ProcessWorks, Inc.
P. O. Box 2490
Brookfield, Wisconsin 53008-2490
www.processworksinc.com
Section 105 Medical Reimbursement Plan (MRP)
Standard Plan Design Options
Employees are reimbursed for: (1) any eligible Internal Revenue Code 213 expense, or (2) health plan deductible expenses
only, or (3) specific types of health related expenses up to an allowable maximum amount each plan year.
Plan Design Options
Option 1: All Internal Revenue Code 213 Expenses
The employer provides an MRP contribution for each eligible employee for reimbursement of expenses as defined by Code
213. Eligible expenses include things not covered by insurance, such as deductibles, patient’s responsibility of co-insurance
and co-payment amounts, office visits, prescription drugs, physicals, clinic visits, lab work, hospital stays, dental expenses,
eye exams, eye glasses, contact lenses, chiropractic services, over-the-counter drugs and medicines, etc.
Option 2: Deductible Reimbursement Only
The employer provides an MRP contribution for each employee who is enrolled in the company sponsored health plan.
Eligible expenses covered under the deductible portion of the employer’s health insurance plan qualify for reimbursement
under this option.
Option 3: Specific Medical Expense(s)
The employer provides an MRP contribution for each eligible employee for reimbursement of a certain category of expenses.
Examples of categories include dental only, vision only, prescription drugs only, etc. Any and all expenses under the specific
category must be eligible for reimbursement. Example: all dental expenses are eligible, not limited to specified procedures
such as teeth cleanings or braces or a percentage for certain types of dental expenses, etc. A combination of categories is not
eligible under this option.
Option 1, 2 and 3 allow expenses incurred by the employee, employee’s spouse and dependent children to qualify for
reimbursement. MRP contributions may be based on a flat dollar amount for each eligible employee, or different amounts
may be provided for employee only, employee + 1, employee + 2 or more, etc. The employer can mandate the employee be
responsible for a certain portion of his or her medical related expenses. The MRP can reimburse from first dollar expense or
only after the employee (and/or family members) have met a certain level of expenses.
Implementation and Renewal
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Implementation
- Coordination of Plan Parameters
- Plan Policy
- Adoption Resolution
Annual nondiscrimination testing (if required)
Update Plan Policy as necessary for inclusion of governmental regulatory
changes
Newsletters and bulletins on regulatory changes and other newsworthy items
Customer Care Center support for questions on plan parameters, Plan Policy,
legislative changes and nondiscrimination testing
Employee Census Information – annual plan set-up and data input. Customer
Care Representatives are available during regular business hours (CST) to
answer questions. Employee information is submitted via a census
spreadsheet template provided by ProcessWorks.
Eligible Employees
Under 101
101 –
500
501 – 1,000
1,001 – 5,000
5,001 – 10,000
10,001 – 20,000
20,001 plus
First Year
$ 300
$ 550
$ 750
$1,050
$1,350
$1,650
$2,150
Eligible Employees
Under 101
101 –
500
501 – 1,000
1,001 – 5,000
5,001 – 10,000
10,001 – 20,000
20,001 plus
Renewal Fee
$ 250
$ 400
$ 600
$ 750
$1,150
$1,350
$1,650
Recordkeeping and Administration
Employee Services
 Daily claims processing
 Weekly claims reimbursement frequency
 Choice of submitting claims by mail or fax
 Toll-free fax claims submission
 Short two-business day turnaround for claims processing
 Employee choice of direct deposit or paper check reimbursements
 Direct deposit advices via e-mail or mailed to employees’ homes
(postage included)
 Paper checks mailed to employees’ homes (postage included)
 24/7 employee account access via Internet
 Automatic e-mail notification of claims receipt or reimbursements
 Detailed explanation of benefits with each reimbursement
 Toll-free Customer Care Center support
Employer Services
 Internet access to view participant account information
 On-demand reports via Internet
 Check register e-mailed or faxed weekly
 No check minimum (unless requested by employer)
 Check and deposit advice stock included
 Toll-free Customer Care Center support
 Paper submission of new hires, terminations, and other life event changes
 Electronic transfer of funds for payment of administration invoices
Fee: $4.50/participant/month
Monthly minimums:
Under 21 eligible employees - $50
21-50 eligible employees - $75
51 or more eligible employees - $100
The above represents the minimum
monthly recordkeeping and
administration fees ProcessWorks
must receive.
Note: When an employer has an FSA
and MRP plan administered by
ProcessWorks, it is likely that some
employees will participate in both plans.
The standard recordkeeping and
administration fee will apply to
employees who participate in one plan.
If an employee participates in the second
plan, an additional fee of $2.00 per
participant per month will apply.
Additionally, the monthly minimum for
the second plan is 50% of the first plan.
Optional Services and Fees
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Debit Card – Employees with the debit card can also obtain one additional
spouse/dependent debit card free of charge. Additional spouse/dependent
cards are available for a one-time $5 fee for each card. Replacement cards
are $5 for each reissuance. These fees are the responsibility of the employee
and are payable by personal check.
$1.50/month/cardholder
Debit card services are available for MRPs that reimburse any Internal
Revenue Code 213 expense, provided the MRP is the first level of
reimbursement with no employee cost share prior to MRP benefits. The
debit card is not available for any other type of MRP plan design.
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Preparation of signature-ready Form 5500 and Summary Annual Report
(if required).
$150
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Direct mail of fourth quarter participant account balance notification
statements to employees’ homes (no charge if statements are sent to
employer for distribution).
$.25/statement plus postage
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Amendments to current Plan Policy.
$100/amendment
All prices provided are based on a one year Service Agreement and are valid for a period of 60 days from the proposal date.
ProcessWorks may bill for services rendered after written acceptance of this proposal should acceptance be cancelled prior to
execution of a Service Agreement. Because of the unique nature of this information, we encourage you to share the contents
with your legal counsel, finance office or business advisor. Consider this information proprietary. We request that your
company not divulge any part of this information to representatives from other benefit-related firms.
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