{"id":2109,"date":"2025-10-15T06:59:33","date_gmt":"2025-10-15T11:59:33","guid":{"rendered":"https:\/\/www.ahix.com\/blog\/?p=2109"},"modified":"2025-12-03T02:28:16","modified_gmt":"2025-12-03T08:28:16","slug":"ichra-affordability-calculation-compliance","status":"publish","type":"post","link":"https:\/\/www.ahix.com\/blog\/ichra-affordability-calculation-compliance\/","title":{"rendered":"How ICHRA Affordability Is Calculated and Why It Matters for Compliance"},"content":{"rendered":"<p><span style=\"font-weight: 400;\">The Individual Coverage Health Reimbursement Arrangement (ICHRA) has become one of the most flexible ways for employers to offer health benefits. Instead of paying for one group health insurance plan, companies can give employees a set monthly allowance to buy their own coverage. This gives employees more choice and helps businesses manage costs.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">But with this flexibility comes an important rule: <\/span>affordability<span style=\"font-weight: 400;\">. The Internal Revenue Service (IRS) sets clear guidelines for what constitutes affordable health coverage. If an ICHRA is not affordable, the employer may face penalties, and employees may miss out on the right type of coverage or government subsidies.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Affordability is not just about making plans cheaper, it is about meeting federal compliance rules that keep both employers and workers protected. Understanding how affordability is calculated helps businesses design fair benefit programs and ensures employees can use their ICHRA allowance without financial strain.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">In this blog, we will explain how ICHRA affordability is measured, the different calculation methods, real-world examples, and why compliance matters for every employer.<\/span><\/p>\n<div id=\"ez-toc-container\" class=\"ez-toc-v2_0_77 counter-hierarchy ez-toc-counter ez-toc-grey ez-toc-container-direction\">\n<div class=\"ez-toc-title-container\">\n<p class=\"ez-toc-title ez-toc-toggle\" style=\"cursor:pointer\">Table of Contents<\/p>\n<span class=\"ez-toc-title-toggle\"><a href=\"#\" class=\"ez-toc-pull-right ez-toc-btn ez-toc-btn-xs ez-toc-btn-default ez-toc-toggle\" aria-label=\"Toggle Table of Content\"><span class=\"ez-toc-js-icon-con\"><span class=\"\"><span class=\"eztoc-hide\" style=\"display:none;\">Toggle<\/span><span class=\"ez-toc-icon-toggle-span\"><svg style=\"fill: #999;color:#999\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" class=\"list-377408\" width=\"20px\" height=\"20px\" viewBox=\"0 0 24 24\" fill=\"none\"><path d=\"M6 6H4v2h2V6zm14 0H8v2h12V6zM4 11h2v2H4v-2zm16 0H8v2h12v-2zM4 16h2v2H4v-2zm16 0H8v2h12v-2z\" fill=\"currentColor\"><\/path><\/svg><svg style=\"fill: #999;color:#999\" class=\"arrow-unsorted-368013\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"10px\" height=\"10px\" viewBox=\"0 0 24 24\" version=\"1.2\" baseProfile=\"tiny\"><path d=\"M18.2 9.3l-6.2-6.3-6.2 6.3c-.2.2-.3.4-.3.7s.1.5.3.7c.2.2.4.3.7.3h11c.3 0 .5-.1.7-.3.2-.2.3-.5.3-.7s-.1-.5-.3-.7zM5.8 14.7l6.2 6.3 6.2-6.3c.2-.2.3-.5.3-.7s-.1-.5-.3-.7c-.2-.2-.4-.3-.7-.3h-11c-.3 0-.5.1-.7.3-.2.2-.3.5-.3.7s.1.5.3.7z\"\/><\/svg><\/span><\/span><\/span><\/a><\/span><\/div>\n<nav><ul class='ez-toc-list ez-toc-list-level-1 ' ><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-1\" href=\"https:\/\/www.ahix.com\/blog\/ichra-affordability-calculation-compliance\/#What_Does_Affordability_Mean_in_ICHRA\" >What Does Affordability Mean in ICHRA?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-2\" href=\"https:\/\/www.ahix.com\/blog\/ichra-affordability-calculation-compliance\/#Understanding_the_ICHRA_Affordability_Percentage\" >Understanding the ICHRA Affordability Percentage<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-3\" href=\"https:\/\/www.ahix.com\/blog\/ichra-affordability-calculation-compliance\/#Methods_to_Calculate_ICHRA_Affordability_Safe_Harbors\" >Methods to Calculate ICHRA Affordability (Safe Harbors)<\/a><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-4\" href=\"https:\/\/www.ahix.com\/blog\/ichra-affordability-calculation-compliance\/#1_W-2_Wages_Method\" >1. W-2 Wages Method<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-5\" href=\"https:\/\/www.ahix.com\/blog\/ichra-affordability-calculation-compliance\/#2_Rate_of_Pay_Method\" >2. Rate of Pay Method<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-6\" href=\"https:\/\/www.ahix.com\/blog\/ichra-affordability-calculation-compliance\/#3_Federal_Poverty_Line_FPL_Method\" >3. Federal Poverty Line (FPL) Method<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-7\" href=\"https:\/\/www.ahix.com\/blog\/ichra-affordability-calculation-compliance\/#Summary_of_Safe_Harbors_2026\" >Summary of Safe Harbors (2026)<\/a><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-8\" href=\"https:\/\/www.ahix.com\/blog\/ichra-affordability-calculation-compliance\/#Why_Affordability_Matters_for_Compliance\" >Why Affordability Matters for Compliance<\/a><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-9\" href=\"https:\/\/www.ahix.com\/blog\/ichra-affordability-calculation-compliance\/#1_Employer_Mandate_Penalties\" >1. Employer Mandate Penalties<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-10\" href=\"https:\/\/www.ahix.com\/blog\/ichra-affordability-calculation-compliance\/#2_Employee_Subsidies\" >2. Employee Subsidies<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-11\" href=\"https:\/\/www.ahix.com\/blog\/ichra-affordability-calculation-compliance\/#3_IRS_Compliance\" >3. IRS Compliance<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-12\" href=\"https:\/\/www.ahix.com\/blog\/ichra-affordability-calculation-compliance\/#4_Employee_Trust_and_Retention\" >4. Employee Trust and