Key Takeaways
- • Cathy Grason, vice president and associate general counsel and head of government affairs at Oscar Health, urged Maryland policymakers to expand education, marketplace support and a formal study of CHOICE arrangements as an emerging health benefits model.
- • CHOICE arrangements, formerly known as individual coverage health reimbursement arrangements (ICHRAs) and including Qualified Small Employer Health Reimbursement Arrangements (QSEHRAs), let employers make a defined, tax-advantaged contribution toward employees' individual market health plans instead of offering a single group plan.
- • Nationally, more than two-thirds of small employers offering CHOICE arrangements or QSEHRAs had never offered health coverage before, according to Grason.
- • Grason framed the model as "not a silver bullet" but an important option that many small employers are unaware of.
- • Grason spoke at the October 1 joint meeting of the Maryland Insurance Administration (MIA) and Maryland Health Benefit Exchange (MHBE) as a member of the Insurance Choice & Affordability Alliance (ICAA).
Summary
Cathy Grason, vice president and associate general counsel and head of government affairs at Oscar Health, used the October 1 joint meeting of the Maryland Insurance Administration (MIA) and Maryland Health Benefit Exchange (MHBE) to press state policymakers on expanding health coverage options for small businesses. Speaking as a member of the Insurance Choice & Affordability Alliance (ICAA), she described CHOICE arrangements as a potential route to coverage for Maryland employers, according to a PRWeb release dated October 8, 2026.
CHOICE arrangements, formerly known as individual coverage health reimbursement arrangements (ICHRAs), and Qualified Small Employer Health Reimbursement Arrangements (QSEHRAs) are employer-funded models. Under these structures, a business sets a defined, tax-advantaged contribution toward employees' individual health insurance rather than selecting a single group plan for its workforce. Employers determine how much they can sustainably contribute, while employees choose an Affordable Care Act (ACA)-compliant individual market plan that suits their own needs.
Grason said the model's greatest value in Maryland lies with small employers that offer no coverage today. Nationally, she noted, more than two-thirds of small employers offering CHOICE arrangements and QSEHRAs had never offered coverage before. She acknowledged the model's limits, telling the panel, "This is not a silver bullet... Choice arrangements ... are not going to be the best option for every group. But it is absolutely an important option in the toolkit that unfortunately a lot of small employers don't know about."
Her remarks called on Maryland policymakers to consider three steps: greater education for employers, marketplace support, and a study of CHOICE arrangements as an emerging health benefits model. The release did not include specific legislative proposals, funding figures or timelines for such a study.
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CHOICE arrangements, formerly known as individual coverage health reimbursement arrangements (ICHRAs), and Qualified Small Employer Health Reimbursement Arrangements (QSEHRAs) are employer-funded models. Under these structures, a business sets a defined, tax-advantaged contribution toward employees' individual health insurance rather than selecting a single group plan for its workforce. Employers determine how much they can sustainably contribute, while employees choose an Affordable Care Act (ACA)-compliant individual market plan that suits their own needs.
Grason said the model's greatest value in Maryland lies with small employers that offer no coverage today. Nationally, she noted, more than two-thirds of small employers offering CHOICE arrangements and QSEHRAs had never offered coverage before. She acknowledged the model's limits, telling the panel, "This is not a silver bullet... Choice arrangements ... are not going to be the best option for every group. But it is absolutely an important option in the toolkit that unfortunately a lot of small employers don't know about."
Her remarks called on Maryland policymakers to consider three steps: greater education for employers, marketplace support, and a study of CHOICE arrangements as an emerging health benefits model. The release did not include specific legislative proposals, funding figures or timelines for such a study.
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