Employee benefits for home health agencies,made easy.
65% of U.S. home health agencies 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.
Home health at a glance
Offering benefits at a home health agency
Aides in high demand, part-time schedules, and Medicaid rules that count benefits as pay. Here’s what shapes a benefits plan for a home health agency.
- of U.S. home health agencies have fewer than 20 employees
- 65%
- openings a year projected for home health and personal care aides, 2025–2035
- 760,500
Source: BLS Occupational Outlook Handbook: home health and personal care aides
- average weekly hours in home health care services in 2025
- 28.4
Source: BLS Current Employment Statistics: home health care services, 2025
Medicaid counts benefits as pay
A federal rule for Medicaid waiver home care requires providers to spend 80% of those payments on direct-care workers’ compensation, and compensation includes health, dental, life, and disability benefits. States have until six years after July 9, 2024 to comply.
Source: 42 CFR 441.302(k)
Affordability and Marketplace subsidies
If an employee’s share of the lowest-cost self-only plan is under 9.96% of household income in 2026 and the plan meets minimum standards, that offer ends their eligibility for Marketplace subsidies. With aides’ median pay at $35,800, it’s worth setting contributions carefully.
Sources: IRS Rev. Proc. 2025-25; BLS Occupational Outlook Handbook: home health and personal care aides
The 30-hour line
Part-time work is common for aides. A SHOP marketplace plan has to be offered to employees averaging 30 or more hours a week, but part-timers’ hours still count toward the 50-employee test.
Sources: BLS Occupational Outlook Handbook: home health and personal care aides; HealthCare.gov: who qualifies for SHOP; IRS: applicable large employers
How part-timers count toward 50
To see whether you’re near 50, add part-timers’ monthly hours (up to 120 per person) and divide by 120. Forty full-time employees plus 20 people working 60 hours a month comes to 50.
Source: IRS: employer shared responsibility questions and answers
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 agency owners ask.
Federal rules treat an employee who averages 30 or more hours a week, or 130 a month, as full time. A SHOP marketplace plan has to be offered to every full-time employee but not to part-time staff. We’ll help you set eligibility that fits your team.
Tell us about your agency.
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?