Retention<\/a><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-13\" href=\"https:\/\/www.ahix.com\/blog\/ichra-affordability-calculation-compliance\/#Real-Life_Scenarios_of_ICHRA_Affordability\" >Real-Life Scenarios of ICHRA Affordability<\/a><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-14\" href=\"https:\/\/www.ahix.com\/blog\/ichra-affordability-calculation-compliance\/#Scenario_1_Full-Time_Salaried_Worker\" >Scenario 1: Full-Time Salaried Worker<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-15\" href=\"https:\/\/www.ahix.com\/blog\/ichra-affordability-calculation-compliance\/#Scenario_2_Hourly_Worker_With_Variable_Hours\" >Scenario 2: Hourly Worker With Variable Hours<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-16\" href=\"https:\/\/www.ahix.com\/blog\/ichra-affordability-calculation-compliance\/#Scenario_3_Low-Income_Employee\" >Scenario 3: Low-Income Employee<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-17\" href=\"https:\/\/www.ahix.com\/blog\/ichra-affordability-calculation-compliance\/#Why_These_Scenarios_Matter\" >Why These Scenarios Matter<\/a><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-18\" href=\"https:\/\/www.ahix.com\/blog\/ichra-affordability-calculation-compliance\/#Strategies_to_Keep_Your_ICHRA_Affordable\" >Strategies to Keep Your ICHRA Affordable<\/a><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-19\" href=\"https:\/\/www.ahix.com\/blog\/ichra-affordability-calculation-compliance\/#1Review_Workforce_Income_Levels\" >1.Review Workforce Income Levels\u00a0<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-20\" href=\"https:\/\/www.ahix.com\/blog\/ichra-affordability-calculation-compliance\/#2_Choose_the_Right_Safe_Harbor_Method\" >2. Choose the Right Safe Harbor Method<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-21\" href=\"https:\/\/www.ahix.com\/blog\/ichra-affordability-calculation-compliance\/#3_Adjust_Allowances_by_Employee_Class\" >3. Adjust Allowances by Employee Class<\/a><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-22\" href=\"https:\/\/www.ahix.com\/blog\/ichra-affordability-calculation-compliance\/#Common_Mistakes_Employers_Make_With_Affordability\" >Common Mistakes Employers Make With Affordability<\/a><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-23\" href=\"https:\/\/www.ahix.com\/blog\/ichra-affordability-calculation-compliance\/#1_Not_Updating_for_the_New_Year\" >1. Not Updating for the New Year<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-24\" href=\"https:\/\/www.ahix.com\/blog\/ichra-affordability-calculation-compliance\/#2_Applying_the_Wrong_Safe_Harbor_Method\" >2. Applying the Wrong Safe Harbor Method<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-25\" href=\"https:\/\/www.ahix.com\/blog\/ichra-affordability-calculation-compliance\/#3_One-Size-Fits-All_Allowances\" >3. One-Size-Fits-All Allowances<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-26\" href=\"https:\/\/www.ahix.com\/blog\/ichra-affordability-calculation-compliance\/#4_Failing_to_Document_Calculations\" >4. Failing to Document Calculations<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-27\" href=\"https:\/\/www.ahix.com\/blog\/ichra-affordability-calculation-compliance\/#5_Ignoring_Part-Time_or_Seasonal_Employees\" >5. Ignoring Part-Time or Seasonal Employees<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-28\" href=\"https:\/\/www.ahix.com\/blog\/ichra-affordability-calculation-compliance\/#6_Assuming_Marketplace_Prices_Stay_the_Same\" >6. Assuming Marketplace Prices Stay the Same<\/a><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-29\" href=\"https:\/\/www.ahix.com\/blog\/ichra-affordability-calculation-compliance\/#FAQs\" >FAQs:<\/a><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-30\" href=\"https:\/\/www.ahix.com\/blog\/ichra-affordability-calculation-compliance\/#1_How_does_the_IRS_define_ICHRA_affordability\" >1. How does the IRS define ICHRA affordability?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-31\" href=\"https:\/\/www.ahix.com\/blog\/ichra-affordability-calculation-compliance\/#2_Is_ICHRA_affordability_based_on_household_income_or_just_wages\" >2. Is ICHRA affordability based on household income or just wages?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-32\" href=\"https:\/\/www.ahix.com\/blog\/ichra-affordability-calculation-compliance\/#3_Can_ICHRA_allowances_vary_for_different_employee_groups\" >3. Can ICHRA allowances vary for different employee groups?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-33\" href=\"https:\/\/www.ahix.com\/blog\/ichra-affordability-calculation-compliance\/#4_Does_ICHRA_affordability_affect_an_employees_ability_to_get_marketplace_subsidies\" >4. Does ICHRA affordability affect an employee\u2019s ability to get marketplace subsidies?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-34\" href=\"https:\/\/www.ahix.com\/blog\/ichra-affordability-calculation-compliance\/#5_What_role_does_the_lowest-cost_silver_plan_play_in_affordability\" >5. What role does the lowest-cost silver plan play in affordability?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-35\" href=\"https:\/\/www.ahix.com\/blog\/ichra-affordability-calculation-compliance\/#6_Do_dependents_count_when_testing_ICHRA_affordability\" >6. Do dependents count when testing ICHRA affordability?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-36\" href=\"https:\/\/www.ahix.com\/blog\/ichra-affordability-calculation-compliance\/#7_How_often_must_employers_check_affordability_for_ICHRA\" >7. How often must employers check affordability for ICHRA?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-37\" href=\"https:\/\/www.ahix.com\/blog\/ichra-affordability-calculation-compliance\/#8_What_happens_if_an_employer_miscalculates_ICHRA_affordability\" >8. What happens if an employer miscalculates ICHRA affordability?