Individual Coverage HRA (ICHRA) is an arrangement where the employer reimburses employees tax-free for individual-market health insurance premiums and medical expenses, instead of offering a traditional group health plan. ICHRAs work especially well for: (1) small employers whose workforce is best served by choice (different employees, different plans), (2) employers with employees in multiple states or remote workforces, (3) employers who want a predictable cost structure (reimbursement caps are fixed by the employer), and (4) employers replacing an unaffordable group health plan with something more tax-efficient. They don’t work as well for: groups concentrated in one labor market where a group plan would be cheaper at scale, or groups with employees who would have trouble shopping the individual market. We model both before recommending.