THE ICHRA SHOP — EMPLOYER AND BROKER RFP INTAKE CHECKLIST
Version 2026.09.19

REQUIRED FOR A COMPLETE QUOTE
- Dependent-level census for every person requesting coverage
- Full name
- Date of birth
- Relationship to employee
- Home ZIP code
- Requested effective date

CURRENT PROGRAM
- Current carrier and plan documents
- Current employee and dependent rates
- Current enrollment by plan and coverage tier
- Employer and employee contribution structure
- Renewal rates or renewal documents, when available

EMPLOYER DESIGN
- Eligible employee count and expected participation
- Employee classes, work locations and waiting periods
- Payroll frequency and payroll provider
- Funding goals and budget constraints
- Enrollment meeting and employee-support needs

OPTIONAL ANALYSIS
- Basic ICHRA quote — no charge
- ICHRA Feasibility Analysis — starting at $1,000
- 2027 Market Intelligence Report — $500 per market
- Predictive Risk Intelligence — starting at $5,000 for eligible groups

SECURITY
Do not email census, claims, prescription, Social Security number, banking or payment-card data. Use only the intake or file-transfer process specifically designated by The ICHRA Shop for the case.