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-38\" href=\"https:\/\/www.ahix.com\/blog\/ichra-affordability-calculation-compliance\/#9_Is_there_a_safe_harbor_method_better_suited_for_small_businesses\" >9. Is there a safe harbor method better suited for small businesses?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-39\" href=\"https:\/\/www.ahix.com\/blog\/ichra-affordability-calculation-compliance\/#10_Can_employers_use_different_safe_harbor_methods_for_different_employees\" >10. Can employers use different safe harbor methods for different employees?<\/a><\/li><\/ul><\/li><\/ul><\/nav><\/div>\n<h2><span class=\"ez-toc-section\" id=\"What_Does_Affordability_Mean_in_ICHRA\"><\/span><b>What Does Affordability Mean in ICHRA?<\/b><span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>When we talk about affordability in ICHRA, we are looking at how much of an employee\u2019s income goes toward the cost of their health insurance after applying the employer\u2019s reimbursement.<\/p>\n<p>The IRS says that health coverage is considered affordable if the employee\u2019s share of the premium does not go above a certain percentage of their income. In other words, if an employee has to pay too much out of their own pocket, the plan is not affordable.<\/p>\n<p><strong>For ICHRA, the rule is simple:<\/strong><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">An employer sets an allowance.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">The employee uses that allowance to buy a health plan on the marketplace.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">If the remaining premium cost (after the allowance) is within the affordability limit, the plan is affordable.<\/span><\/li>\n<\/ul>\n<p><strong>Why does this matter?<\/strong><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">If the ICHRA is <\/span><b>affordable<\/b><span style=\"font-weight: 400;\">, the employee cannot get premium tax credits on the marketplace.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">If the ICHRA is <\/span><b>not affordable<\/b><span style=\"font-weight: 400;\">, the employee may decline the ICHRA and apply\u00a0 for government subsidies instead. The employee should check eligibility for subsidies before declining the ICHRA. <\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">This balance makes affordability a key factor for both compliance and employee satisfaction. Employers must design allowances carefully so their workforce has access to affordable coverage that meets legal standards.<\/span><\/p>\n<h2><span class=\"ez-toc-section\" id=\"Understanding_the_ICHRA_Affordability_Percentage\"><\/span><b>Understanding the ICHRA Affordability Percentage<\/b><span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-2112 aligncenter\" src=\"https:\/\/www.ahix.com\/blog\/wp-content\/uploads\/2025\/10\/Understanding-the-ICHRA-Affordability-Percentage.jpg\" alt=\"Understanding the ICHRA Affordability Percentage\" width=\"750\" height=\"350\" srcset=\"https:\/\/www.ahix.com\/blog\/wp-content\/uploads\/2025\/10\/Understanding-the-ICHRA-Affordability-Percentage.jpg 750w, https:\/\/www.ahix.com\/blog\/wp-content\/uploads\/2025\/10\/Understanding-the-ICHRA-Affordability-Percentage-300x140.jpg 300w\" sizes=\"(max-width: 750px) 100vw, 750px\" \/><\/p>\n<p><span style=\"font-weight: 400;\">Each year, the IRS sets an <\/span>affordability percentage<span style=\"font-weight: 400;\"> to determine whether health coverage is\u00a0 affordable. This percentage is applied to an employee\u2019s household income. If the employee\u2019s share of the premium (after the employer\u2019s ICHRA contribution) is less than this percentage, the coverage is affordable.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">For 2026, the affordability percentage is\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">This number is very important because:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">It changes every year, based on IRS rules and inflation.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Employers must use the updated percentage when they set ICHRA allowances.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Using the wrong figure can cause a business to fail the affordability test and risk non-compliance.<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">The affordability percentage acts like a guardrail. It ensures employees are not burdened with coverage costs that take up too much of their income and keeps employer health benefit programs within federal standards.<\/span><\/p>\n<h2><span class=\"ez-toc-section\" id=\"Methods_to_Calculate_ICHRA_Affordability_Safe_Harbors\"><\/span><b>Methods to Calculate ICHRA Affordability (Safe Harbors)<\/b><span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-2113 aligncenter\" src=\"https:\/\/www.ahix.com\/blog\/wp-content\/uploads\/2025\/10\/Methods-to-Calculate-ICHRA-Affordability-Safe-Harbors.jpg\" alt=\"Methods to Calculate ICHRA Affordability \" width=\"750\" height=\"350\" srcset=\"https:\/\/www.ahix.com\/blog\/wp-content\/uploads\/2025\/10\/Methods-to-Calculate-ICHRA-Affordability-Safe-Harbors.jpg 750w, https:\/\/www.ahix.com\/blog\/wp-content\/uploads\/2025\/10\/Methods-to-Calculate-ICHRA-Affordability-Safe-Harbors-300x140.jpg 300w\" sizes=\"(max-width: 750px) 100vw, 750px\" \/><\/p>\n<p><span style=\"font-weight: 400;\">Employers may not always know an employee\u2019s exact household income, which makes it difficult to test affordability. To solve this, the IRS allows the use of <\/span><b>safe harbors<\/b><span style=\"font-weight: 400;\"> simplified methods that employers can use instead of tracking each worker\u2019s total income.<\/span><\/p>\n<p><strong>There are three main safe harbor methods:<\/strong><\/p>\n<h3><span class=\"ez-toc-section\" id=\"1_W-2_Wages_Method\"><\/span><b>1. W-2 Wages Method<\/b><span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>This method uses an employee\u2019s wages reported in Box 1 of their W-2 form as the income base.