Group Health Broker Benchmarks
ICHRA and QSEHRA Adoption Benchmarks (2026)
The individual-coverage HRA was hyped as the end of the group model. The KFF data says adoption is real but small, and the hype-versus-reality gap is exactly what a broker needs to see clearly. The benchmark on where ICHRA actually stands.
ICHRAs let employers give workers tax-advantaged funds to buy individual-market coverage instead of sponsoring a group plan. Vendors have promoted them as a structural replacement for group insurance, and some brokers fear the model erodes their book. The primary data tells a more precise story: adoption is measurable, growing from a small base, and concentrated in specific employer profiles, which means the broker question isn’t whether to panic but where to position.
Table 1: Adoption today
| Employer segment | Offering individual-coverage funds |
|---|---|
| Firms that offer health benefits | 4% |
| Firms that do not offer health benefits | 9% (11% prior year) |
Table 2: Stated future intent
| Segment | “Very likely” | “Somewhat likely” |
|---|---|---|
| Offering firms (10+ workers) | 2% | 6% |
| Non-offering firms (10–199 workers) | 2% | 16% |
Read the two tables together: the group-replacement story is weak (2% very likely among offering firms), but the group-*creation* story is real: 16% of non-offering small firms are somewhat likely to fund individual coverage. ICHRA’s actual market is employers who were never going to buy a group plan, which makes it incremental commission on employers a broker currently earns nothing from.
Table 3: Where ICHRA fits vs. group
| Profile | Better fit | Why |
|---|---|---|
| Never-offered small employer | ICHRA/QSEHRA | First benefit, defined cost |
| Dispersed / multi-state workforce | ICHRA | Individual market handles geography |
| High-turnover hourly workforce | ICHRA | Class-based design |
| Stable 20–200 life group, strong individual market absent | Group (fully-insured or level-funded) | Richer networks, group underwriting |
| Competitive-hiring professional firm | Group | Benefits as recruiting tool |
Table 4: The broker economics
| Dimension | Group | ICHRA |
|---|---|---|
| Compensation source | Carrier % of group premium | Individual-plan commissions + admin/consulting fees |
| Per-employee revenue | Higher | Generally lower per life |
| Administration | Carrier-handled | ICHRA platform + broker guidance |
| Book risk | — | Low today; watch niche verticals |
| Opportunity | — | Never-offered employers = net-new revenue |
The strategic read for an agency: defend nothing, add selectively. The data shows group books are not eroding at scale, and the honest ICHRA play is offensive: the 16% of non-offering small firms open to funding individual coverage are employers with zero current broker relationship. That’s a prospecting list, not a threat.
Frequently asked questions
- How many employers actually use ICHRAs?
- Per KFF’s 2025 survey, 4% of firms that offer health benefits, and 9% of firms that don’t, provided funds for employees to purchase individual coverage. KFF’s own summary is that ICHRAs “have not taken off.”
- Is ICHRA a threat to group health brokers?
- Not at scale today: only 2% of offering firms say they’re very likely to adopt one within two years. The real signal is opportunity: 16% of small firms that don’t offer benefits are somewhat likely to fund individual coverage, and those employers have no incumbent broker.
- What is the difference between ICHRA and QSEHRA?
- QSEHRA is limited to employers with fewer than 50 employees with contribution caps; ICHRA has no size limit or cap and allows class-based design. Both reimburse individual-market coverage tax-free.
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Sources & methodology
- Adoption and intent data: KFF, 2025 Employer Health Benefits Survey (4% offering / 9% non-offering; likelihood figures by segment); KFF release, October 2025 (“have not taken off”).
- Market shape: Peterson-KFF Health System Tracker companion report on employer ICHRA experience.
- Note on figures: adoption tables are KFF primary survey data. Fit profiles and broker economics reflect how the market has developed and are directional.