Preventive Care Benefits Plan
The Preventive Care Benefits Program (PCBP) is a Self Insured Medical Reimbursement Program (SIMRP) that delivers a comprehensive suite of preventive care benefits to full-time W2 employees with no out-of-pocket expenses for employers or employees. Structured under IRC §105(b), IRC §125, and ACA participatory wellness guidelines, the program generates average FICA tax savings of $1119 to $1186 per employee per year.
According to the Kaiser Family Foundation, the average annual premium for employer-sponsored family health coverage reached $23,968 in 2024. The Preventive Care Benefits Program provides comparable preventive care coverage with no out-of-pocket expenses — while generating employer FICA tax savings instead of costs.
How the Program Works
The PCBP utilizes a Section 125 cafeteria plan to establish a pre-tax payroll deduction of $1,220 per month. This deduction funds the preventive care benefits while simultaneously reducing FICA-taxable payroll. At the combined employer FICA rate of 7.65% (6.2% Social Security + 1.45% Medicare), each participating employee generates $93.33/month in employer tax savings.
Employees' net take-home pay remains virtually unchanged because the pre-tax deduction is offset by reduced income tax and FICA withholding. The result: employers save over $1,100 per employee per year while employees receive thousands of dollars in preventive care benefits with no out-of-pocket expenses.
Legal Foundation
The program is built on established sections of the Internal Revenue Code and ACA regulations:
- IRC §105(b)Excludes employer-provided preventive care benefits from employee gross income
- IRC §125Authorizes the pre-tax cafeteria plan structure that funds the program
- 42 U.S.C. §300gg-4(j)(3)(C)Classifies the program as a compliant participatory wellness program
- IRS CCA 202323006IRS Chief Counsel Advisory confirming compliant SIMRP structures
Comprehensive Benefits, Zero Out-of-Pocket Expenses
Every enrolled employee receives this full suite of preventive care benefits at $0 out-of-pocket expenses.
Preventive Care Prescriptions
Access to over 1,000 preventive care prescription medications with $0 out-of-pocket expenses, covering cholesterol, blood pressure, diabetes prevention, mental health, and more.
Telemedicine
Unlimited 24/7 telemedicine consultations with licensed physicians via phone or video with no out-of-pocket expense.
Mental Health Counseling
Access to professional mental health counseling and behavioral health support services.
Dental & Vision Discounts
Discounted dental and vision care services through a nationwide network of providers.
$150,000 Life Insurance
Group term life insurance coverage of $150,000 with no out-of-pocket expense to the employee, with beneficiary designation.
$150,000 AD&D Coverage
Accidental death and dismemberment coverage of $150,000, providing additional financial protection.
Hospital Bill Reduction
Professional medical bill negotiation services that can reduce hospital bills by up to 35%.
Health Advocacy
Personal health advocacy services to help navigate the healthcare system, find providers, and coordinate care.
Medical Bill Negotiation
Expert negotiators review medical bills for errors and negotiate with providers to reduce out-of-pocket costs.
Identity Theft Protection
Comprehensive identity theft monitoring and protection services for enrolled employees.
Ready to Save on Employer Taxes?
Schedule a complimentary discovery call to see how much your business can save with the Preventive Care Benefits Program.