ICHRA in South Carolina 2026: Greenwood Wins, York Lags

Does ICHRA beat small group in South Carolina?

In most of the state, yes, and by a wide margin in some counties. An ICHRA (Individual Coverage Health Reimbursement Arrangement) currently beats traditional small-group coverage in an estimated 42 of South Carolina's 46 counties for the 2026 plan year, based on a county-by-county comparison of individual-market and small-group benchmark premiums. Those 42 counties make up about 3% of the 1309 counties nationwide where the math currently favors ICHRA, and cover an estimated 84% of South Carolina's population.

If you haven't worked through the general decision yet, our ICHRA vs. small group decision guide walks through the framework this article applies specifically to South Carolina. Here's the part a simple "South Carolina qualifies" headline hides: it isn't one number, it's a range that runs from 18.7% in rural Hampton County near the Georgia line to 44.2% in Greenwood County in the state's western Piedmont. And four counties (Union, Anderson, Spartanburg and York, a cluster along the Upstate's I-85 corridor bordering North Carolina) don't clear the bar we use to build a county page at all. All four still show a small, positive individual-market discount; it's just too thin to be the point of the exercise for most employers. That honest range, not a single statewide percentage, is the actual finding here.

Why South Carolina's rates keep climbing

South Carolina small-group employers are looking at another round of increases before this year's renewal has even fully settled. The state's individual-market carriers posted a final weighted average rate increase of 21.0% for the 2026 plan year, covering more than 600,000 enrollees, according to rate data compiled by ACA Signups from South Carolina Department of Insurance and SERFF filings. That final figure came down from a preliminary 24.0% once the SERFF database was updated with approved filings, but it's still one of the steepest individual-market increases in the country for 2026.

Preliminary 2027 filings run a weighted 17.2% increase for the individual market and an unweighted 8.6% increase for the small-group market, again per ACA Signups' compilation of South Carolina DOI and SERFF filings and the federal Rate Review database. On the individual side, six carriers plan to continue selling South Carolina marketplace coverage for 2027: Absolute Total Care filed 22.1% on roughly 67,070 enrollees, BlueChoice HealthPlan of South Carolina filed 23.4% on about 4,600 members, Celtic Insurance (Ambetter) filed 23.2% on about 1,316 individuals, and InStil Health Insurance filed 23.3% on about 2,500 members. BlueCross BlueShield of South Carolina, the state's largest carrier by enrollment at roughly 300,000 members, filed a comparatively moderate 14.8% average increase. Molina and UnitedHealthcare's filings were heavily redacted in the public SERFF record, so carrier-level figures for those two aren't available.

None of this is happening in a vacuum. When small-group rates move up sharply, as filed for South Carolina's 2027 plan year, the spread this entire strategy depends on can widen, because ICHRA reimbursements ride on individual-market prices, not small-group prices, even if individual-market rates keep rising too, so long as they don't rise as fast. That's exactly why every figure in this article is tied to a specific plan year, and why we rebuild the underlying county dataset every year rather than reusing prior numbers.

The state's own filings, rating area by rating area

South Carolina's Department of Insurance publishes its own year-over-year premium comparison for five counties each fall, ahead of open enrollment: a 60-year-old single adult, no tobacco use, shopping on HealthCare.gov. It's a different measurement than the county-savings dataset later in this article: this one tracks how much individual-market premiums rose from 2025 to 2026 within a rating area, not how individual compares to small group, but it corroborates the same pattern from a second, independent source: Charleston, Greenville and Horry rose sharply; York rose the least of the five.

Charleston's rating area posted the steepest jump of the five, up 21.6%, and Horry's (home to Myrtle Beach) wasn't far behind at 21.1%. York's rating area rose the least, 14.7%, which lines up with the same county turning up as the weakest ICHRA county in our separate savings dataset later in this piece. Two different measurements, two different data sources, the same county standing out for the same reason.

All 46 counties, ranked

South Carolina has 46 counties, the maximum allowed under state law, and this dataset's qualifying list touches almost all of them: from the Upstate's rolling Piedmont, down through the Midlands around Columbia, to the coastal Lowcountry around Charleston and Beaufort. Savings for 2026 run from 18.7% up to 44.2% below the small-group benchmark, averaging 30.4% across all 42 qualifying counties.

Greenville County, the state's most populous at over half a million residents and anchor of the Greenville-Spartanburg metro, qualifies at a comparatively modest 22.8%. Richland County, home to Columbia and the state capital, qualifies wider at 29.5%. Charleston County, the coastal Lowcountry anchor, clears 32.1%, and Horry County, home to Myrtle Beach, sits right alongside it at 29.5%. Every one of the state's ten most populous qualifying counties clears at least 22.8%, which means the counties that don't qualify at all (Union, Anderson, Spartanburg and York) aren't sparsely populated afterthoughts. Spartanburg alone has more than 330,000 residents.

