Health Benefits on Your Budget — Without a Group Plan
You set the monthly allowance. Your employees choose the individual plan that works for them. You reimburse them tax-free. That's the Individual Coverage HRA — and for many small and midsize employers in Northwest Missouri, it's changing how they think about offering benefits.
What Is an ICHRA — and Why Are Missouri Employers Paying Attention?
An ICHRA, or Individual Coverage Health Reimbursement Arrangement, is an IRS-approved alternative to traditional group health insurance. Instead of selecting a single group plan for your entire workforce, you define a fixed monthly reimbursement amount. Employees use that allowance to purchase their own individual health coverage — on the ACA Marketplace or off-exchange — and submit their premiums for tax-free reimbursement.
The result is a benefits structure with no minimum contribution requirements, no participation thresholds, and no carrier negotiations. You control the budget. Your employees control the plan.
ICHRA is available to employers of any size, and reimbursement amounts can vary by employee class — full-time, part-time, seasonal, salaried, and others — giving you flexibility that a standard group plan simply doesn't offer.
WHY OUR CLIENTS CHOOSE US
What the ICHRA Setup Process Looks Like With JJI Agency
ICHRA is straightforward in concept, but the IRS compliance requirements — plan design, employee notice rules, and integration with ACA coverage — require careful setup. We walk you through every step.
- Define your employee classes and reimbursement amounts. We help you structure allowances that align with your budget and workforce composition.
- Draft and distribute the required employee notice. IRS rules require written notice to employees at least 90 days before the plan year begins. We make sure this is done correctly.
- Employees shop for individual coverage. We can assist your employees in finding and enrolling in qualifying individual plans — the same way we support any individual health insurance client.
- Reimburse and document. Employees submit proof of coverage and premiums; you reimburse up to their monthly allowance, tax-free.
- Stay current on compliance. Rules can change. We monitor IRS guidance and ACA requirements so you're not caught off guard.
You handle your business. We handle the compliance work that keeps your benefits program running cleanly.
JJI Agency has been serving employers and families in Northwest Missouri since 1985. What started with John Joe is now led by his son Todd, with a third generation active in the agency — and that continuity matters when you're navigating a benefits decision that affects your entire team.
We're independent brokers, which means we work for you, not for any single carrier. When we recommend ICHRA over a group plan — or a group plan over ICHRA — it's because the numbers and your situation point that direction, not because of a contract we hold.
If you're ready to find out whether an individual coverage HRA is the right move for your business, let's talk.
How ICHRA Compares to a QSEHRA and a Traditional Group Plan
Understanding the differences between your options is the first step to choosing the right structure for your business.
- ICHRA: Available to employers of any size. No annual reimbursement cap. Reimbursement amounts can differ by employee class. Employees must be enrolled in qualifying individual health coverage.
- QSEHRA (Qualified Small Employer HRA): Available only to employers with fewer than 50 full-time equivalent employees. Annual reimbursement limits apply ($6,350 single / $12,800 family in 2024). All eligible employees receive the same reimbursement amount. No group plan can be offered alongside it.
- Traditional Group Plan: Employer selects a single plan (or a small set of options). Employer and employee share premium costs. Minimum participation and contribution requirements typically apply. Works well when your workforce has similar coverage needs.
Neither ICHRA nor QSEHRA is inherently better — the right fit depends on your headcount, workforce diversity, and budget goals. We help you model the numbers and make the call with confidence.
Why a One-Size-Fits-All Group Plan Doesn't Always Fit
A 25-person team is rarely 25 people with the same health needs. You may have single employees in their 20s alongside employees supporting families. Some staff have established relationships with specific physicians. Others are managing ongoing prescriptions that make certain plan networks a better financial fit.
When you force everyone into the same group plan, someone is always paying for coverage that doesn't match their life. ICHRA removes that friction. Each employee selects the individual coverage that fits their doctors, their family size, and their health priorities — while you maintain predictable, fixed costs on your end.
For employers who've struggled to find a group plan that works across a diverse team, ICHRA is often the answer they didn't know existed.
Common Questions About ICHRA
What's the difference between ICHRA and a traditional group health plan?
With a group plan, your business selects a specific insurance plan and employees enroll in it — often with limited choices. With an ICHRA, you set a monthly reimbursement allowance and employees purchase their own individual coverage. You control the budget; they control the plan. There's no group enrollment, no participation minimum, and no carrier negotiation on your end.Can I offer ICHRA to part-time employees?
Yes. One of ICHRA's advantages is that you can define different reimbursement amounts for different employee classes, including part-time, seasonal, and hourly workers. You are not required to offer the same allowance to every employee — but the rules within each class must be applied consistently.Is ICHRA compliant with the Affordable Care Act?
Yes, when set up correctly. ICHRA was created by a joint IRS and Department of Labor rule that took effect in 2020 specifically to expand employer flexibility under the ACA. Employees must be enrolled in qualifying individual health coverage to receive reimbursements, and employers must follow IRS notice and documentation requirements. We make sure your plan meets every compliance standard before it goes live.How much can I reimburse employees tax-free through an ICHRA?
Unlike a QSEHRA, an ICHRA has no annual reimbursement cap. You can set any monthly allowance amount you choose, and reimbursements for qualifying individual health insurance premiums and eligible medical expenses are tax-free for both employer and employee. The IRS does require that reimbursements be made only for substantiated, qualifying expenses.