In order to ensure maximum compliance with the federal regulations governing the MERP, employers set up an arrangement with a third-party provider to facilitate the MERP.
An employer in Texas is currently paying very high premiums to offer a US$ 1,000 deductible plan to their employees.
After learning about the MERP Plan from the DEBS experts, they decided to buy a $5,000 deductible plan, but still offer the $1,000 to their employees; The employer will be funding the difference between the employee deductible to the purchased plan deductible, $4,000.
Sophie Gonzalez, an employee of the company, has a surgery that costs $5,000. As she is covered under the $5,000 deductible plan, her responsibility towards the payment would be $1,000. On receiving the bill from the insurance company, she sends it to the DEBS representative in her office. Once the claim is processed, she receives a reimbursement of $4,000, as she is responsible for the remaining US$ 1,000. She uses the reimbursement plus her contribution to pay the bill to the healthcare provider.