Improving Your Company's Bottom Line

YES. It is IRS-, ACA-, and ERISA-compliant. Some of the relevant codes to look up are IRCs213(d), IRCs105(b), IRCs106(a), and IRCs125. The Participatory model was developed under the Affordable Care Act - see Federal Register, Vol. 78, June 3, 2013, pg 33,161. 

While the codes, laws, and guidelines that support the product have been in place for many years, it wasn't until around 2021 that the pieces of the puzzle finally came together logistically to comprise a comprehensive, usable service plan in such a valuable and meaningful way. It's known as a SIMERP - Self Insured Medical Expense Reimbursement Plan - and is paired with WIMPER guidelines - Wellness Integrated Medical Plan Expense Reimbursement. It started on the East Coast, and as with any new benefits structure, it took time to be tried, tested, and proven. Now in 2026, it has proven to be viable, extremely valuable, and word has started to spread. We firmly believe that incorporating a SIMERP into your benefits plan will be standard for all companies within 3-5 years. 

NO. This is designed to work with your employees' primary health insurance, not replace it. 

NO. Your company can enroll at any point in the year. 

From a company perspective, you will want to have at least 10 employees. From an employee perspective, the ones that qualify will need to be full-time, year-round W-2 employees that make enough money that the plan will be covered by their taxes. We never want any employee's paycheck to be negatively impacted by this. In fact, in most cases, your employees' paychecks will actually increase slightly. 

NO. The employee just has to have primary health insurance coverage through someone - a spouse, a parent, the exchange, etc. They do not have to be on your health plan to qualify for this.

This would cover the employee, the employee's spouse, and up to 5 dependents.

NO. We do all of the heavy lifting. There will be minimal work required on your company's side. We like to say that we do about 93% of the work involved, and we need you to do about 7%.

Right away, starting with the month you roll this out. 

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