Workers Offered CHOICE Health Allowances Should Compare Individual Plans, Networks, and Premiums Before Enrolling for 2027

Thanksgiving 2026 Almanac Outlook Calls for Upper Midwest Snow and Eastern Rain as Travelers Plan AheadThe Old Farmer’s Almanac predicts snow in the Upper Midwest and rain in the East for Thanksgiving 2026. Here is how to plan travel safely and stay healthy. Cervical Cancer Screening Gaps Persist in the South and West as At-Home HPV Testing Expands for WomenA new study shows uneven cervical cancer screening across U.S. regions. Here are current Pap and HPV schedules and at-home testing options. Families with Children of Different Citizenship Status Can Check Each Child’s Eligibility for Medicaid or CHIP SeparatelyA JAMA Network Open study finds that over 1 million U.S. children live in families with mixed citizenship status. Learn how Medicaid and CHIP eligibility is decided for each child. Workers Offered CHOICE Health Allowances Should Compare Individual Plans, Networks, and Premiums Before Enrolling for 2027CHOICE Arrangements let employers fund individual health plans instead of group coverage. Learn the trade-offs before you choose a 2027 plan with your allowance. Mental Health National Depression Screening Advice Was Linked to More Therapy and Less Antidepressant-Only Use Among Distressed AdultsAfter depression screening became routine advice, distressed adults used more therapy and fewer antidepressants alone. What patients can ask. After Bend Elementary School Shooting, Oregon Officials Urge Families to Watch Children for Signs of Trauma and GriefAfter the Bend school shooting, Oregon officials urge families to check in with kids. Trauma signs by age and where to find help. Teens and Young Adults with Depression Had Four Times the Odds of a Prescription Drug Use DisorderYouths with depression had 4 times the odds of a prescription drug use disorder in a national survey. What parents should know about the findings. Ghost Networks Persist in Private Insurance as Fewer Than 1 in 4 Resolved Calls Booked Mental Health VisitsA JAMA Health Forum audit of 5,822 calls found fewer than 1 in 4 resolved calls to listed mental health clinicians led to an appointment. Innovation Patients with Bile Duct Cancer Need FGFR2 Testing Before Lirafugratinib, but the Label Lists No FDA-Authorized Companion TestLirafugratinib treats bile duct cancer with FGFR2 changes, but its label lists no FDA-authorized test. Learn what patients need for testing and eye checks. Breast Lump at 26 Revealed Cancer and a PALB2 Mutation in a Woman with No Known Family HistoryA woman found a breast lump at 26 with no known family history. Tests found cancer and an inherited PALB2 mutation. Here is what young women should know. CMS Official Admits Many Parts of Medicare’s AI-Assisted WISeR Prior Authorization Test in Six States Are Not WorkingA senior CMS official says many parts of Medicare’s AI-assisted WISeR prior authorization test are not working. See which services it covers and how patients can appeal. Older Adults at Fall Risk Had Modestly Fewer Falls When Clinics Could Prescribe Home Strength and Balance ExercisesA trial of 11,945 older adults found modestly fewer falls when clinics could prescribe home balance exercises. Here’s how families can ask. Healthy Living Social Security’s 3.6% Raise for 2027 Could Shrink Once a Projected $6.60 Medicare Part B Increase Is DeductedSocial Security’s 3.6% COLA adds about $75 a month, but a projected Part B increase could take $6.60 back. See what retirees can expect to keep in 2027. Parkview Health to Acquire Ovation Healthcare, Which Works with More Than 500 Health Care Organizations in 48 StatesParkview Health will acquire Ovation Healthcare, which works with more than 500 health care organizations in 48 states. See what the deal could mean for rural hospitals. Cutting Medicaid Adult Dental Benefits Would Save States Only 20 to 50 Cents for Every Dollar CutStates that cut adult Medicaid dental care keep only 20 to 50 cents per dollar because federal funds pay most costs, Harvard researchers report in JAMA Health Forum. Missouri Has Lost 11 Maternity Wards Since 2009 as Midwife Rules Push Some Providers to Practice in KansasMissouri has lost 11 maternity wards since 2009, and its nurse-midwife rules are pushing some providers to Kansas. See what it means for expectant families. Covid – 19 FDA Proposes Requiring Companies to Report Food Additives That Now Reach Grocery Shelves Without Federal ReviewFDA has released its proposed GRAS rule requiring companies to notify the agency about food additives. Here is what the proposal does and does not do. Federal Regulators Warn Some Hair Dryer Brushes Lack the Part That Stops ElectrocutionCPSC warns hair dryer brushes sold on Walmart.com and TikTok Shop lack immersion protection. The seller has not agreed to a recall or refund. A Recalled Teething Toy Broke the Pattern Parents Were Told to Look ForA newly recalled pull-string teething toy has a different model number and design from earlier recalls, and one choking incident has been reported. Trying to Lower Blood Sugar, Cholesterol or Blood Pressure? Different Workouts Suited Different MarkersA pooled analysis of 53 trials found that different exercise types helped different metabolic markers. Most of the evidence was low certainty. Joe Raedle | Getty Images Share on Twitter Share on Facebook Share on Pocket Federal officials are promoting CHOICE Arrangements to Ohio employers as an alternative to group health insurance. Under these arrangements, employers give workers a tax-advantaged allowance to buy their own individual coverage. The Centers for Medicare & Medicaid Services highlighted the approach in an Oct. 16 announcement on an Ohio employer event, the same day Centene said it will extend the model to its own employees in Ohio and Oklahoma for 2027.

