Integrity Health Introduction
Integrity Health is an Accident Plan
Which Includes a no cost virtual preventative and chronic care management program
This is NOT a major medical plan.
Important Distinctions
NOT A REIMBURSEMENT ARRANGEMENT
NOT A WELLNESS INCENTIVE PROGRAM
NOT WAGE RECHARACTERIZATION STRATEGY
COVERED MEDICAL EVENTS — Benefits are paid only upon the occurrence of covered medical events.
INDEPENDENT TPA — Claims are administered by an independent TPA pursuant to ERISA claims procedures.
TAX TREATMENT — Benefits are taxable when required, consistent with IRS guidance and Revenue Ruling 69-154.
EMPLOYER-SPONSORED VOLUNTARY BENEFIT
It is an employer-sponsored (not employer funded) voluntary benefit structure administered by CEHAS, where eligible employees elect participation (through an Opt-out process).
FULLY FUNDED SELF-INSURED PLAN
Integrity Health is a fully funded self-insured plan, meaning there is no potential for future claim liability to the member (employee) or plan sponsor (employer) beyond the disclosed cost of the program.
- Virtual preventative & urgent care, robust accident coverage plan, short-term disability coverage and more. Available for full-time, part-time & seasonal employees.
- Immediate FICA savings realized monthly to cover premium & admin fees. No net cost to the employee and no net cost to the employer for those that qualify.
- Example: 150 employee company x average of $575 per year FICA savings to employer = $86,250 annually
- Section 125 compliance under IRS accepted benefit list.
- No cost Employer Compliance Protection Coverage policy to cover liability – provided by a national A-Rated carrier.
- Group Accident Coverage Insurance (employee only) – Helps supplement existing health insurance coverage or provides added financial support for those without coverage by assisting with expenses related to covered accidents. Includes ambulance, ER, hospital confinement, surgeries, emergency dental, short-term disability and much more! Stackable with existing coverages.
- Amaze Health (household) – Unlimited, on-demand, concierge-style virtual preventative & urgent care. Minimizes healthcare expenses to empower employees to proactively manage their & their families health to mitigate future health risks.
- Rx Valet ACUTE Medication Program (household) – Unlimited, no cost Acute Medication Program with access to over 1,000+ commonly prescribed medications and discounts on others.
- Mental Health & Crisis Management (household) – Unlimited 24/7 mental health and crisis management provided by certified W2 practitioners.
- Chronic Condition Management – A dedicated care team for conditions such as joint pain, diabetes, and more; with regular virtual check-ups and long-term coaching.
- Billing Advocacy (household) – The Amaze team helps employees navigate medical bills with billing advocacy and a plan of action for current or previous medical bills.
- Virtual Pet Care – No more waiting rooms, car rides, or stressful visits. With our virtual care service, connect with licensed veterinarians and certified trainers from the comfort of your home, right when your pet needs it the most.
Employer Benefits:
- Employee participation can result in significant tax savings!
- Attraction & Retention tool.
- Can offer a minimum level of coverage to all full-time, part-time, and seasonal earners who may or may not be able to afford health coverage.
- No net cost to the employer.
- Protects major medical premiums for lower renewals.
- Takes utilization off major medical for preventative & urgent care, ER and ongoing accident care.
- Compliance Protection Coverage Policy to protect employers on tax savings.
Employee Benefits:
- No net cost to the employee & no co-pays!
- Additional money back in every paycheck for those that qualify.
- Telemedicine and HealthPERX benefits are for the employee and anyone in their household!
- Accident Coverage plan to help offset major medical coverage or out of pocket medical expenses for employee.
- Virtual Pet Care is unlimited for all animals in the household!
- Full-time, part-time and seasonal earners may all qualify!
- Typically captures higher participation than major medical plans.
Supplemental Group Accident Coverage (Employee only, 24/7 Virtual Medical Visits, including Virtual Urgent Care,1,000+ Prescription Medications for $0 Copay:
Important: This plan does not replace or interfere with any insurance plan you may already have. It is a supplemental benefit that can be used alone or alongside other coverage (or no coverage).
The Integrity Health Plan serves employers of varying sizes across a broad range of industries.
The minimum participation threshold is 10 enrolled employees. We have seen companies participate with 1,000’s of employees. The program is also utilized by Professional Employer Organizations (PEOs) and co-employment organizations.
Employee eligibility for the Integrity Health Plan is determined through a payroll qualification analysis. The plan uses pre-tax wage reductions to fund the premiums for the employee’s plan.
To qualify, an employee must have sufficient gross taxable wages, after applicable pre-tax deductions and federal tax withholding elections (Form W-4), to support participation in the plan at no net cost to them.
Eligibility is evaluated as part of the implementation process using the employer’s payroll data.
Click HERE to see all the coverages.
IRS Section 125 is a provision of the Internal Revenue Code that allows employers to establish a Cafeteria Plan, through which employees can pay for certain qualified benefits using pre-tax dollars.
When eligible benefits are deducted from an employee’s wages on a pre-tax basis, the employee’s taxable wages are reduced. This can result in payroll tax savings for both the employee and the employer, while allowing employees to receive qualified health and other eligible benefits.
Important Distinctions:
- The program is not a reimbursement arrangement.
- It is not a wellness incentive program.
- It is not a wage recharacterization strategy.
- Benefits are paid only upon the occurrence of covered medical events.
- Claims are administered by an independent TPA pursuant to ERISA claims procedures.
- Benefits are taxable when required, consistent with IRS guidance and Revenue Ruling 69-154.
There are two types of claim payments to understand under the Integrity Health Plan:
- The post-tax claim payment (payroll adjustment/add-back) that an employee receives through the regular payroll process is considered taxable income to the employee.
- Additional claim payments resulting from a covered accident may also be taxable to the extent the payment exceeds the employee’s qualified, unreimbursed medical expenses related to the accident.
The payroll system deducts the applicable plan premium from the employee’s gross wages before calculating applicable taxes. This reduces the employee’s taxable wages for that pay period, which can lower applicable income and payroll taxes.
Employers realize the tax savings each payroll period as the pre-tax deductions reduce taxable wages and the associated employer payroll taxes. The savings are generated throughout the year rather than received as a year-end payment.