A PEO for a home health agency with 100 employees

What pricing looks like at 100 employees

At 100 employees, the employer can seek serious direct-market benefits, workers compensation, ASO, and PEO proposals. Percentage pricing can become expensive for a high-payroll workforce, so convert every administrative quote to an annual amount and PEPM equivalent.

High frequency comp risk: patient lifting and transfer injuries, plus vehicle exposure between visits. Carriers price this class carefully, and PEO master policies vary widely on appetite for it.

Your leverage

Require full cost and plan transparency, a named implementation team, service-level commitments, data-export terms, and a responsibility matrix. The decision is large enough to justify contract review and reference checks tied to the same states and industry.

When a PEO is the wrong answer at this size

A company with competitive direct insurance, concentrated operations, and capable internal HR may prefer an ASO or separate vendors. A multi-state company may still value a PEO, so compare actual scope and risk rather than assuming headcount dictates the structure.

Fit depends heavily on whether the PEO will quote the caregiver duties and loss history at workable terms, and whether its payroll can demonstrate travel-time and overtime calculations. Compare the result with home-care payroll and a direct workers compensation program before choosing the bundle.

What a home health agency should ask every PEO

• The FLSA home care rule makes most caregivers overtime-eligible, and compensable travel time between client homes must be captured separately from commuting time.
• Caregiver turnover and per-visit or hourly pay structures create constant payroll churn.
• Medicaid and managed-care reimbursement rates squeeze margins, so every dollar of comp premium and admin fee is scrutinized.
• Background checks, credential tracking, and state-specific caregiver registries need systematic tracking.

Most agencies want an affordable base health option to aid recruiting without triggering costs the reimbursement rates cannot support. Ask PEOs about minimum-value plan options priced for hourly workforces.

Common questions

Do PEOs accept home health agencies?

Provider and carrier appetite varies by caregiver duties, states, payroll, loss history, transportation exposure, and credential controls. Ask how many current home-care clients the contracting entity serves, then require a written underwriting indication before spending time on benefits and software demos.

Can a PEO handle per-visit pay and mileage?

Good ones can, but verify it in the demo, not the sales call. Ask to see per-visit pay, overtime on blended rates, and mileage reimbursement processed in their actual payroll system before you sign.

Different team size?