A Health Insurance Plan Built Just For You
ClaimLinx specializes in coordinating self-funded Medical Expense Reimbursement Plans (MERPs) from start to finish. First, we offer employer benefits consulting to provide your business with a plan that fits your demographics best. It’s a more comprehensive Health Reimbursement Arrangement (HRA) than you’ve ever seen!
Then, we serve as claims processors for the secondary health insurance plan to ensure that claims are reimbursed accordingly and that members have the support they need to actually use and understand their benefits. Our focus is on making the claims reimbursement process as simple and usable as possible.
Once a health insurance plan is set up, we handle each step of processing for the secondary insurance plan, including determining the correct payout for a claim, collecting the funds from the company, and distributing payment to providers’ offices. Our team members abide by all HIPAA guidelines so our clients never have to worry.
There’s no better way to take hold of your company’s health insurance benefit plan than to set up a customized MERP with ClaimLinx as the MERP administrator.
What is a MERP (Medical Expense Reimbursement Plan)?
A Medical Expense Reimbursement Plan (MERP) is a benefit plan sponsored by an employer to help employees cover their eligible medical expenses. This type of reimbursement plan allows employees to receive reimbursement for their out-of-pocket medical costs that they incurred during the plan year.
You can offer a medical expense reimbursement plan alongside or instead of a group health insurance plan for primary health benefits.
Employers can customize the MERP to their needs by setting contribution amounts, eligible expenses, and reimbursement processes.
How do MERPs Work?
A MERP is any plan that allows businesses to give their employees without any taxes applied to the amount. The money that is given by the employer can only be used to pay off any medical expenses that an employee paid for out of their own pockets. The process of a MERP typically involves five main steps:
Step 1: Your employer will determine the allowance amounts- this means the set amount of monthly allowance that is allowed for each employee; should the medical expenses of an employee exceed the allowance limit, the employer will only be liable to reimburse the employee for the allowance that was predetermined.
Step 2: As the employee, you will have to purchase your own health insurance plan- meaning you will have the discretion to choose whatever health care products best serve your needs and requirements. This purchase, however, will be paid for from your own pocket for the time being.
Step 3: You will be required to provide proof of purchase- once you have made the purchase for your preferred health care products, you will be asked to provide documentation recording that a medical expense was incurrent. This document could be anything from a receipt to an explanation of benefits. However, regardless of the type of document, there should be three key pieces of information present in the document, including the date of the purchase, a description of the health care product or service that was purchased, and your name.
Step 4: Once the document has been submitted, it will be put under review by your employer- this is done so that the employers can make sure that the amount of allowance is not exceeded, the type of product or service purchase qualifies to be reimbursed for under MERP and that all the important information is present. If the documentation is missing anything, you may be asked to submit additional records.
Step 5: You will be reimbursed by your Employer- after reviewing to make sure all information is present and valid and everything else is in, your employer will pay you up to the amount that was required by your predetermined allowance.
