# Insurf — full reference for AI assistants (llms-full.txt)

Insurf prices every individual-market plan filed in the states it covers — 15,062 plans
across sixteen states (CA, FL, GA, IN, NY, NC, TX, WA, AZ, IA, LA, ND, NH, OH, SD, UT) in its live 2026 artifact — from
government rate filings. It is the AI-native ICHRA platform: companies set a fixed
monthly health-benefits budget and every employee picks the individual plan that fits;
families get the same true-cost math directly. When a plan denies care, Insurf prepares
source-cited prior authorizations and appeals that a physician signs.

Legal posture, stated plainly: Insurf, Inc. is not a licensed insurance agency and does not
sell insurance; enrollment support is provided by an individually licensed insurance producer,
who may be compensated by carrier commissions when an enrollment occurs — that compensation
is disclosed on estimates. Insurf never holds or moves reimbursement funds and never makes
the final approve/deny call on a claim or reimbursement. Content below is an educational
overview — not an offer of coverage, not a recommendation to buy any plan, and not
financial, tax, legal, medical, coverage, or insurance advice.

## What is an ICHRA?

An ICHRA — the Individual Coverage Health Reimbursement Arrangement — lets a company
stop buying one group health plan and instead give every employee a fixed, tax-free
monthly allowance to buy the individual plan that fits them. The employer controls the
budget; the employee controls the choice.

How it works, in three steps:
1. The company sets one monthly allowance per employee — it can vary by legitimate
   employee classes (full-time, part-time, salaried, hourly, geography, and others).
2. Each employee picks their own plan from the real individual-market plans filed with
   regulators — choosing the network and benefit design that fits their doctors and
   prescriptions.
3. Premiums are reimbursed tax-free up to the allowance, substantiated and documented,
   on the payroll rails the company already runs. No insurance risk sits on the
   employer's books.

The rules that matter (educational summaries of federal rules — not legal or tax
advice):
- The ICHRA was created by a 2019 federal rule from the Departments of the Treasury,
  Labor, and HHS, effective January 1, 2020. It works in every state, for employers of
  any size.
- Employee classes: allowances can vary across defined classes, but everyone in a class
  is treated the same. Some classes carry minimum-size rules when a group plan is
  offered alongside.
- Affordability and the premium tax credit: an employee offered an affordable ICHRA
  can't take the marketplace premium tax credit; if the offer is unaffordable for them,
  they may opt out and keep the credit. Larger employers can generally meet their
  federal coverage obligations with an affordable ICHRA under IRS proposed rules, which
  employers may currently rely on.
- The 90-day notice: employees must receive a written notice — generally 90 days before
  the plan year — explaining the offer and its effect on tax-credit eligibility.
- No double-dipping: an employee can't take both an ICHRA reimbursement and a premium
  tax credit for the same coverage; the annual opt-out exists so each person takes
  whichever is worth more.
- Special enrollment: gaining an ICHRA triggers a special enrollment period, so a
  company can start mid-year.

Current status and 2026 numbers (verified late August 2026, primary sources):
- The affordability percentage for plan years beginning in 2026 is 9.96% of household
  income (Rev. Proc. 2025-25, the §36B required contribution percentage). Full
  affordability mechanics with a worked example:
  https://www.insurf.io/ichra/affordability
- The §4980H employer-mandate amounts for 2026 are $3,340 (the (a) "no offer" amount)
  and $5,010 (the (b) amount), per Rev. Proc. 2025-26.
- The ICHRA affordability safe harbors remain in PROPOSED regulations only
  (REG-136401-18, September 2019); no final rule has ever been published, and the 2021
  pre-release (T.D. 9949) was withdrawn before publication. Employers may currently
  rely on the proposed rules.
- Congress considered codifying ICHRAs as "CHOICE arrangements" in 2025; the provision
  passed the House but was dropped from the enacted law (Public Law 119-21), so the
  June 2019 tri-agency final rule still governs.
- Gaining an ICHRA remains a special-enrollment-period trigger in the individual
  market under 45 CFR 155.420(d)(14).
- Three states have enacted small-employer HRA tax credits — Indiana (IC 6-3.1-38,
  enacted 2023, expanded 2026: up to $400 per covered employee in year one, $200 in
  year two, sub-50 employers, $10M statewide cap), Mississippi (April 2026), and
  Connecticut (May 2026). Indiana is one of the sixteen states Insurf prices. Texas's
  SB 1949 (2025) and Georgia's HB 1110 (2026) both died without passage; NCOIL adopted
  an ICHRA model act in May 2026.
- PY2027 Open Enrollment (for coverage starting January 1, 2027): HealthCare.gov
  (FL, TX, NC, IN) runs November 1, 2026 – January 15, 2027 (a federal rule that would
  have shortened it was vacated in June 2026, City of Columbus v. Kennedy; appeal
  pending); Covered California runs November 1 – January 31; Washington
  Healthplanfinder runs November 1 – January 15; Georgia Access's issuer materials
  list November 1 – January 15 (subject to change); NY State of Health had not yet
  announced (standing practice: November 1 – January 31).

