Everything we've written, in one place.
Long-form articles for the strategic questions. A 30-term glossary for the vocabulary. Head-to-head comparisons for the buying decision. Three doors into the same library.
Practical reading on FICA savings, IRS compliance, GLP-1 cost impact, school district retention funding, and the math behind self-funded plan claim reduction.
SIMERP, Section 125, Section 105(b), Section 213(d), FICA, ERISA, HIPAA, indemnity plan, Chief Counsel Memorandum 202323006, and twenty more.
EHP vs indemnity plans, vs supplemental insurance, vs doing nothing, and structural comparisons to named products (Champ Plan, Capstone Plan, Oasis Plan).
Start here.
Most employers think their 7.65% FICA tax is fixed. It isn't. Section 125 pre-tax elections reduce both the wage base on the employee's side and the matching employer FICA liability - and a properly structured SIMERP can recapture $40–$60 per employee per month, every month.
In 2023 the IRS Chief Counsel published a memorandum that should have ended the indemnity-style preventative care plan market. It didn't - those products are still being sold. Here's what the memo actually said and what employers need to look for before signing.
Most vendor evaluations get bogged down in the wrong questions. Here are ten that actually separate the products worth your time from the ones you should walk away from. Vendors who answer all ten cleanly are rare and worth a real conversation.
The core vocabulary.
An IRS-recognized plan structure that reimburses employees for qualified medical expenses pre-tax under Section 105(b), funded by a pre-tax employee contribution under Section 125.
The section of the Internal Revenue Code that lets employees pay for qualified benefits with pre-tax dollars, reducing both income tax and payroll (FICA) tax.
The section of the IRC that allows employer-funded reimbursements of qualified medical expenses to be excluded from the employee's gross income.
The section of the IRC that defines what counts as a 'qualified medical expense' for purposes of pre-tax deductions and tax-free reimbursements.
Federal Insurance Contributions Act payroll tax. 7.65% paid by the employer and 7.65% paid by the employee on most wages, funding Social Security and Medicare.
A 2023 IRS Chief Counsel Memorandum addressing fixed-indemnity wellness plans funded through Section 125 cafeteria plans, concluding that indemnity payments made on a tax-free basis under those structures should be treated as taxable wages.
A benefit structure that pays the employee a fixed dollar amount when a specified event occurs (e.g., a doctor visit), regardless of actual incurred cost.
The Employee Retirement Income Security Act of 1974 - the federal law governing employer-sponsored benefit plans, including health, retirement, and welfare plans.
Side-by-side, structurally.
Both products call themselves federally-incentivized preventative care plans. Only one is consistent with the IRS Chief Counsel's published position. Here's the difference, and why it matters at audit time.
Doing nothing is a choice with a price tag. Here's what a 150-employee business spends every year by not adopting a SIMERP - and where that money goes instead.
Supplemental insurance pays the employee cash when something bad happens. A preventative care SIMERP is structured the opposite way - it's about ongoing access and tax savings, not catastrophic events.
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