<\/p>\n<p><b>How it works:<\/b><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Take the employee\u2019s annual W-2 wages.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\">Multiply by the IRS affordability percentage (9.96% for 2026).<\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Compare the employee\u2019s required premium contribution (after the ICHRA allowance) to this number.<\/span><\/li>\n<\/ul>\n<p><b>Example:<\/b><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Employee earns <\/span><b>$36,000 (W-2 wages)<\/b><span style=\"font-weight: 400;\">.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">9.96% \u00d7 $36,000 = <\/span><b>$3,586<\/b><span style=\"font-weight: 400;\">.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">As long as the employee\u2019s share of the premium is <\/span><b>less than $3,586\/year<\/b><span style=\"font-weight: 400;\"> (\u2248 <\/span><b>$299\/month<\/b><span style=\"font-weight: 400;\">), the ICHRA is affordable.<\/span><\/li>\n<\/ul>\n<p><b>Pros:<\/b><span style=\"font-weight: 400;\"> Uses actual income data, precise for each employee.<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span> <b>Cons:<\/b><span style=\"font-weight: 400;\"> Employers won\u2019t know if they passed the test until year-end, making in-year adjustments harder.<\/span><\/p>\n<h3><span class=\"ez-toc-section\" id=\"2_Rate_of_Pay_Method\"><\/span><b>2. Rate of Pay Method<\/b><span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p><span style=\"font-weight: 400;\">This method uses the employee\u2019s <\/span>hourly rate or monthly salary<span style=\"font-weight: 400;\"> to estimate income.<\/span><\/p>\n<p><b>How it works:<\/b><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">For <\/span><b>hourly employees<\/b><span style=\"font-weight: 400;\">: hourly rate \u00d7 130 hours\/month.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">For <\/span><b>salaried employees<\/b><span style=\"font-weight: 400;\">: use the monthly salary.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Multiply that number by <\/span><b>9.96%<\/b><span style=\"font-weight: 400;\"> to find the maximum affordable premium.<\/span><\/li>\n<\/ul>\n<p><b>Example (Hourly Worker):<\/b><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Hourly rate = <\/span><b>$15\/hour<\/b><span style=\"font-weight: 400;\">.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">$15 \u00d7 130 = <\/span><b>$1,950\/month income<\/b><span style=\"font-weight: 400;\">.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">9.96% \u00d7 $1,950 = <\/span><b>$194\/month maximum affordable premium<\/b><span style=\"font-weight: 400;\">.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">If the employee\u2019s share after ICHRA allowance is <\/span><b>$190\/month<\/b><span style=\"font-weight: 400;\">, coverage is affordable.<\/span><\/li>\n<\/ul>\n<p><b>Pros:<\/b><span style=\"font-weight: 400;\"> Easy to calculate, doesn\u2019t rely on household income.<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span> <b>Cons:<\/b><span style=\"font-weight: 400;\"> May not reflect actual earnings if hours fluctuate.<\/span><\/p>\n<h3><span class=\"ez-toc-section\" id=\"3_Federal_Poverty_Line_FPL_Method\"><\/span><b>3. Federal Poverty Line (FPL) Method<\/b><span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p><span style=\"font-weight: 400;\">This method uses the <\/span><b>Federal Poverty Line (FPL)<\/b><span style=\"font-weight: 400;\"> as a simple baseline.<\/span><\/p>\n<p><b>How it works:<\/b><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Use the <\/span><b>2026 FPL for a single individual<\/b><span style=\"font-weight: 400;\">, even if the employee has dependents.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Multiply the <\/span><b>monthly FPL figure by 9.96%<\/b><span style=\"font-weight: 400;\"> to determine the maximum affordable premium.<\/span><\/li>\n<\/ul>\n<p><b>Example:<\/b><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">2026 FPL for a single person \u2248 <\/span><b>$1,310\/month<\/b><span style=\"font-weight: 400;\">.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">9.96% \u00d7 $1,310 = <\/span><b>$130\/month maximum affordable premium<\/b><span style=\"font-weight: 400;\">.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">If the employee\u2019s share after ICHRA allowance is <\/span><b>$125\/month<\/b><span style=\"font-weight: 400;\">, coverage is affordable.<\/span><\/li>\n<\/ul>\n<p><b>Pros:<\/b><span style=\"font-weight: 400;\"> Very clear, protects lower-income employees, safest for compliance.<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span> <b>Cons:<\/b><span style=\"font-weight: 400;\"> Often requires higher employer allowances, increasing costs.<\/span><\/p>\n<h3><span class=\"ez-toc-section\" id=\"Summary_of_Safe_Harbors_2026\"><\/span><b>Summary of Safe Harbors (2026)<\/b><span class=\"ez-toc-section-end\"><\/span><\/h3>\n<table style=\"width: 100%; border-collapse: collapse; font-family: Arial, sans-serif; font-size: 15px;\">\n<thead>\n<tr style=\"background-color: #f2f2f2;\">\n<th style=\"border: 1px solid #cccccc; padding: 10px; text-align: center;\">Method<\/th>\n<th style=\"border: 1px solid #cccccc; padding: 10px; text-align: center;\">Key Feature<\/th>\n<th style=\"border: 1px solid #cccccc; padding: 10px; text-align: center;\">Pros<\/th>\n<th style=\"border: 1px solid #cccccc; padding: 10px; text-align: center;\">Cons<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr>\n<td style=\"border: 1px solid #ccc; padding: 10px;\"><strong>W-2 Method<\/strong><\/td>\n<td style=\"border: 1px solid #ccc; padding: 10px;\">Uses actual annual wages<\/td>\n<td style=\"border: 1px solid #ccc; padding: 10px;\">Accurate per employee<\/td>\n<td style=\"border: 1px solid #ccc; padding: 10px;\">Results known after