What makes a good question?
The best questions are specific, tied to your goals, and backed by a request for evidence.
Instead of “Do you offer employee support?”, ask “Can employees track reimbursement status in real time, and who do they contact if something goes wrong?”
Instead of “Is your platform secure?”, ask for a copy of their latest SOC audit or data retention policy.
Good questions reveal how the provider actually works—especially when something breaks or needs to scale. They help you move beyond the sales pitch to see how the experience will feel for your team and employees.
Claims and reimbursement: how employees experience ICHRA
This is what employees care about most. A clunky claims process leads to frustration, low adoption, and more work for HR.
Ask:
How are claims submitted and reviewed? Look for multiple options—mobile upload, email, and direct portal entry. A good provider automates reviews where possible but includes human oversight for edge cases.
What’s the typical reimbursement timeline? Best-in-class providers process approved claims within 2–3 business days. Delays can erode employee trust.
Can employees track their claim status in real time? Real-time updates reduce confusion and support tickets. Look for email or app notifications at every step.
Does the platform integrate with payroll systems? Integration reduces manual work and ensures reimbursement records are clean and audit-ready.
Who do employees contact for help with claims? A dedicated support channel (not just a generic email) makes a big difference when receipts go missing or documentation is unclear.
Compliance and regulation: protect your business
ICHRA administration touches IRS, DOL, and HHS rules. Mistakes here can lead to fines, audits, or loss of employee trust.
Ask:
Do you create and maintain ERISA-compliant plan documents? A good provider delivers compliant Summary Plan Descriptions (SPDs) and updates them annually—or when rules change.
How do you handle HIPAA, BAAs, and documentation retention? They should sign a Business Associate Agreement (BAA), track access logs, and follow strict data retention policies. Ask to see their audit trail setup.
Do you manage 1095-C reporting for ALEs? Large employers (50+ FTEs) need this for ACA compliance. The provider should be able to produce 1095-Cs on your behalf or integrate with your reporting vendor.
How do you ensure affordability and Minimum Essential Coverage (MEC)? Look for built-in affordability calculators that flag issues automatically based on contribution levels and employee income bands.
Do you manage PCORI fees and Medicare Secondary Payer rules? These details often get missed—but they're required for certain employers and plan types.
Is your platform SOC-audited? A recent SOC 2 Type II audit shows the provider meets strong security and operational standards. Ask for a summary report.
Employee support: make benefits easy to use
Employees aren’t benefits experts. If they don’t understand how to use their ICHRA, they’ll disengage—or make costly mistakes.
Ask:
Do you offer onboarding tools and plan comparison guides? These help employees understand premiums, coverage, and provider networks before choosing a plan.
Are licensed advisors available to answer questions? Talking to a licensed professional can prevent employees from selecting plans that don’t meet their needs.
Is support available in multiple languages and formats? Bilingual and multichannel (chat, phone, email) support ensures accessibility for your entire workforce.
Does the platform integrate with public marketplaces or private exchanges? A smooth connection lets employees shop for qualified health plans (QHPs) without needing to re-enter data.
Do you provide communication templates and educational materials? Look for pre-written emails, guides, and optional webinars that reduce HR workload while boosting employee understanding.
Onboarding and implementation: how the rollout works
Good implementation sets the tone for everything that follows.
Ask:
How long does setup take, and who leads it? A clear timeline, project plan, and dedicated launch manager are signs you’re in good hands.
Do you help with plan design (classes, contributions, eligibility)? They should guide you through IRS rules and help align plan setup with your workforce structure.
Is training provided for HR and payroll teams? Ongoing access to training materials—and a real person to call—makes adoption easier.
Do you help with employee rollout and open enrollment communications? Launching ICHRA requires clear messaging. A good provider supports you with templates and training sessions.
What ongoing support is available post-launch? Ask if you'll have a named contact and what cadence they offer for check-ins or plan reviews.
Integration with insurance marketplaces: remove friction
If employees can’t easily shop for and enroll in plans, ICHRA falls flat.
