How ICHRA Reimbursement Works: Employer & Employee Responsibilities

For agents: This explains how your client's StretchDollar ICHRA reimbursement experience works so you can set expectations with employers and employees. StretchDollar reimburses employees for qualifying individual health premiums — it does not pay carriers on anyone's behalf.

The core model

1. The employer sets each employee's monthly allowance (the reimbursement budget).
2. The employee selects and enrolls in an individual health plan with a carrier, and pays that carrier directly.
3. The employee submits proof of coverage / premium documentation in the Benefits Portal (manual claim or auto-reimbursement setup).
4. The employer admin approves the claim (or approves the auto-reimbursement configuration once).
5. StretchDollar initiates an ACH transfer from the employer's connected bank account to the employee's connected bank account for the approved amount.

The reimbursed amount is always the lesser of the documented premium and the employee's monthly allowance. Anything above the allowance stays out of pocket for the employee.

Two reimbursement paths (important for support questions)

• Manual reimbursement: Employee submits each claim; employer approves or rejects each one; payment is initiated after approval.
• Auto-reimbursement: Employee sets up recurring reimbursement with premium amount and documentation; employer approves the configuration once; StretchDollar then runs it monthly (on the 25th for the following month's coverage). There is 3-5 business day transfer period.

Employer responsibilities (what to coach company admins on)

• Complete account and bank setup so funding can flow.
• Set allowances appropriately for each employee class/group.
• Review and approve reimbursement requests or auto-reimbursement configurations in the Company Portal.
• Keep the company bank account in good standing so ACH pulls succeed.

Employee responsibilities (what client employees should expect)

• Enroll in a qualifying individual health plan and pay the carrier.
• Connect a bank account in the Benefits Portal to receive reimbursements.
• Submit proof of coverage and premium documentation (invoice, portal screenshot, Healthcare.gov confirmation, etc.).
• Cover any premium amount above the monthly allowance.
• Keep coverage active — if coverage ends, reimbursements should stop / be updated.

Important: StretchDollar does not make payments to insurance carriers. Maintaining active coverage is the employee's responsibility and is not guaranteed by StretchDollar or the ICHRA arrangement.