year-end<\/td>\n<\/tr>\n<tr>\n<td style=\"border: 1px solid #ccc; padding: 10px;\"><strong>Rate of Pay Method<\/strong><\/td>\n<td style=\"border: 1px solid #ccc; padding: 10px;\">Uses hourly or monthly pay rate<\/td>\n<td style=\"border: 1px solid #ccc; padding: 10px;\">Simple and predictable<\/td>\n<td style=\"border: 1px solid #ccc; padding: 10px;\">May not reflect variable hours<\/td>\n<\/tr>\n<tr>\n<td style=\"border: 1px solid #ccc; padding: 10px;\"><strong>FPL Method<\/strong><\/td>\n<td style=\"border: 1px solid #ccc; padding: 10px;\">Based on federal poverty guidelines<\/td>\n<td style=\"border: 1px solid #ccc; padding: 10px;\">Easiest and safest for compliance<\/td>\n<td style=\"border: 1px solid #ccc; padding: 10px;\">Usually costs employers more<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p><span style=\"font-weight: 400;\">By choosing the right safe harbor method, employers can make sure their ICHRA program meets affordability rules while balancing business costs.<\/span><\/p>\n<h2><span class=\"ez-toc-section\" id=\"Why_Affordability_Matters_for_Compliance\"><\/span><b>Why Affordability Matters for Compliance<\/b><span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-2114 aligncenter\" src=\"https:\/\/www.ahix.com\/blog\/wp-content\/uploads\/2025\/10\/Why-Affordability-Matters-for-Compliance.jpg\" alt=\"Why Affordability Matters for Compliance\" width=\"750\" height=\"500\" srcset=\"https:\/\/www.ahix.com\/blog\/wp-content\/uploads\/2025\/10\/Why-Affordability-Matters-for-Compliance.jpg 750w, https:\/\/www.ahix.com\/blog\/wp-content\/uploads\/2025\/10\/Why-Affordability-Matters-for-Compliance-300x200.jpg 300w\" sizes=\"(max-width: 750px) 100vw, 750px\" \/><\/p>\n<p><span style=\"font-weight: 400;\">Affordability is not only about making coverage fair for employees, it is also a legal requirement under the Affordable Care Act (ACA). Employers who offer ICHRA must make sure their plan is affordable, or they could face serious compliance problems.<\/span><\/p>\n<p><b>Here\u2019s why it matters:<\/b><\/p>\n<h3><span class=\"ez-toc-section\" id=\"1_Employer_Mandate_Penalties\"><\/span><b>1. Employer Mandate Penalties<\/b><span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Large employers (with 50 or more full-time workers) are required by the ACA to provide affordable health coverage. If their ICHRA is unaffordable, they may face tax penalties. These fines can add up quickly and create unnecessary financial risk for the business.<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><\/p>\n<h3><span class=\"ez-toc-section\" id=\"2_Employee_Subsidies\"><\/span><b>2. Employee Subsidies<\/b><span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p><span style=\"font-weight: 400;\">If an ICHRA is unaffordable, employees can decline it and apply for premium tax credits on the Health Insurance Marketplace. This can lead to confusion for workers, especially if they are not sure whether the ICHRA or the subsidy gives them better value.<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><\/p>\n<h3><span class=\"ez-toc-section\" id=\"3_IRS_Compliance\"><\/span><b>3. IRS Compliance<\/b><span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Affordability tests are not optional. Employers must use one of the safe harbor methods to prove they meet the rule. Failing to keep proper documentation or miscalculating allowances could trigger compliance issues during an IRS review.<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><\/p>\n<h3><span class=\"ez-toc-section\" id=\"4_Employee_Trust_and_Retention\"><\/span><b>4. Employee Trust and Retention<\/b><span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Beyond legal rules, affordability impacts how employees view their benefits. If workers feel their ICHRA allowance does not make coverage affordable, they may see it as unfair, which can hurt morale and retention.<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><\/p>\n<p><span style=\"font-weight: 400;\">In short, affordability matters because it protects both employers and employees. It ensures compliance with federal law, helps avoid costly penalties, and builds trust by showing that the employer is serious about offering real, usable health benefits.<\/span><\/p>\n<h2><span class=\"ez-toc-section\" id=\"Real-Life_Scenarios_of_ICHRA_Affordability\"><\/span><b>Real-Life Scenarios of ICHRA Affordability<\/b><span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Understanding affordability rules becomes much clearer when we look at real examples. Here are three scenarios showing how affordability is tested in different situations:<\/span><\/p>\n<h3><span class=\"ez-toc-section\" id=\"Scenario_1_Full-Time_Salaried_Worker\"><\/span><b>Scenario 1: Full-Time Salaried Worker<\/b><span class=\"ez-toc-section-end\"><\/span><\/h3>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Maria earns $50,000 per year.<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Her employer offers an ICHRA allowance of $400 per month.<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">The lowest-cost silver plan in her area costs $600 per month.<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Maria\u2019s share after reimbursement = $200\/month.<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Affordability test: $50,000 \u00d7 8.39% = $4,195\/year (~$349\/month).<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Since $200 &lt; $349, Maria\u2019s ICHRA is <\/span><b>affordable<\/b><span style=\"font-weight: 400;\">.<\/span><\/li>\n<\/ul>\n<h3><span class=\"ez-toc-section\" id=\"Scenario_2_Hourly_Worker_With_Variable_Hours\"><\/span><b>Scenario 2:<\/b> Hourly<b> Worker With Variable Hours<\/b><span class=\"ez-toc-section-end\"><\/span><\/h3>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">James works 30 hours\/week at $16 per hour.