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Self-Funded Medical Expense Reimbursement Program (SIMERP) is an employer sponsored workplace program that provides employees the opportunity to upgrade their benefit package with a certified Preventative Care Program while reducing both the employer's and employee's health care costs and expenditures. SIMERP can reduce business payroll, give employees a spending credit for benefits and reduce your workers comp premiums.
Each program is customized and monitored by registered nurses, and wellness professionals who provide a personalized roadmap to a successful healthier workplace. This life changing program provides the employer with payroll tax savings averaging $630 per employee per year. It also provides ancillary products such as a guaranteed issue life insurance policy and supplemental insurance such as accident, critical illness, cancer, hospital indemnity, disability, and a plethora of other ancillary products with little or no change in the employees' net take-home pay.
No new out-of-pocket expense for the employer and no reduction in employee's net take-home pay.
To date, 80-100% employee participation rate compared to 30-40% of Cafeteria Plan
All sickness and accident calls utilization is 60% compared to telemedicine 3-8% nationally
Help with common pain points connected with handling high deductibles, co-pays, and claim reductions.
Savings are realized immediately upon each payroll run.
$27,500 in annual payroll taxes. Employees receive a suite of health/wellness benefits.
100% legal. This is a tax qualified Self-Insured Medical Reimbursement Plan with a wellness focus that uses tax advantage provisions under the Internal Revenue Service codes "Section 125 Cafeteria Plan and codes 105, 106, and 213(d)" and ACA wellness rules.
Yes, all benefits can be modified to cover spouse and/or dependents.
No, because the participant is pre-taxing the wellness program under a Section "125" Cafeteria program, the IRS has certain rules that must be followed such as: participant cannot make any changes to the program until "Open Enrollment" each year unless there is a qualifying event. An IRS approved qualifying event allows the participant to make changes during the plan year that are consistent with the event. AYG Insurance and Financial Services advisor will explain this upon enrollment.
By participating in the plan, the employer decides the details regarding the Self-Insured Medical Reimbursement plan including, what is reimbursed, how often reimbursement is made, and who is eligible to participate.
The preventative care management calculates the Wellness Reserve at 95% of participant's annual income. Therefore, if the employee should miss a couple of days during the year, there should be enough in the reserve to pay the premium amounts without affecting take home pay.
The participant will see additional line item deductions on his/her paycheck. To accurately see the effect on take-home pay, compare two identical paychecks (i.e. hours worked, same pay rate, etc.) and that participant will see either a very slight increase in pay or no difference in take home pay.
Yes, after enrolling in the program, participant is approaching retirement age as Social Security is calculated on a 35 year average. One of the benefits we make available to employees is a guaranteed issue cash value life policy that usually accrues cash value at a higher rate than Social Security. (If participant has specific questions on this effect, please consult a CPA).
Participant's year-end taxable income is lowered by the wellness contribution. For specific questions, please contact your tax adviser.
SIMERP allows business owners the opportunity to add and offer additional benefits to their employee packages, increasing employee retention and overall well-being at no additional cost to the employer.
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*total subject to change based on individual situation.