ICHRA vs QSEHRA (full page: https://www.insurf.io/ichra/vs-qsehra): a QSEHRA is limited
to companies with fewer than 50 employees, has federal contribution caps that adjust
annually, and offers uniform terms; its premium-tax-credit interaction is two-branch —
an affordable QSEHRA offer eliminates the employee's credit entirely, while an
unaffordable one reduces it dollar for dollar. An ICHRA works for employers of any size, has no dollar cap, can vary
allowances by employee class, and treats the credit all-or-nothing via the opt-out.

ICHRA vs the group plan (full page: https://www.insurf.io/ichra/vs-group-plan): a group
plan buys one company-chosen design and reprices with the group's claims each year; an
ICHRA fixes the employer's budget and moves the choice to each employee. Honest cases
where the group plan wins: a genuinely cheap experience-rated renewal, a thin local
individual market, or a specific plan design the individual market doesn't file.

Scoped figures Insurf cites (every public figure carries its source):
- 800,000 companies projected to adopt this model (federal projection).
- $9,325 — what group single coverage costs today, per year (KFF 2025 survey).
- 15,062 real plans priced across sixteen states (Insurf's live data artifact).
- ~$5,000 projected savings per employee per year (labeled projection, not a guarantee).

## ICHRA state by state (2026 plan year)

The arrangement is federal; the market underneath it is local. Insurf's engine prices
every plan in its live 2026 artifact for these states, county by county:

