For Insurance Brokers

Section 125 for Insurance Brokers — How to Offer It Without Taking on Plan Administration

You introduce. The operator runs implementation. Your appointments and E&O coverage stay exactly as they are. Recurring referral compensation as long as the client is enrolled. This is the playbook for adding Section 125 to your renewal conversations without changing how you operate.

IRS Section 125 — Federal Law Since 1978
No New Insurance Required
No Changes to Current Benefits
ACA · ERISA · COBRA · HIPAA Compliant
Live in 30–60 Days

The model in one paragraph

Section 125 of the Internal Revenue Code (IRC § 125) lets employers offer pre-tax benefits without the participating dollars counting as taxable wages. The Preventive Care variant we work with goes further — it includes a HIPAA-compliant participatory wellness program that lets a portion of the structured pre-tax reduction return to the employee's paycheck as a post-tax wellness reward. The net effect: the employer saves $681.60/W-2-employee/year in FICA after fees, and the employee's take-home pay rises by ~$72/paycheck — all without changing gross wages, insurance carriers, or any benefits relationship the broker already manages.

Why your clients should hear about this from you

Most business owners have never heard of Section 125 Preventive Care plans. The few who have either heard a confused version of it, or were pitched a non-compliant double-dip variant and ruled it out. They're not going to seek this out. The introduction has to come from someone they trust — and that's you.

The structural argument: when a competitor quote-shops your client's WC at renewal and undercuts your premium, you have a counter — “before you switch carriers, run this Section 125 number; the savings dwarf the premium difference.” The client books the free analysis, gets the exact number, and your renewal holds. You've added a structurally non-shoppable layer to the account.

The compliance stack that makes this safe to introduce

The program is supported by an 8-page formal legal opinion from HitesmanLaw P.A.— Darcy L. Hitesman, a Super Lawyer-rated ERISA attorney with 35+ years in IRC § 125 practice and a co-author of the national ERISA compliance manual (Thomson Reuters / EBIA). Her May 2025 opinion concludes the program satisfies applicable IRS requirements and specifically addresses the IRS Chief Counsel Advice memoranda on “double-dip” arrangements.

Independently, CBIZ Advisors LLC— a top-7 U.S. accounting firm with 135,000+ clients — reviewed the program in August 2025 and confirmed compliance with IRC §§ 125, 105, 106, ERISA, ACA, and COBRA. CBIZ's review was commissioned by a multi-state hospice CFO (himself a CPA) before enrolling his organization.

Backstop: $500,000 of insurance-backed legal protection per enrolled employer, plus $10,000 per employee participant. The protection covers IRS audit defense costs and attorney fees. It exists because the operator stands behind the structure financially — not as a substitute for client-side due diligence.

→ Full compliance authority page (CBIZ + Hitesman + IRS Rev. Rul. 69-154)

The referral compensation model

Brokers earn a recurring per-W-2-employee fee, paid monthly as long as the referred client is enrolled. The exact rate scales with referral volume and your existing book size — discussed individually on the broker intro call, not published publicly. For the economics to be meaningful, the practical floor is around 25-employee accounts; for accounts with 100+ employees, the math is substantial.

You don't handle billing, payroll integration, employee enrollment, nondiscrimination testing, or carrier relationships. The plan administrator does all of that. Your role is limited to the introduction and staying in the loop on milestones.

The four-step playbook

  1. Run the client's numbers in the WC Reduction Calculator. You enter their current WC premium, employee count, and industry. The calculator returns a Year-1 reduction estimate plus the FICA savings layer.
  2. Generate the branded client one-pager.Enter the client's name and your firm. Download a one-page PDF that you can send the same day. The PDF carries the client's specific numbers + Hitesman/CBIZ citations + David Newman's contact for the free 15-minute analysis call.
  3. Mention it in passing during a renewal or planning conversation. Keep it short — Section 125 reduces FICA + WC, verified by Hitesman + CBIZ, the math is in the PDF I just sent. Done.
  4. Client books the free analysis.15 minutes with the tax specialist. Free, no obligation. You're notified. The operator handles implementation if the client moves forward. You earn referral compensation while the client is enrolled.

Common objections (and the actual answers)

“The IRS has flagged double-dip wellness plans.”

Correct — and Hitesman specifically reviewed those CCA memoranda and concluded this program is structured differently. The Preventive Care variant uses a real HIPAA-compliant wellness program with real benefits flowing through a licensed indemnity carrier — not a fabricated benefit pretext. IRS Rev. Rul. 69-154, Situation 3 is the specific published authority supporting the payment-flow mechanics.

“Why hasn't my client's CPA mentioned this?”

Knowing about Section 125 and being able to operate one are different things. CPAs don't draft plan documents, build wellness platforms, hold carrier relationships, or carry the audit-defense backing. Most CPAs will confirm the structure when shown the Hitesman opinion and CBIZ review — but they won't proactively go build it.

