Individual Coverage Health Reimbursement Arrangement
The ICHRA premium reimbursement solution from iStream enables employers to fund premium payments directly, just like with traditional group plans.
Employees don’t have to pay upfront, and employers keep administration simple, secure, and compliant.
Modernize Premium Reimbursements Without the Hassle
ICHRAs give employees the freedom to choose individual health insurance plans while employers continue to contribute. But there’s one big drawback: in many ICHRA programs, employees must pay premiums upfront and then wait for reimbursement—putting unnecessary strain on cash flow.
💡 How it Works
- Employers sponsor an ICHRA plan
- Employees enroll in ICHRA Plan
- iStream assigns an employee account for premium payments
- Employers fund premium disbursement account
- Carriers debit employee premium accounts to fund insurance coverage
- iStream processes ACH activity and provides real-time visibility and advanced reporting
Employers treat the employee portion as a wage advance, recouped through payroll, mirroring the familiar workflow of traditional group plans, while preserving cash flow for employees.
✅ Benefits
- Removes the financial burden on employees — no more paying first, waiting later
- Automates premium payments — reducing admin work and errors
- Supports compliance and security — trusted, transparent, and scalable
- Flexible for employers — works across industries, carriers, and plan types
The Challenge with ICHRA Premiums
With traditional group coverage, premiums are paid up front by the employer, and employees simply have their portion withheld through payroll.
For example:
- Family premium: $1,000/month
- Employer pays 50%: $500
- Employee pays 50%: $500, withheld as $250 per paycheck (semi-monthly)
Employees never have to pay the full premium themselves.
With ICHRA, it’s different. Employees must pay the entire $1,000 premium upfront to the carrier, while still having $500 withheld from their paychecks for the prior group coverage month. That’s a 200% financial hit in the first month, a burden many households can’t manage.
📘 Featured Resource:
Why ICHRA Administrators Choose iStream for Premium Payment Processing
How iStream Solves it
The iStream ICHRA Solution eliminates this cash-flow problem by aligning ICHRA payments with the familiar group plan model:
- Employers fund accounts directly, covering both their share and the employee’s share (as a wage advance).
- Carriers debit premiums monthly from these accounts.
- Employees’ share is recouped gradually through payroll deductions, just like before.
The result? Employees avoid the upfront shock, employers maintain their normal cash-flow rhythm, and everyone benefits from a seamless transition to ICHRA.
Contact us today to learn how our ICHRA solution can benefit your organization.