Ask:
Do you support enrollment through federal and state marketplaces? Confirm that employees in all relevant states can access coverage through the platform.
Do you work with brokers or bentech platforms to support plan comparisons? Integrated tools make it easier for employees to filter by cost, network, and drug coverage.
Do employees get a tailored, guided experience when choosing a plan? Decision support tools improve plan selection and reduce help requests.
Do you manage payments to insurance carriers? Direct premium payments to carriers prevent coverage lapses and simplify accounting.
Flexibility and customization: fit the benefit to your workforce
ICHRA’s flexibility only matters if your provider supports it in practice.
Ask:
Can we create multiple employee classes? You should be able to offer different benefits to salaried vs. hourly, remote vs. onsite, etc., within IRS limits.
Can allowance amounts vary by class or family status? The platform should let you set compliant but customized contribution levels.
Are plan changes easy and affordable to make mid-year? Ask whether changes require manual updates, how long they take, and whether there are fees.
Do you monitor for discrimination compliance? The system should flag issues automatically and provide reports showing compliance with HIPAA, ACA, ERISA, and other applicable state and federal laws.
Is coverage portable for terminated employees? Employees should keep their coverage and switch to direct payments easily if they leave the company.
Pricing and transparency: no surprises
ICHRA should simplify budgeting—not introduce new complexity.
Ask:
Is pricing all-inclusive or modular? Look for a per-employee-per-month (PEPM) model that includes compliance, support, and documentation.
Are there setup fees or minimums? Prefer providers with no extra onboarding charges or headcount requirements.
Is pricing locked for a set period? A 12- or 24-month price lock helps with financial planning.
Are upgrades and new features included? Mature platforms ship improvements regularly—without extra charges.
Do you offer ROI or utilization reporting? Regular reporting shows whether employees are using the benefit and whether it's delivering value.
Track record and trust: can they deliver?
This is a complex, regulated benefit. Choose a partner who’s done it before—and done it well.
Ask:
How long have you been offering ICHRA administration? More time in the market usually means more stability and refined processes.
What’s your client retention rate? A high rate (90%+) is a strong sign of satisfaction.
Can we speak with current clients or see case studies? Peer references help confirm the provider delivers in real-world situations.
What’s your financial position and growth outlook? A partner with stable funding and strong growth is more likely to invest in product improvements and support.
Does your leadership team have industry expertise? Experienced leaders tend to shape—not just follow—compliance best practices.
Scalability and future-readiness: grow without switching
Your business may grow or change. Your ICHRA platform should be able to keep up.
Ask:
Can the platform scale from small business to enterprise? Make sure there’s no cap on employee count or performance bottlenecks.
Do you support multi-state teams and remote employees? This is a must-have in distributed work environments.
Is API access available for custom integrations? APIs let you plug ICHRA data into other systems or workflows.
How often do you release updates? Regular product releases show commitment to innovation and compliance.
Will our account support grow as we scale? A good provider offers tiered or strategic account management as your needs evolve.
Platform and user experience: what best-in-class looks like
The platform is your day-to-day tool. It needs to work well for everyone—HR, finance, and employees.
Look for:
User-friendly employer dashboard with real-time insights into claims, reimbursements, and compliance
Mobile app for employees to upload receipts, track claims, and view allowances
Mobile-responsive design for both employers and employees
HRIS and payroll integrations that sync rosters and automate reimbursements
Custom alerts and notifications for deadlines, missing receipts, or new claims
Secure document storage with audit trails and permission-based access
SSO (Single Sign-On) for ease of access and IT security
Flexible configuration tools so you don’t need support to make simple changes
Why it matters: A great platform reduces admin time, improves accuracy, and gives employees confidence in the benefit. Clunky tools do the opposite.
Pro tip: Don’t just ask about these features—see them. Request a live demo and walk through common scenarios like submitting a claim or adding a new hire.
Action steps
Build your RFP using these question categories
Ask for proof: sample documents, audit reports, workflow screenshots
Schedule a demo with real use cases—not just a product tour
Choose the provider who delivers clarity, confidence, and results