“Sounds too good to be true.”

Three sophisticated due-diligence buyers in our case studies disagree: Brandon Zora at Black Tiger Transportation (CEO and CPA who reviewed the IRS code himself), Dan Salceda at Golden Living (a practicing attorney who reviewed the tax codes himself), and Jason Adelman at Avant-garde (a multi-unit owner who is also an insurance broker). Each independently verified before enrolling. Combined annual savings across those three: ~$510K.

Ready to walk through your client portfolio? Book the 15-minute broker intro call → · Download the toolkit →

Legal & Accounting Proof

Verified by the Best in the Country

Skepticism is the right response. We don't ask you to take our word for it — we bring institutional proof that convinced CPAs, CFOs, attorneys, and insurance brokers to enroll their own companies.

Darcy L. Hitesman, J.D.

HitesmanLaw P.A. · Minneapolis, MN

35+ years as an Employee Benefits attorney specializing in IRC Section 125, ERISA, HIPAA, and the ACA. Her May 5, 2025 opinion letter concludes: “In this firm's opinion, the Program described satisfies applicable IRS requirements.”

She specifically reviewed the IRS Chief Counsel Advice memoranda on "double-dip" arrangements — the exact schemes the IRS has flagged — and concluded this program is built differently and compliantly.

Named a Super Lawyer every year since 2000. AV-rated (highest possible rating) in Martindale-Hubbell since 1998.
Co-author: ERISA Compliance for Health & Welfare Plans (Thomson Reuters/EBIA) — the national compliance standard manual since 1999.
Member, Technical Advisory Group — Employers Council on Flexible Compensation. She helps set the industry standards for Section 125 plans nationally.

CBIZ Advisors LLC

Top-7 U.S. Accounting Firm · Cleveland, OH · 135,000+ Clients

CBIZ independently reviewed the program against IRC §§ 125, 105, and 106, plus ERISA, ACA, and COBRA requirements. Their August 22, 2025 letter concludes: “If operated per its provisions, the Program appears to satisfy the requirements of ERISA, the ACA, and COBRA as well.”

This review was commissioned by Affinity Hospice's CEO before enrolling his nationwide organization — and the CFO (himself a CPA) shared the letter publicly in his testimonial.

Top-7 U.S. accounting firm. 10,000+ employees across 100+ offices. Serves 135,000+ clients nationally.
Review covers: IRC §125 cafeteria plan, §105/106 wellness benefit rules, ERISA plan asset treatment, ACA integration, and COBRA obligations.
$500,000 legal protection per enrolled employer · $10,000 per employee participant · Insurance-backed.
🏛️

Direct From the U.S. Government

Section 125 has been in the Internal Revenue Code since 1978. Congress wrote it there specifically to encourage employers to fund preventive healthcare for American workers. This is not a loophole — it is the precise, intended use of a 47-year-old federal law, grounded in IRS Revenue Ruling 69-154, the specific published ruling supporting the benefit payment structure.

→ Verify on IRS.gov — Section 125 Cafeteria Plans ↗
Broker Questions

Section 125 for brokers — direct answers

No — your role is limited to the warm introduction. The plan administrator (a separate entity, with its own E&O coverage) handles the actual plan documentation, nondiscrimination testing, and ongoing compliance. The program also carries $500,000 of insurance-backed legal protection per enrolled employer, plus $10,000 per employee participant. Most broker E&O carriers categorize "introducing a plan administrator" as a non-covered activity (because it isn't insurance) — review your policy with your broker.
Cleanly. Section 125 is a payroll-tax structure layered on top of group health insurance. Your client's existing health insurance carrier, your appointment with that carrier, and the commission you earn on it are unaffected. Section 125 adds a separate referral compensation stream from a separate operator.
Yes. Many brokers prefer to introduce the program by phone, then dial the operator into a follow-up Zoom or conference call with the client. The operator handles the technical questions; you stay the relationship lead. This is the standard pattern for high-stakes accounts.
10 W-2 employees is the program minimum. The economics start working for you at around 25 employees — that's where the per-employee referral compensation begins to be meaningful at the client level. For accounts with 50+ employees, the math is significant.
HSAs and FSAs are pre-tax-only structures that the employee funds. They reduce the employee's taxable income but don't create employer FICA savings on the participating dollars (because the dollars never become wages). Section 125 Preventive Care is structurally different: it creates a structured pre-tax salary reduction funding a wellness program, which generates direct employer FICA savings of $681.60/employee/year and additional WC base reduction. HSAs/FSAs and this Section 125 structure can coexist with no conflict.
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Verified: CBIZ Advisors LLC (Aug 2025) · HitesmanLaw P.A. (May 2025)
$500K legal protection per enrolled employer · IRS Section 125 · Federal law since 1978