For Legal & Risk Management

100% Compliant, Audit-Ready

Built from the ground up for regulatory compliance. Our program meets all IRS, ERISA, and ACA requirements with comprehensive documentation for any audit.

TL;DR - Compliance Summary

  • IRS: Section 125 cafeteria plan with SIMRP (IRS Section 1.105-11)
  • ERISA: Full compliance with plan documents and SPDs provided
  • ACA: Supplements existing health coverage, does not replace required coverage
  • 213(d): Preventative Care Management Program meets qualified medical expense requirements

Regulatory Framework

IRS Section 125

Our cafeteria plan structure is fully compliant with Internal Revenue Code Section 125, authorizing pre-tax benefit deductions since 1978.

  • • Pre-tax employee deductions
  • • Qualified benefits only
  • • Proper election procedures

IRS Section 1.105-11

Our Self-Insured Medical Reimbursement Plan (SIMRP) meets all requirements under Treasury Regulation 1.105-11.

  • • Proper plan document structure
  • • Eligible employee definitions
  • • Benefit limitations compliance

IRS Section 213(d)

Our Preventative Care Management Program qualifies as medical care under Section 213(d), enabling tax-advantaged treatment.

  • • Qualified medical expenses
  • • Preventive care coverage
  • • Disease management programs

ERISA Compliance

Full Employee Retirement Income Security Act compliance with required plan documents and fiduciary standards.

  • • Plan documents provided
  • • Summary Plan Descriptions (SPDs)
  • • Fiduciary standards met

ACA Compliance

The program supplements existing health coverage and does not interfere with Affordable Care Act requirements.

  • • Supplements, doesn't replace coverage
  • • Employees must maintain ACA coverage
  • • No interference with employer mandate

42 U.S. Code 300gg-4

Our Preventative Care Management Program complies with wellness program requirements under federal law.

  • • Wellness program standards met
  • • Non-discrimination compliance
  • • Reasonable alternatives provided

Audit-Ready Documentation

We provide comprehensive documentation for any IRS, DOL, or internal audit. Your compliance team will have everything needed to demonstrate program legitimacy.

Request Sample Documentation
Section 125 Plan Documents
Summary Plan Descriptions (SPDs)
SIMRP Documentation
Enrollment & Election Records

Questions About Compliance?

Our compliance team is ready to discuss your specific requirements and provide documentation.