
Your Questions Answered
COMPLIANCE FRAMEWORK & FAQ'S
Everything you need to know about your 360° benefits, tax savings, and health coverage.
PAYCHECK & TAXES
Understanding Your Pay
You will see new line items on your paycheck:
- Pre-Tax Deduction – Reduces your taxable income.
- Benefit Credit – Your participation incentive is applied to every paycheck after receiving your preventative health education, creating a healthier you and a healthier paycheck.
- PHP Admin Fee – Service charges applied for the administration cost of the program.
- Universal Life Insurance Premium – Funds your cash-value life insurance policy that builds long-term financial security.
Your tax savings fund the program. The Pre-Tax Deduction reduces your taxable income, lowering the amount of taxes withheld.
- Example: If you were originally paying $500 in taxes, after the plan, you might pay $350, creating a $150 savings.
- This savings covers the cost of the plan, so your net paycheck remains the same.
No, this program functions similarly to a medical expense tax write-off, except it's applied directly in your paycheck. In fact, by reducing your taxable gross income, you may owe less in taxes and could potentially lower your tax bracket.
If you have other write-offs or medical expenses, speak with your tax professional for more details.
This program is a medical tax write-off, reducing your taxable income.
- If you typically overpay taxes to receive a refund, your refund may be slightly lower.
- If you claim dependents or other deductions, your refund could remain unchanged or even increase
When Oaceus 360 first appears on your paycheck, you may notice several new line items. Here’s what’s happening:
- A Section 125 pre-tax deduction — this reduces the income used to calculate certain payroll taxes.
- The costs associated with your Oaceus benefits, including your Preventive Health Plan and Universal Life insurance.
- A benefit credit added back to your paycheck as a reward for participating in the plan.
There are several transactions happening, which can make the paycheck look confusing at first. The important thing to understand is that for qualified employees, the program is designed so the benefits are funded through tax savings rather than creating an out-of-pocket cost. That’s why we encourage you to look at your final net pay — not just one individual deduction.
Still have questions? Your Oaceus Benefits Specialist can walk through your paycheck with you so you understand exactly what you’re seeing.
You can estimate your tax savings by adding the PHP Admin Fee and your Universal Life (UL) Premium together. That total represents the tax savings generated per paycheck through the program.
To estimate your annual tax savings, multiply that number by your pay schedule:
- Weekly: × 52
- Bi-Weekly: × 26
- Semi-Monthly: × 24
- Monthly: × 12
Participation in the program requires that you generate federal tax liability through payroll in order for the tax savings to fund the benefits.
If your payroll withholding changes significantly or your federal withholding becomes $0, it may impact eligibility because tax savings would no longer be generated.
If this occurs, our team will review your eligibility and contact you with available options.
No. The tax advantage is applied directly through payroll using Section 125 rules. Your W-2 already reflects the adjustment, so there are no additional tax forms required.
The deduction is the mechanism that creates the tax savings. By redirecting income before taxes, your taxable wages are lowered, which generates the savings used to fund the benefits.
COVERAGE & BENEFITS
What's Included
No. Your primary health insurance remains the same. The Preventative Health Plan is a supplemental benefit that offers additional preventative health services, helping to prevent disease and promote health.
- Many benefits extend to family members at no additional cost. You can add up to 7 family members.
- Spouses and children living in your home can access services like mental health counseling, virtual urgent care, and telemedicine.
Go to portal.oaceus.com and follow the login prompts.
Coming soon: Downloadable version on the Apple Store and Google Play Store.
The 360 PHP is available to be self-funded after you leave your employer. Speak with the Oaceus Enrollment Department for more details.
Medical Weight Management consultations ($249.99/month) cover your clinical program: medication, coaching, and 24/7 care from your care team.
The following resources are available separately and are not part of your Medical Weight Management consultations:
- Educational Resources
- Nutrition & Dietary Coaching
- Sleep Optimization Guidance
- Hydration Guidance
You can access these additional resources at any time through the “Message a Specialist” tab in your member portal.
