Affordable health coverage for your team — without the broker runaround
SHOP, QSEHRA, and ICHRA give small employers real options that big-company brokers don't bother explaining. ClaimSage helps you find the right fit and navigate enrollment, free.
No broker, no commission, no pressure. We just help you understand your options.
Your options, explained
Three paths to coverage for small teams
Each program works differently. The right choice depends on your headcount, budget, and how much flexibility you want to give employees.
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SHOP Marketplace
Best for: teams of 1–25 FTEs who want group coverage
The Small Business Health Options Program is the ACA's group-plan marketplace for employers with 1–25 full-time-equivalent employees. You pick a plan, employees enroll, and the IRS hands you back up to 50% of premium costs as a tax credit — but only if you offer SHOP coverage. Eligibility requires paying at least 50% of employee-only premiums and having average wages under ~$56,000. Enrollment is year-round (no open enrollment window). You choose the insurer and metal tier; employees pick from your chosen plan or a range of plans depending on your state's SHOP structure.
Tax credit up to 50% of premiums (35% for non-profits)
Credit claimable for up to two consecutive tax years
Available in all 50 states through HealthCare.gov or state exchanges
Requires ≥1 employee enrolled who isn't the owner's spouse
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QSEHRA
Best for: employers under 50 FTEs with no group plan
A Qualified Small Employer Health Reimbursement Arrangement lets employers reimburse employees for individual health insurance premiums and qualified medical expenses — tax-free. You don't manage a group plan at all. Employees buy their own ACA Marketplace or off-exchange coverage, submit receipts, and get reimbursed up to IRS annual limits. For 2026, the IRS limit is $6,350 for self-only and $12,800 for family coverage. Contributions are not subject to payroll tax for employers or income tax for employees (as long as the employee has Minimum Essential Coverage). No minimum contribution required — you set the amount.
2026 limits: $6,350 single / $12,800 family (IRS Rev. Proc. 2025-29)
Zero payroll tax on reimbursements — pure tax-free benefit
No group-plan complexity; employees keep their own coverage
Must be offered uniformly to all eligible employees in a class
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ICHRA
Best for: any size employer wanting class-based flexibility
An Individual Coverage HRA removes the size cap entirely and lets employers define employee classes — full-time, part-time, seasonal, hourly, salaried, by geographic location — with different reimbursement amounts for each class. Employees use their ICHRA allowance to buy any ACA-qualified individual or family plan they choose, then get reimbursed. There's no federal cap on ICHRA contributions. Employees who receive "affordable" ICHRA offers lose eligibility for ACA premium tax credits, so setting allowances carefully matters. ICHRA is the most flexible HRA option and works for 1-person companies or Fortune 500 alike — but administration requires a compliant HRA plan document and annual 90-day notice to employees.
No employer size limit — works from 1 to thousands of employees
No contribution cap — you set any reimbursement amount
Employee choice: they pick their own individual ACA plan
Class-based design allows different rates for different employee groups
Side-by-side
SHOP vs QSEHRA vs ICHRA
A quick reference before you dive into details. Every situation is different — use this as a starting filter, not a final answer.
Estimates use KFF 2024 small-group avg employer cost ($7,584/employee/yr single). Actual savings vary by state, plan design, and employee mix. Not tax or legal advice.
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QSEHRA Employee Management
QSEHRA SaaS — $49/month
A simple, flat-rate tool for employers who want to run QSEHRA properly — without spreadsheets, email threads, or manual tracking. No per-employee fees. No tiered add-ons. Just everything you need.
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Employee onboarding
Add employees, assign them to FT or part-time classes, and set individual reimbursement allowances in minutes.
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Reimbursement workflow
Employees submit receipts. You approve and track every reimbursement — with running totals against 2026 IRS limits ($6,350 single / $12,800 family).
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Annual limit tracking
Automatic alerts when employees approach their IRS annual cap. Full audit trail for every reimbursement — always ready for your accountant.
