ICHRA for churches & ministries · South Carolina
Give your pastors and staff real health benefits with a fixed monthly budget your finance committee can plan around. With a CHOICE Arrangement (formerly called an ICHRA), the church sets a tax-free allowance and each staff member picks an individual plan that fits their family and keeps their doctors. Poston Health sets it up and helps every staff member enroll, here in Greenville.
The church decides the monthly allowance. Premium increases don’t change your budget unless you choose to raise it.
No minimum size. A church with one pastor and a part-time secretary can offer real health benefits.
A young youth pastor and a senior pastor with a family rarely need the same plan. Each chooses what fits.
Set separate classes for full-time and part-time staff, with different allowances or none.
Staff on Medicare can often use the allowance toward Medicare premiums, with help from our Medicare team.
We sit down with each person, check their doctors and prescriptions, and help them enroll.
Here’s what an ICHRA could look like for a Greenville church with four full-time staff. The church sets age-based allowances of $500 a month under 40, $650 in the 40s and $950 at 50 and over. Premiums are actual 2026 prices for Greenville County.
| Employee | Age | Lowest-cost Bronze | Lowest-cost Silver | Monthly allowance | Employee pays for Bronze | Employee pays for Silver |
|---|---|---|---|---|---|---|
| Associate pastor | 31 | $362 | $535 | $500 | $0 | $35 |
| Worship / youth director | 38 | $389 | $575 | $500 | $0 | $75 |
| Office administrator | 44 | $436 | $645 | $650 | $0 | $0 |
| Senior pastor | 52 | $609 | $902 | $950 | $0 | $0 |
| Total | $2,600/mo |
The result: the church budgets a fixed $2,600 a month ($31,200 a year). Every staff member can get a Bronze plan for $0. Two of the four can get a Silver plan for $0 and the other two pay well under $100 a month. The senior pastor’s lowest-cost Silver plan is $902 a month, fully covered by the allowance. Want different numbers? Try the ICHRA estimator.
Premiums: lowest-cost Bronze and Silver plans, self-only, non-tobacco, Greenville County (Rating Area 23), from the CMS 2026 Rate Public Use File. 2027 prices are released November 1. Illustration only, not a quote.
Sources: 26 CFR 54.9802-4; IRS Rev. Proc. 2026-26; CMS CHOICE Arrangements; IRS Publication 517 (ministers). Updated October 2026. General information, not tax or legal advice.
One contact, start to finish. Dave is your church’s point of contact from the first quote through every renewal. No call center and no handoffs.
OWNER | GROUP BENEFITS SPECIALIST
Dave has worked in group benefits since 2011. He helps Greenville-area employers design benefits packages, run open enrollment and keep renewals under control, and he stays your direct point of contact from the first quote through every renewal.
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Yes. Churches, ministries and other nonprofits can offer an ICHRA the same way a business can. The church sets a monthly allowance, each staff member picks an individual health plan, and the church reimburses premiums up to the allowance.
Usually, yes. Most pastors are treated as church employees for income tax purposes, even though they’re self-employed for Social Security. Pastors who are church employees can join the ICHRA like other staff. Because ministers have dual tax status, confirm the details with your tax adviser.
No. An ICHRA has no minimum size. Our group health plans start at 5 employees, so for many small churches an ICHRA is the practical way to offer health benefits.
A health plan set up by a church is usually a “church plan,” which is generally exempt from ERISA and federal COBRA unless the church elects otherwise. Your ICHRA still needs plan documents and an employee notice, and we handle those through the administration platform.
Yes. Within a class, allowances can go up with family size and with age (the oldest can get up to 3 times the youngest). Everyone in the same class must get the same terms.
Yes. Full-time and part-time staff can be separate classes with different allowances. You can also offer the ICHRA to full-time staff only.
In many cases, staff enrolled in Medicare can use the allowance toward their Medicare premiums. Our Medicare team helps them choose coverage. Extra rules apply when a church has 20 or more employees.
Only if you decide to change it. The allowance is the most the church will pay each month, so it’s easy to set as a fixed line in the annual budget. We review allowances and plans with you each fall.
Send us your staff’s ages and home ZIP codes (no names or health information). Dave will put an ICHRA and a traditional group plan side by side with real prices and walk you through it, by phone, online or at our Greenville office.