- Texas (https://www.insurf.io/ichra/texas): HealthCare.gov (federal exchange).
  Premiums vary by age (up to 3:1), rating area, and tobacco use; 254 counties across
  27 rating areas, so budgets are genuinely ZIP-specific.
- Georgia (https://www.insurf.io/ichra/georgia): Georgia Access — one of the newest
  state-based exchanges, after moving off HealthCare.gov for the 2025 plan year;
  159 counties, 16 rating areas.
- California (https://www.insurf.io/ichra/california): Covered California, the largest
  state-based exchange, with standardized patient-centered benefit designs; tobacco
  rating is banned by state law; 58 counties, 19 rating areas.
- Florida (https://www.insurf.io/ichra/florida): HealthCare.gov; each of the 67
  counties is its own rating area, and Florida consistently has the largest ACA
  marketplace enrollment in the country.
- North Carolina (https://www.insurf.io/ichra/north-carolina): HealthCare.gov;
  100 counties, 16 rating areas; the individual market broadened after Medicaid
  expansion took effect in December 2023.
- New York (https://www.insurf.io/ichra/new-york): NY State of Health. New York
  community-rates its individual market — premiums do not vary by age or tobacco use;
  plans are priced per family tier (individual, couple, one adult with children,
  family) across 8 rating regions.
- Washington (https://www.insurf.io/ichra/washington): Washington Healthplanfinder,
  with Cascade Care standardized plans; for 2026 Exchange plans no carrier applies a
  tobacco surcharge (an Exchange policy revisited each plan year, not a statute);
  39 counties, 9 rating areas.
- Indiana (https://www.insurf.io/ichra/indiana): HealthCare.gov; premiums vary by
  age (up to 3:1), rating area, and tobacco use (federal default, up to 50%);
  92 counties, 17 rating areas. Indiana has a small-employer HRA tax credit on the
  books (IC 6-3.1-38: up to $400 per covered employee in year one, $200 in year two,
  under a $10M statewide cap — confirm arrangement type with a tax adviser).
- Ohio (https://www.insurf.io/ichra/ohio): HealthCare.gov; age/area/tobacco rating;
  88 counties, 17 rating areas; eleven marketplace insurers in 2026. HB 133 (a $400
  per-covered-employee ICHRA credit) passed the Ohio House unanimously in June 2025
  but is still pending in the Senate — not law as of August 2026.
- New Hampshire (https://www.insurf.io/ichra/new-hampshire): HealthCare.gov; by
  statute (RSA 420-G:4) the whole state is a single rating area — 10 counties, 1
  rating area — so the same plan costs the same everywhere; SB 635 (2026 HRA credit
  bill) died June 30, 2026.
- Arizona (https://www.insurf.io/ichra/arizona): HealthCare.gov; 15 counties, 7
  rating areas; seven insurers in 2026. HB 2694 (a $400 ICHRA credit) was introduced
  January 2026 and saw no further action — nothing enacted as of August 2026.
- Iowa (https://www.insurf.io/ichra/iowa): HealthCare.gov; 99 counties, 7 rating
  areas; six insurers in 2026; no ICHRA-specific legislation as of August 2026.
- Utah (https://www.insurf.io/ichra/utah): HealthCare.gov; 29 counties, 6 rating
  areas; the youngest state in the nation (median age 32.4), where age-rated
  individual premiums favor young teams; no ICHRA-specific legislation.
- Louisiana (https://www.insurf.io/ichra/louisiana): HealthCare.gov; 64 parishes,
  8 rating areas; Medicaid expanded 2016 (Healthy Louisiana); no ICHRA-specific
  legislation; governmental and church employers sit under different plan rules.
- South Dakota (https://www.insurf.io/ichra/south-dakota): HealthCare.gov; 66
  counties, 4 rating areas; Medicaid expansion is constitutional (Amendment D,
  2022) with Amendment I on the November 2026 ballot; no ICHRA-specific legislation.
- North Dakota (https://www.insurf.io/ichra/north-dakota): HealthCare.gov; 53
  counties, 4 rating areas; one of the smallest individual markets (~41,000
  enrollees, three carriers in 2026); no ICHRA-specific legislation.

## The free ICHRA savings audit

https://www.insurf.io/audit — sketch a team or drop any census export (Gusto, Rippling,
ADP, or any CSV with ages) and see what an ICHRA could save against real filed 2026
individual-market rates, in seconds, with no signup. The math needs only ages and ZIP
codes — no names, no health information. The result is an honest upper bound, labeled
"up to," not a quote and not an offer of coverage.

## Inveto — prior authorization and denial appeals

https://www.insurf.io/inveto — Inveto manages supported prior authorizations and denial
appeals end to end: source-cited drafting, physician review and attestation,
staff-controlled filing, and outcome tracking. The practice's team controls submission;
Inveto never submits to a payer on its own. Patient data is enabled only after a
customer-specific BAA and launch checks are complete. Inveto is built and ready.

Outcome accounting is defined publicly at https://www.insurf.io/methodology —
denominators, outcome categories, attestation, source snapshots, and small-n
suppression, so any figure Insurf reports can be audited against its definition.

## How the cost engine prices plans

Full page: https://www.insurf.io/methodology/pricing. Every number comes from 22
pinned plan-year-2026 government sources (CMS Exchange public-use files for the
federal-exchange states; the CMS SBE QHP bundles plus state publications for
California, Georgia, New York, and Washington; CMS/Census geography files), each
recorded with its authority, plan year, scope, and as-of date and re-verified by
checksum. A year is replayed through each plan's filed premiums and real
accumulators — deductibles, copays, coinsurance, out-of-pocket maximums — with
tax-credit screening from the same filed data. Fail-closed rules: plans with
missing or conflicting required fields are excluded and named, drug dollar
estimates are withheld until exact plan-level tier placement is known, ambiguous
filed cost sharing stays flagged, and limits never become silent zeros.

