Attracting and retaining staff for your practice has never been more challenging.  There are fewer potential staff members to hire, and those looking to work are being offered higher salaries and more comprehensive benefit packages from your competitors; especially those practices owned by large corporations and private equity.

Most offices do offer retirement plans for their staff.  In our most recent benchmarking survey, more than 90% of the practices in our sample offered either a SIMPLE IRA, Safe-Harbor 401k, or some other version of a retirement plan.  We posted a summary of the most popular plans at: Retirement Plan Options Available for Small Businesses and Self-Employed Individuals.

As part of our benchmarking report, we also ask our clients whether they offer health insurance to their staff.  When we gathered this data in January 2023, we discovered that six out of ten practices provided this employee benefit.  For the 40% of practices that didn’t offer health insurance, the primary reason was that all of their staff were covered under their spouse’s insurance. But many also mentioned to us that they are starting to get more inquiries from job candidates as well as from existing staff about having their practice provide some level of health insurance.

Practice owners who want to add a health insurance benefit have a few options. The old-fashioned way is to purchase a group health insurance policy, pay premiums for staff who are otherwise uninsured, and withhold a pre-established portion of those premiums from each participant’s salary.

A few years ago, the government instituted a simpler option called an ICHRA (Individual Coverage Health Reimbursement Arrangement) that allows a practice owner to provide a monthly stipend to their staff to cover a portion of the cost of the health insurance they purchase personally.  The stipend is tax deductible to the practice and tax-free to the staff.  If you decide to offer an ICHRA, you need to make the benefit available to all your staff who work the minimum required hours that you set, and also establish one rate for single individuals and a second for those who need a family plan.

Here’s the good news.  The Dept of Labor (DOL) has provided templates you can use to create and maintain an ICHRA for your practice available at: individual-coverage-model-attestation.pdf (