The HRA Council 2024 Data Report delivers a clear message: Individual Coverage Health Reimbursement Arrangements (ICHRAs) and Qualified Small Employer HRAs (QSEHRAs) have moved from emerging trends to mainstream benefit strategies.

Why the HRA Council 2024 Data Report Matters

This year’s HRA Council 2024 Data Report highlights the strong momentum behind HRAs as employers search for more flexible and cost-effective ways to offer healthcare benefits. The findings are based on extensive, anonymized data from HRA Council members across all 50 states and the District of Columbia.

Key takeaways from the HRA Council 2024 Data Report include:

  • ICHRA Adoption Soars: ICHRA adoption grew 29% year-over-year, marking the fifth consecutive year of strong growth. Applicable Large Employers (ALEs) — businesses with 50+ employees — saw an 84% increase in ICHRA adoption, signaling rapid expansion among mid-sized and large employers.

  • Expanded Access to Benefits: Based on HRA Council member data alone, more than 200,000 employees were offered an ICHRA or QSEHRA in 2024. Broader market estimates suggest over 500,000 lives now have access through these defined contribution solutions — and growing.

  • First-Time Coverage Gains: 83% of employers adopting ICHRA or QSEHRA in 2024 had not previously offered group coverage, showcasing HRAs as a major driver of net new health insurance access, especially for small businesses historically locked out of traditional markets.

  • High Retention Rates: Once employers adopt an HRA, they stay. More than 80% of employers renew year over year, underscoring the sustainability and satisfaction tied to these benefit models.

  • Younger Workforce Engagement: ICHRA/QSEHRA plans attract younger demographics, with the majority of enrollees under 44 — helping stabilize ACA marketplaces and reduce systemic healthcare costs.

  • Employee Choice in Action: 60% of employees offered an HRA opt for ACA Gold or Silver plans, demonstrating informed consumer behavior and preference for robust, value-driven health coverage.

The Rise of ICHRAs and QSEHRAs

According to the HRA Council 2024 Data Report, HRAs are successfully expanding access to healthcare. Smaller employers are gaining the ability to offer affordable health benefits, while larger employers are finding that ICHRAs fit today’s more mobile, remote, and diverse workforces.

Importantly, ICHRAs and QSEHRAs are attracting younger employees. The risk pools for ACA marketplace plans are improving as a result, which could lead to more stable insurance premiums over time.

Looking Ahead

The report signals that HRAs are not just a passing trend. They represent a long-term solution that aligns with the future of work — remote teams, customized benefits, and employee choice.

As ICHRA adoption approaches parity with QSEHRA and larger employers continue to fuel rapid expansion, HRAs are becoming a cornerstone of modern employee benefits strategy.