What is a Medical Expense Reimbursement Plan (MERP)?

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What is a Medical Expense Reimbursement Plan (MERP)?

 

A lot of new health benefits plans have become available to employers in the last few years. Many employers are particularly interested in MERPs or "Medical Expense Reimbursement Plans".  I'm going to go over some basic information you might find interesting about MERPs, and then I'll talk a little bit about what interested employers can do to learn more.health plan

First I should say that a MERP is the same thing as an HRA (Health Reimbursement Arrangement).  Both terms can be used interchangably, but HRA seems to be the more common term.

So what is a MERP?  Basically it's just a way for employers to give tax-free money to their employees which can only be used to pay medical expenses.  Normally, employees pay for their own doctor visits, medicine, etc. and then the employer reimburses them.  The employer can contribute exactly the amount they want so the cost of a MERP doesn't increase from year to year.

MERPs are incredibly flexible so it's very difficult to say exactly how they should be used.  Most companies that administer these plans offer them either as a way to reduce the cost of group insurance or as a vision/dental plan.  These are both great uses, but I think the most promising way to implement a MERP is as an all-inclusive health benefits platform.  Let's go over how all three of these options work:

MERPS with Group Insurance

I wrote an entire post about how HRAs work with group health insurance plans.  To summarize, you basically raise the deductible on the group plan and reimburse employees for the difference in the deductible.  This effectively allows employers to self-insure a portion of their group insurance plan using pre-tax dollars which leads to big savings without any change in coverage.

MERPS for Vision/Dental

MERPS allow employers to only reimburse certain types of expenses.  If an employer wants to offer a vision/dental plan without buying expensive insurance, they can offer a MERP to their employees that only reimburses for visions and/or dental expenses.  This allows the employees to know that they're covered for basic expenses without costing the company absurd amounts of money on insurance premiums.

MERPS as Stand-Alone Health Benefits Plans

Money from a MERP can be used to pay for individual insurance premiums.  This means that rather than offering a group plan and a MERP, employers can just offer the MERP and employees can use that money to buy their own individual policies.  This allows employers to offer great benefits without dealing with the sky-rocketing costs and constant headaches of insurance.

A lot of people have negative opinions about individual insurance, but those are generally based on misconceptions or horror stories from a decade ago.  Individual insurance has come a long way recently and you can learn all about it by reading through the posts on this blog.  In particular, look at these posts about how your employees can find guaranteed insurance if they have preexisting conditions.

So now you know the basics about MERPs, but this obviously isn't enough information for you to decide if a MERP is right for your company.  If you're interested in learning more, there are two sources you can go for more information.

Your first call should always be to a local insurance agent that you trust.  Any knowledgeable agent will be able to help you understand how a MERP (or HRA) could work with your company.

If your insurance agent doesn't know much about these plans, you should try calling an HRA provider directly.  Sorry about giving you such a blatant sales pitch, but when you're considering which HRA provider to use, Zane Benefits should definitely be on your list.

If you have any questions about MERPs, please don't hesitate to let us know in the comments.  You can also email me at blog@ZaneBenefits.com and I'll try to write an entire blog post answering any questions you have.

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Note: This should not be taken as legal or tax advice.

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Comments


As a part-time employee of a large church, can I use MERP to use most of my salary of $3900 for non-tax med expense? Treasurer insists on putting entire salary in box 1 on my W-2, telling me that the IRS will "notice something " and fix it for MERP . As a result, I now have an audit coming up, because of my using my $300 salary as earned income, and using the remaining $3600 of my salary for non-tax health cost payments. Then he submits a W-2 and W-3 to IRS with $3900 in box 1! IRS says "others" have reported a contradiction in my tax return for 2008, and of course there is, since my W-2 has $300 in box 1. Can you write something telling him he is incorrect?

