Is Thatch ICHRA worth it?

What Thatch is

Thatch runs individual coverage HRAs (ICHRAs). You set a monthly budget per employee; employees use it to pick an individual plan from Thatch's marketplace, plus dental, vision and other benefits. Thatch handles enrollment, payments and compliance. It publishes pricing for small employers of $45 per enrolled employee per month plus a $50 monthly compliance fee. It reached a $1 billion valuation in September 2026.

What Thatch does well

• A polished shopping experience for employees.
• A fixed, predictable budget for the employer.
• You pay the platform fee only for employees who enroll.
• Works for teams spread across many states.

Where it goes wrong for employees

The model only looks cheap because the risk moves from the employer's budget to the employee's. Here's what that looks like in 2026:

• Small allowances. Small employers offered single employees an average of $583 a month in 2025, and individual premiums then rose about 26% on average for 2026.
• Closed networks. About 46% of 2026 marketplace plans are HMOs and 33% are EPOs. Neither covers out-of-network care except emergencies. Only about 15% are PPOs, compared with 46% of workers on employer plans.
• Bigger deductibles. The average marketplace deductible rose from $2,759 in 2025 to $3,786 in 2026, and bronze plans grew from 30% to 40% of sign-ups as people traded down to afford premiums.
• Employees carry the gap. Whatever the allowance doesn't cover comes out of their paycheck, and older employees can be charged up to three times as much as younger ones.
• Another layer of admin. At $45 per enrollee per month, a 20-person team pays about $10,800 a year in platform fees, plus $600 in compliance fees, on top of the insurers' own administrative costs. Healthcare already has too many middlemen.

Having trained in medicine, the network point worries me most. A bronze HMO with no out-of-network coverage is fine until someone needs a specialist the plan doesn't include, or gets sick while traveling. That's exactly when an employee finds out what their allowance really bought.

I wrote more about this in Is ICHRA a scam for your employees?

So is Thatch worth it?

The group plan alternative

At Prescience, we design and run your company's health plan, from setup and enrollment to claims, compliance and COBRA. What your team gets:

• An effective $0 deductible, so the plan helps from the first visit.
• Simple copays shown before a visit, capped by a low out-of-pocket maximum.
• A broad national PPO network, plus providers we contract with directly.
• 24/7 physician-led care navigation: a care team that finds the right provider, books appointments and explains costs up front.

What your company gets: one monthly cost set in your quote, usually 10–20% below comparable fully insured coverage and fixed before the plan starts, with no admin fees. You keep your payroll provider, and the plan can start mid-year.