The SIMRP Employer Guide

1. What a SIMRP is

A Self-Insured Medical Reimbursement Plan (SIMRP) is a wellness benefit structured under federally recognized tax codes. It works alongside the compliant health coverage employees already have. The employer does not have to offer health insurance.

2. What the employer gets

Estimate, not guaranteed. Assumes 100% participation. Actual numbers depend on a free, no-obligation payroll census.

3. What employees get

No-copay wellness benefits, including Mayo Clinic resources, Lōvu, a biometric scanner, and more take-home pay for many participants. See Plan Benefits.

4. Who qualifies

• Private businesses with full-time W-2 employees
• K-12 schools, colleges, community colleges and teaching hospitals
• Cities, counties and state government
• Your organization does not have to offer health insurance. Each participating employee needs compliant coverage from any source: a spouse's or parent's plan, their own paid coverage, TRICARE, state subsidies or some Medicaid.
• Federally subsidized marketplace coverage, or no coverage, is not eligible. If 5 or more employees need coverage, SIMRP can provide minimum essential coverage funded by their tax savings so they qualify.

5. Next steps

1. Run the savings calculator.
2. Book a free, no-obligation payroll census.
3. Review the plan design and enrollment.

Common questions

What does the savings estimate assume?

The estimate assumes 100% participation of eligible full-time W-2 employees. Actual numbers depend on a free, no-obligation payroll census. It is an estimate, not guaranteed.

Do we have to offer health insurance to qualify?

No. Your organization does not have to offer health insurance. Eligibility is per employee: each participating employee needs compliant health coverage from any source, such as a spouse's plan, a parent's plan, their own paid coverage, TRICARE, state subsidies or some Medicaid. Coverage paid for with federal health insurance subsidies (a federally subsidized marketplace plan) is not compliant, and employees with no coverage are not eligible, because a SIMRP uses federal tax savings to reward compliant coverage. If 5 or more employees need coverage, SIMRP can provide minimum essential coverage funded by those employees' tax savings, and then they qualify. A free payroll census confirms who is eligible.

Is there a minimum number of employees?

No. There is no minimum number of employees. Organizations of any size can run the free, no-obligation payroll census to see if they qualify.

Which employees are eligible?

Any participating full-time W-2 employee with compliant health coverage from any source qualifies, whether or not the employer offers a plan. Employees on federally subsidized marketplace coverage or with no coverage are not eligible on their own, but a group of 5 or more who need coverage can get minimum essential coverage through SIMRP, funded by their tax savings.

Does a SIMRP replace our current health plan?

No. A SIMRP works alongside the compliant health coverage your employees already have, whether that comes from your organization or another source.

What does the payroll census cost?

Nothing. The payroll census is free and comes with no obligation.