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Exclude Alex’s class no ICHRA offer made
-
Subsidy preserved $580/mo kept