Every fall, it happens again.
Your insurance broker sends over the renewal numbers. Premiums are up — again. The deductibles are higher than last year. The network has changed, which means some of your employees’ doctors are no longer covered. You spend weeks trying to compare plans that all look slightly different and cost significantly more than what you’re paying now. And at the end of it, you sign on for another year of coverage that most of your employees will barely use — until they really need it, at which point they’ll discover how little it actually covers.
If you’re a small business owner, this cycle is exhausting. And for many, it’s becoming unsustainable.
We started Retro Health & Aesthetics as a direct primary care practice because we believe medicine should work differently. What we didn’t anticipate is how many small business owners would find us not because they were looking for a doctor — but because they were looking for a better answer to the benefits question.
This post is for them.
Small businesses get the worst deal in the health insurance market. That’s not an opinion — it’s structural.
Large employers have negotiating power. They can self-insure, set their own plan designs, and absorb risk across thousands of employees. Small businesses — typically defined as fewer than 50 employees — have none of that leverage. They’re buying off the shelf at retail prices, paying premiums that have increased an average of 5-7% annually for the past decade, for plans with deductibles that have climbed so high that most employees are effectively uninsured for routine care.
The result is a system where a small business owner might be spending $800-1,200 per employee per month on health insurance — and their employees still can’t get a same-day appointment, still wait weeks to see a doctor, and still face a $3,000 deductible before their insurance pays for anything meaningful.
That’s not a benefit. That’s a very expensive safety net that most people hope they never have to use.
Direct primary care (DPC) is a membership model that removes insurance from the primary care relationship entirely. Instead of billing insurance for office visits, a DPC practice charges a flat monthly membership fee — and in return, members get direct, unlimited access to their provider.
At Retro Health, that means:
For a small business, this translates to something powerful: your employees have a medical home that actually works. When something comes up — a sick kid, a medication question, a concern that would otherwise send someone to urgent care — there’s a provider they can reach the same day who knows them.
DPC membership is not health insurance. It doesn’t replace catastrophic coverage — your employees still need a plan that covers hospitalizations, specialist care, surgery, and emergency services. But when you pair a high-deductible health plan (HDHP) with a DPC membership, something significant happens.
HDHPs have dramatically lower premiums than traditional PPO or HMO plans. The tradeoff — the high deductible — becomes far less frightening when your employees have a DPC provider handling the vast majority of their healthcare needs without touching the deductible at all. Primary care visits, acute illness, chronic disease management, labs, medications — all covered by the membership, none of it hitting the deductible.
The premium savings from switching to an HDHP often more than covers the cost of DPC membership for your entire team. Many small businesses find they’re spending the same or less overall — while their employees are getting dramatically better access to care.
A recent and significant development for small business owners: the One Big Beautiful Bill Act has expanded HSA eligibility to include direct primary care memberships. This means DPC membership fees can now be paid with pre-tax HSA dollars.
For businesses offering HDHPs with HSA contribution matching, this is meaningful. The tax-advantaged dollars your employees are accumulating can now go directly toward their Retro Health membership — effectively reducing the after-tax cost of DPC for both the employer and the employee.
This is a genuine policy shift that makes the HDHP + DPC combination more financially attractive than it’s ever been.
Beyond the math, there’s a human case worth making.
The most common reason employees don’t use their health benefits isn’t the cost — it’s the friction. Getting an appointment. Taking time off work. Sitting in a waiting room. Not knowing if the visit is covered. Putting off a concern because dealing with the system feels like too much.
The result is that small problems become bigger ones. Chronic conditions go unmanaged. Preventive care gets skipped. And eventually something that could have been handled in a ten-minute conversation becomes an ER visit, a specialist referral, or a serious health event.
DPC removes that friction. When your employees can message their provider and get a response the same day — when a sick visit doesn’t require taking half a day off work — they use their healthcare. And when people use their healthcare proactively, outcomes improve and costs go down.
That’s good for your employees. It’s also good for your business.
Direct primary care as an employer benefit works best for:
It’s not the right fit for every situation — businesses with employees who require frequent specialist care, have complex chronic conditions, or are heavily dependent on specific specialist networks may find that traditional insurance serves them better. The honest answer is that it depends on your workforce and your goals, and we’re happy to talk through it.
Insurance renewal season is coming. Before you sign another year of escalating premiums for a product your employees find frustrating to use, it’s worth understanding what the alternative actually looks like.
We built Retro Health because we believe primary care should be accessible, personal, and built around the patient — not the billing code. That belief translates directly into a model that works for small business owners who want to offer something better.
We’ve put together a dedicated employer benefits page with a tax savings calculator and more detail on how the numbers work for businesses like yours.
Gregory LaFontaine, PA-C is the co-founder and Director of Men’s Health & Wellness at Retro Health & Aesthetics in Worthington, Ohio.
Dr. Bethany Recker, MD is the Medical Director and co-founder of Retro Health & Aesthetics. She practices concierge primary care and functional medicine in Worthington, Ohio.
