Click to learn more about key ICHRA terms
ACA individual market plans
Health insurance policies for individuals or families. These policies come with consumer protections required by the Affordable Care Act (ACA), including coverage of the essential health benefits and no limitations on coverage for pre-existing conditions.
Health reimbursement arrangement (HRA)
An employer-funded account that reimburses employees for eligible health care expenses. Reimbursements are made on a tax-free basis, up to a maximum set by your employer.
Individual coverage health reimbursement arrangement (Individual Coverage HRA, or ICHRA)
An HRA offered to employees instead of traditional employer coverage. In order to be eligible for reimbursement, employees must enroll in an individual market plan.
Off-exchange plans
Individual market plans that are not sold through a public marketplace. Off-exchange plans must comply with the same rules as on-exchange plans. In some markets off-exchange plans may be cheaper than on-exchange plans, and in some cases they may offer a different provider network or plan benefits. Individuals who enroll in off-exchange plans are not eligible for premium tax credits.
On-exchange plans
Individual market plans that are sold through a public marketplace. Premium tax credits are available to eligible individuals who purchase on-exchange plans.
Premium tax credit
Tax credit that lowers your monthly insurance premium when you purchase a plan through a public marketplace. To qualify for this tax credit, your household income must fall between 100% and 400% of the federal poverty level.
Private individual insurance marketplace (aka private exchange)
A privately-run platform through which employees can enroll in individual market plans (including on-exchange plans), receive reimbursements from their HRA, and receive online and call-center support throughout the enrollment process and during the coverage year.
Public health insurance marketplace (aka public exchange)
A publicly-run platform through which individuals can enroll in on-exchange plans and qualify for premium tax credits. In most states healthcare.gov serves as the public health insurance marketplace, though around one in four states operate their own.
Qualified health plan (QHP)
An insurance plan available through a public health insurance marketplace. Also known as an on-exchange plan.