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Section 125, Section 105 Administration, COBRA Administration

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Medical Expense Reimbursement Plan

A Medical Expense Reimbursement Plan falls into Section 105 of the Internal Revenue Code. The goal of the Medical expense Reimbursement Plan is for the employer to be able to save money. They do this by purchasing a high deductible health plan and using the savings to “buy back” a portion of the deductible.

For example, the employer may have been able to offer a low deductible, say $250, to their employees in previous years. With the rise in health care costs this type of plan is no longer viable for the employer. They decide to offer a $1500 deductible, thus getting significant savings in the cost of their premium. The employer then “buys back” the deductible from his employees so that they are still only responsible for the first $250 of their deductible. Only a percentage of the employees will use their entire deductible so the employer's exposure is only that which is used. The end result is savings on premiums by moving to a high deductible health plan and continued employee satisfaction as the employee still only faces a $250 deductible.


How Does the Plan Work?

The employer would select a higher deductible health plan They then would decide how closely they would like to mimic their previous plan. The employer then decides, with the help of eflexgroup.com, how they would like the plan administered for their employees.

Some options the employer has to consider are: Whether to reimburse for all expenses or just vision and dental, or if they are just going to reimburse the deductible. Once the plan is set-up the employees will submit their Explanation of Benefits (EOBs) from their insurance carrier to eflexgroup.com. eflexgroup.com then reviews the claim and remits payment to the employee after the employee has met his/her portion of the deductible.

Not all the employees will use the deductible and thus over time a pool of dollars can be collected. To see how much you can save by implementing a MERP plan use our MERP Savings Calculator.

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