Attentive Health & Wellness has made a commitment to partner with employees to become healthier and more educated about health decisions they make on a daily basis. We are also committed to help employers make informed decisions about the significance of costs and loss of productivity due to illness and lack of physical health. We focus on educating and guiding employers through the process of how to implement and maintain a successful SIMERP™ with a wellness focus.
Our program is an ERISA (Employee Retirement Income Security Act of 1974) qualified Self-Insured Medical Expense Reimbursement Plan (SIMERP™) that focuses on the benefits of a group wellness plan with an employer sponsored medical plan. By combining these plans and pre-taxing them under a Section “125” Cafeteria Plan, it creates a tax savings for each participating employer and employee. The program is on a voluntary basis for each employee. To participate, each participating employee must confirm they currently have medical health insurance through their employer or their spouse’s employer.
Our program is a Health Plan-Related, Participation-Only wellness plan, meaning all employees have to do is participate—not achieve a particular health or wellness goal. It is designed to promote healthier lifestyle choices among employees and their family members. To remain compliant within the program, the employee completes at least four activities per plan year. From the pre-tax savings, employees accumulate a “Wellness Reserve” that they can use to elect voluntary/ancillary benefits without reducing their take home pay.
Since the program is set up as a Self-Insured Medical Expense Reimbursement Plan, the employees are eligible for a reimbursement of premium as specified in the SIMERP™ plan documents. To qualify for reimbursement, all benefits under the wellness plan must be 213(d) compliant.
Employers also benefit from the tax savings generated by permitting the employees to pre-tax this program. Employers see a reduction in claim value and costs, mitigation of the risks related to future disease and conditions. Our data shows a reduction in claim dollars on average of $1,400 per participant over a three-year period. Employees will be healthier, happier, have more energy, and improved overall health.
THE ATTENTIVE HEALTH & WELLNESS PROGRAM (AHW) is based upon research into existing IRS codes and regulations. The plan is a robust Self-Insured Medical Expense Reimbursement Plan with a wellness emphasis that has been validated by the GE/Intel Validation Institute to be 80% – 90% reliable in pre-disease predictive analytics. As health costs are rising and outcomes are poor (sicker populations), those managing the claims and workforce populations are seeking solutions.
The value of the Attentive SIMERP™ wellness program to the employee is a superior wellness program that offers medical care along with the ability to buy valuable supplemental benefits without lowering their take home pay. A wellness reserve is created by pre-taxing the wellness plan according to IRS regulations. The result is a tax savings called a wellness reserve. The reserve averages 150 dollars per month or 1,800 dollars per annualy to purchase ancillary products such as whole life with a cash value, GAP insurance, critical illness, accident, short term disability, hospital, cancer, GAP covering high deductibles, or other value-added benefits after tax. The SIMERP™ provides the opportunity for a reimbursement of medical expenses as defined under the 213(d) definition of medical expenses. The SIMERP™ specifies what can be reimbursed, how much can be reimbursed, and who qualifies. The reimbursement is according to IRS guidelines for medical care reimbursement. The participation is incentivized by the allowable reimbursement and supplemental benefits available from the tax savings generated by participation.
The value to the employer is the ROI that comes from a Section 125 Cafeteria Plan that results in an average FICA savings of 550.00 dollars per annum per wellness participant. There is a 1-2% reduction in total expenditures from a decrease in claims from employees using the wellness benefits. This translates into 1,400 dollars per participant over a three-year period derived from mitigating population health risk management. Results drive reduced claims—68% of callers to our doctors, RNs, and health coaches result in a reduced level of services saving time and money; alternative care includes self-care options 29% of the time avoiding all costs; 72 percent of likely ER visits were mitigated by more appropriate care. A healthier population with less sick days, reduced benefits costs and more flexibility to be creative with savings (contributions to 401k) all add value to attracting and retaining employees.
AHW TOOLS PROVIDED SELECT LIST
Strong incentives motivate individuals to be accountable for their health. The program is about behavioral modification and leading employees to make better health and lifestyle choices. Statistical reduction in claims, reduced health risk management costs, and healthier outcomes result in healthier and happier employees. Incentivized benefits without the need to reduce take-home pay attract quality employees and less turnover. Employer saves on FICA taxes, has reduced claims, and provides increasing benefits.