Medical services are a key component
The Program is always paired with an ACA-approved medical plan to make an integrated 105 plan.
WIMPER Wellness Program
Expand Employee Benefits While Reducing Healthcare Costs
A Wellness Integrated Medical Plan Expense Reimbursement (WIMPER) Program helps employers enhance employee benefits, reduce payroll taxes, lower healthcare costs, and improve employee wellness—all without changing existing health plans.
18–30%
Workers Comp Reduction
$650–$900
Saved Per Employee / Year
500+
Companies Enrolled
98%
Client Retention Rate
Why Wimper Wellness
Why a WIMPER Wellness Plan?
Expanding Benefits while Reducing Costs
18–30% reduction
Slash Workers' Comp Costs
Reduce Workers' Compensation premiums by 18–30% through our IRS Section 106 Wellness Plan — a legally structured benefit that directly lowers payroll-based insurance rates.
$650–$900 / employee
$650–$900 Per Employee Saved
Our four-part compliance structure reduces FICA taxes, lowers insurance premiums, and restructures benefits pre-tax — delivering $650–$900 in annual savings per employee.
️
Audit-ready structure
IRS & ACA Fully Compliant
Built on Section 106, Section 125 Cafeteria Plans, Section 105 SIMRP, and Qualified Health Plans — every element is compliant and audit-ready.
Higher engagement
Genuine Employee Wellness
Employees receive real health resources, preventive care, and financial wellness tools — not just paperwork. Participation drives results.
The Challenge – Healthcare is Broken
Current healthcare landscape is EXPENSIVE
- The United States has one of the highest costs of healthcare in the world. The projected U.S. healthcare spend for 2025 was $4.9 trillion, which averages to $15,074 per person. By comparison, the average cost of healthcare per person in other wealthy countries is less than half as much.
- The average deductible for an individual in 2024 is around $1,787, which is double what it was in 2006 when adjusted for inflation. Roughly 50% of lower-income adults said they wouldn’t be able to afford a $500 unexpected medical bill. Nearly a quarter of those in households with an income of at least $90,000 also said they wouldn’t be able to immediately afford it.
- Pairing a wellness program with voluntary benefits reduces unexpected costs and improves financial security. Medical expenses are a leading cause of bankruptcy in the U.S., contributing to nearly two- thirds of cases (American Journal of Public Health). In 2024, the average hospital stay costs over $2,800, and nearly 50% of Americans cannot afford a $500 unexpected expense without borrowing or selling assets (KFF, Federal Reserve). For many, a single health crisis can lead to financial ruin. Voluntary benefits provide ensure stability in both health and finances.
- Benefits are usually decreasing while premium costs are increasing at record levels.
Clarity on How to Provide Wellness in the Workplacee
- In 2021 the CPA Journal published an article that provides clarity on Wellness in the workplace. This article brought to the forefront the WIMPER and SIMERP structures for providing wellness and preventive care in a tax advantaged way that can truly impact employee health and well being.
- https://www.cpajournal.com/2021/01/27/20-questions-about-the-establishing-a-health-wellness-program-in-the-workplace/
Many believe the WIMPER structure outlined in this article is the baseline for how health and wellness should be structured in the workplace. The author,Peter Karl(CPA, Tax Attorney & Professor of Law and Taxation), has become one of the nation's leading authorities on this topic. - By following this CPA Journal recommendation, it keeps an employer squarely within the codes and regulations provided by HIPAA, ERISA, The ACA, and the IRS.
Steps in the right direction – A Redirection!
PROACTIVE WELLNESS
PREVENTATIVE CARE MANAGEMENT PROGRAM IS A PARTICIPATORY PROGRAM
The I1 Participatory model was developed under the Affordable Care Act (ACA)
Federal Register, Vol.78, June 3, 2013, pg.33,161
This model is an integrated 105 plan requiring at least one activity per year.
42 U.S. Code 300gg-4 (j)(3)(C)
The Solution – A Redirection of Care
01
A WIMPER Wellness Program that includes a SIMERP!
02
Our team builds a tailored compliance structure for your workforce.
03
A lot of unnecessary emergency room visits, urgent care consultations, and other medical costs that are typically being piled up onto the healthcare crises, are now, through these plans, being handled in this Preventive Care Management plan. These are claims that are never being created on the Healthcare side and intercepted with this plan This is why the WIMPER program exists – to Redirect Care. So, employees get quicker access to care, and save time and money, and are NOT a burden on the healthcare crisis! It is not only helping employees to be healthier and saving the employee and the employer money, but in the big picture, it will save the government millions of dollars while providing an actual solution to the healthcare crises that this country is dealing with.
What Employees can expect -
01
Enjoy
more robust benefits with zero out-of-pocket costs.
02
Access
faster care, more options, and second opinions.
03
Reach US Board Certified Physicians
in minutes, access over 1,000 prescriptions, and more — all at no cost for members.
04
These additional benefits
are available for the entire family!
05
Slight increase
in take-home pay – usually over $100 per month.
06
24/7/365 access
through a mobile app and website.
07
Mental health,
marriage, financial counseling, and weight management.
How Employers can benefit -
Add some practical benefits for employees and save Thousands of dollars at the same time.
The program pays for itself and delivers additional savings that start right away.
Save $600 to $1100 per employee per year on FICA taxes.
Save up to 30% on workers’ comp costs (in most states) without changing your plan or broker.
s Save 10% to 30% on a self-insured health plan also without changing your plan or broker.
