Whether you're a business owner with 2 employees or 2,000, offering quality health benefits can set you apart in a competitive hiring market. At SWI Protects, we help you build the right benefits package. One that actually protects your employees and your profit margins.

SIMERP Program (Self-Insured Medical Expense Reimbursement Plan)
The SIMERP program works alongside your existing group health plan. (I can help you with that too).

Here's what happens behind the scenes:

1. You maintain a group health plan (typically a high-deductible or more affordable option).

2. Your employees enroll in a wellness-focused program.

3. A small pre-tax deduction is made from each participating employee’s paycheck.

4. That deduction funds supplemental benefits like dental, vision, critical illness, and short-term disability, without changing their take-home pay.

5. Your business receives FICA tax savings of around $1,000–$1,300 per enrolled employee per year.

It’s a way to redirect taxes you’re already paying into meaningful health benefits your team can use today.

Why Business Owners Choose SIMERP

• Immediate ROI: Employers typically save $1,120 per employee per year in payroll taxes

• Lower renewal costs: By shifting basic care away from your major medical plan, you reduce claims and slow down annual rate hikes

• No disruption: Keep your current group plan. This layers on top.

• Real care access: Employees receive virtual primary care, urgent care, mental health, prescriptions, and wellness coaching all with $0 out-of-pocket

• Fully compliant: IRS, ERISA, HIPAA, and ADA

Perfect For:

• Employers with 5 + W-2 employees working 30+ hours/week

• Companies already offering or planning to offer a group health plan

• Businesses seeking tax savings without cutting coverage

• Organizations looking to attract and retain talent with enhanced benefits

The best part? Employees usually don't see any change in their net pay and in many cases, they gain $100–$200/month in added benefits.

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Traditional Group Health Plans

These are your classic, employer-sponsored health insurance options, including:

• Fully Insured Plans (premiums paid to a carrier like Blue Cross, United, etc.)

• Level-Funded Plans (a hybrid between fully insured and self-funded)

• Self-Funded Plans (you pay employee claims directly up to a stop-loss)

How They Work:

• You choose a plan type, deductible level, and carrier.

• Premiums are paid monthly (by employer, employee, or shared).

• Employees receive coverage through one uniform group policy.

Fully Insured Plans

Best for...

Pros

• Predictable monthly costs (fixed premiums)

• Minimal admin burden—carrier handles claims

• Simple to implement and explain to employees

Cons

• Annual premium increases are common (often 5–10%+)

• Limited flexibility in plan design

• You pay whether employees use the plan or not

Level-Funded Plans

Best for...

Pros

• Potential for refunds on unused claims dollars

• More control over benefit design and networks

• Lower costs than fully insured for healthy groups

Cons

• Still subject to rate increases based on claims history

• May require additional admin and compliance effort

• Can be risky if employees have high utilization

Self-Funded Plans

Best for...

Pros

• Maximum flexibility in plan design and cost control

• Improved transparency in claims data

• No state premium taxes (can reduce cost by 2–3%)

Cons

• High risk exposure. Employer pays medical claims directly

• Requires stop-loss insurance to manage large claims

• Complex to manage. Needs expert TPA and compliance oversight