Partner/Shareholder at Fraser Stryker PC LLO, Omaha, NE
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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”). (contact us for the complete answer)
Q-2. Can the CHAMP Plan be combined with our traditional employer-sponsored health insurance plan?
A-2. Yes. The CHAMP Plan can be combined with a traditional employer-sponsored plan. (contact us for the complete answer)
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. (contact us for the complete answer)
The Health Population Management Plan is the post-tax component of the CHAMP Plan. (contact us for the complete answer)
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. (contact us for the complete answer)
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. (contact us for the complete answer)
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. (contact us for the complete answer)
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. (contact us for the complete answer)
Q-8. There are 2017 and 2023 IRS Tax Memorandums that scrutinize certain wellness indemnity plans that initially appear similar to the CHAMP Plan. Do the addressed in these IRS Tax Memorandums apply to the CHAMP Plan?
A-8. (contact us for the complete answer)
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. (contact us for the complete answer)
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 and use the funds to pay for future qualified medical expenses.
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. (contact us for the complete answer)
About the Author:
Emily Langdon is a Partner/Shareholder at Fraser Stryker PC LLO, a large law firm based in Omaha, NE. Fraser Stryker was established 125 years ago and has corporate and litigation clients across all industries, both national and international.
Emily leads Fraser Stryker’s practice on employee benefits, ERISA, and executive compensation. She has significant experience advising clients regarding health and welfare benefits plans, qualified and non-qualified retirement plans, equity incentive plans, and wellness plans.