What tax code sections govern the plan?

The plan is structured under IRS Sections 105, 106, 125 and 213(d) and has been reviewed for ERISA and ACA compliance. Section 125 governs cafeteria plans and has been in the Internal Revenue Code since 1978.

What did regulators object to in Section 125 wellness plans?

Three recurring objections: plans that promised tax savings without delivering a real benefit employees actually received and used; designs pairing a fixed indemnity policy with a reimbursement arrangement so the same dollars came back twice, known as double dipping; and promoters guaranteeing an exact per-employee savings figure before reviewing any payroll records.

What payroll information should an agency send, and what should it remove?

Send the last two payroll reports with employee names, Social Security numbers, home addresses and any health information removed. Only gross wages for each employee are needed.

Compliance

The documentation behind the plan

Q: Who has reviewed the Unify Wellness Plan for compliance?

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 letters go to an agency owner before signing anything.

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 structured under IRS Sections 105, 106, 125 and 213(d) and has been reviewed for ERISA and ACA compliance.

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

Why some Section 125 wellness plans have drawn scrutiny

The criticism in this category is real, and it is worth understanding rather than dismissing. Several concerns appear repeatedly in regulatory and industry discussions.

Plans that promised tax savings without providing meaningful benefits to employees.
Certain arrangements involving fixed indemnity policies and reimbursement structures have drawn regulatory scrutiny over their tax treatment.
Promoters guaranteeing an exact per-employee savings figure before looking at a single payroll record.

Those concerns are worth taking seriously. 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 access to actual benefits. These include telemedicine, no-cost generics, discounted dental, labs, imaging and vision, plus mental health support. Participation includes a health risk assessment and a qualifying wellness activity each month.
It is not a fixed indemnity product. The Unify Wellness Plan does not use the fixed indemnity and reimbursement structure described in the concerns above.
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, exclude employee names, Social Security numbers, home addresses and dates of birth. We need gross wages for each employee. That is all. Do not pull additional employee information just to provide them.

Ask for the documents

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

Open the estimator

Or start with a quick estimate for your agency. Free, no signup.

Home Care Benefits provides marketing and enrollment support and does not provide legal, tax, accounting or health advice. The Unify Wellness Plan is administered by UnifyWell. Savings figures in any proposal are estimates based on the payroll information provided and are not guaranteed. Federal and state tax laws change. Consult your own CPA or attorney before enrolling.