IRS-Aligned Compliance Structure
The WIMPER-aligned plan operates using the following documented IRS code sections:
IRC §125 – Cafeteria Plan
Enables eligible employees to make pre-tax elections, lowering taxable wage base and reducing employer FICA liability. (26 U.S.C. §125; employer-provided coverage exclusion under 26 U.S.C. §106; FICA wage exclusion for qualifying §125 contributions under 26 U.S.C. §3121(a)(5)(G).)
IRC §105(b) – Self-Insured Medical Reimbursement Plan (SIMRP)
Allows employers to reimburse employees tax-free for qualified medical expenses as defined under §213(d). (26 U.S.C. §105; see also the nondiscrimination rules for self-insured medical reimbursement plans at Treas. Reg. §1.105-11.)
IRC §213(d) – Qualified Medical Expenses
Defines allowable medical services including preventive care, telehealth, chronic care support, wellness counseling, and other services included in the WIMPER/Revive benefit stack. (26 U.S.C. §213; for the IRS list of qualifying medical expenses, see IRS Publication 502.)
How WIMPER Differs From Fixed Indemnity Wellness Schemes
- No cash indemnity payouts
- No double-dipping payroll reimbursement schemes
- Benefits must be §213(d)-qualified
- Requires ACA-compliant wellness participation
- Operates alongside existing group health or MEC plans
This is the key distinction from the arrangement the IRS addressed in CCA 202323006. That non-precedential Chief Counsel Advice describes a fixed-indemnity “wellness” arrangement that paid employees a fixed cash benefit while also excluding the same dollars from wages, a double-dip the IRS concluded did not qualify for exclusion. WIMPER is structured to be distinguished from that fact pattern: it reimburses actual, substantiated §213(d) medical expenses rather than paying fixed cash, so the dollars reflect real medical care. CCA 202323006 is an IRS litigating position and does not endorse, approve, or pre-clear any specific program.
ACA, ERISA, and HIPAA Considerations
The WIMPER structure respects:
- ACA wellness program requirements (participatory), consistent with the wellness program nondiscrimination provisions at 42 U.S.C. §300gg-4
- ERISA plan documentation requirements
- HIPAA privacy protections for medical data
For employer payroll-tax treatment of these arrangements generally, see IRS Publication 15 (Employer’s Tax Guide).
WIMPER Institute provides educational and compliance-oriented guidance to help CFOs understand the legal foundation prior to implementation.
Educational information, not tax or legal advice. This page is provided for general educational purposes only and does not constitute tax, legal, accounting, or actuarial advice. WIMPER Institute does not sell insurance, administer benefits, or provide individualized professional advice. Whether the structure described here is appropriate for, and compliant when applied to, your organization depends on your specific facts and how the program is implemented. Employers should consult their own qualified tax and legal advisors before adopting any structured reimbursement program.
The WIMPER program is built to operate within established IRS and regulatory frameworks. The questions below address the most common compliance concerns we hear from CFOs, controllers, and compliance officers.
Compliance & IRS Structure – Frequently Asked Questions
Does the program include audit support?
A core design principle of the WIMPER program, as implemented by EHP, is to maintain a high level of documentation and process rigor. EHP provides audit support by maintaining detailed records, standardized workflows, and clear documentation intended to demonstrate how the program is structured to comply with IRS rules and applicable regulations. No administrator or advisor can guarantee the outcome of an IRS examination, and nothing here should be read as such a guarantee. The WIMPER Institute’s role is to help employers understand the documentation practices and how the compliance framework is structured.
Is this the same as the wellness plans the IRS warned about?
No. WIMPER uses a Section 105(b) SIMRP combined with qualified §213(d) medical services. It does not use fixed indemnity cash benefits or double-dip reimbursement structures of the kind the IRS addressed in CCA 202323006. WIMPER reimburses actual, substantiated medical expenses rather than paying a fixed cash amount, which is the feature that distinguishes it from that arrangement.
Do employees need to participate in wellness activities?
Yes. To meet ACA participatory wellness requirements, employees must engage with preventive and virtual care programs included in the WIMPER structure.
Does this replace our existing medical plan?
No. WIMPER operates alongside existing major medical or MEC plans and does not modify your core coverage.
How does EHP approach IRS compliance while implementing WIMPER’s SIMERP program?
The WIMPER SIMERP program is designed and structured to comply with IRS Sections 125, 106, 105(b), and 213(d) when properly implemented. EHP maintains internal controls and ongoing regulatory monitoring covering preventative care, documentation, eligible expenses, and employee wellness requirements. Whether any particular plan is compliant depends on the employer’s facts and how the plan is administered, so employers should confirm the structure with their own tax and legal advisors.
What documentation is required for IRS compliance?
EHP—acting as WIMPER’s implementation partner—manages all documentation and reporting requirements needed to maintain IRS compliance. This includes eligibility verification, activity logs, wellness participation records, employee acknowledgments, and properly recorded medical expense reimbursements.
How does EHP handle compliance updates?
EHP continuously monitors changes in IRS regulations and updates its compliance protocols accordingly. This is intended to help WIMPER SIMERP programs stay aligned with current requirements even when documentation standards or preventative care definitions change.
What is IRC 213(d) and how does WIMPER comply with it through EHP?
IRC 213(d) defines eligible medical expenses for tax deduction and reimbursement (26 U.S.C. §213; IRS Publication 502). The WIMPER SIMERP model is designed to align the preventative and medical services it reimburses with the IRC Section 213(d) definition of medical care. EHP supports this through proper classification of services, qualified healthcare providers, secure documentation, and routine internal reviews of covered expenses.
Do employers need a Third-Party Administrator (TPA) for WIMPER’s SIMERP program?
Yes. WIMPER works with EHP to coordinate all required TPA functions, ensuring proper claims adjudication, documentation, and compliance oversight. EHP partners only with approved TPAs that meet IRS and ERISA standards.
How secure is the data used in WIMPER’s SIMERP program?
WIMPER’s implementation partner, EHP, uses advanced data encryption, HIPAA-compliant systems, and strict access protocols to protect employer and employee information. All records, wellness logs, and reimbursement data are stored in secure, audited environments that meet federal standards for healthcare data handling.
How does EHP ensure employee compliance with required wellness activities?
EHP uses automated reminders—email, SMS, and phone—along with a dedicated support team to ensure employees complete their required preventative wellness activity each year. This is essential for maintaining IRS compliance, and EHP handles this process on behalf of WIMPER employers.