The 2026 National ICHRA Report

Traditional group health insurance has long been the standard for employers and their benefits consultants. However, rising premiums, rigid structures, and diversifying employee needs have led many to consider alternatives. Much like the shift from pensions to 401(k)s for retirement benefits, the individual coverage health reimbursement arrangement (ICHRA) moves from a defined health benefit structure that organizations manage to a defined contribution model that employees manage. This shift enables employers of any size to reduce their benefits spend and exit the group health insurance business.

With ICHRA, organizations can offer a defined contribution for employees to spend on individual health insurance plans and, depending on plan design, qualifying out-of-pocket medical expenses. Employers get predictable costs, and employees get more choice in their health insurance networks and costs.

Thanks to the flexibility and personalized nature of ICHRA, its popularity has increased significantly since its introduction in 2020. According to the HRA Council, of which Remodel Health is a member organization, ICHRA adoption has grown more than 1,000% since 2020.

Whether it’s a small business offering health coverage for the first time or an enterprise employer seeking cost-effective solutions for its multi-state team, ICHRA empowers employers to provide tailored benefits that meet their workforce’s needs.

As the leading ICHRA administrator by revenue, the Remodel Health 2026 National ICHRA Report analyzes data and trends from the largest vendor-specific dataset available, from average employer size and industry to carrier payments. Because we manage the end-to-end ICHRA experience for more than 100,000 members, we are uniquely positioned to bridge the gap between high-level strategy and operational reality, providing the industry with the most comprehensive vendor-specific dataset available.

An ICHRA gives employees the freedom to choose the individual health insurance plan that best fits their needs. To participate in an ICHRA, employees need either a qualifying individual health plan, Medicare Parts A and B together, or Medicare Part C, also known as Medicare Advantage.

With multiple carrier and plan options available in most rating areas, employees can use their ICHRA contributions to purchase a plan that works with their doctors, prescriptions, and budget.

That freedom is meaningful, and employees are using it thoughtfully. Rather than defaulting to the lowest-cost option, employees are weighing metal tiers and network types based on their individual circumstances. The result is a distribution of plan choices that looks quite different from what you would see in a traditional group health setting, where a single plan design is applied to an entire workforce regardless of individual need.

To understand what employee choice looks like in practice, consider this: across Remodel Health’s ICHRA+ platform, employees select an average of 14 unique health plans per organization. That ranges from a single plan at the smallest employers to 534 distinct plans at the most complex. Compare that to the traditional group health model, where every employee receives the same one.

The data below breaks down how employees enrolled through Remodel Health are making those decisions.

While Bronze and catastrophic plans are cheaper than other metal levels, employees choosing them aren’t necessarily prioritizing cost savings over coverage. As of 2026, all on-exchange Bronze and catastrophic plans, including their mirrored off-exchange versions, are HSA-eligible16. These employees may have received an HSA contribution offer from their employer, allowing them to easily take advantage of both an ICHRA and an HSA.

As long as an employer offers a premium-only or limited-purpose ICHRA to employees with an HSA, they can contribute to the benefit and save money for future out-of-pocket medical expenses.

Looking more specifically at plan types among ICHRA+ platform members, the most commonly selected plan types were:

Plan network type

We also looked at which network types were most common among customers’ employees with an ICHRA.

Nearly half of all members had a health maintenance organization (HMO), with 45%. This was followed by exclusive provider organization (EPO) at 34%, preferred provider organization (PPO) with 17%, and point of service (POS) with 4%.

When metal tier and network type are combined, the five most common plan combinations among ICHRA+ platform members were: Silver HMO (17%), Bronze HMO (15%), Silver EPO (13%), Gold EPO (12%), and Gold HMO (10%).

Remodel Health is the most trusted and operationally reliable ICHRA partner for large employers. We offer the most complete ICHRA service model in the industry, combining intuitive technology with expert, personalized support. Since 2015, we’ve helped employers across the country transition to modern, flexible health benefits. We partner with brokers to bring this smarter group funding solution to life, delivering a streamlined experience for both benefits administrators and employees.

From benefit design to renewal, we walk customers through every step of the ICHRA process, helping them navigate each stage with clarity and confidence. Whether you’re replacing a group plan or rethinking your benefits strategy, Remodel Health makes it simple, scalable, and built to last.