Switching ICHRA administrators can be challenging any time of year. Here’s what to watch out for.
By Ari Beilin – COO, Gravie ICHRA
ICHRA transitions are complex under any circumstances, and come with their own unique set of risks that brokers and their clients should understand. If you plan to advise your clients to move to a new third-party administrator in the coming year, here are the risks to keep in mind as you evaluate your options, and more importantly, how you can keep your employees happy and satisfied with the solution you chose.
First, let’s talk about what changes and what doesn’t.
If you’re switching platforms mid-year, it’s important that your clients and their employees are aware that while their TPA is changing, their plan remains the same. That’s great news for employers and their employees because they won’t need to worry about their deductibles or out-of-pocket maxes resetting. The TPA change does not trigger a Special Enrollment Period on the individual market. So if an employee wants to change plans, they will most likely have to wait until the Federal Open Enrollment period at the end of the year.
ICHRA platform transitions have many moving parts, and it’s only natural that both employers and employees will have a lot of questions. All of it can be hard to navigate–and that’s why the right service model and support matters. When evaluating ICHRA administrators, look for those who have a high level of employer and member support that you, your clients, and their employees can talk to when questions arise. They can spot small issues before they become a problem, troubleshoot on the fly, and offer guidance and support when you need it.
When considering a new ICHRA administrator, ask: “Who will reach out to my clients’ employees to help them through the transition? Is there someone they can talk to whenever they have questions about their coverage?” If there’s a pause at the other end of the line, then that should give you pause, too.
It’s also important to get clarity on how payments will be handled, and make sure you’re comfortable with the process.
Any mid-year switch comes with a heavy administrative load, particularly when it comes to transitioning the bank accounts used to pay each employee’s plan. Any missed or failed payments could result in a loss of coverage, so seamless bank account changes aren’t just a matter of convenience; they’re absolutely critical.
Finally, you’ll do yourself–and your clients–a huge favor by giving your new ICHRA administrator all the information they need to succeed before they even ask for it.
Give them a thorough list of the health plans for all your employees, and let them know whether those health plans were purchased on or off exchange. The little details matter, and the sooner you get them to your new administrator, the better for everyone involved.
When it comes to ICHRA administrators, a high-tech platform is at its best when it comes with high-touch human support. ICHRA administrators that blend strong, tech-enabled platforms, operational reliability, and personalized human support that can tackle the nuances of the individual market can make your transition simple and less risky.
So before you recommend a switch, do your homework, and ask these questions:
- How quickly can the administrator move a group, mid-year or otherwise?
- Does the administrator offer guidance throughout the implementation process?
- What information, such as employee census and plan data, will the administrator require from your group?
- Is my group prepared to communicate the ICHRA transition to their’ employees, and will they require support for this from the administrator?
- Does the administrator offer educational resources to help employees understand their benefits?
- How does the administrator provide support for billing issues, care coordination, or prescription lookup?
If the answers sound like more work for you, it’s worth seeking out a partner who can make an ICHRA platform transition seamless – mid-year, next year, or any time of year. Gravie is here to help.