FAQS

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Preventative Care Management Program (PCMP)

The Preventative Care Management Program (PCMP) is an ERISA-qualified Self-Insured Medical Expense Reimbursement Plan (SIMERP™) integrated with a participatory wellness program. Voluntary and health-plan-related, this initiative offers employees personalized health dashboards with access to a range of preventative and medical benefits designed to improve their well-being.

Program Details

• Participation requires employees to be enrolled in an active employer-sponsored medical plan.
• By leveraging Section 125 Cafeteria Plans, the program generates tax savings for employers and employees alike.
• SIMERP™ supports premium reimbursements for eligible medical expenses under IRS Code 213(d).

Frequently Asked Questions

1. Where did this program originate?
The PCMP program is rooted in the Affordable Care Act of 2010, combining Section 125 pre-tax employee plans (introduced under ERISA in 1974), healthcare industry efficiencies (from HIPAA in 1996), and a government push to enhance employee benefits post-COVID-19.

2. Why am I hearing about this program now?
With the focus on programs like PPP, ERC, and EIDL during recent years, PCMP was deprioritized. As these initiatives wind down, businesses are rediscovering PCMP to save costs while improving employee wellness and productivity.

3. Why did the government implement this program?
By providing supplemental benefits, the program helps retain employees (ensuring payroll tax collection), supports employer growth, and reduces reliance on government-subsidized insurance programs like Medicare and Medicaid.

4. What are the program’s benefits?

• Employers: Save $650 annually per full-time employee with no out-of-pocket costs, freeing up capital for business growth.
• Employees: Gain wellness benefits like telehealth, counseling, and supplemental coverage (e.g., life and disability insurance) at no additional cost.
• Government: Maintains steady tax revenue from working citizens and businesses.

5. Who is eligible?
Full-Time employees with an annual salary of $32,000 or more . Freelancers and part-time employees are not eligible.

6. What if I’m unsure about my employees’ insurance status?
All employees are blanket-enrolled. Employees without qualifying insurance are removed after attestation, ensuring compliance while retaining eligible participants.

7. How does this affect employee take-home pay?
Paychecks will reflect no change in take-home pay.

8. Who funds the benefits?
The Section 125 pre-tax savings generated by the program cover all costs, leaving no out-of-pocket expenses for employers or employees.

9. Can the program work alongside existing Section 125 plans?
Yes, PCMP complements existing Section 125 plans by adding supplemental benefits.

10. Does PCMP affect current insurance?
No, existing insurance remains unchanged. PCMP supplements, rather than replaces, existing health plans.

11. Will this impact my relationship with my insurance broker?
No changes are required. PCMP integrates seamlessly with qualifying ACA-compliant health plans.

12. Can benefits extend to spouses and dependents?
Yes, benefits can be tailored to include family members.

13. Does this program affect Social Security?
The impact is minimal, as any reduction remains within limits to ensure full Social Security benefits upon retirement.

14. Is employee opt-in required?
No. PCMP uses an auto-enroll process, simplifying management for employers while ensuring employees receive benefits.

15. How are savings realized?
Savings occur through reduced FICA tax payments during payroll processing and are reflected in quarterly or yearly tax filings.

16. How long does implementation take?
The program becomes fully operational within 30-45 days, depending on organizational complexity.

17. What are the implementation steps?

1. Complete a company questionnaire.
2. Provide census data for review.
3. Receive a proposal outlining tax savings.
4. Finalize the contract.
5. Integrate the program with payroll.
6. Receive ongoing management to maintain compliance and accuracy.