Supplemental Medical Care FAQs

A Strategic Approach to Supplemental Medical Care

SIMRP (Self-Insured Medical Expense Reimbursement Plan) is a strategically structured, IRC Section 105–based program designed to enhance employer-sponsored health plans while delivering meaningful medical care and measurable tax efficiency.This is not a replacement for traditional health insurance.
It is a precision-built enhancement—designed to work alongside existing coverage. 

A More Thoughtful Design

SIMRP functions as a service-based supplemental medical care program, integrating federal tax law with modern healthcare delivery. Through this structure, employees gain access to comprehensive wellness and medical services while employers benefit from a more efficient payroll tax position.Participation occurs through a coordinated framework:

• Employees realize a monthly pre-tax contribution via a Section 125 cafeteria plan, reducing taxable income.
• In return, they receive tax-free reimbursement for the fair market value of actual medical and wellness services provided through an integrated platform.

The result is a compliant, intentional design that aligns financial efficiency with real care.

Medical & Wellness Services Delivered

SIMRP provides access to a curated suite of healthcare and wellness services, including:

• 24/7 Virtual Primary Care with licensed physicians
• Behavioral & Mental Health Support with immediate access
• Wellness & Lifestyle Coaching
• Pharmacy Benefits with zero out-of-pocket access to select medications
• Physician-Supervised Weight Health Services
• Preventive & Screening-Based Care
• Chronic Condition Management

Each service is structured to support long-term health outcomes—not transactional care.

Designed for Measurable Advantage SIMRP is intentionally structured to deliver value on both sides:

For Employees

• Access to meaningful medical and wellness services for employee and family members up to age 26
• Reduced taxable income
• No out-of-pocket expense for covered services

For Employers

• Reduced payroll tax exposure
• Enhanced benefit offerings without replacing existing plans
• Improved engagement and retention through modern healthcare access

A Health Screening Indemnity Plan is a preventative care management program designed to encourage proactive healthcare and overall wellbeing.

Rather than replacing traditional health insurance, this type of plan provides indemnity-style benefits as well as a suite of virtual care options. 

Health Screening Indemnity Plans are commonly used to support early detection, promote ongoing wellness engagement, and complement broader benefit strategies. When properly designed and administered, they can be integrated into a comprehensive benefits program while maintaining compliance.

At Optivance, Health Screening Indemnity Plans are evaluated and structured intentionally. They are not universally appropriate and are offered only when aligned with an organization’s objectives, workforce profile, and long-term strategy.

No. SIMRP is not a replacement for traditional health insurance. It is a strategically structured, service-based supplemental medical care program designed to enhance existing employer-sponsored health plans.

SIMRP is designed to work alongside an employer’s current health insurance coverage. It supplements traditional plans by providing access to medical and wellness services while maintaining compliance with applicable federal tax regulations.

When properly structured and administered, SIMRP operates within the framework of IRC Section 105 and Section 125. Compliance, plan design, and documentation are critical—this is why Optivance approaches implementation with precision and oversight.

The amount is calculated using professional actuarial valuation to determine the fair market value of the medical and wellness services provided. Independent actuaries apply established federal frameworks and a conservative methodology to ensure compliance and consistency with accepted valuation standards.