Independent brokerage status
Optimal Benefit Advisors acts as an independent benefits brokerage and advisory firm helping employers evaluate their current benefit environment and, where appropriate, third-party supplemental programs. We are not an insurer, healthcare provider, pharmacy, plan administrator, government agency, law firm, accounting firm, or payroll provider. Program-provider identities and relationships may be confidential and are disclosed when appropriate for an authorized employer evaluation.
Separate program alternatives
Potential programs are evaluated as distinct alternatives. Benefits, economics, eligibility, employee impact, compliance materials, and implementation assumptions from one program are not combined with or attributed to another.
How illustrations work
The calculator presents two standalone answers at the same time. Option 1 uses a $653 annual savings assumption per enrolled employee. Option 2 separately uses a $1,186 annual savings assumption per enrolled employee. The results are never added together. Results may change after eligibility, payroll, program-fee, and census review. An illustration is a planning tool rather than a quote, tax calculation, or final proposal.
Employer-specific variables
Savings figures, take-home-pay changes, participation figures, and cost examples may be based on information supplied by program providers. Outcomes vary with compensation, tax status, employee elections, participation, plan design, existing deductions, payroll setup, governing documents, fees, applicable law, and professional review.
Tax and legal review
Federal rules can distinguish qualified accident-and-health benefits and substantiated medical reimbursements from cash, indemnity, or other payments that remain taxable wages. Before adopting an arrangement, an employer should obtain written review from the applicable program compliance team, qualified benefits counsel, a CPA or tax advisor, its payroll provider, plan administrator, and appropriate fiduciaries. IRS Chief Counsel Advice is not precedent, but recent memoranda show continuing IRS attention to wellness-payment structures.
Healthcare and pharmacy terms
Virtual care and pharmacy services are not replacements for insurance or emergency services. Eligibility, included visits, geography, clinicians, medications, formularies, pharmacy networks, shipping, costs, and benefit limits vary by selected program and employer plan. “No copay” or “no out-of-pocket cost” refers only to eligible services under applicable program terms.
Existing coverage
The featured approach begins with an employer’s existing benefits. Compatibility and any requirement to maintain qualifying medical coverage must be confirmed for the specific arrangement. This website does not bind coverage, establish a plan, change payroll, or create a professional-client relationship.