A Section 105 Plan permits tax-free reimbursement of medical expenses. There are various section 105 plans, which include Medical Expense Reimbursement Plans. Learn more about section 105 by visiting the IRS website.
IIS Benefit Administrators has worked over the decades to provide various types of medical coverage plans to different companies at varied scales and sizes . Typically, smaller businesses were not large enough to invest in a typical self-funded group plan for their employees. More often than not, smaller groups couldn’t withstand the necessary cash flow swings to afford a self-funded program. Because of this, they were forced to avoid 105 plans.
IIS Benefits offers an alternative self-funded solution, giving smaller group’s the benefits of self funding, while protecting them from large cash swings with our MERP solution. IIS Benefits is extremely proud to be one of the few organizations to offer specialized MERP administration in the small business marketplace.
A MERP is a specified version of a Section 105 Self Funded Program designed for small to medium sized groups. A MERP works side by side with an insurance carriers HDHP to deliver hand crafted plan designs to your employer. Group’s will purchase a high deductible health plan with no copays or drug cards on behalf of all their employees. By doing so, employers reduce their fixed premium costs by roughly 35-50%.
IIS Benefit Administrators then creates, manages, and adjudicates the claims for the entire group. With our specialized claims processing technology, we are able to deliver employees traditional style health plans (PPO, HMO, POS, HSA, etc) with no employee obligation to claims processing.
In other words, an employee goes to the doctor, they pay their copay, and they leave a satisfied patient. The claim is processed with IIS Benefits where we make sure that all parties: the member, employer, provider and carrier have all paid the necessary money to fund the claim.
Employers have the ability to fully customize the health plan designs on behalf of their employees . This is one reason why employers are showing interest in MERP because it is a way to create meaningful options for your employees, without a high variance in fixed costs.
Employees are presented with the spectrum of plan designs that their employer, the broker, and IIS have created. They are able to choose how much coverage they can receive. Their contributions will then go into the plans that they have selected.
When the time comes, the employee is seen by their provider for any spectrum of covered claims. The employee arrives at the provider with their IIS Insurance card, and is seen. The only financial obligation the employee has at the time of visit is their copay.
After the member is seen, IIS will distribute the claim from the provider and the carrier and determine ‘who owes what’ for the claim. IIS then bills the employer any outstanding charges to the claim that the member was not responsible for. Simultaneously, IIS will bill the member for their share of the claim.