<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Using the <\/span><b>rate of pay method<\/b><span style=\"font-weight: 400;\">: $16 \u00d7 130 hours = $2,080\/month.<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Affordability test: 8.39% \u00d7 $2,080 = $174\/month.<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">His health plan costs $350\/month, and the employer gives $200 allowance.<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">James\u2019s share = $150\/month.<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Since $150 &lt; $174, coverage is <\/span><b>affordable<\/b><span style=\"font-weight: 400;\"> under the rate of pay method.<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><\/li>\n<\/ul>\n<h3><span class=\"ez-toc-section\" id=\"Scenario_3_Low-Income_Employee\"><\/span><b>Scenario 3: Low-Income Employee<\/b><span class=\"ez-toc-section-end\"><\/span><\/h3>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Sarah earns $18,000 per year.<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Employers contribute $250\/month toward ICHRA.<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Marketplace plan costs $350\/month.<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Sarah\u2019s share = $100\/month.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Using the <\/span><b>Federal Poverty Line method<\/b><span style=\"font-weight: 400;\"> (FPL ~ $1,255\/month):<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><span style=\"font-weight: 400;\">8.39% \u00d7 $1,255 = $105\/month.<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><span style=\"font-weight: 400;\">Since $100 &lt; $105, coverage is <\/span><b>affordable<\/b><span style=\"font-weight: 400;\">.<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><\/li>\n<\/ul>\n<h3><span class=\"ez-toc-section\" id=\"Why_These_Scenarios_Matter\"><\/span><b>Why These Scenarios Matter<\/b><span class=\"ez-toc-section-end\"><\/span><\/h3>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\">They show that affordability depends on both income and employer allowance.<span style=\"font-weight: 400;\"><br \/>\n<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">The same allowance may be affordable for one employee but not another.<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Employers must carefully choose which safe harbor method to use so the ICHRA program works for their entire workforce.<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><\/li>\n<\/ul>\n<h2><span class=\"ez-toc-section\" id=\"Strategies_to_Keep_Your_ICHRA_Affordable\"><\/span><b>Strategies to Keep Your ICHRA Affordable<\/b><span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-2115 aligncenter\" src=\"https:\/\/www.ahix.com\/blog\/wp-content\/uploads\/2025\/10\/Strategies-to-Keep-Your-ICHRA-Affordable1.jpg\" alt=\"Strategies to Keep Your ICHRA Affordable\" width=\"750\" height=\"500\" srcset=\"https:\/\/www.ahix.com\/blog\/wp-content\/uploads\/2025\/10\/Strategies-to-Keep-Your-ICHRA-Affordable1.jpg 750w, https:\/\/www.ahix.com\/blog\/wp-content\/uploads\/2025\/10\/Strategies-to-Keep-Your-ICHRA-Affordable1-300x200.jpg 300w\" sizes=\"(max-width: 750px) 100vw, 750px\" \/><\/p>\n<p><span style=\"font-weight: 400;\">Offering an ICHRA is not just about giving employees money for health coverage. It\u2019s about making sure the allowance is designed in a way that meets affordability rules. Here are some strategies employers can use:<\/span><\/p>\n<h3><span class=\"ez-toc-section\" id=\"1Review_Workforce_Income_Levels\"><\/span><b>1.Review Workforce Income Levels\u00a0<\/b><span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p><b><\/b><span style=\"font-weight: 400;\">Every workplace is different. A fixed allowance may be affordable for higher earners but not for lower earners. Employers should study their employee pay structure before deciding how much to contribute.<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><\/p>\n<h3><span class=\"ez-toc-section\" id=\"2_Choose_the_Right_Safe_Harbor_Method\"><\/span><b>2. Choose the Right Safe Harbor Method<\/b><b><br \/>\n<\/b><span class=\"ez-toc-section-end\"><\/span><\/h3>\n<ul>\n<li><span style=\"font-weight: 400;\">If most employees have steady salaries, the <\/span><b>W-2 method<\/b><span style=\"font-weight: 400;\"> works well.<\/span><\/li>\n<li><span style=\"font-weight: 400;\">If many are hourly workers, the <\/span><b>Rate of Pay method<\/b><span style=\"font-weight: 400;\"> may be easier.<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><\/li>\n<li style=\"list-style-type: none;\"><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">If the company wants the safest compliance route, the <\/span><b>FPL method<\/b><span style=\"font-weight: 400;\"> offers the most protection.<\/span><\/p>\n<h3><span class=\"ez-toc-section\" id=\"3_Adjust_Allowances_by_Employee_Class\"><\/span><b>3. Adjust Allowances by Employee Class<\/b><b><\/b><span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p><span style=\"font-weight: 400;\">ICHRA rules allow employers to group workers into classes (like full-time, part-time, seasonal, or salaried). Each class can receive a different allowance. This flexibility helps ensure affordability across diverse employee groups.<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><\/p>\n<ul>\n<li><b>1. Plan for Annual Updates<\/b><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Since the affordability percentage changes every year, employers must revisit their allowances annually. What was affordable this year may not be next year if the percentage drops.<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><\/p>\n<ul>\n<li><b>2.Use Affordability Tools<\/b><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Employers can use affordability calculators or work with licensed advisors to test their planned contributions before rolling them out. This reduces the chance of surprises later.