How Is SIMRP Structured?
A plan document is required to establish a SIMRP and should include which medical expenses are reimbursable, how reimbursements will be made and who is eligible.
A SIMRP is considered to be a group health plan subject to the ACA which prohibits limiting coverage for essential health benefits. Because insurance premiums are not considered to be essential the plan may limit total reimbursements.
the (SIMRP)
The SIMRP, alongside a Section 125 Plan and a comprehensive plan document, forms a compliant model for reimbursing premiums for 213(d) compliant benefits. Legal reviews by CPAs and ERISA attorneys ensure adherence to regulatory standards.
In essence, the SIMRP stands as a genuine preventative care program, distinct from mere financial loopholes or non-compliant wellness schemes. Compliance is upheld through meticulous adherence to IRS regulations and ACA provisions, ensuring the program's legitimacy and effectiveness in promoting employee wellness.
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