Trend Trend 8: US employers break the bundled group health plan into a fixed budget

Summary

The eighth trend in CB Insights' outlook is the unbundling of employer health plans in the United States. Employers are breaking apart the traditional bundled group plan in favour of modular benefits built on a fixed budget. The main vehicle is the individual coverage health reimbursement arrangement, or ICHRA. Under it, employers set a fixed amount and reimburse employees tax-free for individual health insurance they choose themselves, which offers more flexibility than group coverage. The change is fuelling a new wave of insurtech companies that administer these arrangements. Four of the 50 most promising insurtech startups of 2025 named by CB Insights are ICHRA platforms.