Comprehensive Guide to Employee Health Insurance

Using after-tax savings to purchase supplemental insurance policies allows employees to efficiently allocate their funds toward additional coverage, such as dental, vision, hospital indemnity policies, accident and whole life insurance among others. A major benefit of this method is that any benefits received are tax-free, since the premiums are paid with already taxed dollars. Additionally, this setup requires no immediate out-of-pocket expense, enhancing financial planning and security by enabling employees to extend their insurance coverage using existing savings without impacting their daily finances.

Working Hours: Employees must be W2 employees and work 30 or more hours per week to be eligible for the plan.

Health Insurance Requirement: Employees must have an existing health insurance policy in place.

Dependent Coverage: Dependents, such as spouses and children, could also qualify for coverage under the plan, subject to specific rules.

Enrollment Periods: Participation is subject to enrollment periods set by the employer. Employees must sign up during these designated times unless they experience a qualifying life event that triggers a special enrollment period.

Compliance with Plan Rules: Employees must adhere to all the rules and regulations of the program to maintain their eligibility and receive benefits.

Step 1: Wellness Program Implementation We initiate a wellness program under a Section 125 cafeteria plan, allowing employees to make pre-tax contributions, thereby reducing their taxable income.

Step 2: Income Exclusion We Apply Section 106(a) of the IRC to exclude the fair market value of the wellness program from employees’ gross income, ensuring that these benefits are not taxed.

Step 3: Reimbursement of Expenses We combined Section 105(b) with a self-insured medical reimbursement program to reimburse employees for their wellness program expenses, maintaining the tax benefits.

Step 4: Supplemental Benefits Purchase We then use the tax savings from the reduced taxable income to help employees purchase supplemental insurance benefits, managed and accounted for by your company, with administration handled by a Third-Party Administrator (TPA).

We encrypt all sensitive information to protect it from unauthorized access. This includes personal and financial data related to your participation in the program. Additionally, access to this encrypted data is strictly controlled and limited to authorized personnel only, ensuring that your information remains secure and private. Our security practices are designed to comply with relevant regulations, including privacy laws and financial security standards. This compliance ensures that we not only protect your information but also meet or exceed industry requirements for data protection.

Regarding your financial transactions, it’s important to clarify that we do not handle your pre-tax deductions directly. These deductions are managed by your employer, who withholds them as part of the cafeteria plan benefits. Our company’s subscription fee and the premiums for the policies selected by each employee are billed to your employer by the Third-Party Administrator (TPA), not deducted directly from your salary. This means that the money used for these services comes from the tax savings achieved through the plan, not out of your direct income.

The answer is yes, we offer guaranteed issue policies, meaning we remove the hassle of health checks, as we provide you with the coverage you need, regardless of your medical history.

This self-funded program operates on a unique model. While we invest in your wellness and implement mechanisms to drive savings, benefits, and positive change, you don’t incur any direct costs. Our subscription fee is a monthly charge that is contingency-based, meaning it’s dependent on the savings we generate for you. Should we fail to create savings, we don’t charge for our services.

Your after-tax savings play a pivotal role in covering the cost of your supplemental policies and our fee. Any surplus is returned to you, enhancing your paycheck.

The wellness program is crucial in order to create savings. Without it, we wouldn’t be able to take advantage of the $1,216 in pre-tax deductions and income exclusions. This is because the Internal Revenue Codes require employers to offer health benefits to qualify for these tax benefits. Our wellness program is vital for the well-being of employees as it focuses on preventative care .Through our platform, you no longer need to wait weeks for a doctor’s appointment to discuss health concerns. Instead, you have access to tele-health providers 24/7 who can assess your issues and provide guidance toward solutions, even in emergencies. Additionally, our program offers valuable information to help you find the most affordable and effective treatments or treatment centers. You also gain access to smoking cessation treatments and unlimited online mental health therapy, which is one of the healthcare needs with highest demand and low supply, therefore expensive for the public.

No, this wellness program serves as a supplementary benefit to your existing health insurance coverage. It is essential to maintain your current insurance as a prerequisite for participation in the program.