Your estimate vs a CHOICE Arrangement (ICHRA) · Filed 2026 rates · Nothing transmitted
Would a CHOICE Arrangement (ICHRA) cost less than your group plan?
First, what it is. A CHOICE Arrangement (formerly ICHRA) is a plan design, not a product. You fund a fixed monthly amount per employee, tax-free, and your people buy their own Individual (Marketplace) plan with it.
So it has no market price. It has a contribution you pick. The real question is what equivalent coverage would cost through marketplace plans instead.
How to use this
What do I actually need to enter?
- Pick your state. The benchmark pre-fills with your state median. Overwrite it with your own county for a real number.
- Enter total monthly plan cost. Employer plus employee, before payroll deductions.
- Enter your census by age band, then covered spouses and children.
Green: the individual market prices lower than your plan.
Orange: your group plan prices lower. Funding to equivalence would cost more.
The gap is the size of the conversation, not the savings. Silver sits at roughly 70% actuarial value, so a richer group plan is worth more than the comparison shows. Nothing you enter is transmitted.
Step 1 · Where your people are
Step 2 · Who is enrolled
HOW TO READ THE GAP
What is the number actually telling you?
Four things worth knowing before you take it into a renewal conversation.
01
Your renewal carries your own history
One high-cost claimant follows you into next year's rate. A rough year means you gain more than this comparison shows. A clean one means you gain less.
02
Individual rates are pooled statewide
Your group's experience never enters that math. One market isn't cheaper than the other. They price different risk.
03
The age curve runs 3:1 both ways
A 64-year-old pays exactly 3 times a 21-year-old, individual and small group alike. A young census prices well in both, so claims history decides it.
04
Left out on purpose
Tax credits, admin fees, payroll tax effects. Each would flatter the result or ask you to trust a number we can't verify for you.
WHAT'S IN IT FOR YOU, AND FOR YOUR PEOPLE
How does giving my people more actually lower my cost?
Because cost gets diverted, not shifted. Care that happens sooner, closer and at $0 to the member doesn't turn into an ER visit, a surgery, or three weeks of somebody not at work.
The part people miss. These aren't perks you buy with the savings. They're a cost lever in their own right, because better access changes what happens next. What structure frees up is how you fund them without touching budget.
| What your people get | What it costs them | What it prevents |
|---|---|---|
| 2,400+ medication formulary Generics, OTC, brand and specialty. The list includes medications retailing for up to $1,900 / month, with no cap on coverage. Whole household | $0 | The refill they skipped because of cost, which becomes an admission |
| Virtual urgent care and telehealth Includes medications prescribed from the visit | $0 | The ER visit, and the half-day off work that comes with it |
| Behavioral health, licensed clinicians No per-member session cap, subject to clinical appropriateness | $0 | Medical claims, absence, and the resignation you didn't see coming |
| Pain and musculoskeletal care Including physical therapy at home | $0 | The surgery, and the weeks of recovery around it |
| Cardiometabolic care Diabetes, blood pressure, weight | $0 | The cardiac event. A generic costs dollars. An admission does not |
| Women's health | $0 | Care deferred on a high deductible, which presents later and costlier |
| Wellbeing and care navigation | $0 | The wrong site of care, at several multiples of the right one |
| Accident protection Pays a set amount per covered event. Not major medical, does not replace a health plan | Varies | The deductible that turns an accident into a household crisis |
| Member discount programs Legal, identity, caregiver, pet, household. Discount programs, not insurance | Varies | The distraction that costs you attendance before it costs you claims |
WHAT YOU GET
- Lower plan cost. Care that happens sooner and cheaper never reaches your claims fund.
- Fewer days lost. A same-day virtual visit isn't a half-day off work.
- An offer people stay for. $0 at the point of care is a benefit someone can describe to their spouse.
- Less financial stress on your team, which shows up in attendance long before it shows up in claims.
- Budget certainty. Fixed cost on this layer, no renewal surprise.
WHAT THEY GET
- $0 at the point of care, so cost stops being the reason a visit gets postponed.
- The whole household, not just the employee.
- No per-member visit or session cap, subject to clinical appropriateness.
- Care that comes to them. Virtual, and physical therapy at home.
- A deductible that stops being a crisis when something goes wrong.
How it gets paid for
- $0 upfront.
- Budget freed on day 1.
- Savings realized monthly.
- No layoffs, no plan cuts, no disruption to people, systems or processes.
Most employers haven't had visibility or access to this previously. It sits outside the commissioned channels most brokers work in, which is structural and isn't anyone's fault.
BEFORE YOU QUOTE THE NUMBER
What else should you know?
Does this tell me what a CHOICE Arrangement would cost me?
Should I enter my cost or my employees' cost?
My group plan is richer than Silver. Does that break this?
Why don't you include premium tax credits?
How much does the age band midpoint distort this?
My people are in several states. What then?
Why is my state missing a pre-filled rate?
What happens to what I type here?
How do I get cheaper health insurance?
Is a CHOICE Arrangement cheaper than a group health plan?
What else should I run before I take this to my CFO?
Three free tools, all built from filed 2026 rate data. No form, no login.
Get the exact benchmark, not the state median
Lowest-cost Silver by county and age across 3,137 counties, plus the affordability test number your offer has to clear.
Is your plan high, or is your census just older?
Your percentile against filed 2026 small group premiums in your state, and nationally. All 50 states plus DC.
These are only 2 of the 6 options you have
Level funded, self-funded and shelf-rated structures compared by group size, census age and industry.
The next question
You have the gap. Do you know which levers close it without touching your people?
Changing funding structure is one way. It is not the only way, and it's rarely the fastest.
Most of what we find sits on top of the plan you already have. No layoffs, no plan changes, no disruption to people, systems or processes. Budget freed on day 1, savings realized monthly, $0 upfront.
See what's available to youNo obligation. Nothing to sign.
Sources and limits. Individual market premiums are the lowest cost Silver plan filed for the 2026 plan year in the rating area each county sits in, from the CMS Qualified Health Plan public use files, covering the 30 states on the federal platform. Age factors are the federal default age curve. A small number of counties span more than one rating area; where that happens the tool uses the area CMS lists first, and rates for your employees may differ by ZIP. 21 state-based exchanges do not file into the federal dataset and require manual entry. This tool compares premium against premium. It does not account for actuarial value differences between your plan and Silver, administration fees, payroll tax effects, or premium tax credits, which an employee with an affordable CHOICE Arrangement offer cannot claim. Output is general educational information, not a quote, not an offer of coverage, and not insurance, tax or legal advice. All calculation happens in your browser and no inputs are transmitted or stored.
