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Workers with cash from individual coverage health reimbursement arrangements might be more likely to choose lean bronze plans this year and less likely to choose rich gold plans.
HealthSherpa — a company that helps insurance brokers sell individual major medical coverage and Medicare plans — has raised that possibility in an early ICHRA market data snapshot.
Mike Levin, an executive at HealthSherpa, looked at the company's own transaction data for the first week of the enrollment period and found that the percentage of ICHRA users choosing mid-level silver-level coverage rose just a bit, to 28%, from 27%.
The percentage choosing rich gold plan coverage fell to 28%, from 38%, and the percentage choosing lean bronze plans rose to 42%, from 35%.
One reason for the shift to bronze plans could be that ICHRA users are reacting to soaring prices for gold plans by choosing cheaper plans, Levin said.
He suggested that another reason could be provisions in the One Big Beautiful Bill Act that will make it easier for bronze coverage users to put money in health savings accounts and use HSA cash to pay for direct primary practice memberships, or arrangements that offer to provide routine care for a pre-set monthly, quarterly or annual fee.
Levin is starting to post the ICHRA market snapshots on his LinkedIn feed.
He emphasized that the picture could change as the enrollment period moves forward.
Other HealthSherpa ICHRA market insights: Levin found that about 60% of the ICHRA users the firm sees are getting their individual coverage away from the ACA exchange system, rather than through the exchange system.
He has also compiled very early state ICHRA sales rankings.
Florida now appears to be the top ICHRA market, up from third last year, and Arizona has dropped to 11th place, from fifth, according to Levin's reckoning.
ICHRAS: When employers put cash in ICHRAs, workers can use the cash to buy their own individual major medical coverage.
ICHRA plan administrators and health insurers with an interest in the ICHRA market are hoping that this will be the year when ICHRAs start to become a mainstream employee health benefits option.
The enrollment period: The annual enrollment period for individual major medical coverage started Nov. 1 and is set to end Dec. 15 in most of the country.
HealthSherpa: HealthSherpa supported 34% of Affordable Care Act exchange plan enrollments in 2025. It operates in Georgia and in the states that use the federal government's HealthCare.gov platform.
The firm also helps insurers sell ACA-compliant individual major medical coverage outside of the ACA exchange system.
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