How Employers Can Reduce Costs While Delivering More Value to Employees
Employers are under pressure from both directions: healthcare costs continue to consume more of the benefits budget, while employees are looking for benefits that provide meaningful, everyday value.
ProfitMax works with Essentials Health Plan (EHP) | The Employer’s Choice, an approach designed to work alongside an employer’s existing health and benefits structure — not replace it.
EHP can generate employer FICA savings, increase participating employees’ take-home pay and provide employees with additional healthcare services – all without additional out-of-pocket program cost to the employer or participating employees.
Built Around Healthcare Services – Not Just Tax Savings
EHP is structured around the coordinated use of a SIMERP, Section 125 Cafeteria Plan and wellness program that provides participating employees with actual healthcare services through Revive Health.
Those healthcare services are fundamental to the program – not an incidental benefit added to create tax savings. Participating employees have access to services such as 24/7 urgent and primary care, mental health support, clinical weight management and prescription benefits.
Importantly, participating employees are required to use at least one Revive Health service during the year, and EHP monitors participation as part of its ongoing compliance process.
EHP incorporates healthcare services, participation requirements and ongoing program monitoring into its structure. Employers and their professional advisors can review the program’s compliance approach directly with EHP as part of the evaluation process.
Questions about structure or compliance are welcome. EHP can provide additional information and address questions from you or your professional advisors as part of the evaluation process.
The Economics Can Benefit Both Sides
Employer
Approximately
$640 annually
Employer FICA savings per eligible participating W-2 employee.
Employee
Approximately
$100 per month
Typical additional take-home pay for a participating employee,
with access to additional healthcare services and no additional
out-of-pocket program cost.
That creates an unusual alignment: the employer can reduce costs while employees can receive both additional healthcare services and more take-home pay.
And There May Be Additional Savings
The availability of commonly prescribed medications through Revive Health may also help reduce prescription expenses for participating employees and, where applicable, claims costs under an employer’s existing health plan.
For employers – particularly those with self-funded health plans – the financial opportunity may extend beyond FICA savings. When employees use Revive Health for services that otherwise might have been delivered through the employer’s medical plan, that utilization may reduce claims expense under the underlying plan.
Depending upon the employer and applicable state requirements, there may also be opportunities for workers’ compensation savings.
Designed to Complement Existing Benefits
EHP does not require an employer to replace its health plan or change medical carriers. It can work with fully insured and self-funded employers and is designed to complement the benefits already in place.
The question is not, ‘What do we have to replace?’ It is: ‘Could this make what we’re already providing work better – for both the organization and its employees?’
A Program Employees Can Actually Use
One of EHP’s most compelling advantages is that participating employees can receive additional take-home pay while gaining access to valuable healthcare services through Revive Health — without additional out-of-pocket program costs for the core program.
Participating employees can benefit from:
- Approximately $100 more in monthly take-home pay, depending on individual circumstances.
- 24/7 virtual primary and urgent care, providing convenient access to healthcare professionals.
- Mental health support, with access to behavioral healthcare services.
- Clinical weight management and GLP-1 medications, including medically supervised weight-management programs and access to certain GLP-1 and other weight-management medications at substantially discounted member prices, subject to clinical eligibility. Medication costs are separate from the no-cost core program.
- Approximately 1,000 commonly prescribed medications at no cost, subject to program coverage and eligibility.
These services complement employees’ existing health benefits, providing convenient access to care, opportunities to reduce healthcare expenses and additional take-home pay.
For employers, the combination of meaningful healthcare services, potential payroll-tax savings and opportunities to reduce certain healthcare claims costs creates additional value without requiring a change to their existing health plan.
Why ProfitMax Is Involved
My background has been in healthcare, managed care and employee benefits for more than 30 years. One thing I’ve learned is that reducing employer costs and improving employee benefits don’t always have to be competing objectives.
My role isn’t to replace the professionals you already rely on. It’s to recognize an opportunity that may warrant consideration, bring the appropriate EHP expertise into the discussion and help determine whether the economics, benefits and structure make sense for your organization.
Questions and Professional Review
If questions arise during your evaluation, EHP is prepared to address them and provide additional information for you or the professional advisors you choose to involve.
Want to Learn More Before We Talk?
Could This Make Sense for Your Organization?
If you’re an employer, benefits professional or trusted advisor and something here raises a worthwhile question, ProfitMax can help you explore it.
There is no fee to engage ProfitMax for the conversation or introduction. ProfitMax is compensated through its relationship with the solution provider.
The first step is simply determining whether EHP warrants a closer look.