Employee benefits for counseling and behavioral health practices,made easy.
95% of U.S. mental health practices have fewer than 20 employees.
You want great benefits for your team. You don’t have the time or the resources to get them.
That isn’t on you. For decades, the benefits industry has been built for big companies, and small businesses have been left to figure it out alone. Cakewalk was built for you.
How it works
You run your business. We handle the benefits.
Tell us about your business.
Start with your business name. We fill in what we can find. Connect payroll and your team comes with it.
Hundreds of options. One tailored package.
We compare hundreds of plans for your team. You get one package, priced and ready to adjust.
We get your team covered.
We invite your team. You see who has started. Each person gets help choosing. Everyone is covered.
Benefits admin. Off your plate.
New hires and departures sync from payroll. Each employee gets a benefits wallet. Their questions come to us, not you.
Your benefits team. On the house.
You pay for coverage. Insurance carriers pay us a commission, so we can handle everything from building your package to supporting your team year round, at no cost to you.
Behavioral health at a glance
Offering benefits at a counseling practice
Growing demand, part-time clinicians, and contract therapists. Here’s what shapes a benefits plan for a counseling or behavioral health practice.
- of U.S. mental health practices have fewer than 20 employees
- 95%
- projected growth for substance abuse, behavioral disorder, and mental health counselors, 2025–2035
- 18%
- average weekly hours at mental health practitioners’ offices in 2025
- 27.5
Source: BLS Current Employment Statistics: offices of mental health practitioners, 2025
Contract therapists
Whether a contract therapist is really an employee follows the IRS’s common-law test (behavioral, financial, and relationship factors), and offering insurance is evidence of employment. Form SS-8 gets an official ruling.
Mental health coverage is included
Small group plans that aren’t grandfathered must cover mental health and substance use disorder services, including behavioral health treatment.
Source: CMS: essential health benefits
The 30-hour line
Part-time work is common for counselors. Federal rules treat 30 or more hours a week as full time, and a SHOP marketplace plan has to be offered to full-time employees but not to part-time staff.
Sources: BLS Occupational Outlook Handbook: substance abuse, behavioral disorder, and mental health counselors; IRS: identifying full-time employees; HealthCare.gov: who qualifies for SHOP
If you own the business through an S corporation
Premiums for an owner with more than 2% of an S corporation are deductible by the company and reported as wages on the owner’s W-2, but they aren’t subject to Social Security or Medicare tax. The owner may then be able to deduct them personally.
Source: IRS: S corporation compensation and medical insurance
Benefits are your choice under 50
Employers with fewer than 50 full-time employees, counting full-time equivalents, aren’t subject to the federal requirement to offer coverage. Offering benefits is a decision you make for your team, not a mandate.
Source: IRS: applicable large employers
The small business tax credit
The federal credit can cover up to 50% of premiums for employers with fewer than 25 full-time equivalent employees and average wages under $68,200 in 2026, if you pay at least half of employee-only premiums and buy through the SHOP marketplace. Owners and their families don’t count toward the totals. SHOP plans aren’t offered everywhere, so check your state’s guide.
The whole benefits package.
Medical, dental, vision, life insurance, and income protection. Built around your business and the people who power it.
Start with your team’s needs and your business’s budget. Explore medical coverage online, or work with a benefits advisor to understand your options and choose your next step.
Questions practice owners ask.
A group plan covers employees, generally the people you pay on a W-2. Independent contractors buy their own coverage, through the Marketplace for example. Whether someone is a contractor follows the IRS’s common-law test.
Tell us about your practice.
We’ll follow up to learn about your business and walk you through your options. There’s no cost to work with us.
Prefer to start on your own?