Frequently Asked Questions
Straight answers about how BizCare360's no-net-cost health program works, who qualifies, and what it means for your business and your employees. Jump to the section you actually need: is it legitimate, do you qualify, or what happens after you sign up.
Is this legitimate?
This sounds "too good to be true"?
We understand, it's only natural to question something that offers substantial benefits with no net cost to you or your employees. However, our program is a legitimate health program focused on prevention and it is possible through a little known Affordable Care Act (ACA) regulation and the IRS Section 125 Cafeteria Plans. This is what makes this program possible and available to businesses and their W-2 employees at no net cost.
How do I know this type of plan is compliant?
Short answer: yes, and here's the plain-English version. It's a Self-Insured Medical Reimbursement Plan built on IRS Section 125 pre-tax rules, paired with an ACA-approved medical plan, and reviewed against every relevant IRS, ERISA, HIPAA, and ADA requirement.
Read the full code-by-code breakdown
The program 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 and are paired with an ACA-approved medical plan to make an integrated 105 plan. Deductions for the plan are pre-tax eligible.
The deduction of plan cost from an employee's gross wages is addressed by IRS Code 106(a). The Office of Chief Counsel Internal Revenue Service Memorandum (Number: 201703013, Dated: 1/20/2017) states that 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.
Wouldn't companies have tax advisors that are helping them with this?
This is a specialized area most generalist CPAs and HR teams haven't studied in depth, not a flaw in your advisor, just a different specialty. We'd rather you loop your CPA in and have us answer their specific questions directly than ask you to take our word for it.
Does my business get any benefits from offering this plan?
Absolutely yes! In addition to taking care of your employees, increasing retention, reducing sick days, and making your company more attractive to new hires, you will see an average savings of $600 per employee per year on your FICA tax bill. Additionally, you could also save on workers comp costs.
Does my business qualify?
Who qualifies for this plan?
Businesses with a minimum of 25 W-2 employees, who work full-time (at least 30 hours per week), and who earn a minimum of $26,000 annually.
Will this health plan affect our existing health insurance coverage?
No, our program is designed for seamless integration with your current health benefits program, or as a stand-alone plan if you are not offering healthcare to your employees.
Are my employees' family members covered under this health program?
Yes, eligible family members of enrolled employees also have access to these health program benefits.
Do employees need to change their current doctors?
No. If they currently receive care and choose to remain enrolled in their current health plan, they do not need to make any changes.
If employees do not have current medical coverage, the MEC (Minimum Essential Coverage) plan included will allow them to see any doctor and use any urgent care facility in the Private Health Care System PPO network (PHCS), one of the largest PPO networks in America.
Does this health plan meet the definition of Minimum Essential Coverage (MEC)?
Yes.
Can employees access benefits throughout the United States?
Yes, our program's virtual healthcare services are accessible from anywhere in the United States.
What happens after I sign up?
How much does the health plan cost?
There is a cost for the items provided, however the cost comes out of tax savings, so there is no net cost to employers or employees.
Are there any out-of-pocket costs for my employees to use these benefits?
No, there are no costs for service, no claim forms, no co-pays, and no deductibles.
Does this program affect employee tax filings?
We are not accountants, but our program actually lowers your employees' taxable income when it is payroll deducted. Remember, there is a cost for this program, but the cost is covered by tax savings, so there is no net cost to the employer or employee.
Can we enroll any time?
Your initial enrollment will set an enrollment period for your company, which will be scheduled on the 1st to 10th day of the month after you accept the program. However, if you accept the program after the 15th of the month, your enrollment period will be scheduled for the 2nd month following. New employees can join the plan as hired.
How are my employees enrolled into this health program?
Our program provider educates your employees with the information they need about the program to make a great decision on benefits for themselves and their families. Our provider also conducts the enrollment of each employee, which makes no extra work for your HR department. In fact, the only thing we need from HR is a census report, and we have automated systems in place and a census team to make this fast and easy.
Are there any use requirements for my employees?
Employees need only use one service each year to keep their tax-deductible status. Every month, employees will receive push notifications, messages, text reminders, and emails providing them with important information about their plan benefits and information intended to help improve their health.
Are there any limits on the number of times an employee can use the plan services and benefits?
No, members can access their program services and benefits as frequently as needed, with no annual limits.
Can my employees unenroll from the health plan at any time?
ACA rules state that, unless an employee experiences a Qualifying Life Event, an employee who enrolls in this health program will not be eligible to make changes to their program until the end of the plan year, which is your annual open enrollment period.
How do I enroll my business into this program?
The first step is to schedule your Discovery Call. This 15 minute Zoom goes over all the details, tax savings, and benefits of our program. Contact your Solutions Advocate or fill out the form on our Contact page and we'll get your discovery call scheduled. These benefit tax savings are not retro-active, so don't delay, reach out now!
Still have questions?
Schedule a short discovery call and we'll walk you through exactly how BizCare360 would work for your business.
Schedule Your Discovery Call