Attentive
Compliant structure.
Wellness Plan: All benefits meet the IRS § 213(d) definition of medical expenses; only bona‑fide medical expenses are reimbursed, preventing the tax issues associated with programs that misclassify lifestyle expenses. The IRS has warned that plans paying non‑medical wellness expenses are taxable.
Section 125 cafeteria plan: Employees fund the plan through pre‑tax contributions under IRC § 106, reducing payroll taxes for both employer and employee.
Self‑Insured Medical Reimbursement Plan (SIMRP): Defined in Treasury Regulation § 1.105‑11, this plan reimburses employees dollar‑for‑dollar for qualifying medical expenses when they participate in wellness activities.
The Attentive program is built on three well-established legal documents:
Holistic wellness ecosystem
A secure, bilingual portal provides employees with a personal health dashboard, health‑risk assessments, telehealth visits, Mayo Clinic programs, self‑guided challenges, activity tracking and mental‑health counseling. Addiction‑recovery support and relationship counseling are available, and employees can extend benefits to spouses and dependents. Access is available 24/7 via desktop or mobile.
Tangible financial impact
Payroll tax savings fund the wellness program on average $1800 per employee annually. Employers typically realize around $575 in payroll savings per participating employee per year. In addition, participants see an average $1400 reduction in claims costs over three years (based on program experience).
Employee choice and security
Employees use their cost savings to purchase supplemental insurance—accident, critical illness, identity theft protection, hospital indemnity, legal services or life insurance—without affecting take‑home pay. All reimbursements correspond to § 213(d) medical expenses to ensure tax‑free treatment and avoid the pitfalls highlighted by recent IRS guidance.
How it works
For employers
Census & proposal: Provide a simple employee census. We determine eligibility (W‑2 status, working ≥ 30 hours/week, less than 2 % ownership and existing health coverage) and estimate projected savings.
Plan documents & setup: Sign the client agreements; our administrators prepare the SIMERP, cafeteria plan and wellness plan. We integrate with your payroll provider and develop a customized communications strategy.
Launch & education: Employees receive a welcome email, enroll online, complete a health‑risk assessment and schedule a consultation with a licensed health professional. We supply marketing materials and conduct training sessions.
Ongoing administration: Our team manages payroll deductions, reimbursements and plan compliance. Savings are realized immediately on each payroll cycle.
For employees
Enrollment: Employees join through the portal, complete a personal health assessment and review their wellness benefits.
Personalized plan: Health professionals collaborate with participants to design plans addressing physical, emotional, social and financial goals.
Engage & earn: Employees earn wellness dollars by engaging in telehealth visits, coaching sessions, courses and challenges. The wellness dollars reimburse their pre‑tax contributions on a dollar‑for‑dollar basis.
Protect: Use the wellness reserve to purchase supplemental insurance (critical illness, accident, disability or life) for themselves and their families.
Compliance & integrity
Recent IRS guidance warns employers that misclassifying general wellness expenses—like gym memberships, personal training or general nutrition coaching—as medical expenses can result in reimbursements being treated as taxable wages. To protect employers and employees:
Qualified expenses only: Attentive reimburses only bona‑fide § 213(d) medical expenses, such as physician services, telemedicine and approved supplemental insurance.
Documented structure: Our legal documentation is reviewed by ERISA attorneys and CPAs to align with the latest guidance and regulatory updates.
Ongoing training: We keep plan documents current and train clients to maintain compliance with ERISA and ACA requirements.
Success story
A Manufacturing company with 200 employees - After implementing the Attentive program, this Midwest manufacturer saw a 12% reduction in major medical claims within three years, saving more than $ 120, 000 in premiums. Participation exceeded 90 % and turnover dropped by 15 %. Employees cited telehealth access and supplemental insurance as key reasons for staying.