See the full South Carolina savings breakdown for every qualifying county, or the national savings map to check a specific county by name.

Why York County is the outlier

York County's 2026 individual-market benchmark runs $800 a month against a small-group benchmark of $830, a gap of just $30, or 3.6%, worth about $363 a year per employee. That's the thinnest margin of any county in the state, qualifying or not. York County anchors Rock Hill and sits directly across the state line from Mecklenburg County, North Carolina (Charlotte's home county) and functions as a commuter suburb of that metro more than as a standalone South Carolina market. Its individual-market rating area prices closer to what a Charlotte-adjacent market looks like than to the rest of upstate South Carolina, which compresses the gap this entire strategy depends on.

The same pattern shows up in the three other non-qualifying counties. Spartanburg County clears just 8.6%, worth about $902 a year. Anderson and Union Counties both clear 9.8%, worth roughly $986 and $992 respectively. All four sit along or near the I-85 corridor that runs from Greenville through Spartanburg toward Charlotte, the most economically integrated part of the state with North Carolina's individual market, and the part where South Carolina's small-group and individual benchmarks sit closest together.

A worked example: Greenwood County versus York County

Here's what the county-level math actually looks like for a small employer with a split South Carolina workforce, using real 2026 rate data for two counties at opposite ends of the state's range. Assume a 20-employee company with 12 employees in Greenwood County and 8 employees in York County.

Notice what this example does not do: claim a single statewide "South Carolina saves X%" figure. A headline like that would blur the fact that the Greenwood County side of this workforce is worth roughly twelve times more per employee than the York County side. Checking counties individually, not trusting a state average, is the entire argument for county-level data, and South Carolina is one of the clearer examples of why that matters, because its range runs wider, top to bottom, than most states we've covered.

The affordability test, in plain numbers

Every ICHRA has to clear the IRS's affordability test to avoid pushing an eligible employee's premium tax credit decision the wrong way. Under IRS Revenue Procedure 2025-25, the required contribution percentage for plan years beginning in 2026 is 9.96% of household income. In plain terms: an employer's ICHRA is considered affordable for an employee if that employee's own required monthly contribution toward the lowest-cost silver plan in their rating area doesn't exceed 9.96% of their household income, divided by 12.

The subsidy trade-off, stated plainly

Taking an ICHRA is not free money layered on top of a marketplace subsidy. Per HealthCare.gov's own guidance on individual coverage HRAs: if an employer's offer is considered affordable, the employee and their household members "won't be eligible for the premium tax credit on Marketplace coverage, even if they don't use the Health Reimbursement Arrangement." If the offer isn't considered affordable, the employee can choose between the ICHRA and the premium tax credit, "but not both": to get the premium tax credit, they have to decline the ICHRA offer entirely.

Why more South Carolina employers are looking at this now

South Carolina's rate filings aren't happening in a vacuum. The HRA Council, an industry association that aggregates anonymized enrollment data from 17 member organizations, released its newest annual report on August 12, 2026: Growth Trends for ICHRA & QSEHRA, Vol. 5. It found that more than 20,000 US businesses now offer ICHRA or QSEHRA, covering at least 500,000 employees nationally as of January 31, 2026. Among small employers, more than two-thirds of those offering ICHRA, and 93% of those newly offering QSEHRA in 2026, had previously offered no health coverage at all. Applicable Large Employers were the fastest-growing segment, more than doubling their average ICHRA adoption since the prior year, and more than half of enrollments nationally, on- and off-exchange, are by employees under 45.

That distinction matters for a South Carolina employer weighing this for the first time. On the current individual marketplace, the state's 2026 open enrollment period saw 587,567 plan selections, down from 631,948 during the 2025 open enrollment period, a 7.0% year-over-year decline, according to KFF's Marketplace Enrollment Snapshot for the 2026 open enrollment period. South Carolina uses HealthCare.gov as its marketplace platform in both years, so that drop reflects real people leaving the individual market, not a technical platform change. For most small businesses in the state's qualifying counties, the realistic comparison isn't "ICHRA versus our current group plan." It's "ICHRA versus offering nothing," which is a much easier case to make when you're competing for talent against employers who already offer some kind of benefit, and a more urgent one with individual-market rates already up 21.0% for 2026 and small-group filings up 8.6% for 2027. The IRS, DOL and HHS final rule that created ICHRA in 2020 sets no employer size minimum at all; a single-employee company can offer one on the same terms as a 500-person company, part of why adoption keeps climbing fastest among the smallest employers in the HRA Council's data.