LIFE INSURANCE
Your Policy Details
No, this policy is guaranteed issue. There are no medical exams and no pre-existing condition restrictions.
Life insurance coverage amounts vary because policies are based on several underwriting factors. While we can provide general examples, individual policies are determined based on:
- The premium generated through tax savings
- Age
- Sex / mortality risk factors
For example, if $100 per month in premium is generated through tax savings:
- A 20-year-old female might receive approximately $75,000–$100,000 in coverage.
- A 56-year-old male might receive approximately $25,000–$35,000 in coverage.
Life insurance carriers typically activate online portals within 45–60 days after the policy has been issued.
Once the portal is active, you will be able to:
- View your policy details
- Designate or update beneficiaries
- Review policy values
- Access carrier documents
Your Universal Life policy provides a death benefit designed to financially protect the people you care about. Depending on your policy, age, available coverage, and Transamerica’s requirements, you may have options to request an increase in your death benefit.
Additional coverage isn’t automatically guaranteed and may require additional information or underwriting. Increasing your coverage may also increase the premium you’re responsible for — typically as an additional out-of-pocket premium beyond what your tax savings fund.
Your Oaceus Benefits Specialist can help you understand your current coverage and direct you to the appropriate next steps with Transamerica. Life changes — it’s a good idea to periodically review whether your coverage still meets your needs.
A rider is an additional benefit or feature that may be added to a life insurance policy. Depending on your Universal Life policy and the options available through Transamerica, certain riders may provide additional protection beyond your base coverage.
Not every rider is available to every policyholder, and adding a rider may require additional underwriting, approval, or an additional premium. That’s why it’s important to review your individual policy before making a change.
If you’re interested in adding additional protection, contact your Oaceus Benefits Specialist. We can help you understand your existing coverage and connect you with the appropriate resources to determine what options may be available.
Death claims are handled directly by Transamerica. As the beneficiary or authorized representative, here is how to begin:
- Download the Death Claim Form and the instructions for completing it.
- Contact Transamerica at 800-797-2643 to report the claim.
- Complete the claim form and return it with the supporting documentation Transamerica requests.
- Transamerica will communicate directly with the appropriate authorized individual, because claims involve private policy and personal information.
Your Oaceus Benefits Specialist can help guide you to the right resources, but Transamerica makes all claim determinations based on the terms of the policy.
Having these items ready before contacting Transamerica will help the claim move as smoothly as possible:
- The insured’s full name and policy number, if known
- A certified copy of the death certificate
- The beneficiary’s identification and contact information
- The completed Transamerica claim form
- Any additional documentation Transamerica requests for the specific claim
Transamerica will confirm exactly what is required for your claim when you contact them at 800-797-2643.
Life insurance isn’t necessarily something that can only be used after you die — your policy’s living benefits may allow access to benefits during your lifetime under the conditions described in your policy.
- Contact Transamerica at 800-797-2643 to request the living benefit claim forms for your policy.
- As the insured, you may need to provide medical and other documentation required by the policy.
- Return the completed forms and documentation as Transamerica instructs.
Your Oaceus Benefits Specialist can help you get started, and Transamerica makes all claim determinations based on the terms of the policy.
Your Universal Life policy may build cash value over time. Depending on the value available in your policy and the terms of your coverage, you may have options to access some of that value through a withdrawal or policy loan.
- Log into your Transamerica policyholder account or call 800-797-2643 to review your current policy values and available options.
- Request the loan or withdrawal paperwork for your policy and follow Transamerica’s instructions.
Before taking money from your policy, make sure you understand the potential impact: loans and withdrawals can reduce your policy’s cash value and death benefit and may have other policy or tax consequences. Decisions involving withdrawals or loans should be reviewed directly with Transamerica and, when appropriate, your financial or tax professional.
Your beneficiary is the person — or people — you designate to receive your life insurance benefit. Keeping this information current is extremely important.
- Log into your Transamerica policyholder account at secure2.transamerica.com/login and locate your beneficiary information.
- Review who’s currently listed and make any updates according to Transamerica’s instructions.
- Have identifying information ready for anyone you’re adding before you begin.
