America's Benefit Specialist January-February 2023

ICHRAs

benchmark will likely see cost savings when transitioning to the ICHRA model. Of course, with advantages comes drawbacks. One of these is that the individual marketplace has narrow provider networks depending on each state exchange. There may be many options with different deductibles, maximums and co-pays, but the network offering can be limited when it comes to selecting a doctor. This can serve as a deterrent for employees seeking specialized care or with strong preferenc es on where they go for treatment. Navigating the exchange and selecting the best-fitting plan can also be a challenge for employees. They have many options, which can lead to frustration when considering only about four percent of working Americans understand what a deductible, co-pay, co-insurance and out-of-pocket maximums are. Employees are accustomed to being offered a cohesive one to four plans that either have a broad network or are suited to the company’s specific location. Administration and advocacy can also be a limitation. Employees are relatively “on their own” when navigating their health plan, as the employer and broker do not have access to their benefit package and cannot advocate on the

employee’s behalf. In the event of a claim situation or error, the employee must handle it directly with the carrier. For employers, payroll deductions are a manual process, due to the unique pricing that each employee has with the variety of ages and plan choices. Overall, an ICHRA can be a great option for organizations with the right needs. After considering the implications of an ICHRA, both positive and negative, companies should carefully consider whether this plan will provide the greatest benefit to their administration and employees.

Connor Sir is responsible for working with employers on developing cost-effective employee benefits strategies. His back ground includes working at a medical carrier and a financial planning office, and selling

life, disability, dental, vision and worksite products. Prior to joining Holmes Murphy in 2021, Connor was a sales rep at Principal Financial Group. He earned a bachelor’s degree from the University of St. Thomas Opus College of Business.

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