The rules

Let's talk about the IRS warnings first.

Most vendors bury this page. We lead with it — because our favorite subject is the difference between what the IRS targets and what EWP is.

The test the IRS actually applies

The dividing line comes straight from the regulations — and EWP passes it by design. The IRS has warned against wellness programs that pay employees cash regardless of whether any medical care was received. That warning is correct.

Reimbursements are tied directly to the actuarially determined value of comprehensive service-based medical care: primary care, urgent care, mental health, and pharmacy. Every medical interaction is tracked with CPT and ICD codes, creating a documented audit trail that actual Section 213(d) medical care occurred.

ON THE RECORD

"Section 105(b) does not apply to amounts a taxpayer would receive 'irrespective of whether or not he incurs expenses for medical care.'"

— Treasury Regulation §1.105-2

One sentence decides the whole category. Programs that pay irrespective of care fail it. A plan that reimburses only documented medical care passes it — and can prove it in an audit.

What the IRS targets, next to what EWP is

Characteristic by characteristic — the targeted design next to the EWP design.

Design test
Targeted design
EWP
Funded through an employee pre-tax election
Paid irrespective of whether medical expenses are incurred
Reimburses only actual Section 213(d) medical care
Every medical interaction documented with CPT and ICD codes
Benefit valued by independent professional actuaries
Passes the §1.105-2 "irrespective" test

Four questions every skeptic asks

Answered the way we answer them on the assessment call, with the citations attached.

See it for yourself first.

Start with a no-obligation contact and find out exactly what your company qualifies for.