Overview

CHOICE (formerly known as ICHRA) has moved from an alternative worth testing to a mainstream benefits strategy. For 2027, the question is no longer whether employers will consider it. It’s where the next surge of growth will come from.

This study shows how employers and the consultants who advise them view CHOICE and traditional group coverage today. It also identifies which segments now view CHOICE most favorably: small, mid-market, and large employers, staffing firms, and multi-state employers.

What's Inside the Study

Premium increases and perceived value. Examines whether back-to-back years of significant ACA premium increases have changed employer perceptions of CHOICE’s value, and how that has influenced when and how brokers position it.
How employers see CHOICE. Shows whether employers view it primarily as a cost-control strategy, a recruitment and retention tool, or a workforce personalization strategy.
Risk of reversal. Identifies whether any employer segments are considering a return to traditional group coverage in 2028, and what would trigger that decision.

What’s New

This year, we also looked at what it takes to move employers from considering CHOICE to adopting it:

Transition support. Shows what employers need during the transition to CHOICE, and how those needs change over time.
From consideration to adoption. Examines what it takes to move current group employers to act on CHOICE.
Proactive brokers. Identifies what brokers need to shift from a reactive to a proactive posture with clients.
National networks. Tests whether carriers making their national networks available to CHOICE is enough to remove its most common objection.
Response to rising premiums. Shows whether employers are passing ACA premium increases to employees or absorbing the difference.
State subsidy legislation. Measures how much the growing list of states with passed (4) or pending (7) CHOICE subsidization legislation shapes employer and broker views of CHOICE’s future.

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Explore Last Year’s Insights

2026 ICHRA Part I Study: Brokers and Employers SIP

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Insights from the 2026 Report:

Broker Influence Is the Primary Driver of ICHRA Adoption
Awareness of ICHRA continues to rise among employers, particularly those with 50–499 employees. Brokers and benefits consultants play a central role in this growth, with nearly half of employers first learning about ICHRA through their broker. Employers who work with brokers are also significantly more likely to expect to adopt ICHRA in the future.

Employers See ICHRA as a Cost Control Solution
Despite premium volatility in the Individual Market, employers that have experience with both ICHRA and traditional group coverage generally believe ICHRA delivers better cost outcomes for both their organizations and employees. Brokers who offer both solutions similarly view ICHRA as a stronger tool for controlling future healthcare costs.