Straight answers.

The question

A Self-Insured Medical Expense Reimbursement Plan: an employer-sponsored plan that reimburses employees for real medical care tax-free. Because those reimbursements are excluded from wages, both the company and its employees stop paying FICA payroll taxes on those dollars, and the savings fund the care.

The question

Because until recently it could not be delivered. A plan like this needs a third-party administrator and a medical provider built to work together, and it needs service-based medical care employees can actually reach without driving anywhere: primary care, urgent care, mental health, and prescriptions. Once care could be delivered that way, tax law that has been on the books for decades could finally be put to work. The law is old. Being able to deliver on it is new. That is also a different question from why your CPA or broker has not raised it, which is that the plan sits across tax law, benefits law, and healthcare regulations, and neither advisor was hired to work all three.

The question

No. There is no carrier, no policy, and no premium. SIMERP is additive: it sits alongside your existing group health plan and changes nothing about it.

The question

Nothing on net. The FICA savings the program generates fully cover the cost of implementation, and the average business keeps $53.33 per enrolled employee per month after all program costs. That is roughly $640 per enrolled employee per year.

The question

From payroll taxes you are currently paying but are not required to pay. IRS Publication 15 states that medical care reimbursements under an employer's self-insured medical reimbursement plan are not wages and are not subject to social security, Medicare, and FUTA taxes.

The question

No, it goes up. The pre-tax election lowers each employee's taxable income, which lowers their taxes. In a modeled example for an employee earning $44,460 a year, net take-home pay rose by $160.88 per month. Results vary by state, salary, and plan structure.

The question

No. Your existing health insurance, your broker relationship, and your payroll provider all stay exactly as they are. Employees' gross pay does not change either.

The question

30 to 60 days from signed paperwork to launch, and your HR team typically spends under 5 hours on it. We prepare the core plan documents, give your team exact payroll instructions for your provider, and run employee onboarding.

The question

No. IRS warnings target programs that pay employees cash whether or not medical care happened. SIMERP reimburses only actual medical care as defined in IRC Section 213(d), documented with CPT and ICD codes, which is exactly the line Treasury Regulation §1.105-2 draws.

The question

Businesses with 25 to 3,000+ W-2 employees, in every industry, in all 50 states. Construction, healthcare, manufacturing, transportation, retail, professional services, and more. If you run payroll for W-2 employees, your Recovery Ledger will tell you exactly what the program is worth to your company.

The question

24/7 virtual urgent care with a doctor typically in under 20 minutes, primary care appointments scheduled in days, around-the-clock mental health support from licensed clinicians, more than 1,000 medications at no cost (maintenance delivered to your home, acute picked up at a local pharmacy), and physician-supervised weight health with scheduled visits. Zero copay, zero deductible, no fee for services, covering the employee plus up to 6 legal dependents.

The question

SIMERP sits at the intersection of tax law, employee benefits law, and healthcare policy. Your CPA focuses on tax compliance and your broker focuses on premiums, so this structure lives in neither of their lanes. That is why SIMERP specialists exist.

The question

You answer a few questions about your headcount and payroll, which takes about three minutes, and you get an estimate on the spot. If it looks like a fit you book a 20 minute Discovery Call right there. No cost, no obligation.