ICHRA isn't a new product — it's a new role for brokers

I've been through thousands of individual coverage health reimbursement arrangement implementations and still remember what it felt like to not understand any of it. Not just the details — the entire concept. 

That's exactly where most brokers, employers and their employees are right now. And that makes sense. Group health insurance has been the only model in the employer-provided benefits space for 80 years. There are habits that come with that, so ingrained that you don't even realize they won't apply in ICHRA. I know because I had to unlearn them. too. That's the real challenge. Embracing ICHRA requires letting go of how you've always done things. 

For brokers in particular, it's hard to be confident selling something you're not an expert in. Most brokers haven't had the reps yet, and you just don't know what you don't know. When you're talking about opening a single group to dozens or hundreds of carriers that all operate differently, that's not a small leap. There's a lot you haven't seen and sitting with that discomfort is part of the process. 

The good news is that the infrastructure is catching up. Resources that didn't exist just two years ago such as continuing education from the HRA Council are now available. But there's still nothing like experience. That's been true for me and it'll be true for every broker entering this market. 

While you're building that experience, though, your clients aren't waiting. There's a critical mass of adoption now, and if you're not bringing ICHRA to the table, employers are going to hear about it from someone else. It needs to be in your arsenal. 

Even when ICHRA isn't the right fit, it creates leverage. Employers may get an ICHRA quote showing six- or seven-figure cost savings — and, whether they switch or not, that quote puts pressure on the current carrier to negotiate. For smaller businesses, especially, that kind of leverage didn't exist before. This is about power.

That leverage disappears if you're pitching ICHRA on the wrong assumptions — and many brokers are, because the two biggest assumptions they bring to it are outdated.

The first: ICHRA is just cheaper health insurance. ICHRA isn't a discount on the same familiar coverage. Rather, it's cash on hand that gives employees more options to choose what fits today, with more flexibility for how they budget. What if employees could buy less insurance for the big expenses and access cash upfront for prescriptions, eyeglasses and doctor's visits? At scale, that changes how we think about paying for healthcare and puts more of that decision in employees' hands.

The second assumption: the Affordable Care Act marketplace is too risky. Many brokers are still thinking about the ACA we had in 2013 or 2014 when it was new. It's been 12 years. Today, the marketplace is stable, more carriers are entering and it's more competitive every year. ICHRA got caught up in a conversation about expiring subsidies that was never really about ICHRA. The market responded better than expected — and that's a tailwind.

Where I've actually seen most early implementations break down is a bad rollout. A broker sets expectations for how they think it's going to go, but trust erodes fast if the reality looks different. 

So, what does a good implementation actually look like?

Start by being honest with yourself about what you don't yet know. You don't have to go it alone – look for partners that can be educators as well as vendors. The most successful broker relationships, in my experience, have been genuine two-way streets: brokers gain a better understanding of ICHRA and they push for better answers from the data. They become real thought partners and that's where the work gets fun.

Then check the cultural fit and finances. Is the workforce ready to make that kind of leap? Some employees may not want to choose — they still want to be handed a plan. And there's nothing wrong with that; it's a preference that could make ICHRA feel like a burden instead of a benefit. HR may not be ready to let go of some control yet, either. The brokers who find out up front will have a much more productive conversation when they walk in. 

If you still feel a twinge of discomfort, think of it as a signal that you're headed in the right direction. New territory means new opportunity. For brokers, ICHRA represents a shift from selling products to becoming real strategic partners. The 80-year-old playbook got us this far, but it won't take us where we're going.