Compliance

The documentation behind the plan

Every claim on this site should be checkable. This page is where the checking happens.

The two opinion letters

We are marketers, not tax advisors. We do not explain the tax mechanics in our own voice and we do not ask anyone to take our word for it.

CPA opinion letter

CBIZ, Inc. A top-seven US accounting firm. Reviewed the plan structure and issued the accounting assurance.

Legal assurance letter

HitesmanLaw, P.A. Darcy Hitesman has practiced ERISA, Section 125 and ACA law for over 35 years, and works only in employee benefits law.

Both letters go to an agency owner before signing. Not after, not on request. If you want to read them before you have any conversation at all, ask and we will send them.

The statutory basis

The plan is administered under IRS Sections 105, 106, 125 and 213(d), and is built to comply with ERISA and the ACA.

ProvisionWhat it governs
Section 125Cafeteria plans. In the Internal Revenue Code since 1978. Allows employees to elect qualified benefits on a pre-tax basis.
Section 105Amounts received under employer-provided accident and health plans.
Section 106Employer contributions to accident and health plans.
Section 213(d)Defines qualifying medical care expenses.
ERISAPlan documentation, fiduciary conduct and participant disclosure.
ACACoverage and reporting requirements.

What regulators actually objected to

The criticism in this category is real, and it is worth understanding rather than dismissing. The recurring objections were three specific things.

  • Plans that promised tax savings with no real benefit delivered. If employees never receive or use anything, the structure is hard to defend.
  • Designs pairing a fixed indemnity policy with a reimbursement arrangement so the same dollars came back twice. This is the double-dipping problem, and it drew the most scrutiny.
  • Promoters guaranteeing an exact per-employee savings figure before looking at a single payroll record.

Those criticisms describe real products that were really sold. The American Staffing Association published a piece titled "Section 125 Plans Offering Wellness Benefits Warrant Caution," and there is similar material from benefits consultants and law firms.

We would rather you read it than not. A plan that only looks good when you avoid the criticism is not worth putting in front of your caregivers. We covered where these plan designs get risky and where they do not in our own guide.

How this design differs

  • Employees receive an actual benefit and must use it. Telemedicine, no-cost generics, discounted dental, labs, imaging and vision, plus mental health support. Participation requires a health risk assessment and a qualifying wellness activity each month.
  • It is not a fixed indemnity product. The double-dipping structure that drew IRS attention is not how this plan works.
  • It is an addition, not a replacement. It sits alongside existing coverage. You keep your broker and your policies.
  • Nothing is guaranteed before payroll review. Every proposal is an estimate built from actual payroll records, and it says so on the document.

What we ask you to do

Have your own CPA read it.

We encourage this on every call. If your accountant raises a question we cannot answer, we will put you directly on the phone with UnifyWell's compliance people.

An offer that cannot survive your accountant's review is not one you should accept, from us or from anyone else.

On the data you send us. When you send payroll reports for an analysis, remove employee names, Social Security numbers, home addresses and any health information first. All we need is wage figures, filing status and pay schedule. We do not want the rest and we should not have it.

Ask for the documents

Both opinion letters, before any conversation about signing. Call Charley at 435-999-5450 or email [email protected].

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