As you evaluate whether using a Zane solution makes sense for your company, you will likely have questions about how Zane's online platform works. This document addresses common questions employers ask about our online health benefits software and how they can offer it as a health benefit plan.
To help you find the information you need quickly and easily, questions are categorized as follows:
What is Zane's Online Platform?
Zane's online platform is an HRA, which is an employer-funded plan that may be used to reimburse employees for medical expenses, including health insurance premiums. An HRA is not health insurance, but can be used to supplement health insurance benefits and pay for a range of medical expenses not covered by insurance.
What types of expenses are allowed for reimbursement through the Zane online platform?
Zane's platform may reimburse any expense considered to be a qualified medical expense by the IRS, including premiums for personal health insurance policies. Within the IRS rules, employers may restrict the list of reimbursable expenses in any way they choose. For more information, see IRS Publication 502 or request a copy of Overview of Reimbursable Eligible Medical Expenses, published by Zane Benefits.
Is there a minimum or maximum contribution limit?
No. There is no limit to the amount of money an employer can contribute to an employee’s benefits.
Is there a minimum or maximum number of participants that must enroll?
No. Federal regulations do not stipulate a minimum or maximum number of participants. Zane Benefits serves clients of all sizes and can administer the platform for a company of any size.
What are the tax benefits of implementing the Zane online platform?
Reimbursements made are tax-free to employees and tax-deductible for employers. Reimbursements are not included in employees’ income and thus not subject to any income or payroll tax withholding. From an employer’s point of view, the reimbursements are deductible as a business expense, the same way as premiums paid for a group insurance policy or other benefits expense.
Tax deductions for reimbursements received by employees who are proprietors, partners and some S Corp shareholders are limited. See additional FAQs below.
Can I set up an the Zane online platform for my family?
No. The online software platform can only be used by an employer for the benefit of employees, former employees and retired employees. However, funds in the plan can be used for expenses of these groups and their dependents.
Can I roll balances from year to year?
Yes. Balances may roll forward from year to year. Employers can prevent balances from rolling over; however, doing so defeats one of the advantages. Employers may not pay out unused balances to any employee in cash or other benefits.
What if an employee’s claim exceeds his/her available balance?
Zane Benefits’ online platform tracks and carries-forward unpaid balances until adequate funds have been accumulated. If an eligible expense will exceed an employee’s available balance, the employee may submit the claim immediately instead of waiting until sufficient funds accumulate. The approved claim is paid off as allowances accrue. Employees will continue to receive partial reimbursements until the entire claim has been reimbursed.
Where do employers keep the accumulated balances? Do they send the money to Zane Benefits or set up a separate bank accounts to keep track of the liability?
This is a notional arrangement; no funds are expensed until reimbursements are paid. With a Zane Benefits solution, employers reimburse employees directly only after the employees incur approved medical expenses. Zane Benefits recommends employers pay reimbursements out of the employer’s general funds (e.g., general purpose bank account) via direct deposit, payroll or check. The liability is tracked in real-time on the employer’s Zane Benefits plan website.
How should my accountant keep track of the allowances?
For financial reporting purposes companies will want to accrue a liability on their balance sheets for the portion of unused contributions that they believe will ultimately be used. Currently, no specific accounting standards exist for recording or specifically disclosing liabilities. The most conservative treatment is to accrue 100% of the unused contributions on the balance sheet date.
Employers are not required to report their obligation to the IRS. Employers with more than 100 employees do need to report the total reimbursements made during the year on IRS Form 5500. Additionally, employers must include reimbursements paid to employees who are proprietors, partners and some S-Corp shareholders in these employees' gross income.
Plan Design Questions
What defines an employee class?
Employee classes are defined by the employer and must be based on genuine job classifications. Criteria that may be used to define a class include job description, full-time versus part-time status, active versus retired status, geographic location and membership in a collective bargaining agreement (e.g. union). Employers may also give different benefits to employees based on the employees’ choice of plan (e.g., an HRA may be available only to those selecting a high-deductible group plan or only to those opting out of a group plan).
Can I offer this to only my key employees?
All employees in the same class should be treated equally. The plan does not have to benefit all employees so long as benefits offered to one or more classes of employees do not discriminate in favor of highly compensated individuals.
Can I give different allowances to different employees?
Employees in different employee classes may receive different allowances and different benefits. All employees in the same class should be treated equally.
How can I minimize my exposure?
