Questions an employer should ask its own advisors before offering DPC

Some questions about employer DPC belong to the employer, not to you. How the benefit fits their health plan, their tax treatment and their legal paperwork are for their broker, CPA and attorney. Handing them a clear list shows you know the ground and keeps you from giving advice that isn't yours to give.

Why hand over a list

Employers will ask you things like "Is this a benefit plan?" and "Do we have to offer it to everyone?" You may know part of the answer, but you aren't their advisor, and a wrong answer can cause problems for both of you. A written list of questions lets them get the right answers quickly and keeps the deal moving.

For their benefits broker

• How does DPC fit with our current health plan and plan year?
• If we have a high-deductible plan and HSAs, does the DPC arrangement meet the rules in IRS Notice 2026-5?
• Should we offer it to all employees, or to a defined group like full-time staff?
• How should we explain it to employees during open enrollment?

For their CPA

• How do we record and deduct what we pay for employees' memberships?
• If employees pay part of the fee, can that be pre-tax, and what does it mean for their HSAs?
• Does anything need to be reported on employees' W-2s?

For their attorney or benefits counsel

• Is our DPC offering part of a group health plan, and what plan documents and notices does that require?
• Do continuation coverage rules apply when an employee leaves?
• Are there state rules on DPC that affect how we offer it?
• What should our contract with the practice say about privacy, termination and payment?

What you can answer

You can answer questions about your practice: what the membership includes, your fees, how enrollment and billing work, and what you'll report. Keep those answers in writing and consistent. The proposal outline covers them.

Protect yourself too

Your own healthcare attorney should review your employer contract and how you describe the membership. Your materials should match the law where you practice.

What I'd do this week

• Copy these questions onto a one-page handout with your practice name.
• Add a line saying you are not giving legal or tax advice.
• Ask your attorney to review the handout and your contract template.

Common questions

Won't a list of legal questions scare the employer off?
It shows you've done this before and you aren't hiding anything.

Can I recommend a broker or attorney?
Yes, if you know good ones. Make clear the choice is theirs.

Should I answer if I know the answer?
Answer about your own practice. For their plan, tax and legal questions, point them to their advisors.