Start by naming the problem you are solving
Employers usually describe one goal — "we want to offer healthcare" — but underneath it there are three separate problems: protecting employees from a financially catastrophic event, giving employees access to routine care so small issues do not become absences, and staying competitive when hiring. Different tools solve different ones, and buying the wrong tool for your actual problem is how benefit budgets get wasted.
| Option | What it solves | What it does not solve |
|---|---|---|
| Group health insurance | Catastrophic and specialist costs | Access, wait times, day-to-day convenience |
| Primary care membership | Everyday access and continuity | Hospitalization, surgery, emergencies |
| Reimbursement arrangement (e.g. ICHRA) | Letting employees choose their own plan | Simplicity; employees must shop and decide |
| Untaxed cash raise | Nothing specific, but it is honest | Any healthcare-specific outcome |
Where a primary care membership fits
A membership gives every covered employee a named provider, 24/7 virtual access and included in-person primary care. For an employer, the appeal is that the cost is a fixed monthly number per person and there is no claims process to administer. For an employee, the appeal is that using it does not involve a deductible calculation.
It does not replace insurance, and any vendor telling you otherwise is misleading you. See the full breakdown of pricing on Employer Plans, and the mechanics of the care model in how direct primary care works.
The combination most small teams land on
Cover the catastrophic risk
Either a lean group plan or support for employees carrying individual coverage. This is the part membership cannot do.
Cover the everyday layer
A primary care membership so nobody delays a sick visit or a refill because of cost or a two-week wait.
Make it easy to use
One phone number, one provider, no prior authorisation for the routine layer. Utilisation is the whole point.
Presence does not sell insurance and does not give tax or benefits-compliance advice. Confirm how any arrangement interacts with your existing plan and payroll treatment with your broker or accountant.