Zane Benefits’ reporting features make real-time monitoring of liabilities, reimbursements and utilization easy. Employers can change plan benefits at any time, or cancel the entire plan at any time. Further, Zane Benefits’ solutions allow employers to establish plan-year maximum reimbursements for any given category of expense (e.g., dental) and to establish a maximum balance that any participant class may hold at a time.
How can the online platform be used for retiree health benefits?
Zane Benefits allows employers to keep their plan open for retirees so these former employees may use funds previously accrued. Employers may also permit retirees to accrue additional dollars. Retirees are not required to pay taxes when they receive reimbursement for medical expenses from a Zane solution.
How can I learn more about using employee classes?
Offering varied benefits for different classes of employees is one of the main reasons you should set-up a Zane plan. Using employee classes turns your health benefit plan into a powerful compensation tool for employee recruiting and retention.
Ask your benefits advisor for a copy of The Power of Employee Classes and How IRS Rules Impact HRAs, published by Zane Benefits, for more information on how to use employee classes. You may also contact a Zane Benefits Benefits Consultant, who can answer your questions and demonstrate how Zane Benefits' online platform enables you to use classes to improve your benefit plan.
What are the advantages of setting this up for owners of a sole-proprietorship, partnership, S Corporation, or LLC (Limited Liability Company)?
IRS rules limit the deductibility of medical expenses for employees who are also business owners. Using an Zane's online software platform enables business owners to secure all income and payroll tax deductions to which they are legally entitled. Additionally, Zane Benefits’ online platform tracks expenses to provide information needed for federal and state income and payroll tax filings. Reimbursements made to employees of these companies who are not owners of the business are tax-free. All reimbursements made are tax deductible to the company itself. See Tax Savings For Business Owners, published by Zane Benefits, for more information.
Can I offer this benefit to my independent contractors?
Zane Benefits’ solutions make it easy to reimburse independent contractors for qualified medical expenses. Contractors who do not earn W-2 wages may still receive reimbursements but must report these reimbursements as taxable income. Independent contractors can go to the company’s Zane Benefits website to view their total income from reimbursements each year.
What is the difference between group and individual health insurance?
Individual and group health insurance policies differ in terms of cost, coverage, and portability. In 45 states, individual policies are subject to medical underwriting, which makes them much less expensive than group policies for healthy individuals. However, individuals with adverse health conditions may not be able to obtain coverage. Group policies are more expensive but guarantee the same coverage to every participant.
Employer group policies may only be held by a company's employees. In contrast, individual coverage is not conditioned on employment, so employees keep their insurance policies when they change employers.
In most states, individuals who cannot secure individual coverage can obtain guaranteed coverage from a state risk pool at a cost somewhat higher than a group policy or from a spouse’s group plan. Under HIPAA, employees who have at least 18 months of creditable coverage under an employer group health plan, have exhausted available COBRA coverage, and who are not eligible for another group plan must be accepted by an insurance carrier without medical underwriting.
I don’t want to leave my employees on their own for individual/family policies. How can I help them find insurance coverage?
Any employee participating in a Zane solution may learn about and shop for a personal policy online, or by calling his/her insurance agent, an insurance agency recommended by the employer, or an insurance carrier that offers plans in the employee's state. Your company's broker, benefits advisor, or Zane Benefits can also recommend trusted insurance partners as needed.
Are individual insurance policies available in all states?
Individual insurance policies are available in every state. Your broker or benefits advisor will provide you with recommendations on how to balance regulations, locations, and budgets to create the optimal health benefits program for employees you have in these states.
Compliance and Regulatory Questions
Can the Zane online software be used to reimburse individual insurance premiums in my state?
Any U.S. employer may use the Zane online software in any state to reimburse IRS-approved medical expenses, which include individual health insurance premiums.
Are Zane's solutions subject to COBRA?
Zane's solutions are subject to COBRA, which requires that employers with 20 or more employees provide terminated employees with the option to access benefits for a fee (usually 102 percent of the cost of the benefits). Zane Benefits does not provide COBRA administration services, but does provide employers with guidelines on how to determine the cost of the services for purposes of COBRA.
Online Health Platform Platform Questions
Can I administer my own plan and still use your software? If so, is there a difference in price?
Zane Benefits gives you full control over your plan design, which you may modify at any time. Technically, you (the employer) are the Plan Administrator. Zane Benefits processes claims for you. This service is included in the price of your Zane Benefits solution and may not be unbundled.
Will you provide on-site training for our employees?
Zane Benefits provides customized welcome packets to your employees with easy-to-follow instructions for submitting claims and learning about their plan as well as unlimited online and telephone support. For large employers, Zane Benefits may provide on-site employee training for an additional cost-based fee.