Do Home Care Caregivers Actually Use the Benefits You Offer?
Two thirds of American adults take a prescription drug right now. That is your answer. A Section 125 wellness plan hands a caregiver medication at the pharmacy counter, a doctor on the phone at eleven at night, and a counselor who picks up. The need was already there. Low utilization belongs to a different kind of benefit.
Open your scheduling software and read last month's call-outs.
Not the no-shows. The ones where a caregiver called at six in the morning because a child woke with a fever, or because she was headed for an urgent care waiting room, or because a refill she could not pay for ran out. Count them.
Most owners read that list as a staffing problem. It is also a usage forecast, and the money ones are the tell.
Nobody set this up badly. Call-outs live in operations and benefits live in a folder nobody opens, so the two numbers never land on the same page in anyone's week.
Your call-out log already tells you who would use this.
Which benefits get used first?
Pharmacy, then virtual care, then counseling. Need sets the order. KFF's health tracking poll in March found 66 percent of adults currently take at least one prescription drug, and about one in five have cut pills in half or skipped doses over cost. An April 2025 survey of 2,500 adults put care skipped or postponed over price at 38 percent.
Understanding is the thin part. EBRI's 2025 workplace wellness survey, fielded to 1,401 workers last summer, found that only three in ten say they understand their employer's health benefits extremely well. The gap is in the explaining.
| Benefit | The moment it gets used | Cost to the caregiver |
|---|---|---|
| Free generic medications | The next refill at CVS or Walmart | $0 |
| Virtual urgent care, 24/7 | A fever at nine on a Sunday | $0 |
| Virtual primary care | A condition that needs following | $0 |
| Licensed phone counseling | A stretch that is genuinely hard | $0 |
| Annual wellness physical | Once a year, preventive | $0 |
Pharmacy moves first, and what that benefit covers is worth ten minutes.
What using it looks like on a Sunday
Denise works three days a week for two agencies. She picks up a Saturday when she can. Her daughter is fourteen. Strep comes around once a winter, and last time it started on a Sunday, so Denise waited until Monday, took the morning off, and paid at the front desk.
With the plan she opens an app Sunday night, sees a doctor within minutes, and the antibiotic is waiting at the Walmart counter at no cost.
She did not use a benefit. She fixed a Sunday.
Composite example, not an actual member.
You costed a raise, not this
Two dollars an hour on a thirty-hour caregiver runs $3,120 a year, and FICA at 7.65 percent puts the real number at $3,359, which across forty caregivers is $134,360. That is the margin. No wonder the spreadsheet closed.
This one funds differently. The employer payroll tax already leaving the business every pay period is what pays for it, which is why the net employer cost lands close to zero. CBIZ wrote the CPA opinion, HitesmanLaw the legal assurance, and the legitimacy question has its own page.
My caregivers are part-time, so they would not qualify
Thirty hours is a group carrier's rule. It is not tax law. A Section 125 election is open to any W-2 employee regardless of how many hours she works, which is why this reaches a roster that group health never will. Part-time is the normal case here. What part-time caregivers can actually get lays the alternatives side by side.
Where this does go unused
This does fail sometimes. A plan handed out as a PDF on someone's first day gets ignored. If enrollment is a link in an onboarding email and nobody sits with a caregiver to show her the medication search, she will not find it, and you pay a fee for a card in a drawer.
Ask any vendor how enrollment runs and who does the sitting.
What would this look like at your agency?
Two inputs answer it: how many caregivers you run, and roughly what they earn. That is the whole ask. The estimator takes those two numbers and shows what your agency pays in employer payroll tax now, what turnover at the industry median costs you, and how much of the first could be redirected into caregiver benefits instead.
UnifyWell's published example nets an employer roughly $640 per participating employee per year on a $44,000 earner, after the monthly administration fee, and caregiver wages sit below that. Across Home Care Wellness's own proposals it has landed between $300 and $900 per participating employee per year. That is a range, not a quote. Only your own numbers answer which caregivers qualify and what reaches their checks. Have your CPA read the plan documents.
Run your own numbers
Two inputs, thirty seconds. See what you already pay in employer payroll tax and how much of it could reach your caregivers instead.
Open the estimatorFree, no signup. Nothing to upload and nothing to send us.
Home Care Wellness is not a law firm, an accounting firm or an insurance company, and a Section 125 wellness plan is not health insurance. Figures shown are estimates and illustrations, not guarantees, and results depend on an agency's own wages, headcount and participation. A plan may also lower workers' compensation exposure in some states, which is not certain and depends on the carrier. Tax and legal statements are attributed to the named sources cited. Have your own CPA and counsel review the plan documents before adopting anything.
