In the developing work environment, employers seek various benefits to offer employees apart from their basic salary. These benefits can include medical coverage, paid leave, and holiday packages. These benefits make it simple for the employer to retain the employee and attract a fresh pool of talent in the organization. One such key benefit offered by the employer is SIMERP. It is a unique method by which employers contribute towards the healthcare expenses and the eligible medical benefits of employees. The key advantage of this benefit is that it is pre-tax, reducing the employer’s overall tax burden.
This blog elaborates on what SIMERP is and why most employers prefer it over other plans. It also highlights an innovative and advanced plan, Lumara Health for employers, that leverages the benefits of SIMERP with a Section 125 plan.
What is SIMERP?
A self-insured medical reimbursement plan, or SIMERP, is an employer-funded health benefit arrangement where the organization assumes the financial responsibility for employees’ eligible medical expenses, rather than purchasing traditional insurance. This model provides flexibility in plan design, cost control, and transparency. Employers typically set aside funds for claims and may purchase stop-loss insurance to limit exposure to high-cost cases. Governed by ERISA and relevant IRS regulations, such plans are generally best suited for mid-sized to large employers with the financial stability to manage healthcare risk effectively.
Benefits Included in SIMERP
The SIMERP offers a range of valuable health-related benefits designed to improve access to care while reducing overall costs. Here are the key benefits included in the plan:
- 24/7 access to virtual care
- Mental health and counseling support
- Preventive care and wellness programs
- Coverage for spouse and dependents
- Substance abuse and recovery assistance
- Employee Assistance Program (EAP) access
- Health screenings and biometric monitoring
- No copays for covered services
Why More Employers Are Preferring SIMERP Over Other Plans?
More employers are choosing the SIMERP over traditional health plans due to its cost-effectiveness, flexibility, and compliance advantages. SIMERP allows businesses to control healthcare spending by reimbursing actual medical expenses rather than paying fixed premiums. It also offers tailored benefit options, tax savings, and minimal administrative burden through managed services. With rising healthcare costs and increasing demand for personalized benefits, SIMERP presents a strategic, sustainable solution that aligns with both business objectives and employee well-being.
Lumara Health: The Best Integrated SIMERP Plan for Small Businesses
The Lumara Health plan is a strategically designed health benefit solution that leverages a compliant, tax-advantaged structure to optimize healthcare delivery and cost management. It integrates a Section 125 plan, a Preventive Care Management Program (PCMP), and a Self-Insured Medical Reimbursement Plan (SIMRP). These components work together to facilitate non-disruptive implementation alongside existing coverage. The plan emphasizes early intervention through scheduled preventive care services, while the reimbursement framework ensures eligible medical expenses are managed efficiently. With built-in administrative automation, it provides a streamlined, scalable approach to healthcare planning and regulatory compliance.
What does Lumara Health offer to the Employees?
The Lumara Health plan delivers a comprehensive suite of health and wellness services designed to enhance employee well-being, support families, and improve financial outcomes, all with no out-of-pocket costs. Some of the key employee benefits of the Lumara Health plan include:
- Increases monthly net pay by approximately $100
- On-demand access to 24/7 telemedicine services
- Inclusive coverage for spouses and dependents
- Confidential support through Employee Assistance Program
- Integrated mental health and counseling resources
- Evidence-based programs via Mayo Clinic partnership
- Personalized support for addiction recovery
- Relationship-focused services, including couples counseling
What does Lumara Health offer to the Employers?
The Lumara Health Plan delivers a sophisticated, tax-advantaged solution that enhances cost control, streamlines compliance, and reduces administrative overhead for employers. Key employer benefits include:
- Approximately $600 in annual savings per W-2 employee
- Lowers overall healthcare expenditures by 5–10%
- Implements seamlessly with no upfront financial commitment
- Reduces internal administrative burden through full automation
- Decreases employer payroll tax obligations
- Maintains alignment with IRS and ERISA regulatory standards
Conclusion – Learn How to Maximize Healthcare Savings
As healthcare costs continue to rise in 2025, more employers are embracing the SIMERP for its cost-efficiency, tax advantages, and flexibility. SIMERP empowers businesses to take control of benefit spending while offering meaningful healthcare support to employees. Lumara Health stands out as a trusted provider with fully managed, compliant solutions that integrate seamlessly into existing structures. For employers seeking smarter, sustainable benefits strategies, Lumara Health offers the expertise and innovation to make SIMERP work effectively.
Take the First Step Toward Smarter Benefits
Book a 10-minute consultation today from Lumara Health to explore a tailored, tax-efficient benefits solution that aligns with your business goals and maximizes long-term savings.
