For employers and brokers exploring a benefits change. Read the possible next steps here, or answer the questions above to collect the relevant ones in a brief you can print or download.
These are planning prompts. Each selected answer adds 0, 2 or 3 points to a score out of 18; no score proves savings, legal affordability or suitability. The brief uses the same guidance shown below.
Question 1 of 6 · Employer / HR
Why are you considering a change to health benefits?
A benefits change needs a specific purpose. A high planning score does not establish that ICHRA is the right solution.
I am learning about the options
Write down the benefits problem first. If the current arrangement is working and no change is needed, use this brief to learn rather than start a provider purchase.
Our current benefits need improvement
Separate cost, participation, administration and employee-choice concerns. Set a measurable objective and compare alternatives against the same baseline.
We are evaluating a change
Confirm the intended plan year, decision owner and approval date. Record the outcomes a change must deliver before requesting proposals.
Evidence still needed: A written objective, current benefit baseline and decision owner.
Question 2 of 6 · Broker / qualified advisers
Where do your employees live?
Individual insurance options depend on where employees live. One county cannot stand in for a workforce spread across several markets.
Mostly in one local area
Check plans, networks and premiums in the local market. A concentrated workforce does not by itself make ICHRA suitable or unsuitable.
Across several regions or states
Compare availability, premiums, networks and support requirements in every relevant rating area. Do not apply one location’s result to all employees.
Across many locations
Create a market-by-market review and employee-support plan. Require providers to explain how they handle coverage differences and enrollment across locations.
Evidence still needed: Relevant counties, current plan-year premiums and confirmed doctor, hospital and prescription coverage.
The Market Explorer contains a dated 2026 premium snapshot for 30 states and six example ages. It is not a 2027 quote or confirmation of a doctor network, and premiums alone do not establish savings or affordability.
Question 3 of 6 · Finance / broker
How well is your current group health plan working financially?
Employer savings and employee costs are different questions. Compare the complete costs of both arrangements.
Costs and participation are acceptable
Keep the stable group-plan arrangement as a serious option. Require evidence of an improvement after employer fees, employee costs and administration are considered.
Some employees or locations face problems
Identify the locations or employee groups under pressure. Compare those groups separately while preserving a whole-workforce view of cost and impact.
We face major cost or participation problems
Document renewal pressure and its causes. Model several contribution and coverage scenarios; do not assume moving to ICHRA will solve the cost problem.
Evidence still needed: Current group-plan renewal, proposed reimbursements, administrator fees and employee premium and care costs.
This worksheet requires your own written administrator quotes; published starting prices are not personalized proposals.
Question 4 of 6 · HR / qualified advisers
Do you have current employee information for a benefits comparison?
A useful model needs current inputs and the rules for the intended plan year. Data completeness is not the same as a valid affordability calculation.
Not yet
Assemble eligibility, age, location and proposed class information through a secure process with your adviser. Do not upload employee data to this worksheet.
Some information is ready
Resolve missing or outdated census fields and reference premiums. Record which assumptions still prevent a reliable employee-level model.
The information is ready
Confirm the census is current and the modeling method uses the correct plan year, reference coverage and rules. Having data ready does not validate its conclusions.
Evidence still needed: A secure, current employee census, proposed classes, reference premiums and a qualified review of the applicable tests.
Choose the intended plan year. Neither this assessment nor its score calculates legal affordability.
Question 5 of 6 · HR / broker / administrator
How important is individual plan choice?
Having more plans to choose from helps only when those plans meet employee needs and people can get help choosing and using coverage.
Low
Compare the value of a uniform group-plan experience with individual shopping responsibilities. Make sure any proposed change serves the stated employee needs.
Moderate
Identify who needs additional choice and who needs enrollment assistance. Ask providers to demonstrate both shopping and ongoing support.
High
Verify actual plan and network options, not just the number of plans. Require a clear process for licensed guidance, enrollment questions and coverage problems.
Evidence still needed: Plan documents, network and prescription checks, enrollment assistance and an ongoing support process.
Question 6 of 6 · Employer sponsor / administrator
Who could organize the change and help employees enroll?
A benefits change involves notices, payroll, enrollment and payments. Each task needs an owner and a workable deadline.
We have not assigned the work
Resolve ownership, communications, payroll and enrollment capacity before committing to a launch. Ask an adviser to assess whether the intended timeline is feasible.
We would need outside help
Request a written division of work between employer, broker and administrator. Identify who handles notices, data cleanup, payments, enrollment and escalations.
We can assign the work
Turn readiness into a written milestone plan with owners and dependencies. Validate the timeline, employee communications and exception handling before approval.
Evidence still needed: A written implementation schedule, assigned responsibilities and a process for exceptions and unresolved problems.