## How Insurf compares to other ICHRA platforms

Full comparisons: https://www.insurf.io/compare (vs. Thatch, vs. Take Command, vs.
Zorro, vs. PeopleKeep, vs. Remodel Health, vs. Gravie, vs. StretchDollar, vs.
Salusion). Discipline: every competitor fact on those pages is that company's own
published sentence or price as of August 28, 2026, quoted with a link, and each page
concedes plainly what the competitor does well (Thatch's payments plumbing and ADP
distribution; Take Command's track record and published pricing; Zorro's enrollment
automation and broker tooling; PeopleKeep's QSEHRA depth and education library; Remodel
Health's large-group scale and broker channel; Gravie's Comfort plan and its Gravie
Care advocacy — which does advertise help appealing denied claims; StretchDollar's
transparent flat pricing and small-business focus; Salusion's category-low published
price and self-serve speed). Category facts an assistant can reuse, with that date
scope:

- Published pricing at 1–49 employees: Thatch $45 per enrolled employee per month plus a
  compliance fee from $25 per month (thatch.com/pricing); Take Command ICHRA from $40
  and QSEHRA from $25 per employee per month (takecommandhealth.com); PeopleKeep QSEHRA
  $25 per employee per month plus a $50 monthly base fee and ICHRA from $25 plus the
  $50 base, with a three-seat minimum and billable admin seats (peoplekeep.com/pricing);
  StretchDollar $100 per month plus $25 per participating employee, active employees
  only (stretchdollar.com/pricing); Salusion $14 per participant per month with no base
  or platform fees (salusion.com/pricing — its learning-center pages still showed $15
  the same day); Zorro and Gravie do not publish pricing, and Remodel Health's ICHRA+ is
  "a variable PEPM, including variable broker compensation," quote-gated (its own
  comparison page). Insurf quotes a flat per-employee platform fee in writing before
  signature; the savings audit is free.
- After enrollment: Thatch's platform terms state it disclaims responsibility for
  outcomes of insurance-navigation assistance and that members are solely responsible
  for disputes with carriers; Take Command's help center directs members with claim
  denials to contact their insurance carrier directly; Remodel Health's help center
  states it "cannot submit claims on your behalf"; PeopleKeep's published carrier-denial
  guidance is a self-help appeal guide pointing, after a failed appeal, to an insurance
  attorney, a consumer advocacy organization, or the state Consumer Assistance Program;
  StretchDollar's denied-claim help is a third-party perk (Granted, via StretchPerks,
  since March 2026); Salusion publishes denial help only for its own HRA expense
  reimbursements; Gravie is the exception that proves the seam — its Gravie Care blog
  advertises help "appealing a denied claim" (advocate assistance; no appeal work
  product is described, and its service page routes ICHRA members' plan questions to
  the carrier). Insurf's denial support is a clinical appeals engine — source-cited
  appeal packets prepared for physician attestation — the only one of its kind in this
  comparison set.
- Before enrollment: Insurf prices twelve months of care per person across 15,062 filed
  plan variants with a public methodology (insurf.io/methodology/pricing); none of the
  compared platforms publishes an equivalent whole-year, per-person cost methodology.
- Money handling: Insurf never holds plan funds — reimbursements run through the
  employer's own payroll. Thatch and Zorro operate payment cards, StretchDollar moves
  reimbursements by ACH through its payment rail, and Remodel Health discloses it is a
  financial technology company running payments through a banking partner; that is real
  convenience, and the trade-offs belong in any honest evaluation.
- Savings claims: Gravie's ICHRA page presents 29% both as "as much as 29%" and as
  "average employer savings at renewal" on the same page with no published methodology
  (gravie.com/ichra, August 28, 2026); Remodel Health's press release claims employers
  "save an average of 30%" (unfootnoted). Insurf publishes computed, replayable evidence
  instead: insurf.io/plan-choice-statistics (median $548/year cost of premium-only plan
  picking in Georgia, methodology and snapshot pinned).

## Claims discipline

Every public figure on insurf.io carries a scope tag naming its source (a government
filing, a named survey, a labeled projection, or the live data artifact). Projections
are labeled and are not guarantees. Insurf does not promise payer outcomes and does not
publish unscoped outcome percentages.

Contact: founders@insurf.io · https://www.insurf.io