Franchise Operator Guide · Visiting Angels · Last reviewed May 2026

Section 125 for Visiting Angels Franchise Operators

By David Newman · Referral Partner, Section 125 Savings · San Pedro, CA

Caregiver wages $26-34K — exactly in range. Every caregiver gets $72/month automatically.

Typical Visiting Angels operator profile: 30-200 W-2 employees per location · $26K-$34K salary range

Visiting Angels franchisees run W-2 caregiver workforces in the 30-200+ range, with caregiver wages typically falling in the $26K-$34K band — the sweet spot for Section 125 eligibility. The retention pitch writes itself: every caregiver gets approximately $72 more per paycheck automatically, plus 24/7 telemedicine, 400+ free generic medications, and dental savings — at zero out-of-pocket cost to them or to you.

Affinity Hospice (multi-state) is the closest case study. Their CFO is a CPA who commissioned the CBIZ Advisors LLC review himself before enrolling. Reported annual savings: $140K+. The same structure applies to home-care franchise operators with similar W-2 caregiver workforces.

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Minimum 10 W-2 employees  ·  $25K+ salary  ·  ACA-compliant health coverage required
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IRS Section 125 — Federal Law Since 1978
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How it works for Visiting Angels operators

On a 75-caregiver Visiting Angels franchise, Section 125 Preventive Care delivers $51,120/year in net employer FICA savings (75 × $681.60) plus an estimated $27,000/year in Workers' Comp reduction at the home-health 5% rate (conservative half-rate model). Combined: $78,000+/year. Plus 75 caregivers each take home an additional $863/year ($65,000 of additional employee compensation, at zero net employer cost).

The retention math compounds: in home-care, average annual turnover is 60-90% per CMS reporting. Even modest reductions in turnover (1-2 caregivers per quarter) save the franchise $10,000+ in recruiting and training costs per saved hire. The ~$72/paycheck raise + wellness benefits package is one of the most cited retention factors by franchisees who've enrolled.

Want to model your specific footprint? Use the Multi-Location Calculator → for combined savings across all your Visiting Angels locations.

Closest case study analog: Affinity Hospice

CBIZ conducted rigorous vetting and issued a letter determining that the plan qualifies as a cafeteria plan meeting the requirements of IRC Section 125.

Ariel Joudai, CPA, CFO, Affinity Hospice, Affinity Hospice
Read the full Affinity Hospice case study →
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Skepticism is the right response. We don't ask you to take our word for it — we bring institutional proof that convinced CPAs, CFOs, attorneys, and insurance brokers to enroll their own companies.

Darcy L. Hitesman, J.D.

HitesmanLaw P.A. · Minneapolis, MN

35+ years as an Employee Benefits attorney specializing in IRC Section 125, ERISA, HIPAA, and the ACA. Her May 5, 2025 opinion letter concludes: “In this firm's opinion, the Program described satisfies applicable IRS requirements.”

She specifically reviewed the IRS Chief Counsel Advice memoranda on "double-dip" arrangements — the exact schemes the IRS has flagged — and concluded this program is built differently and compliantly.

Named a Super Lawyer every year since 2000. AV-rated (highest possible rating) in Martindale-Hubbell since 1998.
Co-author: ERISA Compliance for Health & Welfare Plans (Thomson Reuters/EBIA) — the national compliance standard manual since 1999.
Member, Technical Advisory Group — Employers Council on Flexible Compensation. She helps set the industry standards for Section 125 plans nationally.

CBIZ Advisors LLC

Top-7 U.S. Accounting Firm · Cleveland, OH · 135,000+ Clients

CBIZ independently reviewed the program against IRC §§ 125, 105, and 106, plus ERISA, ACA, and COBRA requirements. Their August 22, 2025 letter concludes: “If operated per its provisions, the Program appears to satisfy the requirements of ERISA, the ACA, and COBRA as well.”

This review was commissioned by Affinity Hospice's CEO before enrolling his nationwide organization — and the CFO (himself a CPA) shared the letter publicly in his testimonial.

Top-7 U.S. accounting firm. 10,000+ employees across 100+ offices. Serves 135,000+ clients nationally.
Review covers: IRC §125 cafeteria plan, §105/106 wellness benefit rules, ERISA plan asset treatment, ACA integration, and COBRA obligations.
$500,000 legal protection per enrolled employer · $10,000 per employee participant · Insurance-backed.
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Direct From the U.S. Government

Section 125 has been in the Internal Revenue Code since 1978. Congress wrote it there specifically to encourage employers to fund preventive healthcare for American workers. This is not a loophole — it is the precise, intended use of a 47-year-old federal law, grounded in IRS Revenue Ruling 69-154, the specific published ruling supporting the benefit payment structure.

→ Verify on IRS.gov — Section 125 Cafeteria Plans ↗
Visiting Angels Operator FAQ

Questions specific to Visiting Angels franchises

Eligibility runs on annualized W-2 earnings — part-time and PRN caregivers crossing $25K annualized qualify. The plan administrator runs an annual eligibility check. Caregivers who don't cross the threshold remain on standard payroll without participating in the Section 125 layer.
No. Section 125 is a federal payroll-tax structure operating independently from CMS Medicaid waiver clinical and billing rules. Your CMS billing, eligibility, and reimbursement processes are entirely separate and unaffected.
No — implementation is at the franchisee entity level. Each LLC enrolls separately. Your franchise agreement does not control payroll-tax structure. Visiting Angels corporate is unaffected.
First payroll cycle after go-live (typically 6-8 weeks from signed agreement). The pre-tax reduction shows up in the deduction column; the wellness reward shows up as a post-tax line item. Net take-home pay rises by ~$72/paycheck.
Eligible. Participating employees must be covered under an ACA-compliant group health plan — through your franchise OR through a spouse's employer. Spousal coverage qualifies the caregiver for participation in the Section 125 wellness layer.

Content reviewed by Virginia Fish, CPA — tax and employer benefits specialist with 10+ years in financial reporting and payroll tax strategy.

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Verified: CBIZ Advisors LLC (Aug 2025) · HitesmanLaw P.A. (May 2025)
$500K legal protection per enrolled employer · IRS Section 125 · Federal law since 1978