Long-form reading on SIMERPs and FICA savings.

Self-funded employers see effects from claim reduction that fully-insured employers do not. The math compounds in ways that are easy to miss in a year-one analysis but become dominant by year three.

School districts that cannot raise a levy and cannot reallocate general fund dollars have a third option for retention spend: payroll-tax savings that sit outside both. The mechanism is durable and underused.

ERC and SIMERP-based preventative care incentives are commonly confused because both reduce an employer's federal tax burden. They are different mechanisms with different windows, different documentation, and different audit profiles.

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.

GLP-1 medications are the most significant cost variable in employer health benefits since the introduction of biologics. They are also one of the highest-impact preventative interventions available. Both can be true at once.

The headline figure is not a marketing line. CDC and BLS data put roughly 70% of working-age US adults at elevated risk for one or more preventable chronic conditions. The good news for employers: a small set of levers moves the number measurably.

Preventative care plans look broadly similar from the outside. The differences that actually matter are buried in the plan document. Here is the short list of questions that separates a product worth your time from one that is not.

If your renewal arrived with a 15-20% increase this year, you are not an outlier. The drivers are structural and they are not going away on their own. The question is which levers you actually control.

Section 125 has been on the books since 1978. The mechanics don't change much from year to year, but the categories of qualifying elections do - and the audit posture of the IRS on certain structures has shifted notably since 2023.

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.

SIMERPs and HRAs both reimburse employees for qualified medical expenses. From a tax-treatment standpoint they live in the same Section 105 neighborhood. From an employer standpoint they do different jobs.

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.