Small Business/Employers
Why DPC is Attractive for Small Businesses
Cost control
Employers pay a predictable monthly membership (typically $50–$100 per employee) instead of only relying on expensive premiums.
Prevention = savings
Unlimited visits, chronic condition management, and urgent care keep issues from becoming costly claims.
Employee satisfaction & retention
24/7 access to a personal physician, longer visits, and no copays boost morale.
Regulatory fit
DPC by itself isn’t ACA-compliant, but pairing it with the right insurance plan provides full coverage.
How to Pair DPC with Coverage for Big Medical Needs
DPC covers most everyday care (about 80–90% of employee health needs). Combine it with one of these options:
| Option | How It Works | Pros | Considerations |
|---|---|---|---|
|
A. High Deductible Health Plan (HDHP) + DPC |
Employees use DPC for routine needs; HDHP covers hospital/surgery/specialty. |
Meets ACA requirements, HSA-compatible. |
Deductibles apply for major care. |
|
B. Health Sharing + DPC |
DPC handles basics; sharing ministry/association spreads risk for big events. |
Often cheaper than group insurance. |
Not ACA-qualified; gaps possible. |
|
C. Minimum Essential Coverage (MEC) + DPC + Catastrophic/Stop-loss |
MEC satisfies ACA; DPC gives unlimited doctor access; catastrophic plan handles hospitalizations. |
Affordable, layered protection. |
More moving parts; employees must understand limits. |
|
D. QSEHRA + DPC |
Employer funds tax-free allowance; employees buy individual coverage + use DPC. |
Flexible, scalable. |
Employees manage their own plan selection. |
Sample Plan for a Small Business
| Component | Approx. Monthly Cost (per employee) |
|---|---|
|
Direct Primary Care membership |
$75 |
|
HDHP Bronze plan (catastrophic) |
$300–$400 |
|
Optional HSA employer contribution |
$50–$100 |
|
Estimated Total |
$400–$500 |
Employees receive:
Unlimited primary care (no copays, fast access)
Protection for hospitalizations, specialists, emergencies
A lower total cost than traditional small-group plans (often $700–$900)
Savings & Business Value
Lower premiums
Reduced claims
Early, convenient care = fewer ER/urgent visits → lower renewals.
Tax advantages
Insurance premiums, HSA contributions, and many DPC fees are deductible business expenses.
Retention & productivity
Employees get better access to care, miss less work, and appreciate the benefit.
What’s Changing in 2026 – “Big Beautiful Bill”
Starting January 1, 2026:
Having a DPC membership no longer disqualifies employees from contributing to an HSA.
DPC memberships become HSA-eligible medical expenses (up to $150/month individual, $300/month family, indexed annually).
Bronze and Catastrophic ACA marketplace plans will qualify for HSA contributions.
✅ Employers can fund HSAs; employees can pay for DPC memberships tax-free within the new limits.
Bottom Line
With Direct Primary Care as the foundation, small businesses can offer:
Unlimited doctor access for routine & preventive care
Catastrophic protection for major events
New HSA tax advantages (starting 2026)
—all at a price well below traditional health insurance alone.