I have been asked to respond to some of the most frequently asked questions posed by the clients and potential clients of Champion Health regarding the Champion Health Plan (the “CHAMP Plan”). I have reviewed the CHAMP Plan in detail and assessed its components under applicable law. Based on my experience as an ERISA attorney, the following are my responses to many of the CHAMP Plan™ frequently asked questions. 

Q-1.     What are the components of the CHAMP Plan? 

A-1.     The CHAMP Plan is a single employer-sponsored plan comprised of two separate components: (1) the pre-tax Champion Health Minimum Essential Coverage Plan (the “MEC Plan”); and (2) the post-tax Champion Health Population Management Plan (the “Health Population Management Plan”). (request access to the entire article) 

Q-2.     Can the CHAMP Plan be combined with an employer’s major medical plan?

A-2.     Yes. The CHAMP Plan can be combined with an employer’s major medical plan. (request access to the entire article) 

Q-3.     How does the CHAMP Plan savings comply with applicable law?

A-3.     There are two distinct components of the CHAMP Plan. The MEC Plan is the pre-tax component of the CHAMP Plan. (request access to the entire article) 

The Health Population Management Plan is the post-tax component of the CHAMP Plan. (request access to the entire article) 

Q-4.     If the employee does not login to the CHAMP Plan app on a continuous basis, what safeguards are in place to ensure the employee and employer don’t have any negative financial consequences associated with no action taken?

A-4.     When an employee initially enrolls in the CHAMP Plan, the employee is required to log into the CHAMP Plan app (or website) and complete a health risk assessment. The completion of the health risk assessment is a condition to enrollment in the CHAMP Plan. (request access to the entire article) 

Q-5.     Are there any prohibitions on referrals related to the CHAMP Plan?

A-5.     Referral rules related to the CHAMP Plan largely depend upon the regulations governing the potential referring party. (request access to the entire article) 

Q-6.     How is it possible that the post-tax $120/month premium covers a plan benefit of approximately $1,130?

A-6.     As with any healthcare plan, it is not unusual for the benefits to the plan member to exceed the premiums (or contributions) the member pays to participate in the plan.

Here, the Health Population Management portion of the CHAMP Plan is self-funded by the employer. (request access to the entire article) 

Q-7.     What are the advantages of the CHAMP Plan being self-funded?

A-7.     Because the CHAMP Plan is self-funded, the employer is responsible for paying all claims under both plan components – BUT only pays the plan claims…

…Self-funding the CHAMP Plan can result in significant advantages because the employer controls the funding of the two separate plan components. (request access to the entire article) 

Q-8.     There are certain IRS Tax Memorandums that scrutinize certain wellness indemnity plans that initially appear similar to the CHAMP Plan. Do these memorandums apply to the CHAMP Plan?

A-8.    (request access to the entire article) 

Q-9.     There are certain articles stating the CHAMP Plan is “too good to be true.” Is this a concern?

A-9.     This is not a significant concern. It’s true that there are several very similar articles that scrutinize certain healthcare plans that appear similar to the CHAMP Plan. These articles are largely based on isolated cases and address a situation referred to as the classic “double dip.”…

…While it’s clear that certain plan arrangements have attempted to impermissibly reduce certain taxes or “double-dip”, the CHAMP Plan is wholly distinguishable from these arrangements. (request access to the entire article) 

Q-10.   Is a participant in the CHAMP Plan eligible to contribute to a health savings account (“HSA”)?

A-10.   A participant in the CHAMP Plan is not eligible to contribute to an HSA because the MEC Plan component provides coverage for primary care services and urgent care services with a $0 copayment before any deductible has been met.

However, if an individual enrolls in the CHAMP Plan, the individual can still maintain his or her HSA.

Q-11.   Is a participant in the CHAMP Plan also eligible to participate in a high deductible health plan (“HDHP”)?

A-11.   Yes. The ability to participate in an HDHP and the eligibility to contribute to an HSA are two separate things. (request access to the entire article) 

Q-12.  Is a participant in the CHAMP Plan also eligible to participate in a health flexible spending arrangement (“Health FSA”)?

A-12:  Generally, yes. As set forth in IRS Publication 969, Health FSAs are employer-established benefit plans that may be offered in conjunction with other employer-provided benefits as part of a Section 125 cafeteria plan. (request access to the entire article) 

Q-13.  Is a participant in the CHAMP Plan also eligible to participate in a dependent care flexible spending arrangement (“Dependent Care FSA”)?

A-13:  Yes. A participant in the CHAMP Plan is also eligible to participate in a Dependent Care FSA.

Q-14.  Does the “pet consultation” access potentially disqualify the CHAMP Plan under the IRC Section 125 rules?

A-14:  No. Pets are not considered “dependents” under the IRC. Accordingly, “pet insurance” is not an eligible expense under the MEC Plan.(request access to the entire article) 

Q-15.  Are CHAMP Plan sponsors required to establish separate claims funds for the MEC Plan and Health Population Management Plan components?

A-15:  Yes. The MEC Plan and Health Population Management Plan as two completely distinct self-funded plans under the CHAMP Plan program. CHAMP Plan sponsors are required to set up separate claims funds for each plan. These separate claims funds are never commingled.(request access to the entire article)