Quick Answer: The Premium and Cost Recapture Program is a self-funded employee benefit plan built on Section 125 of the IRS tax code. Enrolled employees direct a portion of their pay into the plan before taxes are calculated. The result is a lower taxable wage base, higher net pay for your employees, and a reduced payroll tax obligation for your practice.
Building a thriving practice requires meaningful investment. Your practice may have invested in the Helios peptide protocol education, practice revenue growth program, or World Insurance Network’s products liability and malpractice peptide coverage program.
Understanding the Savings
Through Section 125 of the IRS tax code, a portion of each enrolled employee’s compensation is directed into a qualified benefit plan before payroll taxes are assessed. The result is a lower taxable wage base, higher net pay for your employees, and a reduced payroll tax obligation for your practice.
The Internal Revenue Service states that “qualified benefits under a cafeteria plan are not subject to FICA, FUTA, Medicare tax, or income tax withholding.”
The Employee Perspective.
Based on $4,000 in monthly pay:
- Portion of pay directed into the plan before taxes: $1,200
- Health benefit returned in the paycheck: Plus $1,130
- Modest after-tax premium: Less $120
- Employee’s net cost for the plan: $190
- Reduction in the employee’s taxes: $306
- Increase in monthly take-home pay: $116
The Practice Perspective
Per enrolled employee:
- Monthly pay no longer subject to the 7.65% employer payroll tax: $1,200
- Employer payroll tax savings: $91.80
- Program administration fee: Less $44.00
- Net savings per enrolled employee, per month: $47.80
- Net savings per enrolled employee, per year: $573.60
How the Savings Compound
Your practice may allocate those savings toward part or all of its investment in the Helios peptide protocol education, practice revenue growth program, or World Insurance Network’s products liability and malpractice peptide coverage program. Based on the program’s standard illustration, your practice may save approximately $47.80 per enrolled employee per month, or $573.60 per year, after the administration fee. That ranges from approximately $5,736 annually with 10 enrolled employees to $43,020 annually with 75 enrolled employees. There is no limit to the number of full-time W-2 employees who can enroll in the program. Savings can compound as enrollment increases with no limit to participation numbers.
The extent to which those savings offset part or all of your investment in the Helios peptide protocol education, practice revenue growth program, or World Insurance Network’s products liability and malpractice peptide coverage program depends on two factors: the number of employees who enroll and their compensation levels. Only full-time W-2 employees are eligible to enroll, so your savings are based on your full- time W-2 staff.
In return, employees and their families gain access to a comprehensive suite of health benefits designed to complement, not replace, your existing health insurance:
- unlimited primary and urgent care visits
- 100% coverage for preventive care
- $0 copay on the most commonly prescribed medications
- 24/7 access to board-certified virtual physicians
- confidential mental health support and counseling
- at-home lab testing
- personal vitals tracking
- virtual veterinary care
All benefits are accessible through a single, intuitive mobile app.
Lower out-of-pocket costs for your employees.
Most employer-sponsored medical plans require employees to meet a deductible and pay moderate copays for routine care received outside the hospital, such as office visits, urgent care, and prescriptions. These everyday services are known as frequency claims because employees use them most often. The Premium and Cost Recapture Program redirects these frequency claims away from your major medical plan. For the services listed above, employees pay a $0 or $1 copay in place of the higher deductibles and copays their existing medical plan would otherwise impose.
Potential relief on your health plan renewals.
Insurance carriers set renewal rates largely based on how many claims your group files. When routine, high-frequency claims are handled through this program instead of your major medical plan, your group’s claims experience may improve. Over time, this may help moderate the premium increases your practice faces at renewal.
Does My Practice Qualify?
Your practice is likely a strong candidate if it:
- operates under a medical director with an active NPI number
- employs full-time W-2 staff on its payroll
- can provide a recent payroll register detailing each employee’s gross pay, deductions, and taxes
In compliance with federal nondiscrimination requirements, participation by practice owners and highly compensated employees may be limited or excluded. Final eligibility is confirmed as part of your custom proposal.
Who Administers the Program, and What Is World Insurance Network’s Role?
The plan is administered by Champion Health, Inc., which oversees enrollment, payroll integration, benefit delivery, and ongoing member support.
Your net cost is zero. The program is funded entirely with money your practice is already spending. Your practice receives a single monthly invoice of $234 per enrolled employee, which consists of two parts:
- $190 is the employee’s own plan contribution, withheld from their paycheck and remitted on their behalf. These are dollars your practice would have paid out in wages regardless.
- $44 is the program administration fee, paid from the $91.80 your practice no longer sends in payroll tax deposits for that employee.
World Insurance Network serves as your strategic partner throughout the process. We introduce the program, coordinate your custom proposal, and demonstrate how your savings may be allocated toward those investments. The result is a single, trusted partner for both protecting and strengthening your practice.
See What Your Practice Could Recapture
Your custom proposal is built from your practice’s own payroll data and shows exactly how much you may recapture and how those savings may be allocated.
All illustrations are examples only. Actual savings vary by practice and are not guaranteed to offset any specific cost. Renewal outcomes depend on your carrier and overall claims experience and are not guaranteed. This plan is designed to complement major medical coverage and does not replace it. Please refer to the Summary Plan Description and Plan Document for complete details, exclusions, and limitations. This information does not constitute legal, tax, or financial advice. Please consult a qualified tax professional.
Does World Insurance Network only write peptide coverage? No. World Insurance Network is a full-service brokerage. Peptide coverage is one specialty alongside a complete range of commercial and personal insurance coverages sold.
May I still participate if I own a business outside of the healthcare industry? Yes. Any employer with more than 10 employees may participate, regardless of industry.
When should I expect a response? A licensed broker responds to you directly, not a call center. Submit a Coverage Gap Review request or call us, and we will reply during normal business hours.
Your custom proposal is built from your practice’s own payroll data and shows exactly how much you may recapture and how those savings may be allocated. Call 725-269-2721 or See What Your Practice Could Recapture.
Key Takeaways
- Through Section 125 of the IRS tax code, a portion of each enrolled employee’s compensation is directed into a qualified benefit plan before payroll taxes are assessed.
- The result is a lower taxable wage base, higher net pay for your employees, and a reduced payroll tax obligation for your practice.
- Only full-time W-2 employees are eligible to enroll, so your savings are based on your full-time W-2 staff.
- The plan is administered by Champion Health, Inc., which oversees enrollment, payroll integration, benefit delivery, and ongoing member support.
- All illustrations are examples only. Actual savings vary by practice and are not guaranteed to offset any specific cost.