Spousal Medical Expense Reimbursement Plan
(Spousal MERP)
Reducing your healthcare costs without changing your plan or your broker.
The Spousal MERP, designed to reverse “external adverse selection,” is a supplemental medical plan. Employees on the employer’s existing medical plan, who have access to benefits elsewhere, are eligible to participate in this unique type of MERP.
The MERP reimburses plan participants, who move to their spouses plan, for deductibles, co-pays and co-insurance. The coverage extends to the employee, as well as any family members who were on the employers plan. If the required contribution in the alternative plan is greater than that required by the existing plan then the delta is reimbursed to the plan participant.
On average, the Spousal MERP Strategy saves an employer approximately 20% on the medical and prescription premiums, allowing them to use those savings to pay down corporate debt or institute other fringe benefit programs such as deferred compensation, corporate disability and long-term care programs.
Highlights of Spousal MERP include:
- No financial risk to the employer
- Current provider and plan designs remain the same
- No reduction in benefits to participants.
- Reduces cost for the employer and the employee
- Generates immediate savings
- Increases EBITDA and free cash flow.
- Reduces company healthcare liability
- Reduces future shock claims
- Increases employee healthcare benefits
- Profits increase every year
(video from current MAF site here?)
Highlights of Spousal MERP include:
- No financial risk to the employer
- Current provider and plan designs remain the same
- No reduction in benefits to participants.
- Reduces cost for the employer and the employee
- Generates immediate savings
- Increases EBITDA and free cash flow.
- Reduces company healthcare liability
- Reduces future shock claims
- Increases employee healthcare benefits
- Profits increase every year
MERP FAQs
No. The MERP is an alternative to your current medical plan. It doesn’t replace anything you currently have in place.
No. We manage the MERP plan, and process all of the claims.
Zero. The MERP is a savings program. We keep a portion of the savings to manage the program. Your company keeps the rest.
We have solutions that work for all group sizes, but the MERP typically works best with groups that have 300 or more employees.
Yes. The plan can be implemented in groups that have union and non-union employees.
“Discrimination” means treating people differently, which happens all the time, such as salaried employees getting one benefit while hourly employees get a different one, or union employees getting one benefit while non-union employees get a different one. It’s a legal problem only if the difference is based on a prohibited factor, such as age, race, sex, national origin, etc.
The MERPs do not treat employees differently based on any prohibited factor. For example, the MERP treats employees differently based on whether they are eligible for group health coverage under a plan of their spouse’s employer, which is not a prohibited factor.
