074: The Payroll Tax Credit Most Business Owners Never Claim (and Their Employees Never Knew They Had)
A Section 125 wellness program lets employers lower payroll taxes by an average of about $500 per employee per year, while employees often take home $100 to $200 more each month with no change in salary. In Episode 74, Ed De La Rosa, CPA, explains how the program works alongside existing health insurance and what it means for business owners planning an exit. Most new employee benefits come with a bill. Either the owner pays for it or the employees pick up the tab. Steve Burton sits down with Scale to Sell teammate Ed De La Rosa to talk about a program built to work differently. Ed is a CPA and has been an Ed Slott trained advisor since 2019, including time serving on Ed Slott's board. He has spent years helping business owners increase company value, prepare for a sale, and reduce taxes along the way. Ed walks through how a provision tied to the Affordable Care Act, available since 2014, allows employers to pair a Section 125 cafeteria plan with a wellness program that enhances their existing major medical coverage. The payroll tax savings are realized with each payroll run rather than claimed later as a refund. Employees gain zero copays on in-network doctor visits and about 5,000 acute-care prescriptions, along with virtual care and mental health support. For owners thinking about an exit, the connection is direct. Stronger margins and steadier health care costs make a business more attractive to a buyer. Chapters 00:00 Net zero cost: the short version 00:37 Introducing Ed De La Rosa 02:36 Why a wellness program belongs in exit planning 03:00 Section 125 and the 2014 ACA provision 04:31 What it costs the employer 05:30 What employees gain in take-home pay 05:57 Does it replace health insurance? 07:05 Impact on health premiums over time 08:05 Using it without major medical: MEC and minimum value 09:35 Virtual care, mental health, and pet telehealth 11:04 How the quote process works 12:42 Which companies it works for Steve and Ed discuss: Why a wellness program belongs in an exit planning conversation How Section 125 plans and the 2014 ACA provision work together The "net zero cost" structure and why savings arrive with each payroll Average employer savings of about $500 per employee per year Why employees typically take home $100 to $200 more each month How the plan enhances major medical rather than replacing it Zero copays on in-network doctor visits and roughly 5,000 prescriptions Virtual care, mental health support, wellness tools, and telehealth visits for pets How two to three years of loss runs can help stabilize premium increases What employers with more than 50 employees need to know about MEC and minimum value How the quote process works through ADP and other major payroll providers Why companies from a handful of employees to Fortune 50 firms are using it Frequently asked questions What is a Section 125 wellness program? It pairs a Section 125 cafeteria plan with a wellness benefit. Employees pay for part of their benefits with pre-tax dollars, which lowers taxable payroll for both the employer and the employee. Does a Section 125 wellness plan replace health insurance? No. It is designed to enhance existing major medical coverage. Employees can use it for in-network doctor visits and acute-care prescriptions with zero copays, while major medical stays in place. How much can an employer save? Ed De La Rosa reports conservative average savings of about $500 per employee per year in payroll taxes. The savings are realized with each payroll run, not claimed later as a refund. How much more do employees take home? On average, employees see $100 to $200 more per month, depending on their state, income, and family size. Can a company use the program without offering major medical? Yes, but there are tradeoffs. Employers with more than 50 employees must meet ACA coverage requirements. The wellness plan meets minimum essential coverage but not minimum value, so a smaller penalty may still apply. What is needed to get a quote? Companies using ADP or another major payroll provider can authorize access to payroll data for an employee-by-employee quote. Others can provide a payroll summary as a PDF or spreadsheet. Want to see the numbers for your company? Book a discovery call at ScaletoSell.com/discovery and Ed's team will build a quote down to each employee. Resources: Book a Discovery Call: ScaletoSell.com/discovery Free Business Valuation: ScaletoSell.com/value How to Beat the IRS, Legally: [link] Episode 071: How to Beat the IRS Legally: Tax Planning Strategies for Business Owners Episode 073: How to Do a Roth Conversion Without Draining Your Retirement Savings to Pay the Tax with Ed Lyon All episodes: ScaletoSell.com/podcast Connect with Our Team: Website: Scale to Sell Email: [email protected] Phone: 757-313-4080 LinkedIn: Scale to Sell Facebook: facebook.com/ScaletoSell Instagram: @scaletosell YouTube: Scale to Sell Connect with Adam Burton and Steve Burton: LinkedIn: Adam Burton LinkedIn: Steve Burton This episode is for educational purposes only and is not tax, legal, or investment advice. Consult a qualified professional about your specific situation.