A preventive health program paired with a Section 125 cafeteria plan. Employees typically take home more, get virtual care, therapy and prescriptions with no copay, and the company's payroll tax typically goes down after every program cost is paid. Nothing changes in your group health plan. It sits alongside it.
Most of the value in a first call is telling you quickly whether this applies to you. Here is the short version.
Every pay period, payroll and income taxes on wages leave the company and its employees, and neither side keeps them. A Section 125 wellness program redirects a portion of those dollars. The employee elects a pre-tax contribution to a preventive health plan, that contribution funds qualified medical care for the employee and dependents, and when the employee completes a simple monthly wellness activity the plan pays a reward. The paycheck shows all three lines, and take-home pay typically ends up higher than before.
The company's side is simpler: its share of payroll tax on the pre-tax contribution goes away, and that saving is larger than the program's administration fee. That is what makes it cost-neutral by design, with a net saving that depends on wages, participation and state.
The reason to be careful is that the market is full of look-alike programs sold with claims that don't hold up, and the IRS has said so in writing. Owners and their CPAs are right to be skeptical. The way through is not a louder pitch, it's paper: plan documents drafted by outside ERISA counsel with a written opinion letter, an independent review and opinion letter from a national accounting firm, a third opinion from a firm of former IRS auditors, and an audit defense agreement signed with your company directly. You read all of it before you sign anything, and so does your CPA.
Your team's time is a payroll file, a few signatures and help scheduling enrollment meetings. The program's team does the rest.
Send a census with wages, filing status and pay frequency under a Business Associate Agreement. You get back the company's estimated saving, each employee's before-and-after paycheck, and who qualifies at which tier. No cost, no commitment.
Share the opinion letters and plan documents with your own tax and ERISA counsel. If the numbers and the paper hold up, you sign the employer agreement and cafeteria plan documents.
The program is set up as a standard deduction in your payroll system with a dry run. Employees see a personal paycheck comparison and choose. Participation is voluntary.
First payroll runs about eight weeks after signing. Employees open the app, complete a five-minute health profile and one wellness activity a month. One monthly invoice to the company.
The invoice has two parts: a flat administration fee paid by the company, and the employee's share of the benefit cost, which is withheld from the employee's own tax saving. The company's net is its payroll tax saving less the admin fee. In the illustrative case of the standard plan tier, that net is positive per enrolled employee per month; the exact figure for your company comes from the payroll analysis, not from this page.
No. It supplements your group health plan and does not touch it. The preventive care, virtual visits and prescriptions are added on top of the coverage you already offer.
No program is, and anyone who tells you theirs is should worry you. What this program has is written opinion letters from outside ERISA counsel, from an independent national accounting firm and from a firm of former IRS auditors, plus an audit defense and indemnification agreement that the last of those signs with your company directly. Your CPA can read all of it before you decide.
No, and the program doesn't. Each employee sees a personal paycheck comparison before enrolling and can opt out. Most typically do take home more; reward payments in excess of unreimbursed medical expenses may be taxable to the employee, and the enrollment materials say so.
A share of the benefit cost is withheld from the employee's own tax saving, so it doesn't come out of their existing take-home pay. The health benefits themselves carry no copays.
Owners of S corporations above 2%, partners and K-1 members are treated as self-employed and cannot participate in a Section 125 plan. They benefit through the company's savings.
As a partner. CPAs get a compliance-first program to evaluate for their clients, with a CPE course taught by the ERISA counsel who built it. Payroll firms and PEOs run it as a standard deduction on their existing book, with the compliance carried by the program.
The analysis is free and takes about a week. If it shows a real saving, we go through the opinion letters together with your CPA. If it doesn't, you've lost nothing.