EMPLOYER

Frequently Asked Questions

Who qualifies for this plan?

1.) Employees must be W-2

2.) Employees must be full-time (at least 30 hours per week)

3.) Employees must have health insurance because the program is an Integrated 105 plan. (4980D) (If an employer already has a health plan in place, great, you may keep what you have. If an employer does not have a health plan in place, one will be provided as part of the Essentials Health Plan package at no additional cost).

Do employees need to change their current doctors?

No. If they currently receive care and choose to remain enrolled in their current plan, they do not need to make any changes. If employees do not have current medical coverage, the MEC (Minimal Essential Coverage) plan included will allow them to see any doctor and use any Urgent Care in the Private Health Care System PPO network, one of the largest PPO networks in America.

Does the business get any benefits from offering this plan?

Besides being able to take care of the employees, increase retention, reduce sick days and make your company more attractive to new hires? Yes! You will see an average annual savings of $500-$600 on your FICA tax and workers comp.

How do I know this type of plan is Compliant?

EHP is a Self-Insured Medical Reimbursement Plan (SIMRP) and was purposely created, fully researched, and found compliant with IRS 213(d), 106(a), 105(b), 1.105-11(i), and 104(a)(3) codes, and all applicable IRS memos, ERISA regulations, HIPAA, and the ADA. Medical Services Are a Key Component EHP is always paired with an ACA-approved medical plan to make an integrated 105 plan.

Deduction of The Plan Is Pre-Tax Eligible The deduction of plan cost from an employee's gross wages is addressed by IRS Codes 106 (a). The Office of Chief Counsel Internal Revenue Service Memorandum (Number: 201703013, Dated: 1/20/2017) states: "The value of coverage by an employer-provided wellness program that provides medical care (as defined under §213{d)) is generally excluded from an employee's gross income under §106(a). The pre-taxing of this deduction made possible under a Self-Insured Medical Reimbursement Plan and a Cafeteria Plan (§ 125) creates the reduction of taxable income, generating savings for the employee and the employer.

How do I implement this plan to my employees?

It’s simple! Schedule a time to speak with one of our agents.

What benefits are included?

1.) Access to doctors, urgent care and even specialists

2.) Telemedicine

3.) 24/7Dental / Vision.

4.) Accident

5.) Hospital

6) Indemnity

7.) Universal Life

The full list of benefits will be included in your offer once you send us a census.

Can we enroll any time?

No. As a compliant plan, we must set an enrollment period for your company, which will be scheduled on the 1st to 10th day of the month after you accept the offer, however offers accepted after the 15th of the month will be scheduled for the 2nd month following. New employees can still join the plan when they are hired.

Does The Essentials Health Plan™ meet the definition of Minimum Essential Coverage (MEC)?

Yes, however, if you are trying to avoid the tax penalty for not providing health insurance to your employees, the MEC plan only covers the larger of the 2 penalties. Ask your agent how to cover the smaller of the 2 (if required in your state based on company size).

Request a No-Cost Offer

With the Essentials Health Plan™ there is never a cost to you. After learning about your company we

will create a customized package of benefits for your company. Give us a call and let us help you

provide the benefits your employees need!

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