At CHOICE in Action: Ohio, the conversation kept returning to a challenge Ohio employers know well: how to offer health benefits when group plan costs are difficult to sustain, employees have different needs, or the company has never been able to offer coverage.
The October 16 event in Cleveland brought together Ohio employers, benefits professionals, state lawmakers, CMS, the Small Business Administration and Take Command. The focus was not just on raising awareness of CHOICE Arrangements. It was on the decisions employers face when deciding how to provide benefits and what support employees need along the way. www.cms.gov
The employers’ situations were different
Some small employers are looking for a way to offer health benefits for the first time. Others have offered group coverage but are finding that costs, participation or the needs of their workforce make the current approach hard to maintain.
Those differences matter. A benefit strategy that works for one Ohio employer may not work for another. The discussion in Cleveland included a behavioral health nonprofit and other businesses sharing their experience with CHOICE. Their examples put the focus on the practical questions: Can the employer keep offering a meaningful benefit? Can employees find coverage that suits their needs? What kind of support will make the change manageable?
CHOICE Arrangements, formerly known as Individual Coverage Health Reimbursement Arrangements (ICHRAs), give employers another model to consider. The employer sets a contribution for eligible employees, who use it toward qualifying individual health coverage they choose. The employer still funds the benefit; employees select their coverage. www.cms.gov
Ohio lawmakers brought the state policy question into the room
Representative Meredith Craig discussed Ohio House Bill 133, a proposal that would create a nonrefundable tax credit for small employers offering an individual coverage HRA. The bill passed the Ohio House in June 2025 and was referred to the Senate. It remains a proposal, not a tax credit employers can currently claim. www.ohiohouse.gov
That state-level discussion gives Ohio employers another reason to follow the issue. But a policy proposal does not answer the individual employer’s main question: does this approach fit our budget, workforce and available coverage options?
A change in benefits takes more than a new contribution
Speakers also emphasized the learning curve for employers and employees moving from a group plan to individual coverage choices. Employees may need help understanding their options, while employers need to plan for communications, enrollment, documentation, reimbursements and ongoing support.
Take Command CEO Jack Hooper shared what he had heard from employers about adapting over time: “Year two is easier. Year three is easier than year two.”
That is a useful reminder for employers weighing a change. A successful transition depends on preparing employees and having the right support in place, not simply setting a contribution
Start with the Ohio workforce
For Ohio employers, evaluating CHOICE means looking at the people and places behind the plan: where employees live, what coverage is available to them, what they need from a benefit and what the organization can sustainably contribute.
The Cleveland event brought those questions into a statewide conversation. Federal attention may make more employers and consultants hear about CHOICE, but the decision remains local to each organization. Benefits consultants can help employers compare the model with their current approach; an experienced administrator can help assess the design and operational requirements
Considering CHOICE for an Ohio business or client?
Talk with Take Command about your goals and what an evaluation involves.
