What's Included
Six real benefits.
Zero change to take-home pay.
Employees often assume "no cost to you" means "not worth much." It's the opposite here. This is what's actually in the program — and what it pays when someone needs it.
In plain English
What this program actually is
A Section 125 cafeteria plan, paired with a self-insured medical expense reimbursement plan and a preventive care management program. Employees get a package of health and financial benefits. Their take-home pay doesn't change. The employer's taxable payroll drops — and so does their FICA bill.
Show me the IRS code it operates under
The program is built on IRC §125 (cafeteria plans), §105(b) and Treas. Reg. 1.105-11 (self-insured medical reimbursement plans), §106(a) (employer-provided coverage excluded from gross income), §213(d) (definition of medical care), and §104(a)(3) (exclusion of certain benefit payments).
The wellness component is a participatory program under the framework described in the Federal Register, Vol. 78 (June 3, 2013), p. 33,161, and 42 U.S.C. §300gg-4(j)(3)(c). The plan is designed to meet ERISA, HIPAA, and ADA requirements, and it must be paired with an ACA-compliant medical plan to form an integrated 105 plan.
The benefits
What every participating employee receives
Benefit amounts below are typical program values. Exact figures depend on the plan design selected for your group and on the issuing carrier.
Virtual Care Platform
Primary care, urgent care, mental health and EAP, physical therapy, pharmacy, fitness and nutrition, weight health, and live chat — on the phone or the web, day or night.
$0 copay · unlimited visits
Short-Term Disability
State disability typically replaces about 55% of income. This closes the gap toward roughly 72% — the maximum generally allowed — for off-the-job injury or illness.
About $600/mo in additional benefit
Critical Illness with Cancer
A lump sum paid immediately on diagnosis of internal cancer, heart attack, stroke, kidney failure, or other major critical illness. Guaranteed issue — no health questions.
$10,000 paid on diagnosis
Hospital Indemnity
Cash paid directly to the employee for a covered hospital stay — not to the hospital. Use it for the deductible, the mortgage, or anything else.
$2,000 admission + $200/day confined
Accident Coverage
Covers accidents on or off the job, 24/7, and pays a schedule of benefits for treatment received — surgery, ER, ambulance, and more.
$2,000 first 24 hrs + $500/day — doubles in ICU
Guaranteed Issue Life
Whole life to age 95 with no underwriting questions. Builds cash value the employee can borrow against, and pays the full face value if they live to 95.
Face value based on age — often $100k+
Benefits are issued by licensed insurance carriers. Amounts, availability, and exact terms vary by state, by group, and by the plan design selected. Supplemental policies are not comprehensive health insurance and do not satisfy minimum essential coverage requirements.
How employees pay for it
A monthly benefit reserve, funded by the tax savings
Employees don't write a check for any of this. The arrangement creates a monthly reserve, and they choose which benefits to spend it on. Here's a representative example.
Monthly benefit reserve
The reserve is not deducted from take-home pay. Net pay is designed to stay exactly the same.
What the remaining $190.88 can buy
Representative monthly costs. Employees choose the mix — these are options, not a required bundle.
Figures are illustrative examples from a sample plan design and vary by age, state, carrier, and elected benefit amounts.
The two things employees ask
Both answers, up front
"Your net paycheck does not change. Not by a dollar."
"This doesn't replace your current coverage. It pays in addition to it."
Those two sentences resolve nearly every objection that comes up during enrollment. We say them first, out loud, in every employee meeting — and then we show the math.
Proof
The same paycheck, before and after
A sample monthly paycheck for an employee earning about $3,705 per month. Look at the last row — that's the number employees care about, and it doesn't move.
| Monthly paycheck | Current | With the program |
|---|---|---|
| Gross monthly pay | $3,705.00 | $3,705.00 |
| Existing health deductions | $465.00 | $465.00 |
| Pre-tax program deduction | — | $1,220.00 |
| Taxable income | $3,240.00 | $2,020.00 |
| Federal withholding | $388.80 | $242.40 |
| State withholding | $186.30 | $116.15 |
| Social Security | $200.88 | $125.24 |
| Medicare | $46.98 | $29.29 |
| Benefits purchased (post-tax) | — | $309.88 |
| Non-taxable plan reimbursement | — | $1,220.00 |
| Net take-home pay | $2,882.04 | $2,882.04 |
What changed for this employee
Their take-home pay is identical to the dollar. What's different is that they now have disability, critical illness, hospital, accident, and life coverage plus a virtual care platform — roughly $310 a month of benefits they weren't carrying before.
What changed for the employer
This one employee's monthly FICA liability dropped by $93.33. Net of the $40 fee, the company keeps $53.33 — every month, for this one person. Multiply by headcount.
Illustration based on a sample employee in a single state. Figures vary with wages, withholding elections, state of residence, and plan design.