ProfitGuard Plus

Five sections of the Internal Revenue Code and one Treasury regulation: Section 125 for the pre-tax election, Section 106(a) for employer provided coverage, Section 105(b) for tax free reimbursement of medical care, Section 213(d) for what counts as medical care, Section 104(a)(3) for reimbursements from employee contributions, and Treasury Regulation 1.105-11(i) for how a self-insured plan handles both. All of them are spelled out in IRS Publication 15, the Employer's Tax Guide.

Because every piece follows the code the IRS wrote for it. Employees make a pre-tax election under a Section 125 cafeteria plan. The benefits they receive are medical care under Section 213(d). Reimbursements flow under a Self-Insured Medical Reimbursement Plan (SIMRP) per Treasury Regulation 1.105-11(i), never back through the cafeteria plan. The plan is paired with a real ACA medical plan, and the plan documents are reviewed by CPAs and ERISA attorneys before go-live.

The IRS Office of Chief Counsel addressed the designs that fail. Some pay employees for completing an activity each month, which is not a reimbursement for medical care. Some send the money back out through the cafeteria plan itself, or through flex credits, which makes it taxable. Some run an indemnity insurance premium through the plan before taxes, which turns the claim payment into income the employee has to report. And some cannot show you their plan documents. ProfitGuard Plus is built to avoid all four.

Your employees choose a pre-tax election through the Section 125 plan. That election funds the Preventative Care Management Program: 24/7 telemedicine, mental health support, Mayo Clinic backed wellness, health screenings, and care coaching for the whole family. Qualified medical care is reimbursed through the SIMRP after tax. Gross pay never changes, the employer's FICA bill goes down, and take-home pay stays the same or goes up. Set-up runs 30 to 45 days, with plan documents, payroll integration, and a mock payroll before go-live.

No. It requires a qualifying ACA group medical plan and sits alongside it as an integrated Section 105 program. It does not replace major medical.

Yes. The program is structured so participating employees see the same or higher take-home pay after the pre-tax election and the post-tax reimbursement run through payroll.