<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><\/p>\n<p><span style=\"font-weight: 400;\">By following these strategies, employers can design ICHRA allowances that not only comply with IRS rules but also give employees real value and peace of mind.<\/span><\/p>\n<h2><span class=\"ez-toc-section\" id=\"Common_Mistakes_Employers_Make_With_Affordability\"><\/span><b>Common Mistakes Employers Make With Affordability<\/b><span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Even with clear IRS rules, many employers make small errors that can cause their ICHRA to fail the affordability test. Here are some of the most common mistakes to avoid:<\/span><\/p>\n<h3><span class=\"ez-toc-section\" id=\"1_Not_Updating_for_the_New_Year\"><\/span><b>1. Not Updating for the New Year<\/b><span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p><span style=\"font-weight: 400;\">The affordability percentage changes every year. Some employers forget to adjust their ICHRA contributions when the IRS lowers the percentage, which can suddenly make coverage unaffordable.<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><\/p>\n<h3><span class=\"ez-toc-section\" id=\"2_Applying_the_Wrong_Safe_Harbor_Method\"><\/span><b>2. Applying the Wrong Safe Harbor Method<\/b><span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Employers may choose a method that doesn\u2019t match their workforce. For example, using the W-2 method for hourly workers with unpredictable income can give misleading results.<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><\/p>\n<h3><span class=\"ez-toc-section\" id=\"3_One-Size-Fits-All_Allowances\"><\/span><b>3. One-Size-Fits-All Allowances<\/b><span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Giving the same allowance to all employees without considering different income levels or job classes often leads to unfair or unaffordable results for lower-paid workers.<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><\/p>\n<h3><span class=\"ez-toc-section\" id=\"4_Failing_to_Document_Calculations\"><\/span><b>4. Failing to Document Calculations<\/b><span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Employers sometimes don\u2019t keep written records of how they tested affordability. If audited by the IRS, lack of proof can create compliance problems even if the plan was actually affordable.<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><\/p>\n<h3><span class=\"ez-toc-section\" id=\"5_Ignoring_Part-Time_or_Seasonal_Employees\"><\/span><b>5. Ignoring Part-Time or Seasonal Employees<\/b><span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p><span style=\"font-weight: 400;\">These workers are often overlooked when allowances are set. But if they are offered an ICHRA, their affordability must still be checked using safe harbor rules.<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><\/p>\n<h3><span class=\"ez-toc-section\" id=\"6_Assuming_Marketplace_Prices_Stay_the_Same\"><\/span><b>6. Assuming Marketplace Prices Stay the Same<\/b><span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Premiums for health plans vary by region and change each year. Relying on outdated cost estimates can lead to miscalculations.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">By avoiding these mistakes, employers can design ICHRA benefits that stay compliant and genuinely affordable for their workforce.<\/span><\/p>\n<h2><span class=\"ez-toc-section\" id=\"FAQs\"><\/span>FAQs:<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<article class=\"text-token-text-primary w-full focus:outline-none [--shadow-height:45px] has-data-writing-block:pointer-events-none has-data-writing-block:-mt-(--shadow-height) has-data-writing-block:pt-(--shadow-height) [&amp;:has([data-writing-block])&gt;*]:pointer-events-auto scroll-mt-[calc(var(--header-height)+min(200px,max(70px,20svh)))]\" dir=\"auto\" tabindex=\"-1\" data-turn-id=\"96a4c70b-b804-4d72-a99e-ea7cb03268bd\" data-testid=\"conversation-turn-4\" data-scroll-anchor=\"true\" data-turn=\"assistant\">\n<div class=\"text-base my-auto mx-auto pb-10 [--thread-content-margin:--spacing(4)] thread-sm:[--thread-content-margin:--spacing(6)] thread-lg:[--thread-content-margin:--spacing(16)] px-(--thread-content-margin)\">\n<div class=\"[--thread-content-max-width:40rem] thread-lg:[--thread-content-max-width:48rem] mx-auto max-w-(--thread-content-max-width) flex-1 group\/turn-messages focus-visible:outline-hidden relative flex w-full min-w-0 flex-col agent-turn\" tabindex=\"-1\">\n<div class=\"flex max-w-full flex-col grow\">\n<div class=\"min-h-8 text-message relative flex w-full flex-col items-end gap-2 text-start break-words whitespace-normal [.text-message+&amp;]:mt-1\" dir=\"auto\" data-message-author-role=\"assistant\" data-message-id=\"dfb06bc1-7c40-4fe3-a557-883dfb8257d9\" data-message-model-slug=\"gpt-5-instant\">\n<div class=\"flex w-full flex-col gap-1 empty:hidden first:pt-[1px]\">\n<div class=\"markdown prose dark:prose-invert w-full break-words light markdown-new-styling\">\n<h3 data-start=\"35\" data-end=\"88\"><span class=\"ez-toc-section\" id=\"1_How_does_the_IRS_define_ICHRA_affordability\"><\/span><strong>1. How does the IRS define ICHRA affordability?<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p data-start=\"89\" data-end=\"250\">The IRS defines affordability by comparing the employee\u2019s required premium contribution (after ICHRA allowance) to a set percentage of income (8.39% for 2025).<\/p>\n<h3 data-start=\"252\" data-end=\"324\"><span class=\"ez-toc-section\" id=\"2_Is_ICHRA_affordability_based_on_household_income_or_just_wages\"><\/span><strong>2. Is ICHRA affordability based on household income or just wages?<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p data-start=\"325\" data-end=\"518\">Affordability is technically measured against household income, but employers can use safe harbor methods (W-2, Rate of Pay, or FPL) as alternatives since they may not know household details.