ICHRA Required Documents for Premium Reimbursements
These instructions are for participants receiving ICHRA benefits. If you are a participant in a health reimbursement arrangement (HRA), please visit the QuickStart Reimbursement page.
When submitting documentation for premium expenses, please include one of the following: monthly premium statements, insurance coverage confirmation letters, or annual notices indicating the premium amount. Ensure that the documents confirm acceptance into the plan and payment of the initial premium. Multiple documents may be needed to provide all required information.
Required documentation must include:
Premium coverage period (e.g., January 2026)
Premium type (e.g., Medicare, Medical)
Carrier (e.g., Ambetter, Anthem, Cigna, etc.)
Individual serviced (e.g., John Doe)
Monthly amount (e.g., $200.00)
Note: Proof of payment is required for future expenses. Include proof the provider processed your payment, such as a receipt or cancelled check.
Medicare Part B Premium Reimbursement
For Medicare-eligible employees, submit your annual Social Security Benefit Verification Letter or Medicare Premium Bill for Part B. The Social Security Benefit Verification Letter, usually sent in October or November, specifies your Social Security benefit and deductible amounts for the coming year. If you don't have this letter, call the Social Security Administration at 1-800-772-1213 to request another copy or retrieve it online at ssa.gov.
Uploading Documentation
Reimbursement documentation can be uploaded on the mobile app or website.
Images can be any of the following file types: PDF, GIF, JPG, TIF, or BMP up to 5 MB in size.
An unlimited number of files can be uploaded.
You can use your mobile camera or desktop scanner to create documents to attach to your reimbursement request.
Unacceptable Documentation
Documentation that isn't acceptable includes:
Statements showing estimated costs or pending insurance
Balance forward statements
Proof of payment without supporting information (See: What documents must include)
Handwritten changes to documents (with limited exceptions such as translations)