Why Home Care Caregivers Pick One Agency's Shifts Over Yours
At $17.21 an hour, a caregiver builds her week out of whatever shifts she can stack. Yours is one of two or three rosters she is on. She is not weighing agencies, she is deciding which text to answer first on a Tuesday morning, and the one she answers has something the other two do not. Wage is not it. Everyone in your county pays the same.
Open the job boards in your county. Three agencies, sometimes five, posting the same shifts in nearly the same wording at a rate within a dollar of yours. Your caregivers have seen all of them, and a few are working two of those rosters in the same week you are trying to cover Saturday.
Nationally, 5.4 percent of employed Americans held more than one job in August 2026, the highest reading in the current run of that series, and the median home health and personal care aide earns $35,800 a year. A part-time schedule does not fill a week. Stacking agencies is how the week gets filled.
None of this is disloyalty. A caregiver on three rosters is doing arithmetic. The shift she takes first comes from the agency that gave her a reason to answer.
My caregivers are part-time. Doesn't that rule this out?
No. The thirty-hour threshold is a group health carrier rule, not tax law. A Section 125 election is open to any W-2 employee and hours do not enter into it, which is why an agency built on twenty-hour schedules can run one at all.
Almost nobody at your size does. Among small firms that offer health coverage, 18 percent extend it to part-time workers, per KFF's 2025 employer survey. The other agencies on her phone sit in the 82 percent. More on the mechanics in health benefits for part-time caregivers.
I ran the numbers on a raise and closed the spreadsheet
You costed the obvious version. Two dollars an hour on a thirty-hour caregiver is $3,120, and employer FICA at 7.65 percent carries it to $3,359 a year, which becomes $134,360 across a roster of forty. That is the margin, so the spreadsheet closed.
A Section 125 wellness plan funds from somewhere else. It redirects employer payroll tax you are already remitting into benefits your caregivers can use, so it does not need new money.
The structure has been in the tax code since 1978. CBIZ wrote the CPA opinion and HitesmanLaw the legal assurance, both on the compliance page.
What she is actually comparing
| What she weighs | The other agencies on her phone | Yours, running a wellness plan |
|---|---|---|
| Hourly rate | $16 to $18 | $16 to $18 |
| Hours offered | Partial week | Partial week |
| Health coverage as a part-timer | None | Included, no hours test |
| Generic prescriptions | Retail price | No cost at the counter |
| Counseling by phone | None | Included |
Rate and hours look identical everywhere. Flexible hours moved to 28.2 percent in HHAeXchange's 2025 survey of more than 8,200 caregivers, up from 23.8 percent a year earlier, and the rest of what caregivers name costs money you do not have. The agency covering the household is the one whose shift gets taken. That pattern runs through retention without raising wages too.
Where this does not help
Benefits do not fix a schedule. If she stops answering because a call went unreturned at six on a Sunday morning, or because a client was a bad match and nobody moved her off it, a wellness plan changes none of that. It also only reaches caregivers who enroll, and the employer side of the arithmetic comes from participants, so an agency that mentions the plan once in a break room email collects less than the math on paper suggests.
What would this look like at your agency?
Two numbers answer it. How many caregivers you run, and roughly what they earn. That is the whole ask and it stays that small deliberately, because nobody should have to hand over paperwork to a stranger just to see a first figure.
The estimator takes those two inputs and shows what you currently pay in employer payroll tax, what turnover at the industry median is costing you, and what could be redirected into caregiver benefits instead. Thirty seconds. No signup.
UnifyWell's published example nets an employer roughly $640 per participating employee per year on a $44,000 earner, after the monthly administration fee. Caregiver wages sit below that. Across Home Care Wellness's own proposals the figure has landed between $300 and $900 per participating employee per year, a range rather than a quote. Which of your caregivers qualify, and what reaches their check, only your own numbers answer. Have your CPA read the plan documents.
Open the estimator
Two inputs, thirty seconds. See what your agency already pays in employer payroll tax and what could go to your caregivers instead.
Open the estimatorFree. No signup, and no documents to send.
Home Care Wellness is not a law firm, an accounting firm or an insurance carrier, and a Section 125 wellness plan is not health insurance. Figures shown are estimates based on published examples and prior proposals, not guarantees. Actual results depend on wages, participation and plan design. Tax and legal conclusions cited are those of CBIZ and HitesmanLaw. Speak with your own CPA or counsel before adopting any plan.
