ICHRA Design Intake Worksheet
Help users capture the basic employer design facts before moving into classes, contributions, geography, and implementation planning.
Purpose
Help users capture the basic employer design facts before moving into classes, contributions, geography, and implementation planning.
When to use
Use at the beginning of employer discovery, before building classes, contribution strategy, market-fit review, vendor scope, or launch planning.
Who should use this
Advisor, employer sponsor, HR, finance owner, operations lead, or HRB designee supporting design intake.
Review boundary
This worksheet supports discovery and design planning. It does not determine legal, tax, affordability, class, or compliance outcomes.
Resource sections
Employer goals
- Business goals for moving to or reviewing ICHRA are stated.
- Cost, choice, recruiting, renewal, or administrative goals are separated.
- Success measures and unresolved questions are noted.
Current benefit situation
- Current group plan, reimbursement arrangement, or no-offer status is summarized.
- Renewal pain points and timing are captured.
- Existing vendor, payroll, or broker roles are noted.
Workforce overview
- Workforce size, locations, employee groups, and eligibility facts are summarized.
- Census/workforce source is identified.
- Seasonal, variable-hour, or controlled-group questions are flagged.
Employee classes under consideration
- Potential classes are listed before final design.
- Class rationale and employee impact are noted.
- Nondiscrimination or same-terms questions are routed for review.
Contribution strategy direction
- Initial contribution intent is captured.
- Budget floor, replacement goal, or employee-value goal is noted.
- Affordability or funding questions are routed.
Market/geography considerations
- Key employee geographies are identified.
- Known market, carrier, network, provider, or drug issues are noted.
- Market-fit review need is flagged.
Administrative capacity
- Employer capacity for files, payroll, reimbursements, notices, support, and evidence is considered.
- Vendor/platform support needs are noted.
- Implementation owner is named.
Communication and support needs
- Employee education needs are described.
- Support lane and escalation path are identified.
- Sensitive topics are routed to human review.
Review owners
- Design, finance, compliance, and implementation review owners are named or flagged as missing.
- Decision owner and reviewer are distinct where needed.
- Next review step is recorded.
Evidence location
- Discovery notes, census/workforce summary, current benefit data, and market notes have a location.
- Recommendation record or export is retained.
- Related tool outputs are linked.
Evidence to retain
- Employer discovery notes - Retain with the audit file, evidence map, or review record as applicable.
- Census or workforce summary - Retain with the audit file, evidence map, or review record as applicable.
- Current benefit information - Retain with the audit file, evidence map, or review record as applicable.
- Contribution assumptions - Retain with the audit file, evidence map, or review record as applicable.
- Market/geography notes - Retain with the audit file, evidence map, or review record as applicable.
- Review or recommendation record - Retain with the audit file, evidence map, or review record as applicable.
Evidence is not saved in this static version. Assign an owner, repeat the process consistently, review exceptions, explain the rationale, and retain copies in the employer file or local project record.
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No database records or server-side files are created. Use these browser-only actions to retain a local copy.
This worksheet supports discovery and design planning. It does not determine legal, tax, affordability, class, or compliance outcomes.