Regulatory Alignment

Compliance Framework

A detailed breakdown of how the WIMPER structure aligns with IRS Sections 125, 105(b), and 213(d), and how it differs from IRS-flagged fixed indemnity arrangements.


IRS-Aligned Compliance Structure

The WIMPER-aligned plan operates using the following documented IRS code sections:

IRC §125 – Cafeteria Plan

Enables eligible employees to make pre-tax elections, lowering taxable wage base and reducing employer FICA liability.

IRC §105(b) – Self-Insured Medical Reimbursement Plan (SIMRP)

Allows employers to reimburse employees tax-free for qualified medical expenses as defined under §213(d).

IRC §213(d) – Qualified Medical Expenses

Defines allowable medical services including preventive care, telehealth, chronic care support, wellness counseling, and other services included in the WIMPER/Revive benefit stack.

How WIMPER Differs From Fixed Indemnity Wellness Schemes

ACA, ERISA, and HIPAA Considerations

The WIMPER structure respects:

WIMPER Institute provides educational and compliance-oriented guidance to help CFOs understand the legal foundation prior to implementation.

The WIMPER program is built to operate within established IRS and regulatory frameworks. The questions below address the most common compliance concerns we hear from CFOs, controllers, and compliance officers.

FAQ

Compliance & IRS Structure – Frequently Asked Questions

Does the program include audit protection?

Yes. A core design principle of the WIMPER program, as implemented by EHP, is to maintain the level of documentation and process rigor required to withstand regulatory scrutiny. EHP provides comprehensive audit support by maintaining detailed records, standardized workflows, and clear documentation that demonstrates compliance with IRS rules and applicable regulations. The WIMPER Institute’s role is to make sure employers understand these protections and how the compliance framework is structured.

Is this the same as the wellness plans the IRS warned about?

No. WIMPER uses a Section 105(b) SIMRP combined with qualified §213(d) medical services. It does not use fixed indemnity cash benefits or double-dip reimbursement structures flagged by the IRS.

Do employees need to participate in wellness activities?

Yes. To meet ACA participatory wellness requirements, employees must engage with preventive and virtual care programs included in the WIMPER structure.

Does this replace our existing medical plan?

No. WIMPER operates alongside existing major medical or MEC plans and does not modify your core coverage.

Is EHP fully compliant with IRS regulations while implementing WIMPER’s SIMERP program?

Yes. EHP rigorously complies with IRS Sections 105, 106, 125, and 213(d). The WIMPER SIMERP program is structured to meet all IRS standards for preventative care, documentation, eligible expenses, and employee wellness requirements. Compliance is maintained through strict internal controls and ongoing regulatory monitoring.

What documentation is required for IRS compliance?

EHP—acting as WIMPER’s implementation partner—manages all documentation and reporting requirements needed to maintain IRS compliance. This includes eligibility verification, activity logs, wellness participation records, employee acknowledgments, and properly recorded medical expense reimbursements.

How does EHP handle compliance updates?

EHP continuously monitors changes in IRS regulations and updates its compliance protocols accordingly. This ensures that WIMPER SIMERP programs remain fully compliant, even when documentation standards or preventative care definitions change.

What is IRC 213(d) and how does WIMPER comply with it through EHP?

IRC 213(d) defines eligible medical expenses for tax deduction and reimbursement. EHP ensures that all preventative and medical services offered under the WIMPER SIMERP model meet IRS 213(d) definitions. This includes proper classification of services, qualified healthcare providers, secure documentation, and routine internal reviews of covered expenses.

Do employers need a Third-Party Administrator (TPA) for WIMPER’s SIMERP program?

Yes. WIMPER works with EHP to coordinate all required TPA functions, ensuring proper claims adjudication, documentation, and compliance oversight. EHP partners only with approved TPAs that meet IRS and ERISA standards.

How secure is the data used in WIMPER’s SIMERP program?

WIMPER’s implementation partner, EHP, uses advanced data encryption, HIPAA-compliant systems, and strict access protocols to protect employer and employee information. All records, wellness logs, and reimbursement data are stored in secure, audited environments that meet federal standards for healthcare data handling.

How does EHP ensure employee compliance with required wellness activities?

EHP uses automated reminders—email, SMS, and phone—along with a dedicated support team to ensure employees complete their required preventative wellness activity each year. This is essential for maintaining IRS compliance, and EHP handles this process on behalf of WIMPER employers.