Frequently Asked Questions

The Preventive Care Benefits Program (PCBP) is a Self Insured Medical Reimbursement Program (SIMRP) that provides comprehensive preventive care benefits to full-time W2 employees with $0 out-of-pocket expenses for employers. The program is structured under IRC §105(b), §125, and ACA participatory wellness guidelines, generating average FICA tax savings of $1,119 to $1,186 per employee per year.

The program requires $0 out-of-pocket expenses from employers. There is no employer contribution required. The program is funded through a pre-tax payroll restructuring under IRC §125, which simultaneously generates FICA tax savings for the employer averaging $93.33 per employee per month ($1,119.96 per year).

When employees participate in the program, a $1,220 monthly pre-tax deduction is taken under a Section 125 cafeteria plan. This reduces the employer's FICA-taxable payroll. At the combined FICA rate of 7.65% (6.2% Social Security + 1.45% Medicare), employers save approximately $93.33 per participating employee per month, or $1,119.96 per year.

Yes. The program is structured as a participatory wellness program under 42 U.S.C. §300gg-4(j)(3)(C) and complies with all applicable ACA regulations. It is not a group health plan and does not replace or interfere with existing health insurance coverage. Compliance is further supported by IRS Chief Counsel Advisory 202323006.

No. The Preventive Care Benefits Program is a supplemental preventive care program, not a health insurance plan. It works alongside any existing group health insurance, individual marketplace plans, or even if no health insurance is in place. Employees keep all of their current coverage.

The program is designed for businesses with full-time W2 employees. There is no strict minimum, but the program is most impactful for businesses with 5 or more eligible employees. All full-time employees earning at least $26,000 annually are eligible to participate.

Implementation typically takes 2-3 weeks from initial enrollment to the first payroll cycle with the program active. Our team handles all plan documentation, compliance filings, and employee communication during this period.

No. Employees' net take-home pay remains virtually the same. The program uses a pre-tax payroll restructuring — not a wage reduction. The pre-tax deduction reduces taxable income, which offsets the deduction amount through lower income tax and FICA withholding. Employees receive comprehensive preventive care benefits at no effective cost.

You receive a comprehensive package of preventive care benefits including: over 1,000 preventive care prescriptions with no out-of-pocket expense, unlimited telemedicine visits, mental health counseling, dental and vision discounts, $150,000 life insurance, $150,000 accidental death & dismemberment (AD&D) coverage, hospital bill reduction of up to 35%, health advocacy services, medical bill negotiation, and identity theft protection.

No. Your net take-home pay remains virtually the same. The program works through a pre-tax payroll restructuring under Section 125 of the Internal Revenue Code. While a pre-tax deduction appears on your pay stub, it reduces your taxable income, which lowers your income tax and FICA withholding. The result is that your net pay stays about the same while you gain comprehensive preventive care benefits.

After enrollment, you receive a prescription benefit card that can be used at participating pharmacies nationwide. Over 1,000 preventive care medications are available with $0 out-of-pocket expenses. The list includes medications for cholesterol, blood pressure, diabetes prevention, mental health, and many other preventive categories.

You have access to unlimited telemedicine visits with licensed physicians 24/7. Consultations can be conducted via phone or video. Doctors can diagnose conditions, recommend treatment, and prescribe medications when medically appropriate — all with no out-of-pocket expense to you.

No. The Preventive Care Benefits Program is not health insurance — it is a preventive care wellness program. You can participate whether or not you have health insurance. The program works alongside any existing coverage you may have (employer group plan, marketplace plan, Medicare, etc.) without conflict.

As part of the program, you receive $150,000 in group term life insurance coverage with no out-of-pocket expense to you. This coverage is effective as long as you are an active participant in the program. You can designate your own beneficiaries.