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What Is ICHRA?

The Individual Coverage Health Reimbursement Arrangement (ICHRA) is a new type of health care reimbursement plan that provides employees with greater flexibility and choice in their health insurance coverage. Through this arrangement, Wendy’s contributes funds to your ICHRA account, which you can then use to purchase individual health insurance or Medicare coverage that best meets your personal needs. This innovative approach allows you to select from all available individual health policies in your area, giving you control over your health care decisions while receiving employer support for your premiums.

Coverage through the ICHRA

Plan Selection and Management

Your ICHRA coverage is administered through SureCo, our designated ICHRA administrator. Through SureCo’s platform, you can shop the insurance marketplace, compare different policy options and select coverage that aligns with your specific health care needs and budget preferences.

Metal Tier System

Individual market plans are categorized using a metal tier system that determines how you and your insurance carrier share medical costs:

Bronze plans offer the lowest monthly premiums but typically have high deductibles. The insurance pays approximately 60% of covered medical costs, making these plans ideal for relatively healthy individuals seeking cost-saving options.

Silver plans provide a balance with slightly higher premiums than Bronze but lower deductibles. Insurance covers approximately 70% of covered medical costs, reducing your out-of-pocket expenses to meet deductibles.

Gold plans feature higher monthly premiums but lower deductibles compared to Silver plans. With insurance covering approximately 80% of covered medical costs, these plans work well for individuals anticipating expensive medical needs throughout the year.

Platinum plans have the highest monthly premiums but provide the most comprehensive coverage, with insurance paying approximately 90% of covered medical costs. These plans benefit individuals who frequently visit doctors, take multiple medications or want minimal out-of-pocket costs.

Payment Process

The enrollment process includes seamless monthly premium bill payment with premiums automatically deducted from your paycheck through SureCo’s ICHRA portal.

Employee Contributions

Your contribution amount is determined by two primary factors:

• Age as of January 1, 2025 – Older employees typically face higher costs due to individual market pricing structures
• Coverage level – Whether you enroll yourself only, or include spouse and children

Individual market plan costs vary by county, and it’s important to understand that pricing can fluctuate based on your geographic location and the coverage tier you select.

Individual vs. Family Plan Selection

When choosing between individual or family coverage, consider these key factors:

• Coverage vs. cost analysis: Determine your preference between comprehensive health coverage with higher premiums versus lower premiums with higher out-of-pocket costs when services are needed.
• Provider network evaluation: Eliminate plans that exclude your current doctor or essential providers and specialists in your area. Ensure your preferred health care professionals are included in the plan’s network.
• Comprehensive network comparison: Compare all health plan networks side by side to make an informed decision about which option provides the best access to care in your location.
• Essential services coverage: Verify that your chosen plan covers regular and necessary care including prescription medications and specialist visits that you anticipate needing.

How to Enroll

You will receive an email from the Benefits Department with detailed instructions for navigating the SureCo enrollment platform, followed by a direct email from SureCo notifying you when benefit selection begins. Access the enrollment platform at EnrollMe.SureCo.com/Login. Create your account and begin shopping and comparing coverage options available in your area. During enrollment, you must either select a medical plan that meets your needs or formally waive coverage if you have alternative arrangements.
A dedicated Enrollment Specialist is available to guide you through the process at 949.989.4906.

Important Enrollment Reminders

Active enrollment required: You must complete your enrollment to receive benefit coverage for the plan year. This is not an automatic process.

Post-enrollment communication: After enrolling in individual medical coverage, your insurance carrier will send information directly to you via mail or email.

Payment instructions: If you receive invoices from your insurance carrier, do not pay these invoices directly or cancel your coverage. Premium payments are handled automatically through your paycheck deduction.

Ongoing support: SureCo remains available to answer questions throughout the enrollment process and beyond to ensure you have the support needed to maximize your ICHRA benefits.

For Employees 65 and Over and Disabled Dependents

Under ICHRA, if you are 65 or older, or if any of your dependents are on Medicare due to disability, you must enroll in Medicare Part A and Part B or Part C to be eligible for nontaxed employer contributions and reimbursements for your health care coverage.

Medicare is a federal health insurance program for people who are 65 or older, certain younger people with disabilities and people with permanent kidney failure. You are eligible to sign up for Medicare three months before you turn 65 and until three months after the month you turn 65.

Go to Medicare.gov to understand your Medicare options and enroll.

Note: Medicare enrollment is not automatic and is not managed within the SureCo Platform. Enrolling in Medicare will not affect your employer’s contribution toward your health care premiums. As a Medicare-eligible employee, you are eligible to receive a nontaxed expense reimbursement from Wendy’s to offset the cost of your Medicare premiums. To finalize the amount of your nontaxed reimbursement, you will be asked to verify your enrollment status in Medicare Part A and Part B or Part C and your monthly out-of-pocket premiums.

To learn more, contact an Elite Medicare Specialist at 804.898.3412 You can also check out the SureCo Medicare video for information on the steps you need to take to get the Medicare reimbursement. You will need to report your Medicare enrollment update to SureCo as soon as possible so Wendy’s can begin applying your nontaxed expense reimbursement to future payroll checks.