For CFOs & shareholders
Show me the math. Then show me the risk.
One line of savings, one disputed question, and a list of documents that settle it. All footnoted.
Illustrative photo · not a real employee
Required federal noticeFixed indemnity insurance
IMPORTANT: This is a fixed indemnity policy, NOT health insurance
This fixed indemnity policy may pay you a limited dollar amount if you're sick or hospitalized. You're still responsible for paying the cost of your care.
- The payment you get isn't based on the size of your medical bill.
- There might be a limit on how much this policy will pay each year.
- This policy isn't a substitute for comprehensive health insurance.
- Since this policy isn't health insurance, it doesn't have to include most Federal consumer protections that apply to health insurance.
Looking for comprehensive health insurance?
- Visit HealthCare.gov or call 1-800-318-2596 (TTY: 1-855-889-4325) to find health coverage options.
- To find out if you can get health insurance through your job, or a family member's job, contact the employer.
Questions about this policy?
- For questions or complaints about this policy, contact your State Department of Insurance. Find their number on the National Association of Insurance Commissioners' website (naic.org) under "Insurance Departments."
- If you have this policy through your job, or a family member's job, contact the employer.
The math
Where the savings come from — and where they don't.
The employer saving is one line: employer FICA not owed on pre-tax premiums.[40, 41] Less the program fee.[34, 35] We leave out FUTA, state unemployment and workers' comp effects to stay conservative.[42]
It reaches operating income directly. For shareholders, that's margin; for a PEO or a company being valued on EBITDA, see the PEO page.
| Qualify | Enrolled | Employer FICA / yr, before fees |
|---|---|---|
| 50% | 250 | $137,700 |
| 63% (default) | 315 | $173,502 |
| 80% | 400 | $220,320 |
63% is Elysian's PEO case data (967 of 1,533); its proposal example was 79.8%.[43] $600 is the lowest tier on one client's form.[30]
Use your own inputsThe risk register
What a careful CFO underwrites.
Are claim payments wages?
Elysian's counsel says no; the IRS has said yes for activity-based payments.[33, 51, 58]
No unreimbursed expense?
Tax-free only up to actual medical costs. The bundled care is $0, and most 100+ employers also offer major medical.[48, 58]
Trigger definition
Requested in writing. It decides which side of the IRS line the plan sits on.[31]
Held back from this site
The numbers by headcount, the IRS-line checklist, and 20 questions to ask any vendor.
Work email and company name. We email you a link to confirm it's really you, and the link unlocks the PDF.[41, 58, 69]
The risks are not gated: the federal notice, the IRS positions and every source stay free to read.
Email me the kit