2026 plan set · illustrative team · modeled, not observed
ICHRA for Georgia medical & dental practices: what a 14-person practice's numbers look like
The ICHRA itself is federal: a fixed, tax-free monthly allowance each employee uses to buy their own individual plan. What a Georgia practice actually saves depends on the ages on payroll and the plans filed in its county. Below, the free audit's math run on an illustrative 14-person practice in Gwinnett County — 14 people at one Gwinnett County ZIP (30043), ages 24 to 60 — against the 2026 plan set. Your team's ages and ZIPs will differ, so treat every figure as a labeled illustration, then run your own.
The 14-person practice, in five figures.
An illustrative 14-person practice in Gwinnett County; your team's ages and ZIPs will differ.
up to $2,079/mo
up to $24,954/yr
up to — best-case premium savings vs. the KFF 2025 single-coverage average, per month (2026 plan set; modeled, not observed)
$20,579/yr
modeled, not observed
Care-modeled optimal picks — the same team when each member picks the lowest premium plus modeled cost sharing (savings stays premiums-only)
$130,536/yr
Group benchmark the savings are measured against: $777/mo × 14 people (KFF 2025 average, editable in the audit)
113
Plans filed in Gwinnett County (2026 plan set)
$0/yr
90th percentile $2,568/yr
Cost of premium-only shopping per person, median (2026 plan set; illustrative profiles)
- 2026 plan set
- modeled, not observed
- illustrative team — your team's ages and ZIPs will differ
The illustrative team, stated plainly.
Every figure above is the free audit's math — the same functions, the same 2026 filed-rate snapshot — run once on a hypothetical practice whose assumptions are listed here so they can be checked. Nothing about this team is a real client, and your team's ages and ZIPs will differ.
Assumption 1
Headcount 14; ages 24, 27, 31, 34, 35, 38, 41, 42, 46, 47, 51, 53, 57, 60.
Assumption 2
One office: ZIP 30043, Gwinnett County.
Assumption 3
5 salaried, 9 hourly (36% salaried).
Assumption 4
14 W-2 employees in Lawrenceville (Gwinnett County): 5 salaried clinicians and 9 hourly staff (front desk, billing, medical/dental assistants). Owner-physicians or owner-dentists who are partners or more-than-2% S-corporation shareholders are not counted (not employees for HRA purposes).
Assumption 5
The hourly class is flagged for the split-class engine: assumed pay of $32,000–$40,000 a year each, single-person tax households, 40 hours a week — the income band where an 'affordable' allowance can end a premium tax credit.
Assumption 6
Group benchmark: $777 a month per person, the KFF 2025 Employer Health Benefits Survey average for employer single coverage — the audit's editable default, not a quote for any company.
Assumption 7
Illustrative care profiles are assigned deterministically by member index (never real data) and choose each member's modeled pick; they never change the savings figure, which stays premiums-only.
What premium-only shopping costs this team, per person.
For this illustrative team the per-person median is $0: for at least half of the 14 members the lowest-premium plan was also the lowest modeled 12-month total, so a routine year often makes the cheapest plan right. The 90th percentile is still $2,568 a year (43% of members would pay more by premium-shopping) — the cost lands on the managed-condition profiles, not the routine ones (2026 plan set). These are modeled, not observed: each member carries an illustrative care profile whose assumed care flows through every plan's real filed deductible and out-of-pocket maximum under one uniform, labeled rule; plans with missing accumulator data are excluded, never assumed $0.
Full method and the statewide evidence: plan-choice statistics · the True-Cost Score spec.
The hourly staff: offer or no offer, per person.
The whole-practice figure above counts all 14 people. The split-class engine, run on the same illustrative census, says the two classes should not be treated alike: for the 5 salaried clinicians the verdict is OFFER (up to $293/mo for that class alone, $3,513 a year); for the 9 hourly staff it is NO OFFER, because all 9 hold a modeled 2026 premium tax credit (average $473 a month) that an "affordable" allowance would end.
| Hourly staff (illustrative) | Age | Assumed pay | Income band | Modeled credit | Verdict as drawn |
|---|---|---|---|---|---|
| Staff 1 | 24 | $32,000 | 201% FPL (credit + CSR at stake) | $316/mo | no offer |
| Staff 2 | 27 | $33,000 | 207% FPL (credit + CSR at stake) | $328/mo | no offer |
| Staff 3 | 31 | $34,000 | 213% FPL (credit + CSR at stake) | $370/mo | no offer |
| Staff 4 | 35 | $35,000 | 219% FPL (credit + CSR at stake) | $388/mo | no offer |
| Staff 5 | 38 | $36,000 | 226% FPL (credit + CSR at stake) | $387/mo | no offer |
| Staff 6 | 42 | $37,000 | 232% FPL (credit + CSR at stake) | $413/mo | no offer |
| Staff 7 | 46 | $38,000 | 238% FPL (credit + CSR at stake) | $485/mo | no offer |
| Staff 8 | 51 | $39,000 | 244% FPL (credit + CSR at stake) | $651/mo | no offer |
| Staff 9 | 57 | $40,000 | 251% FPL (credit at stake) | $918/mo | no offer |
Every income-known worker in this class holds a modeled credit (average $473/mo). An affordable allowance ends those credits; an unaffordable one is declined. Recommend NO OFFER to this class.
