TPA Services

By providing our clients with in-house administration of your cafeteria plans and funding arrangements, we have proven strategies that give you the confidence that your benefits package is working favorably towards your bottom line. Rather than decreasing coverage, our focus is to help your business add value to your employee benefits package.

We offer administration for the following:

  • Section 125/105
  • Health Reimbursement Accounts (HRA)
  • Health Savings Accounts (HSA)
  • Flexible Spending Accounts (FSA)

Our in-house compliance services also keep you ahead of laws and regulations. From COBRA administration to Non-Discrimination testing, SimcoHR reduces the administrative burden placed upon employers by incorporating state-of-the-art systems and capabilities to efficiently manage and simplify these processes.

Compliance Services

Our expertise gives you peace of mind

At SimcoHR we provide you with the precise resource and the expertise of our staff to help keep you educated on all legal requirements that affect your employee’s benefits.

Services Offered
  • COBRA Administration
  • SimcoHR works with you to stay ahead of the on-going changes to COBRA, ensuring that you are in compliance with Federal regulations. Once you notify us of an individual’s COBRA eligibility, we:
    • Coordinate the mailing of all communications and notifications, including the initial notification issued to COBRA eligible employees
    • Coordinate open enrollment planning and fulfillment
    • Provide expert, individualized customer service to each participant
    • Update you and eligible employees whenever plan changes occur
  • Non-Discrimination Testing
  • In order to qualify for a tax-favored status, a section 125 plan must not discriminate in favor of highly compensated employees and key employees with respect to eligibility, contributions, and benefits. In order to document compliance an annual test must be performed and the results documented for each section 125 plan. The results are subject to an audit by the IRS.

We understand that the process of keeping up with the ever-changing regulations can be overwhelming. By continually monitoring legislative activity we keep you informed of all current developments that affect you and your business. Let us offer you the peace of mind of working with a benefits advocate that keeps you in compliance with health care laws and regulations.

Health Reimbursement Accounts (HRA)

You save money, while your employees still have affordable coverage

Faced with the rising cost of health care, most employers have implemented High Deductible Health Plans (HDHPs) to save money while giving their employees the power to become true consumers of their health care. A crucial component of these plans is the setup of a Health Reimbursement Account (HRA).

A Health Reimbursement Account is an employer-funded plan that reimburses employees for incurred medical expenses that are not covered by the company’s standard insurance plan. Because you as the employer fund the plan, any distributions made are considered tax deductible to your business.

SimcoHR offers flexible in-house HRA solutions that provide flexibility and control. HRAs vary greatly in design depending on what you see fit for your employees. Whether your HRA covers all or a portion of the deductible and co-pays on your health care plans, or is designed to only reimburse the employee for dental and vision expenses. Let us help you setup a plan that fits your needs while saving you and your employees money.

Section 125/105 Plans

A pre-tax solution to the rising cost of health care

SimcoHR offers pre-tax programs to reduce the impact of rising health insurance premiums, higher co-pays and out-of pocket expenses. Our clients can choose from a variety of different pre-tax programs resulting in immediate savings for both the employer and employees.

A section 125 cafeteria plan allows an employer to set up two or more benefit plans, giving employees the opportunity to save money in reduced taxes. This is accomplished through payment of certain qualified expenses with pre-tax dollars by redirecting a portion of their salary into the plan.

Full cafeteria plans are popular with mid-sized to large companies due to the high level of flexibility offered to employees.

What is a Premium Only Plan (POP)?

A Premium Only Plan enables employees to pay their portion of medical premiums with pre-tax dollars. Both the employer and the employees benefit from this type of plan:

  • Employees’ premium contributions are automatically deducted from their salaries before taxes are taken out
  • Employees reduce their taxable income, increasing take-home pay
  • With employee pre-tax income lowered, employers pay less in FICA payroll taxes

These plans are easy to set up and require little to no maintenance once in place.

SimcoHR offers the following POP administration services:

  • Legal documents and administrative forms
  • Initial benefit election forms
  • Reports for payroll to setup employee deductions
  • Non-discrimination testing

Flexible Spending Accounts (FSA)

Flexible savings, dependable coverage

A Cafeteria Plan (section 125) allows employees to pay for their employer-sponsored insurance premiums with pre-tax dollars. The employer may also implement a Flexible Spending Account into the Cafeteria Plan, which allows employees to also pay for expenses such as deductibles, co-insurance, co-pays, prescription drugs, vision expenses, and dental expenses with pre-tax dollars. Even the most comprehensive insurance policies have out-of-pocket expenses. FSAs can help your employees save on these expenses.

Flexible Spending Accounts encompass all aspects of a POP plan with these additional value-added services:

  • Case setup/employee communication
  • Online/on-site enrollment
  • Claims submission to our in-house claims department
  • Payments via direct deposit, check or debit card
  • Online participant inquiry and reporting

By implementing an FSA into your Cafeteria Plan, you can reduce your employees’ taxable compensation.

Health Savings Accounts (HSA)

Whether your employees are spenders or savers, these plans will help them do both

If your employees are covered by a high-deductible health plan then a tax-advantaged Health Savings Account will be an added benefit to them. Health Savings Accounts, usually referred to as HSAs, are accounts set up to pay for medical care including dental and vision and allow you to build up savings to pay for future medical expenses. HSAs are available in conjunction with a qualified high deductible health insurance plan.

SimcoHR offers a Health Savings Account (HSA) Solution that will fit your employee’s needs and help them budget:

  • No application fee
  • Outstanding interest rates paid
  • Monthly fee is waived for the first 90 days
  • Low monthly account fee
  • Free HSA Visa® Debit Card for easy account access, with up to $1,500 per day for point of sale purchases
  • Convenient ways to make deposits
  • Full online account access
  • Low monthly fee deducted directly from your account
  • Free first order of checks
  • FDIC insured
Unused Contribution Rollover

Your employees are not obligated to use the money that they contribute to their HSA each calendar year. The money can remain in the account and earn interest until they need it – whether that’s next month, next year or in 10 years. At the age of 65, the account can continue to be used for medical expenses or as retirement savings.

Summary Plan Descriptions (SPDs)

Keeping you in compliance and your employees informed

The Summary Plan Description (SPD) outlines the different benefits provided by your health insurance plan, as well as your legal rights outlined by the Employee Retirement Income Security Act (ERISA). ERISA is a federal law that protects the health benefits of people in the U.S. Your SPD provides information about the health care coverage for you and your covered dependents and about different services provided by your health insurance plan. In addition, the SPD states at what point your employer can change or end your health benefits plan.

All group health plans subject to ERISA must provide participants with an SPD regardless of size. Both insured and self-funded group health plans must comply with the federal laws governing SPDs.

Participants must receive an SPD:

  • Within 120 days of the plan becoming subject to ERISA
  • Within days of enrollment for new participants
  • Every 5 years if material medications are made during that period
  • Every 10 years if no amendments occur

SimcoHR will create and provide these summaries for you and your employees to keep you in compliance with the laws and regulations governing your health plans.