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ComplianceMarch 31, 20268 min read

SIMERP Compliance: Understanding IRS, HIPAA, and ERISA Requirements

A comprehensive look at the regulatory framework behind the Self-Insured Medical Expense Reimbursement Program and why compliance-conscious executives trust it.

SIMERP Compliance: Understanding IRS, HIPAA, and ERISA Requirements

For any executive evaluating a tax savings strategy, compliance is the first question—and rightfully so. The Self-Insured Medical Expense Reimbursement Program is built on a foundation of well-established federal tax law and regulatory standards.


The IRS Framework


SIMERP operates under several interconnected sections of the Internal Revenue Code:


  • IRC §105(b): Authorizes the exclusion of amounts received by employees through employer-provided accident and health plans
  • IRC §106(a): Establishes that employer contributions to accident and health plans are not included in employee gross income
  • IRC §125: Governs Cafeteria Plans, allowing employees to choose between taxable compensation and qualifying nontaxable benefits
  • IRC §213(d): Defines qualifying medical expenses
  • Treas. Reg. §1.105-11(i): Provides specific guidance on self-insured medical reimbursement plans
  • IRC §104(a)(3): Covers amounts received through accident and health insurance for personal injuries

    • These are not novel interpretations or aggressive tax positions. They are established provisions that have been in the tax code for decades.


    HIPAA Compliance


    The Health Insurance Portability and Accountability Act requires that all health-related programs protect employee medical information. SIMERP and the associated Revive Health platform maintain full HIPAA compliance, including:


  • Secure data handling and storage
  • Limited access to protected health information
  • Regular compliance audits

    • ERISA Compliance


    As an employer-sponsored benefit plan, SIMERP adheres to the Employee Retirement Income Security Act, including:


  • Plan document requirements
  • Summary plan descriptions
  • Fiduciary responsibilities
  • Reporting and disclosure obligations

    • ADA Compliance


    The program maintains compliance with the Americans with Disabilities Act, ensuring accessible design and equitable benefit delivery across the workforce.


    The Legal Protection Plan


    Every SIMERP implementation includes a Legal Protection Plan. This means the program comes backed by legal review and documentation that protects employers in the event of any regulatory inquiry.


    The Bottom Line for Compliance Officers


    SIMERP is not a gray area strategy. It is a clearly defined, well-documented arrangement under existing federal law. Companies that implement it do so with confidence that every dollar saved is fully compliant.

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