Deconstruct Benefits: ICHRA, Stipends, and Marketplace Explained

20 May 2026 · 0 min

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In this brief segment, Chrissy Myers and a co‑speaker outline three common approaches small employers use for health benefits. They first describe the Individual Coverage Health Reimbursement Account (ICHRA), a flexible, employee‑driven reimbursement model. Next they discuss cash stipends, noting that many employers give a taxable stipend that employees must use to purchase coverage, often through the ACA Marketplace (healthcare.gov) or comparable exchanges. Finally, they explain that regardless of the purchase channel, plans follow the familiar metal‑tier structure—gold, silver, bronze—so employees can compare options using the same criteria they’d see on the public exchange.

One is they do what they call an ICHRA, okay, which stands for Individual Coverage Health Reimbursement Account. Or we've seen them do stipends, okay. Or we've seen them just scrap benefits altogether. In the small groups, I've seen more of, we'll give you a stipend and then you have to go to Marketplace. And then you have to go to Marketplace, but that stipend is taxable.
Yeah, so for those that don't understand Marketplace, we're talking about healthcare.gov, right?
Exactly, okay. Yes, or you can also go outside of Marketplace as well, but plans are pretty— they're built on the same model. They look very similar. They're very similar. You still have your gold, silver, bronze.