To offer without leaving anyone worse off you would need ≥ $918/mo per worker (binding: Staff 9) — $99,144/yr for the class, replacing credits the workers already hold.
Any allowance up to $220/mo stays unaffordable for every credit-eligible worker here (binding: Staff 1); above it the lowest earner's credit is the first to go.
Split-class basis: 2026 filed premiums, 2026 tax constants (9.96% required-contribution percentage, the 2026 poverty guidelines at $15,960 for one person), single-person tax households, 40 hours a week, routine care profile; class summaries only — no plan or carrier is named. ICHRA classes must be drawn on a permitted basis (26 CFR 54.9802-4(d)(2): full-time, part-time, seasonal, salaried, hourly (non-salaried), geographic rating area, waiting period, collective-bargaining, temporary-staffing, non-resident alien, or combinations). Income is NOT a permitted class basis. Minimum class sizes (26 CFR 54.9802-4(d)(3)) apply only when a traditional group plan is offered to another class.
ICHRA affordability for family members is tested on the employee's self-only lowest-cost silver plan (26 CFR 1.36B-2(c)(5)); the employee's related HRA individuals lose premium-tax-credit eligibility on that same self-only test (26 CFR 1.36B-2(c)(3)(i)(B)), so an affordable self-only offer ends the whole household's modeled credit. Not tax advice; affordability determinations are the employer's and the IRS's, never Insurf's.
The questions Georgia medical & dental practices ask.
Front desk and billing staff earn far less than the clinicians. Does an ICHRA help them?
Often not — and this is the caveat every practice should hear first. For staff earning roughly $32,000–$40,000 an "affordable" allowance can end their premium tax credit; the honest answer for that class is often no offer — the member-by-member audit that follows the free run shows this per person. In this illustration all 9 of the 9 hourly staff hold a modeled 2026 credit averaging $473 a month; an allowance that makes the lowest-cost Silver plan "affordable" replaces that federal credit with the practice's dollars, and the split-class engine's verdict for the hourly class as drawn is NO OFFER. The salaried clinicians, all above the credit line, come out the other way: OFFER.
Can we offer the ICHRA to clinicians only?
Yes, if the line is a permitted class line: "salaried" and "hourly (non-salaried)" are both permitted bases, income is not, and no minimum class size applies unless a traditional group plan is offered to another class. Owner-physicians or owner-dentists who are partners or more-than-2% S-corporation shareholders are not employees for HRA purposes and are not counted here. For the 5 salaried clinicians alone the same audit math gives up to $293 a month ($3,513 a year) against the KFF group average — smaller than the whole-practice figure because the illustrative clinicians are older and their filed premiums sit closer to the group benchmark.
What allowance would keep the hourly staff's credits intact, or make them whole?
Two thresholds from the engine, both for this illustrative class only: any allowance up to $220 a month stays "unaffordable" for every credit-eligible hourly worker (they decline the ICHRA and keep their credits, so the money reaches nobody), and it would take at least $918 a month per worker ($99,144 a year for the class) before no hourly worker is worse off taking the ICHRA than keeping the credit they already hold. That is why the verdict for this class is no offer. Not tax advice; affordability determinations are the employer's and the IRS's.
What do "up to" and "modeled" mean here, and are these 2027 numbers?
"up to" is the audit's best-case bound: every one of the 14 illustrative members takes the lowest-premium plan filed in their county at their age (real filed, unsubsidized 2026 rates), compared with the KFF 2025 average cost of employer single coverage ($777 a month per person). "Modeled" is the same team when each member picks the plan with the lowest premium plus modeled cost sharing under an illustrative care profile — $20,579 a year here — and the savings figure stays a premium comparison, not a benefits-equivalence claim. Every dollar is the 2026 plan set; no 2027 premium exists yet. Georgia carriers' filings propose a +20.7% statewide weighted-average increase for the individual market (proposed, not final; Georgia's Insurance Department decides final 2027 rates this fall).
See your practice's own number.
Ages and ZIP codes are all the math needs. Sketch the team or drop any census export; no names, no health information, no signup.
Source: the free audit's math (lib/surely/team-savings + team-audit) on the 2026 filed-rate snapshot snapshot_8827361338bd…, filings as of 2026-06-03; group benchmark $9,325/yr single coverage, KFF 2025 Employer Health Benefits Survey.
Insurf, Inc. is not a licensed insurance agency and does not sell insurance; enrollment support is provided by an individually licensed insurance producer, who may be compensated by carrier commissions when an enrollment occurs — that compensation is disclosed on estimates. Every figure on this page is an illustration modeled from filed public data under labeled assumptions for a hypothetical team: informational only, not a quote, not an offer of coverage, not a recommendation to buy or drop any plan, and not financial, tax, legal, medical, coverage, or insurance advice. Projections are labeled and are not guarantees. Insurf is not affiliated with or endorsed by Georgia Access or any state, state-based marketplace, or insurance regulator; every figure is computed from public government filings.