Cash in Lieu of Wage Parity Benefits: 5 Reason NOT To

In a complicated business, the cash vs. benefits decision doesn’t have to be complicated, too.

Since the Home Care Worker Wage Parity Act of 2011, New York home health care agencies must pay a minimum base pay of $15 an hour to home health care workers plus an additional $3 – $4.09, depending on location. Agencies can choose whether to pay the additional amount in employer benefits or wages.

Some agencies struggle with the decision. Paying in wage parity benefits is a program unto itself and takes time and attention. Most businesses need to hire a third party company to manage those benefits. Cash benefits for employees may, therefore, seem easier and cheaper. 

But Shaya Sternhill, Melody’s Head of Marketing and Business Development, explains that reality is just the opposite.


Here’s why giving cash in lieu of benefits is almost never a good idea:

1. Wage parity benefits save agencies money on taxes

It’s simple math, says Shaya. 

Every dollar you pay your employees is subject to payroll taxes, such as FICA, worker’s comp, unemployment taxes, and more. Average total cost is 15%. 

Those taxes apply to wage parity cash benefits, too. In NYC, for example, if you’re paying your home health care workers in cash only, that’s $19.09 per hour. ($15 base pay + $4.09 wage parity.) The bottom line is you’ll be paying approximately $2.86 an hour in payroll taxes— a whopping15% of $19.09.

Most wage parity benefits, however, aren’t taxed. Going back to our NYC example, let’s say you’re paying $15 per hour in cash and $4.09 in medical, dental, and dependent care benefits. In this case, you’d only pay the 15% taxes on the $15 base.

Your net savings? $.61 per hour. That doesn’t sound like much, but when you multiply 61 cents by an annual average of 1560 hours, you save $951.60 per employee per year!

Net savings for a 1000-employee agency paying wage parity benefits can be close to $1,000,000 annually!

Multiply $951.60 by 100 or even 1000 employees, and your savings reach 5 or 6 digits.


2. Benefits are better for cash flow

Building on point #1, Shaya adds that offering benefits does more than save you money. Benefits can directly impact your cash flow, too.

How? Your aides work this week and get paid at the end of next week. In other words, you need enough positive cash flow to pay wages weekly or bi-weekly. 

Unfortunately, your agency doesn’t get reimbursed that quickly. Many agencies work with multiple MLTC (Managed Long Term Care) systems to pay them. Agencies often have to wait for their payments, creating a crunch when they need to pay their employees more quickly and more often.

Wage parity benefits break this cycle because they are paid out once a month. “Reducing your weekly cash wages responsibility gives your agency breathing room,” says Shaya. 


3. Cash in lieu of benefits costs you more in overtime

Once again, some basic arithmetic shows the benefits of benefits.

An HHA who works more than 40 hours a week is entitled to overtime pay at time and a half. Looking at an NYC example again, if an agency pays aides the full $19.09 in cash, time and a half is $28.64.

But wage parity benefits aren’t subject to overtime regulations. So if an agency pays $15 cash and $4.09 in benefits, only the $15 is multiplied. The total overtime pay adds up to only $26.59.

That’s a $2.05 savings per overtime hour. And we saw in the previous examples that the savings multiply quickly.

As Shaya says, “Paying overtime is a killer for home health care agencies.” Paying wage parity in benefits can help contain the ballooning cost of overtime.


4. Taking care of your employees is good for your business

Consider these available wage parity benefits:

  • Phone
  • Transit
  • Dependent care
  • Education
  • Medical and pharmacy
  • Dental
  • Vision
  • 401k
  • Supplemental insurance
  • Life insurance


Giving wage parity benefits is giving essential benefits to your employees.

Employees without phone service can miss important agency calls. Without money for transit, they can’t come to work. Aides without proper health insurance may take more sick leave. Moms without childcare—you get the idea.

Employees getting wage parity benefits have the tools to succeed at work. By setting up your HHAs with benefits, you set up your business for success, too.


5. Employees like wage parity benefits

Shaya explains that aides like wage parity benefits for a few reasons:

  1. They need the benefits. (See #4 above.)
  2. Benefits are pre-tax, so they don’t add to an employee’s reportable income. HHAs may be on the edge of qualifying for Medicaid, food stamps, and other government programs. These programs are income based so reporting less income may be highly beneficial to your aides.
  3. Employees in a slightly higher tax bracket, will save on taxes since the benefits are pre-tax.


Keeping your employees happy is always good for business. High retention and engagement rates save an agency time and money. They give you a competitive edge in an industry plagued with record-breaking churn rates.

Melody Benefits’ clients enjoy a 90% average employee retention rate.

Staying compliant does more than keep you from incurring penalties. It offers the opportunity to take care of your employees, building loyalty and engagement.

And THAT’s the secret to an agency surviving—and thriving—in an ever-evolving industry.

Discover how 27+ home health care agencies are already maximizing savings and keeping employees satisfied with Melody Benefits.