How ICHRA Savings helps

None of the county math above requires talking to anyone. The savings map lets you look up every South Carolina county by name and see the same individual-market and small-group benchmark premiums used in this article, so you can check whether your specific workforce sits inside a strong-margin county like Greenwood or Bamberg, a thin-margin one like Hampton, or one of the four that don't clear the bar at all, before you spend time on anything else. Beyond the map, we help employers design and set up an ICHRA: building employee classes correctly, modeling affordability against your real census instead of a rule of thumb, and getting the required employee notice right and on time. We don't pick your employees' plans for them; that decision, and the choice of network, stays with each person buying their own coverage. Our part is the budget, the design and the compliance scaffolding around it.

Before anything else, check whether your county is one where this works well: https://ichrasavings.com/ichra-savings-map/. Ten minutes there tells you whether the rest of this process is worth starting, and whether your county lands closer to Greenwood's 44.2% or York's 3.6%.

One more wrinkle worth flagging for South Carolina specifically: several of its metros straddle a state line or sit inside a larger cross-border labor market. York County functions as a Charlotte, North Carolina suburb; Aiken County sits across the Savannah River from Augusta, Georgia. An employer with staff living on either side of either line needs each employee's actual county checked individually: North Carolina and Georgia run their own separate rate filings and their own separate qualifying counties on our savings map, not a mirror of South Carolina's numbers.

Setting up an ICHRA in South Carolina

South Carolina doesn't add state-specific ICHRA rules on top of the federal framework. The same IRS, DOL and HHS final rule that governs ICHRA everywhere applies here, and the setup sequence is identical to any other state:

1. Pull your census by county, not by office address. A company headquartered in Greenville with field or remote staff in Columbia, Charleston or Rock Hill has a materially different savings story per location.
2. Check each employee's county on the savings map. Don't assume a statewide average applies; a 44.2% county and a 3.6% county both technically sit in "South Carolina," but they aren't the same decision.
3. Model affordability using the 2026 threshold. At 9.96% of household income, the required contribution percentage sets how much an ICHRA contribution needs to cover to count as affordable.
4. Define employee classes carefully, if you use them. An employee class is a group defined by an objective factor the IRS permits, such as full-time versus part-time status, geographic location, or salaried versus hourly work. Class rules carry minimum-size requirements and cannot offer the same class a choice between ICHRA and group coverage.
5. Send the required notice on time. Under 26 CFR § 54.9802-4(c)(6)(i)(A), eligible employees generally need written notice at least 90 calendar days before the plan year begins, with specific required content about the offer and its effect on subsidy eligibility.
6. Budget for onboarding support. Employees who have never shopped South Carolina's individual marketplace on their own need guidance, once, at enrollment, especially with six carriers competing statewide and coverage options varying meaningfully by county.

See our full ICHRA setup timeline for the detailed rollout plan, including the exact notice content requirements, and our guide to ICHRA employee classes if your South Carolina workforce spans more than one rating area.

The honest limits of this data

How these numbers are calculated

Every county figure in this article comes from the same dataset that powers our savings map, not from a survey or a sales estimate. For each of South Carolina's 46 counties, we compare a 2026 individual-market benchmark premium, the second-lowest-cost silver plan available to a representative 50-year-old enrollee, against a small-group benchmark premium built from comparable small-group plan filings for that county's rating area. A county "qualifies" for its own page when the gap between those two benchmarks reaches at least $100 a month per employee; the percentage and dollar savings figures in this article are the full gap between those two numbers, expressed as an annual per-employee figure at 12 times the monthly difference, for every county including the four below that $100 threshold. The separate rating-area premium comparison in this article comes directly from the South Carolina Department of Insurance's own published 2025-vs-2026 report; the 2026-final and 2027-preliminary statewide rate-filing figures come from South Carolina DOI and SERFF filings as compiled by ACA Signups, and neither is reflected in the county-level qualifying dataset above, which uses the 2026 benchmark comparison described here.

Three limitations are worth stating plainly. First, benchmark premiums are built around a representative enrollee profile, so an unusually young or unusually old workforce will see a different real-world spread than the county average implies. Second, these are benchmark plans, not every plan on the market; an employee who chooses a richer or leaner plan than the benchmark will see a different premium, though the relative spread tends to hold directionally. Third, rates are filed and refreshed annually, so a county that qualifies for 2026 is not guaranteed to qualify for 2027 once the current filings are approved. We rebuild this dataset each plan year rather than reusing prior-year figures, and we recommend employers do the same before every renewal.

Questions South Carolina employers actually ask