The questions we get on every first call.

EHP is a preventative care membership program structured as a Self-Insured Medical Expense Reimbursement Plan (SIMERP). It supplements an employer's existing group health plan by giving W-2 employees no-cost access to telehealth primary care, urgent care, mental health support, a prescription discount benefit, and family coverage - funded via a Section 125 pre-tax employee contribution that also generates employer FICA tax savings.

EHP operates the plan; Revive Health provides the clinical telehealth network and member services. We are an independent affiliate that introduces qualified employers to the program and supports them through onboarding.

No. It is a preventative care membership and reimbursement plan, not insurance. Employees and their families still need a qualifying group health plan to satisfy ACA minimum essential coverage - this program sits alongside that plan.

No. It is a prescription discount plan. The discount on most generics happens to be 100%, but it is structurally a discount benefit, not insurance. Federal law prohibits a person from having two prescription insurance plans, which is why this is structured as a discount plan.

W-2 employees working 30+ hours per week who are currently enrolled in a qualifying group health insurance plan. Part-time, seasonal, and 1099 contractors are not eligible.

Yes. The employee's spouse and up to five dependents are covered on every benefit - primary care, urgent care, mental health, prescription discount, and weight health - at no additional cost.

They are not eligible. The program is designed to supplement an existing primary plan, not to replace it. Employers who don't offer group health coverage are not a fit for this program.

No. Partners receiving guaranteed payments / K-1 income are not W-2 employees and therefore not eligible. Same for 1099 contractors.

Each enrolled employee makes a Section 125 pre-tax election (typically around $700/month) to fund the SIMERP. That election reduces the FICA-taxable wage base. The employer pays 7.65% FICA on a lower wage base, which works out to approximately $53/employee/month in employer FICA savings on a typical census.

The employee's Section 125 pre-tax election lowers their income tax and FICA withholding. The post-tax reimbursement from the SIMERP (under Section 105(b)) replaces those after-tax dollars on the paycheck. The net effect on a typical census is an increase in take-home pay of $100–$150 per month per employee.

The pre-tax reduction and the post-tax reimbursement net to approximately the same gross-pay equivalent - except the employee saves the tax in between. The employer's savings come from the FICA tax that was never paid on the pre-tax portion.

Typical timeline from discovery call to first payroll: 4–6 weeks. That includes proposal, plan document setup, payroll integration, employee enrollment communications, and a kickoff webinar.

Very little ongoing. Enrollment is run by EHP/Revive directly with employees (not by your HR team). Payroll integration is configured once at setup. Ongoing maintenance is essentially the payroll feed and one re-enrollment communication per year.

Yes - ADP, Paychex, Paylocity, UKG, Workday, Gusto, Rippling, and most other major providers are supported. Smaller payroll providers are handled via file feed.

Yes. The program is structured as a SIMERP under Sections 125, 105(b), and 213(d) of the Internal Revenue Code. It is consistent with the IRS's published position on preventative care reimbursement plans, including the 2023 Chief Counsel Memorandum on indemnity wellness plans (which addresses a different structure that this program is not).

The program is governed by ERISA with a formal plan document and SPD provided to participants. It does not affect ACA minimum essential coverage obligations (the employee's existing group health plan satisfies that). All health information is handled under HIPAA - employers see only aggregate, de-identified utilization data.

Indemnity plans pay the employee a fixed cash benefit when a trigger event occurs (a telehealth visit, a screening). The IRS Chief Counsel Memorandum 202323006 took the position that those payments are taxable wages. EHP's SIMERP reimburses employees for actually-incurred Section 213(d) qualified medical expenses - a structurally different mechanism that aligns with the IRS's position.

Through a mobile app and member portal. They book primary care, urgent care, mental health, or weight health visits directly, present a card at the pharmacy for the Rx discount, and manage family member access from one account.

Yes, with the exception of DEA-scheduled controlled substances, which most state telehealth rules prohibit from being prescribed without an established in-person relationship.

The program's telehealth doctors refer to in-person care when appropriate. In-person specialist visits, imaging, surgery, and hospitalization continue to run through the employee's existing group health plan.

There is a per-employee-per-month administration fee (currently $40/employee/month, billed in arrears) that is paid directly from the employer FICA savings. The program is net-positive to the employer from day one.

Nothing out of pocket. The employee makes a pre-tax election to fund the plan, and receives a post-tax reimbursement of approximately the same amount through Section 105(b). Net effect: a modest increase in take-home pay, not a deduction.

No standard setup fees. Custom integrations for non-standard payroll systems may have a one-time configuration cost; this is disclosed in the proposal.

The SIMERP structure has been recognized since the 1980s and the underlying statutes (Section 125, Section 105(b), Section 213(d)) are durable. Risk of an unfavorable IRS shift specifically against SIMERPs is low. The plan document and EHP's compliance team monitor regulatory developments.

Participation is voluntary. Most employers see 65–80% enrollment in year one. Below 50%, the FICA savings math still works but the per-dollar admin overhead increases. EHP/Revive runs the enrollment communications, which is the largest single driver of participation rates.

The plan can be discontinued at any open-enrollment period or sooner under specific change-in-status provisions of the plan document. There is no long-term lock-in. Most employers who cancel do so because of an acquisition or major workforce restructuring, not because the math stopped working.

Yes. Public school districts, ESCs/BOCES, cities, counties, and other public-sector employers are eligible. Board approval and counsel review are part of the standard implementation path.

Yes. Employer FICA savings are federal and unaffected by state income tax. The employee's take-home pay increase is modestly smaller in no-state-income-tax states because the pre-tax election doesn't reduce state tax (since there isn't one), but the program still works.

Yes - in fact self-funded employers benefit most. Every primary care, urgent care, and mental health encounter that moves to the SIMERP-side stays off the self-funded plan's loss ratio, which directly reduces stop-loss premiums and claim reserve requirements at renewal.

No. We are an independent affiliate that introduces qualified employers to EHP and supports them through onboarding. We are not licensed insurance brokers, financial advisors, or tax attorneys. We always recommend that employers consult their own benefits broker, CPA, and (where appropriate) labor counsel before adopting any new benefits program.

We earn a per-employee-per-month referral fee from EHP for employers who enroll through us. We do not charge employers a separate fee. Our economic incentive is for the program to work for your business long-term - the referral fee continues only while your employees are enrolled.