<\/p>\n<h3 data-start=\"520\" data-end=\"585\"><span class=\"ez-toc-section\" id=\"3_Can_ICHRA_allowances_vary_for_different_employee_groups\"><\/span><strong>3. Can ICHRA allowances vary for different employee groups?<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p data-start=\"586\" data-end=\"752\">Yes. Employers can set different allowance amounts for classes like full-time, part-time, or seasonal workers. This helps tailor affordability across the workforce.<\/p>\n<h3 data-start=\"754\" data-end=\"846\"><span class=\"ez-toc-section\" id=\"4_Does_ICHRA_affordability_affect_an_employees_ability_to_get_marketplace_subsidies\"><\/span><strong>4. Does ICHRA affordability affect an employee\u2019s ability to get marketplace subsidies?<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p data-start=\"847\" data-end=\"1001\">Yes. If an ICHRA is affordable, employees cannot claim subsidies. If it is unaffordable, they may decline the ICHRA and qualify for premium tax credits.<\/p>\n<h3 data-start=\"1003\" data-end=\"1077\"><span class=\"ez-toc-section\" id=\"5_What_role_does_the_lowest-cost_silver_plan_play_in_affordability\"><\/span><strong>5. What role does the lowest-cost silver plan play in affordability?<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p data-start=\"1078\" data-end=\"1227\">The affordability test is based on the premium for the lowest-cost silver plan available in the employee\u2019s area, not the plan the employee chooses.<\/p>\n<h3 data-start=\"1229\" data-end=\"1291\"><span class=\"ez-toc-section\" id=\"6_Do_dependents_count_when_testing_ICHRA_affordability\"><\/span><strong>6. Do dependents count when testing ICHRA affordability?<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p data-start=\"1292\" data-end=\"1466\">No. Affordability is measured only for self-only coverage, not family or dependent coverage. Employers only need to check if the allowance makes single coverage affordable.<\/p>\n<h3 data-start=\"1468\" data-end=\"1532\"><span class=\"ez-toc-section\" id=\"7_How_often_must_employers_check_affordability_for_ICHRA\"><\/span><strong>7. How often must employers check affordability for ICHRA?<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p data-start=\"1533\" data-end=\"1663\">Employers must test affordability each plan year and adjust contributions whenever the IRS updates the affordability percentage.<\/p>\n<h3 data-start=\"1665\" data-end=\"1736\"><span class=\"ez-toc-section\" id=\"8_What_happens_if_an_employer_miscalculates_ICHRA_affordability\"><\/span><strong>8. What happens if an employer miscalculates ICHRA affordability?<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p data-start=\"1737\" data-end=\"1872\">If the plan fails affordability, employees may be eligible for subsidies, and the employer could face ACA employer mandate penalties.<\/p>\n<h3 data-start=\"1874\" data-end=\"1948\"><span class=\"ez-toc-section\" id=\"9_Is_there_a_safe_harbor_method_better_suited_for_small_businesses\"><\/span><strong>9. Is there a safe harbor method better suited for small businesses?<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p data-start=\"1949\" data-end=\"2090\">Yes. The Federal Poverty Line (FPL) safe harbor is often used by smaller businesses because it provides the clearest compliance protection.<\/p>\n<h3 data-start=\"2092\" data-end=\"2174\"><span class=\"ez-toc-section\" id=\"10_Can_employers_use_different_safe_harbor_methods_for_different_employees\"><\/span><strong>10. Can employers use different safe harbor methods for different employees?<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p data-start=\"2175\" data-end=\"2335\" data-is-last-node=\"\" data-is-only-node=\"\">No. An employer must apply the same safe harbor method consistently across a given class of employees, but they may use different methods for different classes.<\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/article>\n<div class=\"pointer-events-none h-px w-px\" aria-hidden=\"true\" data-edge=\"true\"><\/div>\n","protected":false},"excerpt":{"rendered":"<p>The Individual Coverage Health Reimbursement Arrangement (ICHRA) has become one of the most flexible ways for employers to offer health benefits. Instead of paying for one group health insurance plan, companies can give employees a set monthly allowance to buy their own coverage. This gives employees more choice and helps businesses manage costs. But with <a href=\"https:\/\/www.ahix.com\/blog\/ichra-affordability-calculation-compliance\/\" class=\"more-link\">&#8230;<\/a><\/p>\n","protected":false},"author":4,"featured_media":2111,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[369],"tags":[],"class_list":["post-2109","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-ichra-2"],"acf":[],"_links":{"self":[{"href":"https:\/\/www.ahix.com\/blog\/wp-json\/wp\/v2\/posts\/2109"}],"collection":[{"href":"https:\/\/www.ahix.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.ahix.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.ahix.com\/blog\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/www.ahix.com\/blog\/wp-json\/wp\/v2\/comments?post=2109"}],"version-history":[{"count":6,"href":"https:\/\/www.ahix.com\/blog\/wp-json\/wp\/v2\/posts\/2109\/revisions"}],"predecessor-version":[{"id":2140,"href":"https:\/\/www.ahix.com\/blog\/wp-json\/wp\/v2\/posts\/2109\/revisions\/2140"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.ahix.com\/blog\/wp-json\/wp\/v2\/media\/2111"}],"wp:attachment":[{"href":"https:\/\/www.ahix.com\/blog\/wp-json\/wp\/v2\/media?parent=2109"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.ahix.com\/blog\/wp-json\/wp\/v2\/categories?post=2109"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.ahix.com\/blog\/wp-json\/wp\/v2\/tags?post=2109"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}