Giving health benefits to workers is not just about following rules—it’s also a smart way to grow a business. One of the most effective ways to do this today is through a self-insured medical reimbursement plan. But not all health plans are created equal. Many business owners face a key decision: should they manage a plan themselves or go with a traditional insurance company plan?
The Lumara Plan gives a better choice. It saves money. It keeps workers happy. It follows all the rules. It uses smart programs like Section 125, PCMP and SIMRP. Let us look at both types of plans and see why many people now pick Lumara Health.
What is a Fully-Insured Health Plan?
Most employers use a fully insured health plan, which provides predictability but tends to incur expensive costs and little flexibility. Employers and employees may encounter challenges that render these plans undesirable in the current dynamic benefits scene.
Here are its challenges for Employers:
- You pay a constant monthly premium to the insurance company regardless of whether your employees utilize very little healthcare.
- Most policies do not permit tailoring, so you have little say in what is included and how much it will cost.
- Insurers do not usually provide full details of claims, so it is difficult to know where your money is spent.
- Annual rate hikes are typical, and you cannot negotiate lower expenses.
Here are its challenges for Employees:
- Workers usually must pay steep deductibles before the plan will cover care
- Out-of-pocket expenses such as copays and coinsurance can be costly
- Plan options typically only include what the employer’s chosen carrier provides.
- Supplemental benefits such as wellness programs or preventive care enhancements are typically absent o sparse.
What is a Self-Funded Medical Expense Reimbursement Plan?
In contrast, a self-funded model means the employer pays for claims out of pocket as they are incurred, rather than pre-paying to a carrier. This offers more flexibility and potential savings, but also introduces risk and administrative complexity. But not all self-funded plans are the same.
The Lumara Plan is a self-insured medical expense reimbursement plan that solves for these concerns by combining:
- Preventative Care Management Plan (PCMP)
- Specialized Insurance Medical Reimbursement Plan (SIMRP)
- Section 125 health plan components
Together, these create a compliant, low-risk, and high-impact solution.
Introducing the Lumara Plan: A Smarter Self-Funded Alternative
The Lumara Plan is built to help businesses save money while offering better benefits to their employees. It is not just any other health plan. It uses smart tools and systems to make healthcare easier, more affordable, and more effective for everyone involved.
Here is how the Lumara Plan Works:
- Uses Section 125 to offer substantial tax benefits for both employers and employees.
- It goes way beyond general cafeteria plans by offering more services and support.
- It offers a Preventative Care Management Plan that keeps the employees healthy and aids in the diagnosis of diseases at an early stage.
- Provides a Medical Reimbursement Plan that reimburses employees for approved out-of-pocket medical bills.
- Provides automated onboarding for employees, making it easy to sign up and understand the benefits.
- It ensures full legal compliance, so businesses do not have to worry about rules and regulations.
Why Employers Choose the Lumara Plan?
The Lumara Plan gives clear wins for your business. It puts more money in your pocket, saves you time, and makes your team feel valued.
It has the following financial benefits:
- You can save about $600 every year for each W-2 employee on your team.
- If your company has 100 employees, that’s nearly $60,000 in yearly savings.
- You don’t need to pay anything upfront to get started with the plan.
- Healthcare claims can go down by around $1,400 over three years per employee.
- You may also see a 5% to 10% reduction in overall healthcare costs.
- These savings start quickly and directly improve your business’s financial performance.
It offers the following operational advantages:
- Simple digital setup is done in 30 to 45 days
- Works just as well for ten workers as for thousands
- HR and payroll teams spend less time on paperwork
It has the following strategic gains:
- Richer benefits help you hire and keep top talent
- Healthier staff are more focused and miss fewer days
- Better perks lift morale and spark stronger engagement
How Employees Benefit from the Lumara Plan?
The Lumara Plan is not just good for employers, it’s great for employees too. It puts more money in their pockets and gives them useful benefits without extra cost.
It offers a higher take-home pay:
- Employees take home 3% to 4% more from their paycheck
- That’s around $100 extra each month, depending on income
It has zero-cost, high-value benefits:
- Employees get 24/7 access to virtual doctor visits (telemedicine), all with $0 copay.
- Spouses and dependents are also fully covered, and their services also come with $0 copay.
- The plan includes access to an Employee Assistance Program (EAP) for emotional and mental well-being.
- Employees can receive mental health support, counseling, and addiction recovery help.
Conclusion: Make The Right Medical Choice for Your Business
Choosing the right health plan is a big step for any business. A self-funded option like the Lumara Plan can help you save money and offer you with better benefits and care. It follows all government rules and gives strong benefits that support both employers and employees. Unlike old insurance plans, Lumara includes helpful features like tax savings and wellness care.
It is easy to understand, simple to manage, and built for today’s business needs. Many business owners are now making the smart switch. Give your team better care and your business a stronger future with the Lumara Plan.