Cancel anytime · No setup fee · Instant access after payment
Why ClaimSage
The advocate brokers aren't incentivized to be
Brokers earn commission on premiums. ClaimSage earns nothing from your insurer. That difference changes every recommendation we make.
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Cost transparency, not cost concealment
We show you the true loaded cost of each option — premiums, tax credits, payroll tax savings, admin overhead — so the total picture is clear before you commit.
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AI navigation, not a sales script
Our AI reads IRS guidance, ACA regulations, and your state's exchange rules to surface what applies to your team's specific situation — not a generic broker pitch.
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Zero broker commissions
Traditional brokers can earn 3–6% of annual premiums. On a 10-person team, that's thousands per year baked into your rates. ClaimSage charges nothing for the assessment.
Get your free coverage assessment
Tell us about your team and we'll map out which programs you qualify for, estimated tax savings, and next steps. No commitment, no sales call unless you want one.
By submitting, you agree to ClaimSage's Terms of Service and Privacy Policy. We do not sell your information. You may receive follow-up emails about your assessment; you can unsubscribe at any time. ClaimSage is not a licensed insurance broker or advisor. Information provided is for educational purposes only.
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You're on the list
We'll review your team's details and send you a personalized coverage breakdown — usually within one business day. Check your inbox (and spam, just in case).
Common questions
What small employers ask us most
Can I offer both SHOP and QSEHRA at the same time?
No. QSEHRA is only available to employers who do not offer a group health plan. If you're enrolled in SHOP — which is group coverage — you cannot simultaneously offer QSEHRA. You can, however, offer ICHRA alongside SHOP for different employee classes (e.g., SHOP for full-time staff, ICHRA for part-time workers), as long as you follow the class-definition rules.
Does the SHOP tax credit apply to S-corp owner-employees?
No. The Small Business Health Care Tax Credit does not cover premiums paid for sole proprietors, partners in a partnership, shareholders owning more than 2% of an S-corp, or their spouses. The credit applies only to premiums paid for employees who are not owners. This means a company with only one owner-employee does not qualify — at least one non-owner employee must be enrolled.
What happens to my employees' ACA subsidies if I offer ICHRA?
If your ICHRA offer is considered "affordable" under IRS rules (the lowest-cost silver plan in the employee's area minus your ICHRA contribution costs ≤ 9.02% of household income in 2026), the employee cannot claim ACA premium tax credits. If your ICHRA is not affordable, employees can opt out of the ICHRA and claim credits instead. This is why sizing your ICHRA allowances correctly matters — an undersized allowance that's technically "unaffordable" lets employees access better subsidies.
Is there a minimum employer contribution for QSEHRA?
No. There is no IRS minimum contribution for QSEHRA — you can offer $1 or $6,350. However, you must offer the same amount uniformly within each permitted employee class (full-time vs. part-time, for example). The one structural constraint is that family reimbursement amounts cannot exceed 2× the single rate. Outside that, you have complete flexibility to set the contribution at whatever level fits your budget.
We're a new startup with 3 people. Which option makes the most sense?
For most early-stage startups with 1–10 employees, QSEHRA is the simplest starting point. There's no plan-selection complexity, no minimum contribution, and employees keep their existing coverage (useful if co-founders already have plans through a spouse's employer). If your average wages are low enough and you want to capture the 50% SHOP tax credit, that may be worth the extra administration. ICHRA is optimal when you have multiple employee classes or want no contribution cap. Get the free assessment above and we'll model out the tax math for your specific headcount and payroll.
Not Legal, Tax, or Insurance Advice. ClaimSage provides AI-powered health insurance education and tools. We are not a licensed insurance broker, law firm, or tax advisor. The QSEHRA and ICHRA limits cited reflect IRS guidance current as of the date this page was published; verify current limits at IRS.gov before making plan decisions. Always consult a licensed benefits advisor or tax professional for guidance specific to your situation.