Posted @ Friday, April 06, 2012 4:15 PM by Malcolm Goodell
Hi Malcom,
MERP is actually not a technical tax term. The thing you want to find out is what section of the IRC (105 or 125 for example) your plan falls under. Your employer's plan documents might give the company the ability to limit the amounts pre-tax salary you can redirect to avoid discriminating. Regardless, you may be able to deduct most of your expenses on lines 1-4 of Schedule A, Form 1040. See http://www.irs.gov/publication... for an example and instructions.


Posted @ Friday, April 06, 2012 4:15 PM by Rick Lindquist
I'll back again for sure, thanks for great article :D

Posted @ Friday, April 06, 2012 4:19 PM by Dental Plan
Great Article! I have been recommended MERPs for all my self employed clients. Usually, business owners' income is so high, they are not able to write off medical expenses on their taxes. The MERP is the perfect answer and they turn the medical expenses into business tax deductions! It's great! http://small-business-tax-info...

Posted @ Friday, April 06, 2012 4:20 PM by BizTaxPro
Type your comment here. Can the employee make contributions to the MERP or just employers?

Posted @ Friday, April 06, 2012 4:20 PM by Jfinkjr
It depends on how the MERP is set up. If the MERP is set up as a Section 125 Flexible Spending Account, an employee can make contributions. If the MERP is set up as a Section 105 Health Reimbursement Arrangement (described above), the employee cannot contribute. Often times employers set up an HRA for employer contributions and an FSA for employee contributions.

Posted @ Friday, April 06, 2012 4:20 PM by Zane Benefits
My employer is refusing to reimburse me for MERP.  What can I do to obtain this remibursement?

Posted @ Friday, April 06, 2012 4:22 PM by Dh90726
You can review your plan documents for the appeals process, and file appeal with the Plan Administrator according to the plan rules.

Posted @ Friday, April 06, 2012 4:22 PM by Rick Lindquist
Can employers charge the cost of the MERP to an employee who is buying COBRA from them?

Posted @ Friday, April 06, 2012 4:23 PM by Joan
can you point me to a place that I could get a template for a section 105 health reimbursement plan?

Posted @ Friday, April 06, 2012 4:23 PM by Jdoherty
see www.sales.zanehra.com/demos

Posted @ Friday, April 06, 2012 4:23 PM by Test
We have medical reimbursement at my place of work. A former EE who has been gone for 7 years (was a former owner) will receive a medical reimbursement for premium payments he has made. Is this legal?
Posted @ Tuesday, August 21, 2012 9:31 AM by CSalis
Is is if 1) the expense is eligible for the plan and 2) the HRA has been in place for all 7 years and your plan documents have been setup to vest the former employees HRA. 
Posted @ Friday, August 24, 2012 8:57 AM by Rick Lindquist
I was told by a previous insurance carrier that my father William Gang has a MERP plan. Now the new carrier is denying it. I have no documentation other than he said she said over the telephone. Not that I don't beleive her. Could a new carrier just drop that plan if he had it? He was medically disabled from a stroke in 1989, a union member, and worked at Reynolds Aluminum Company for many years. Which now has been bought out by Alcoa. No other benefits have ever changed to our knowkedge. Please Advise 
 
William G Gang 
 
Tracey L Grinnell 
daughter
Posted @ Friday, January 25, 2013 10:30 PM by Tracey Grinnell c/o William G Gang Jr.
Hi Tracey - I recommend contacting Alcoa.
Posted @ Monday, January 28, 2013 3:12 PM by Rick Lindquist
If a company has hired a PEO (professional employee organization) how do we approach that company about a HRA since the PEO already handles their benefits admin, payroll and insurance?
Posted @ Saturday, April 27, 2013 8:41 AM by Eric Brown
Hi Eric, 
Reach out to us and we'd be happy to talk about how to approach a company with a PEO.
Posted @ Monday, April 29, 2013 10:25 AM by Christina Merhar
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Disclaimer: The information provided on this website is general in nature and does not apply to any specific U.S. state except where noted. Health insurance regulations differ in each state. See a licensed agent for detailed information on your state. Zane Benefits, Inc. does not sell health insurance.