CHOICE Arrangements are the new name for Individual Coverage Health Reimbursement Arrangements, or ICHRAs, which were created during President Trump’s first administration. “CHOICE Arrangements offer a practical alternative to traditional group health insurance,” CMS Administrator Dr. Mehmet Oz said.

For workers, the shift moves a major decision onto the household. Instead of enrolling in one company plan, each employee picks an individual plan, and the right choice depends on income, family size, doctors, and medications.

Under the model, the employer sets a monthly amount and reimburses workers for individual health insurance premiums and, in some cases, other medical costs. Employees and covered family members must be enrolled in individual coverage or Medicare to receive the money. CMS explains the rules on its CHOICE Arrangements information page.

Employers generally cannot offer both a traditional group plan and a CHOICE Arrangement to the same class of workers. That means many employees will not be deciding whether to give up group coverage. They will be deciding which individual plan to buy with the allowance.

Employers generally must give written notice at least 90 days before the plan year starts. Workers who newly gain access to an allowance qualify for a special enrollment period, so they can buy coverage outside the usual open enrollment window.

Centene said it launched the program for its Indiana employees in 2026. Its Ambetter Health Solutions business sells individual plans that work with these arrangements in 13 states, including Ohio, Indiana, Texas, Georgia, and Florida.

Supporters say workers gain flexibility. An employee can choose a plan built around a preferred doctor or hospital instead of accepting a single company option. Employers get more predictable benefit costs, which CMS and the Small Business Administration pitched as a help for small businesses facing rising group premiums.

The risks are tied to the individual market itself. Marketplace insurers proposed a median premium increase of 15% for 2027, the second straight year of double-digit increases, according to the Peterson-KFF Health System Tracker. If the allowance does not rise as fast as premiums, workers cover the difference. The individual market is also shrinking, with enrollment down 18% from June 2025 to June 2026, according to a KFF analysis of enrollment trends.

Networks are another concern. Individual plans can have narrower provider lists than some employer plans, so a worker may need to switch doctors or pay more to keep one. Families with a member who has a chronic illness or ongoing treatment face the greatest risk of disruption.

Subsidies work differently, too. If the employer’s offer is considered affordable under a federal income test, the worker and covered family members cannot get marketplace premium tax credits. Accepting the allowance also rules out the credit, even when the offer is not affordable.

Start with the math. Compare the monthly allowance with the premium for the lowest-cost silver plan in your area, then add the deductible and out-of-pocket maximum to estimate a full year of costs.

Next, check networks and drugs. Confirm that your primary care doctor, specialists, and nearest hospital are in network, and look up every prescription in the plan’s drug list. Ask about prior authorization rules for any ongoing treatment.

Lower-income workers should ask whether the offer passes the affordability test. If it does not, opting out may allow them to claim premium tax credits instead, which could be worth more. A marketplace navigator or tax professional can help run the numbers.

Older workers near 65 should ask how the allowance works with Medicare, since these arrangements can reimburse qualifying Medicare premiums.

Families should also map out who needs coverage. A spouse or child with a chronic condition may need a plan with a broader network or stronger drug coverage, even if the premium is higher. Comparing two or three plans side by side, using the same list of doctors and prescriptions, makes the trade-offs easier to see.

Important unknowns remain. CMS did not release data on how many Ohio employers use the model, and there is little public evidence comparing worker costs and satisfaction with traditional group plans. This article is general information, not financial or tax advice.

A CHOICE Arrangement can work well for some households, but only after a careful comparison of total costs, networks, and medications.

What is a CHOICE Arrangement? It is an employer-funded allowance that reimburses workers for individual health insurance. It was formerly called an ICHRA.

Can my employer offer both a group plan and a CHOICE Arrangement? Generally not to the same class of employees.

Do I have to buy my own insurance? Yes. You and covered family members must be enrolled in individual coverage or Medicare to receive reimbursement.

Can I still get ACA premium tax credits? Only if the offer is unaffordable under federal rules and you opt out of the allowance.

When will I get notice? Employers generally must notify workers at least 90 days before the plan year begins.

What should I compare first? The allowance compared with total plan costs, plus whether your doctors and drugs are covered.