What is the difference between an HMO and a PPO?

The main difference is provider flexibility. With an HMO, you generally have to use in-network providers for non-emergency care. You may also need a referral to see specialists. PPOs generally allow you to see specialists without referrals and provide some coverage for out-of-network care, although you'll usually pay more.

Which health insurance network type is best for individual coverage?

There isn't one network type that is best for everyone. The right choice depends on your preferred doctors and hospitals, how often you see specialists, whether you need out-of-network coverage, and your budget. When comparing individual plans, review the provider network, covered services, premiums, deductibles, and other cost-sharing requirements.

Can employees choose different health insurance networks through a CHOICE Arrangement?

Yes. A CHOICE Arrangement, formerly known as an ICHRA, allows eligible employees to choose individual health insurance coverage that meets their needs, subject to the terms of the employer's arrangement. This means employees can select plans with different network types, such as HMOs, PPOs, EPOs, or POS plans, rather than all employees enrolling in the same group health plan.

What are the largest individual health insurance companies?

For the 2026 Affordable Care Act (ACA) Marketplace, KFF identifies UnitedHealthcare, Centene Corporation, Oscar Health, Elevance Health, Molina Healthcare, Cigna Healthcare (exiting the market in 2027), and Kaiser Permanente among the major national participants. KFF reports that they operate in 30, 29, 20, 18, 14, 11, and 10 states, respectively.

Is Blue Cross Blue Shield an individual health insurance carrier?

Blue Cross Blue Shield is a system of independent, locally operated insurance companies rather than one nationwide carrier. Availability, networks, and plan designs vary by the specific Blue Cross Blue Shield company serving your area.

How do I find out which health insurance carriers are available in my area?

Visit HealthCare.gov or your state's health insurance exchange. Enter your location to see the plans and carriers currently available to you. CMS also provides Marketplace data showing insurer service areas by state, county, and ZIP code.

Can employees choose their own health insurance with a CHOICE Arrangement?

Yes. With a CHOICE Arrangement, employees receive employer-funded contributions that they can use toward individual health coverage. Rather than being limited to an employer-selected group plan, employees can select an individual plan that meets the benefit’s requirements and is available in their area.

Do individual health insurance carriers offer the same plans in every state?

No. Carriers can offer different plans, networks, premiums, and benefits by state and county. A carrier may also change its service area from one year to the next. KFF's 2026 Marketplace analysis documents substantial county-level changes in insurer participation.

Can employees use a CHOICE Arrangement to pay for individual dental or vision insurance?

Yes, employees can use a CHOICE Arrangement to pay for individual dental and vision insurance premiums or out-of-pocket costs, if their employer's plan design allows for it.

Can a small business offer a CHOICE Arrangement and a QSEHRA at the same time?

No. An employer generally can't offer both a CHOICE Arrangement and a QSEHRA to the same employees. Small businesses should evaluate which HRA best fits their benefits strategy.

Can employers offer a CHOICE Arrangement and an HSA at the same time?

Yes, but certain requirements apply. To contribute to an HSA, an employee needs an HSA-eligible HDHP, and the CHOICE Arrangement must be structured to avoid providing disqualifying coverage.

Is ICHRA software enough to administer an ICHRA?

It can be, depending on your team's resources and the software provider's capabilities. ICHRA software can automate many administrative tasks, but your team may still be responsible for plan setup, employee questions, compliance, documentation, and ongoing administration. Employers with experienced benefits staff may be comfortable managing these responsibilities internally.

Is full-service ICHRA administration more expensive than software?

Full-service administration typically costs more than software alone because you're paying for both technology and professional support. However, the total cost should also account for the time your internal team spends managing the ICHRA. For growing companies with lean HR teams, outsourcing more administrative tasks can reduce internal workload and free up time for other priorities.

Is full-service ICHRA administration better for growing companies?

Full-service administration can be a strong fit for growing companies because ICHRA administration can become more complex as an organization adds employees, expands into new states, or develops more nuanced benefits strategies. Having technology and dedicated benefits professionals can help employers scale their ICHRA without putting all of the additional administrative work on their HR team.

What is the average ICHRA contribution?

According to Remodel Health's 2026 National ICHRA Report, average employer contributions vary significantly by industry and family status. For employee-only coverage, average monthly contributions range from approximately $441 to $730, while family contributions can exceed $1,400 in some industries.

How much should an employer contribute to an ICHRA?

