The MERP, or Medical Expense Reimbursement Plan, is an IRS approved plan that reduces claims, lower costs, and provides 100% fully paid benefits, without changing the plan design, carriers, brokers or consultants.

Employees are offered full reimbursement for all out-of-pocket medical costs — co-pays, deductibles, coinsurance, and even premium contributions — when they choose to participate in other group health insurance.

No. There is no cost to the employee to enroll in the MERP.

Other group health coverage includes other employer group health plans such as one offered by your spouse’s employer or a retirement plan for which you may be eligible from a previous employer.  A High-Deductible Health Plan (HDHP) with a Health Savings Account (HSA), Medicare, or Tricare Plans do not qualify.  If the other health plan coverage is a HDHP and you are able to waive the HSA, you may become eligible to enroll in the MERP.

MERP enrollees will have 100% fully paid health insurance benefits. They will be reimbursed for ALL out-of-pocket costs -- co-pays, deductibles, and coinsurance. In addition, there is reimbursement for premium contributions. By eliminating out-of-pocket costs, families will save, on average, about $5,000 per year.

Plan Sponsors will realize immediate and guaranteed savings from premiums, medical claims, and pharmacy claim reductions, as well as being able to offer better coverage for employees.

Typical savings will range between 5-15% per year from reduced claims.

Paying out-of-pocket costs for enrollees in lieu of claims, amounts to significant savings. And unlike claims, the Employer’s liability is capped under the ACA, where out-of-pocket costs are limited to $10,600 for single coverage and $21,200 for family coverage. per year.

Employees, spouses, and/or dependents who are currently enrolled on the Employer’s Plan and have access to other group health coverage may be eligible to enroll into the MERP. When enrolling in the MERP, coverage is waived for the Employer’s Plan.

Yes, because the entire family is currently enrolled in the Employer’s Plan, the entire family would enroll into your spouse’s group plan and the entire family would be covered under the MERP.

As long as you let the Employer know within 30 days of a Qualifying Event, you and your eligible dependents can enroll into the Employer’s Plan with no lapse in coverage.

Some examples include marriage/divorce, having a baby or adopting/fostering a child, moving, losing your job-based or government-funded health insurance, and death of family member who was the primary policy holder.

Your first inquiry should be made to us to get it resolved.

No, IRC Section 105 excludes reimbursements from health insurance plans from an employee’s gross income.