For years, "health insurance through work" meant one thing: your employer picked a plan, you enrolled during a short window, and that was it. An ICHRA — Individual Coverage Health Reimbursement Arrangement — flips that. Instead of one company plan, your employer gives you a monthly allowance, and you choose and buy your own individual health plan, usually through the ACA Marketplace. That's a bigger shift than a new insurance card, so here's what it actually changes.
What stays the same
- You still get help paying for coverage. The dollar amount comes as a reimbursement instead of a payroll-deducted group premium, but the employer is still putting money toward your health insurance.
- The reimbursement is still tax-free when it's used for qualifying coverage, the same general tax treatment as a traditional group benefit.
- You still choose a plan during an enrollment window — it just becomes your own individual enrollment window instead of a single company-wide sign-up sheet.
What actually changes
- You pick the plan, not HR. Instead of choosing from two or three group options, you're shopping the individual market — potentially dozens of plans across several carriers.
- The policy is yours. It's in your name, not the company's group policy. That means it moves with you if you change jobs.
- Your network and drug list can change. An individual plan's network and formulary won't automatically match your old group plan's — this is the single most important thing to check before you enroll.
- Your ACA subsidy eligibility may change. If your employer's allowance is considered "affordable" for your income, accepting it generally means you can't also claim a premium tax credit on a Marketplace plan.
How to actually choose a plan
- List your must-haves first. Current doctors, ongoing prescriptions, and any planned procedures.
- Compare total cost, not just premium. A lower premium with a high deductible can cost more overall than a slightly higher premium with better coverage — run the math for how you actually use care.
- Check the network by name. Don't assume "the same insurance company" means "the same network" — individual and group plans from the same carrier can use different networks entirely.
- Confirm your allowance covers what you need. If the plan that fits you best costs more than your allowance, you'll cover the difference out of pocket — worth knowing before you enroll, not after your first paycheck.
ICHRA vs. your old group plan
| ICHRA (individual plan) | Old group plan | |
|---|---|---|
| Who picks the plan | You | Employer, from a short list |
| Plan ownership | Yours — portable if you leave | Employer's group policy |
| Network & formulary | Varies by plan you choose | Fixed for everyone |
| ACA subsidy eligibility | May be affected by allowance | Not applicable |
| What to double-check | Doctors, drugs, and total cost per plan | Usually pre-vetted by employer |
Not sure which plan to pick?
We'll compare your options against your actual doctors and prescriptions — free, no pressure.
Get free enrollment helpQuestions worth asking your employer
Before you shop, it helps to know the exact monthly allowance, when your coverage needs to start, and whether the allowance varies for you specifically (some employers set different amounts by employee class). Your HR contact or the notice you received should have these details — if anything is unclear, it's worth confirming before you start comparing plans.
How Honorbrook helps
We sit down by phone with employees whose companies have moved to an ICHRA, walk through the Marketplace and off-exchange options available in your area, check that your doctors and prescriptions are actually covered, and handle the enrollment paperwork. It's free to you — we're paid by the carrier, not by you or your employer — and we're licensed across Virginia, Maryland, Georgia, Texas, Michigan, North Carolina, South Carolina, Alabama, Louisiana, Indiana, and West Virginia.