Life changes — marriages, divorces, births, and other family changes are all good reasons to review your beneficiary designation. Don’t assume it’s already correct; take a few minutes to check it today.
When your policy has a valid beneficiary designation on file, the death benefit is generally paid directly to your named beneficiary by Transamerica — outside of your estate and without going through the probate court process.
If no valid beneficiary is on file (or no named beneficiary survives you), the benefit may instead be paid to your estate. Assets that pass through an estate typically go through probate, which can add significant time, court involvement, and expense before your loved ones receive anything.
This is why keeping your beneficiary designation current matters so much: it is the simplest way to make sure the benefit reaches the people you intend, as quickly as possible. Oaceus does not provide legal advice — for questions about your estate plan, consult a licensed attorney.
PARTICIPATION
Staying Healthy
No — participation is voluntary. Qualified employees receive information about the program and a 30-day period to review their benefits and decide whether they want to participate, with opportunities to ask questions or complete an opt-out during that window (see the Opt-Out & Enrollment section below).
If you do participate, the after-tax benefit credit on your paycheck is a reward for participating in the plan’s health education — it's very easy and takes minimal effort on your part.
You will receive a preventative health education that is created special for you and diagnostic in nature. As you become more aware of how to minimize health risks for you and your family, your participation will reflect in your healthier outcome.
OPT-OUT & ENROLLMENT
Managing Your Participation
Employees have an initial 30-day enrollment window to review the program and make a decision. If you choose to opt out within this period:
- Your participation will be cancelled
- There will be no changes to your paycheck, as payroll changes are not implemented until after this review window
- No additional documentation is required
To opt out during the first 30 days, complete the Opt-Out SRA Form.
After the initial 30-day enrollment period, the program becomes part of the employer's benefit plan administration. At this point, opting out requires a Qualifying Life Event (QLE).
Examples of a QLE may include:
- Marriage or divorce
- Birth or adoption of a child
- Gain or loss of other coverage
- Change in employment status (hours reduced, job ended, new position)
- Change in residence or address
- Change in dependent eligibility
To opt out after 30 days:
- Complete the QLE Opt-Out Form
- Upload supporting documentation for your Qualifying Life Event
If you do not have documentation, you must have your HR department complete and sign the QLE Verification Form and upload the signed form to the QLE Opt-Out Form.
If you opt out after the enrollment window:
- Payroll deductions and tax savings will stop
- Your Universal Life Insurance policy remains yours (portable)
You will have the option to:
- Continue the policy by paying premiums directly to the insurance carrier (previously funded through tax-advantaged savings)
- Allow the policy to lapse according to the policy terms (you have 120 days to set up premium payments)
Yes. During the annual anniversary period, employees may opt out without needing a Qualifying Life Event (QLE). No QLE or documentation is required during this time.
Complete the Opt-Out SRA Form to opt out during the anniversary period.
No. Employees who have previously opted out will not be automatically re-enrolled during the anniversary open enrollment period. Once you opt out, you will remain opted out unless you take action to re-enroll.
You may opt back in at any time by completing the Opt-In SRA Form. Once submitted and approved, the program will be added back into your payroll structure based on eligibility.
GENERAL
Good to Know
Yes. The Oaceus 360 program is an employer-sponsored benefit administered through your employer’s Section 125 cafeteria plan, with preventive medical benefits provided under the employer-sponsored health plan provisions of the Internal Revenue Code (Sections 105 and 106). It uses the same pre-tax payroll principles as other familiar benefits, such as 401(k) contributions and health insurance premiums.
The plan structure has been reviewed by tax professionals and legal counsel to ensure compliance with federal and state regulations, and all enrollment changes are administered under IRS rules governing Section 125 plans.
Tax Savings Mechanism – Works like a 401(k) pre-tax deduction, reducing taxable wages and lowering Federal, State, Social Security, and Medicare taxes.
Tax-Free Cash Value Growth – Your life insurance cash value grows tax-free and can be accessed tax-free if structured properly.
Social Security Impact – The reduction in taxable wages has a minimal impact on Social Security benefits.
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