SOURCE: Venteur
One of the most notable trends in the 2026 filings is the rise of ICHRA-specific plans, which are filed off-exchange only and are priced up to 20 percent lower than their on-exchange counterparts.
Why are these plans cheaper?
Here’s your revised bullet list with the new point about morbidity factor incorporated smoothly:
ICHRA enrollees are typically younger, healthier, and more engaged in their healthcare compared to the broader ACA population. As a result, ICHRA-specific plans are underwritten with a lower morbidity factor, reflecting the improved risk profile of this population.
• While employees tend to use more healthcare services than self-employed individuals, they typically rely on lower-cost care, such as primary care and prescriptions, rather than emergency or inpatient services.
• Member retention is higher with ICHRA. Most ACA members stay on a plan for less than a year, whereas ICHRA participants are tied to employer funding and tend to remain enrolled for longer periods.
• A longer relationship with a member results in more predictable utilization and leads to greater lifetime profitability for the carrier.
A handful of carriers, including Centene Corporation, have launched new subsidiaries targeting this segment and are securing early pricing advantages. Other insurers are beginning to follow.
2026 is shaping up to be a pivotal year for the individual market. Plan pricing is being recalibrated in response to shifting federal policies, evolving risk dynamics, and carrier strategies. For ICHRA stakeholders, this represents a more complex environment but also one with more opportunities than ever before.
