37% of brokers shift clients to ICHRAs as employer health costs spike 26%

ICHRA adoption hits mainstream as cost pressure mounts

Fifty-six percent of benefits brokers and advisors now actively recommend or implement individual coverage health reimbursement arrangements (ICHRAs), up sharply from prior years. The share of brokers who have moved at least one client to ICHRA doubled from 15% in 2024 to 37% in 2026, according to "The State of ICHRA 2026" report published by ICHRA administrator SureCo and sponsored by healthcare technology company Oscar Health. The report draws on three years of nationwide survey data from 1,500 human resources professionals, employees, and benefits consultants.

The driver is raw cost pressure. Employer-sponsored family premiums reached $26,993 in 2026, a 26% increase over five years that outpaces both inflation and wage growth (per SureCo's analysis). Nearly 90% of surveyed employers faced a rate increase in 2026, and one in three absorbed double-digit hikes. Fifty-two percent of senior benefits decision-makers said medical costs keep them up at night, and 94% have explored alternative cost-containment strategies.

ICHRA proved effective even when the individual market spiked an average of 15% following the expiration of enhanced ACA premium tax credits. More than 91% of employers who adopted ICHRA said it was the right move. Brokers report average client savings of approximately 15.5% after switching (company-reported). Most brokers (92%) who moved clients to an ICHRA saw their compensation increase.

The structural shift: ICHRA is now part of standard renewal

SureCo CEO Matthew Kim noted that ICHRA "is no longer confined to edge cases or moments of disruption. It is increasingly being evaluated as part of the standard renewal process and is discussed earlier, modeled more rigorously, and positioned as a viable path forward, not just a fallback."

What changed is not just awareness. The entire market's behavior around ICHRA has shifted. Benefits teams are now comparing ICHRA to traditional group coverage in their renewal modeling, not treating it as a defensive move when a company faces crisis. The individual market's 15% spike would have killed ICHRA's appeal in prior years; instead, it remained attractive relative to group premiums, signaling that employer-sponsored plans are the outlier in cost dynamics, not the individual market.

This matters because it reorders how HR and benefits consultants think about their role. As Kim put it, "What determines who wins the next phase is execution; specifically, the quality of education and support employers and administrators deliver to employees. As employers shift away from selecting a single plan toward enabling employee choice, success will depend on education, decision support and a redefinition of the employer's role in benefits."

What benefits teams should do now

Start with internal modeling. Run a side-by-side projection of your current group renewal cost against ICHRA reimbursement at the same covered-population level. Include the 15.5% savings benchmark (company-reported) as a floor, not a ceiling, since your actual savings depend on your claims profile and local individual market rates.

Second, audit your broker's capability. If your broker is among the 37% actively implementing ICHRA, ask them for two comparable case studies: one in your industry, one in your geographic market. If your broker is not yet actively recommending it, this is the year to push the conversation or find one who will.

Third, plan for employee education as a separate work stream. ICHRAs shift the employee's role from plan selection (one choice) to plan shopping and reimbursement tracking. Build education and decision support into your renewal timeline, not as an afterthought. Rollout success depends on this; it is not optional.