Boost morale and loyalty by enhancing employee benefits.
Reduce sick days, absenteeism, and workplace accidents.
Improve performance, productivity, satisfaction, retention, and recruitment.
Keep existing wellness programs or replace paid ones with ours at no cost.
Fits squarely within guidance from HIPAA, ERISA, ACA & IRS.
Program has been vetted and approved by major Insurance Companies and Carriers.
All the savings start immediately for both the employees and the employer!
COMPLIANCE
Deduction of the plan is pre-tax eligible
The deduction of plan cost from an employee's gross wages complies with IRC regulations and creates significant taxable income reduction for employees.
Plans designed for compliance
The plan is purposefully created to comply with IRC 213(d), 106(a), 105(b), HIPAA, ACA and all applicable IRS regulations.
Post-tax program reimbursements
Reimbursements for qualified medical expenses are tax-free and excluded from employee gross income.
Reimbursement allowances
Allowable pre-tax reimbursements are based upon fair market value and applicable IRS regulations.
WELLNESS
- IRCS106(a) - ERISA
- IRC213(d) - ADA
- IRCS105(b) HIPAA
- IRC 5125
- IRC105.11
MEDICAL
- IRC213(d) ACA
PRE-TAX
- IRC 213(d)
- IRC106(a)
- IRC s125
POST-TAX
- IRC213(d)
- IRC105(b)
- 1.105.11(i)
- 104.(A)(3)
- 1.105.11(k)(1)
- 1.105.11(k)(2)
Preventative Care Management Program Legal & Tax Overview:
- These Preventative Care Management programs operate as an integrated Section 125 medical reimbursement plan, allowing for an annual reimbursement (divided & allocated per pay period) that is excludable from taxable income under IRC Section 105(b), even if the employee incurs or documents no specific medical expenses during a particular month. This is permissible because the program is structured to provide qualified medical care as defined in IRC Section 213(d), which encompasses services for diagnosis, cure, mitigation, treatment, or prevention of disease, including wellness and preventive care.
- Under IRS guidelines for Section 105 plans, the minimum requirement to maintain the plan's tax-favored status is at least one qualified Section 213(d) medical care activity per year. However, these programs typically exceed this threshold by delivering a robust suite of services. The Preventative Care Management Programs ensure a conservative approach that aligns reimbursements with the substantial benefits provided.
- A key aspect of compliance is the provision of continuous 24/7 access to qualified Section 213(d) medical care. This can include on-demand primary care, urgent care, mental health support, nutritional consultations, fitness coaching, prescription access, and more - all available irrespective of whether an employee actively uses them in any given period. This ongoing availability satisfies the "irrespective" test outlined in Treasury Regulation § 1.105-1, which allows benefits from an employer-sponsored accident or health plan to be excluded from gross income without requiring proof of specific expenses incurred at the time of reimbursement. The reimbursements are thus treated as payments for medical care furnished by the plan itself, rather than as taxable wages, because the program's design directly ties them to the delivery of substantive, always-accessible medical services that qualify under the statute.
- This framework mitigates risks of wage recharacterization under IRC Section 3121 and related provisions, as the benefits are rooted in the plan's provision of verifiable medical value, not arbitrary cash payments, protecting against potential penalties.
- Furthermore, top rated insurance companies have thoroughly underwritten this program.
The WIMPER (with SIMERP) Program is firmly grounded in established federal tax law and IRS guidance:
- Qualified Structure - The program meets the definition of a Self-Insured Medical Reimbursement Plan (SIMERP) under Treasury Regulation §1.105-11, as it is a written plan providing reimbursement for medical expenses.
- Non-Taxable Employer Reimbursements - Under IRC §105(b), reimbursements for qualified medical care (as defined in §213(d)) are excluded from employee income. The services provided—ranging from physician access to medications and mental health care—clearly fall within this definition.
- IRS Confirmation: Not Wages - IRS Publication 15 explicitly states that reimbursements under a self-insured medical reimbursement plan are not wages and are not subject to payroll taxes or income tax withholding.
- No Itemization Requirement - Congress has repeatedly declined IRS proposals (2023 and 2024 Greenbooks) to require itemization of reimbursed medical expenses under §105(b). As a result, no itemization is required under current law.
- Tax Treatment Based on Access, Not Usage - Federal tax treatment hinges on access to medical care, not the level of utilization. This is consistent with IRC §106(a), which excludes employer-provided health coverage from income regardless of whether services are used.
- Insurance Costs Qualify as Medical Care - IRC §213(d) explicitly includes amounts paid for insurance covering medical care within the definition of medical care.
- Program Qualifies as “Insurance” Under Federal Law - While not regulated as insurance at the state level, the Program meets the federal definition of insurance established in Helvering v. Le Gierse. The program involves real risk transfer, including variability in utilization, frequency, and severity of claims—hallmarks of an insurance arrangement.
- In conclusion, the WIMPER/SIMERP Program delivers significant, measurable value to employees while aligning squarely within established federal tax law and IRS guidance. Its structure as a self-insured medical reimbursement plan, combined with the clear statutory definitions of medical care and longstanding tax treatment principles, provides a strong legal foundation.
- Final thoughts directly from the CPA Journal article previously mentioned, the WIMPER concept provides an opportunity for employees to receive cash reimbursements for participation in health and wellness programs with the tax saving benefit of reducing FICA tax liability for both the employee and employer. In addition, employees can save income taxes because, when part of a WIMPER program, pretax contributions of gross pay are made to an IRC section 125 cafeteria plan.