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ICHRA plans are already providing health coverage for more than 5 million Americans.

But Maya Perl, the chief product officer at Zorro, an ICHRA program manager, said in a recent email interview that ICHRA plan administrators are working with insurers to simplify ICHRA enrollment and help the plans reach their full potential.

"A key challenge with ICHRA is that each insurer has its own enrollment process, which varies in complexity," Perl said.

Perl sees some insurers — especially insurers in regions where ICHRA plans are still gaining traction — adapting more slowly and using their own manual, time-consuming application processes, with little ability to communicate with employers.

For a health benefits administrator, simply tracking whether the workers in an ICHRA plan have gotten covered can be complicated.

"Many of these challenges stem from a lack of familiarity with ICHRA rather than resistance to the model itself," Perl said. "Standardization across insurers would be a major step forward. A uniform enrollment protocol for individual health plans across all states would simplify processes for insurers, brokers, employers and employees alike."

One way for an employer and workers to avoid having to deal with the complexity is to work with an ICHRA plan administrator that works with the insurers to streamline enrollment, reporting and other tasks for the plan sponsors and participants.

The future: Some insurers have created or are creating teams to improve how they support ICHRA users, Perl said.

Those insurers are taking steps such as changing how they share plan and pricing data and adding ICHRA-related data fields to enrollee records.

Another goal is helping ICHRA users cope with what might be a long list of coverage options.

AI-driven decision support tools can give workers with simple needs a way to find affordable plans that cover their doctors and medications without forcing the employer to create a plan menu, Perl said.

"For those who need additional guidance, most providers will provide access to benefits specialists who can provide personalized support," Perl added.

In the long run, Perl said, the ICHRA programs should improve small and medium-sized businesses' health benefits, by pulling young, healthy workers back into the risk pool and forcing health insurers to compete for the workers' ICHRA cash.