Questions

Frequently asked questions

The questions agency owners actually ask, including the ones with answers we would rather not have to give.

Is a Section 125 wellness plan legal?

Section 125 cafeteria plans have been in the Internal Revenue Code since 1978 and are used by a large share of American employers. The provisions are long-standing and well established. If you want the long version, read our guide to Section 125 wellness plans for home care agencies.

The category's reputation is mixed, and some of that is earned. What regulators objected to was a specific design that paired a fixed indemnity policy with a reimbursement arrangement so the same dollars came back twice. That is not how this plan is built. The longer honest answer is here.

Are part-time caregivers eligible?

Yes. The 30-hour threshold you have seen on every group health quote is a carrier rule, not tax law. A Section 125 election is open to W-2 employees regardless of hours worked.

What varies with hours is how much each person gains, not whether they can participate.

Where does the money come from?

It is not new money. Employee contributions come out pre-tax, which lowers the wage base both the agency and the caregiver pay FICA on. The employer payroll tax that stops going out is what funds the benefits.

Does this replace our health insurance?

No, and it is not insurance. It sits alongside whatever coverage you already offer, and you keep your broker and your existing policies. For an agency offering nothing today it is a first real benefit rather than a complete one. A no-cost MEC plan is available where one is needed.

Will my caregivers' take-home pay drop?

No. The pre-tax deduction is paired with a matching post-tax reward in the same paycheck. Most caregivers see the same or a slightly larger net paycheck than before.

Does every caregiver qualify?

No, and anyone who tells you otherwise is guessing. Qualification depends on wages, filing status and pay schedule. The proposal shows exactly who does and who does not, before you sign anything.

What do you need from us to build a proposal?

To get started, just headcount, average hours and pay range. To build the real analysis we need your last two payroll reports, with employee names, Social Security numbers, home addresses and any health information removed. All we use is wage figures, filing status and pay schedule.

How much will we save?

Across the proposals we have run, the employer figure has landed between $300 and $900 per participating employee per year, net of the administration fee. That is a range and not a quote.

We will not give you an exact number before seeing your payroll. Promoters who do are one of the specific things regulators have criticized in this category.

Who reviewed the plan?

CBIZ, Inc., a top-seven US accounting firm, wrote the CPA opinion letter. HitesmanLaw, P.A., where Darcy Hitesman has practiced ERISA, Section 125 and ACA law for over 35 years, wrote the legal assurance letter. Both go to you before you sign anything.

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

Can our own CPA review it?

We ask you to. 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 anyone else.

How much work is this for our team?

UnifyWell handles caregiver communication, enrollment meetings and questions, which is roughly 95 percent of the work. Your side is payroll code setup with your provider, and giving them access to the roster for enrollment.

What does a caregiver have to do each month?

Complete a health risk assessment and a qualifying wellness activity. That requirement is deliberate. The designs that drew objection were the ones where employees never actually received or used a benefit.

Does this lower our workers' comp?

It may. Workers' compensation premiums are typically calculated on payroll, so a lower wage base can reduce them. We keep this conditional because it depends on your carrier and your state, and we will not present it as a certainty. The fuller explanation is on the pricing page.

What happens if tax law changes?

Tax law does change, and the plan documents say so plainly. We will not tell you any tax provision is permanent.

How does Home Care Wellness get paid?

UnifyWell pays us a per-enrolled-employee monthly fee. You do not pay us, and we are not paid a percentage of your savings.

How long does the whole thing take?

A proposal is usually back in a day or two. From signing to a plan actually running, the pacing depends on your payroll cycle and how quickly enrollment meetings can be scheduled with your caregivers.

Still unanswered?

Call Charley at 435-999-5450 or email [email protected]. One person answers, and if the answer is that this is not a fit for your agency, that is what you will hear.

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