There is no required minimum contribution for an ICHRA. However, applicable large employers with 50 or more full-time equivalent employees must offer an affordable ICHRA contribution to satisfy the Affordable Care Act's employer mandate. The right contribution depends on your workforce, budget, local insurance market, and benefits goals.

Can employers contribute different amounts to different employees?

Yes. ICHRAs give employers flexibility to vary contribution amounts based on factors permitted under federal IRS guidelines and the ICHRA final rules, such as employee age and family size. Employers can also offer different contribution amounts to eligible employee classes, like part-time and full-time employees.

Do employees usually enroll in the benchmark plan?

Not always. Many employees choose different carriers, provider networks, deductibles, or metal levels based on their healthcare needs and budget. The benchmark plan simply serves as a reference point for establishing employer contributions.

How does ICHRA compare to QSEHRA?

Both the individual coverage HRA (ICHRA) and qualified small employer HRA (QSEHRA) allow employers to offer tax-advantaged health benefits, but they serve different needs. ICHRA is available to employers of all sizes, while QSEHRA is only for small employers with fewer than 50 full-time equivalent employees (FTEs). The IRS also sets annual contribution limits for QSEHRA.

Does ICHRA help employees pay for individual health insurance coverage?

Yes. With an ICHRA, employees receive a tax-free employer contribution that they can use toward their individual health insurance premiums.

Do employees have to choose the same health insurance plan with ICHRA?

No. One of the biggest advantages of ICHRA is that employees can choose individual health insurance plans based on their own healthcare preferences, budget, and preferred providers.

Where can employees buy individual health insurance plans with ICHRA?

Employees can purchase individual health insurance plans through the Health Insurance Marketplace, a state marketplace, or directly from an insurance company. With ICHRA, employees may also have the option to choose off-exchange plans, which can provide additional plan choices depending on their location. With Remodel Health’s ICHRA+, most employees enroll in off-exchange plans through our platform.

What are the most popular health plan types chosen by Remodel Health ICHRA+ members?

Gold copay plans, bronze HSA plans, and silver copay plans make up the majority of selections.

Do employees with ICHRA tend to choose gold or bronze plans?

Gold and bronze plans are both popular choices among Remodel Health ICHRA+ members, with 28% choosing Gold copay plans and 27% choosing Bronze HSA plans.

An individual coverage health reimbursement arrangement (ICHRA) is an employer-sponsored benefit that allows organizations to provide tax-free contributions employees can use toward individual health insurance premiums and eligible medical expenses. Unlike traditional group health plans, ICHRA gives employees more flexibility to choose coverage that fits their needs.

Is ICHRA only for small employers?

No. Employers of all sizes use ICHRA to provide flexible health benefits.

Do employees have fewer health plan options with ICHRA?

No. ICHRA often gives employees access to a wider range of individual health plans. Instead of choosing from a limited number of employer-selected group plans, employees can compare available options and select healthcare coverage based on their providers, prescriptions, budget, and healthcare needs.

Can an employer switch ICHRA administrators midyear?

Yes. Employers can transition administrators midyear. However, switching administrators doesn't trigger a special enrollment period (SEP) for employees.

What information do I need from my current ICHRA administrator when changing partners?

Employers should request a complete enrollment file, including employee and dependent details, plan IDs, member IDs, contribution amounts, and payment information.

How long does an ICHRA administrator transition take?

The timeline depends on the size of the group, carrier processes, available data, and whether employees are making plan changes. A strong transition partner will help create a clear timeline and guide employers through each step.

Will switching ICHRA administrators affect my employees’ health plans?

It depends on the timing of an ICHRA vendor change. If you’re exploring a midyear change, employees’ plans won’t be impacted, as changing ICHRA vendors doesn’t create an SEP. However, changing vendors during the annual Open Enrollment period would allow employees to change their plans for the new benefit year.

What should I look for in an ICHRA administrator?

You should look beyond tech-only ICHRA platforms and evaluate vendors based on their customer service model, compliance support, and change management.

Holly Bengfort

Holly Bengfort is a content marketing specialist at Remodel Health and PeopleKeep, with three years of experience in HRAs and health benefits. Having experienced the QSEHRA firsthand as an employee, Holly provides invaluable insights into how it can benefit small businesses and their workforce. Before joining the team in 2023, Holly worked in television news as a broadcast journalist. With her experience as a news anchor and reporter, Holly has an exceptional ability to break down intricate stories into clear, compelling narratives that resonate with diverse audiences. Her talent for simplifying tricky topics ensures that everyone can fully grasp important information. Outside of work, Holly enjoys spending time outdoors, staying active, and relaxing on the beach.

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