Reviewed by Erik Osborne, PA-C, Co-Founder | August 2026
The Quick Answer: Direct Primary Care (DPC) is a flat monthly membership that gives employees unlimited access to a primary care doctor, no copays and no claims for routine care. More than 7,200 employers now offer it as a benefit, and employer groups with DPC spend roughly 52% less on healthcare than comparable non-DPC groups [3]. Because most employer health plans renew on a January 1 plan year, August and September are exactly when this decision gets made, before open enrollment opens on November 1, 2026 [5][6].
If your renewal packet just landed, or is about to, you already know the pattern. Average family premiums for employer-sponsored coverage climbed to $26,993 this year, up 6% from 2025, and single coverage now averages $9,325 [1]. Costs have been rising faster than wages for three years running [1]. Every fall, the same conversation happens: absorb the increase, shift more of it to employees, or cut something from the plan.
There is a fourth option that more employers are quietly adding to that list: layering Direct Primary Care underneath whatever medical plan you already offer.
Why This Is a Renewal-Season Decision, Not a January Decision
Most employers with a calendar-year plan hold their own open enrollment in October or November, ahead of the ACA Marketplace’s public open enrollment window, which runs November 1 through December 15, 2026 for 2027 coverage, a shorter window than prior years [5][6]. That means whatever changes you are making to your benefits lineup for 2027 need to be decided, priced, and communicated well before your open enrollment meetings start.
DPC is not something you can bolt onto a plan two weeks before enrollment. Contracting with a local practice or a national DPC network, setting up payroll deductions or a direct employer contribution, and writing enrollment materials that explain a benefit most employees have never heard of all take lead time. August is early enough to do this properly. October is not.
What Direct Primary Care Actually Is, in Employer Terms
Direct Primary Care is a membership model where a primary care physician is paid a flat monthly fee per employee, rather than billing insurance per visit. In exchange, employees get:
- Unlimited primary care visits, with no copay
- Same-day or next-day appointments, typically 30 to 60 minutes long instead of the 7 to 10 minutes typical in a traditional practice [7]
- Direct text, call, or telehealth access to their doctor
- Chronic condition management, preventive care, and often wholesale-priced labs and prescriptions
For an employer, DPC is usually layered underneath a separate plan for catastrophic coverage, such as a group HDHP, an ICHRA, or a health sharing arrangement, not offered as a standalone replacement for major medical coverage.
The Numbers Employers Are Looking At
DPC has moved from a niche idea to a mainstream benefits conversation over the past few years. Some of the data driving that shift:
| Metric | Figure |
|---|---|
| Employers currently offering DPC | 7,200+ [3] |
| Share of all DPC memberships that are employer-sponsored | 60% [4] |
| Healthcare spend reduction for employer DPC groups vs. non-DPC groups | ~52% [3] |
| Employer retention of DPC after year one | 85% [4] |
| Employer retention at the two-year mark | 70% [4] |
| Reduction in ER visits associated with DPC access | Up to 40% [4] |
| Reduction in hospitalizations associated with DPC access | Up to 30% [4] |
The retention numbers matter as much as the cost numbers. A benefit that 85% of employers keep after the first year is not a fad; it is something employers are seeing work in practice, not just on paper.
What DPC Solves for an Employer Specifically
Cost predictability. Instead of a premium increase that varies year to year based on your group’s claims history, a DPC membership fee is flat and known in advance. It does not eliminate the need for a catastrophic coverage layer, but it removes a meaningful, volatile chunk of your healthcare spend from the unpredictable side of the ledger.
Retention and recruiting. In a job market where health benefits are one of the first things a candidate compares between offers, being able to say employees get same-day access to a doctor who actually knows them, with no copay, is a differentiated pitch, especially against employers who only offer a high-deductible plan with no primary care layer underneath it.
Fewer downstream costs. Employer groups using DPC have seen meaningfully fewer ER visits and hospitalizations, which are the costs that most damage a group’s claims experience and next year’s renewal number [4].
A lighter lift than a full plan change. Adding DPC does not require replacing your current medical plan. It can be layered on top of a group HDHP, an ICHRA, or, for smaller employers exploring alternatives to traditional group coverage, a health sharing arrangement.
Three Ways Employers Are Structuring It
- Fully employer-paid DPC, employee-paid catastrophic layer. The employer covers the flat monthly DPC fee for all enrolled employees and dependents, and employees choose their own major medical coverage separately, often through an ICHRA allowance.
- DPC plus group HDHP. The employer keeps a traditional group HDHP for catastrophic coverage and adds DPC as a supplemental, employer-funded benefit on top of it. As of January 1, 2026, DPC membership fees paid this way may also be HSA-eligible for employees, up to $150 per month for individuals and $300 per month for families, under the One Big Beautiful Bill Act [8].
- DPC plus health sharing for small groups. Some small employers, particularly those who have moved away from a traditional group plan entirely, pair employer-funded DPC with a health sharing arrangement for the catastrophic layer, at a combined cost that is often meaningfully below a traditional small-group premium.
Questions to Answer Before Your Renewal Meeting
- Is there a DPC practice, or a national DPC network, that can actually serve your employees’ location(s)?
- Will DPC replace part of your current plan, or sit alongside it as a new, separate line item?
- Do you want to fund it fully, partially, or make it voluntary and employee-paid through payroll deduction?
- How will you explain a benefit most employees have not heard of, clearly, in your open enrollment materials, without it sounding like a downgrade?
- What is the realistic timeline to have a contract signed and enrollment materials ready before your open enrollment window opens?
Frequently Asked Questions
Is Direct Primary Care a replacement for our group health plan? No. DPC covers primary care only. Employers pair it with a separate plan, such as an HDHP, ICHRA, or health sharing arrangement, for hospitalization, surgery, specialist care, and emergencies.
How much does it cost per employee? Monthly DPC fees typically range from $50 to $100 for adults, and less for children, depending on the practice and region. Employer contracts with a DPC network can sometimes negotiate volume pricing.
Can employees use HSA funds for DPC if we offer both? As of January 1, 2026, yes, up to $150 per month for individuals and $300 per month for families, as long as the employee also maintains a qualifying HDHP [8].
Is this realistic for a small business, not just a large employer? Yes. Much of the recent growth in employer-sponsored DPC has come from small and mid-size employers specifically, often as an alternative to absorbing another year of double-digit premium increases on a traditional small-group plan.
What is the timeline to add this before our 2027 plan year? If your plan year starts January 1, 2027, you want a decision made and a contract in place well before your own open enrollment period, which typically runs in October or November, ahead of the ACA Marketplace’s public window of November 1 through December 15, 2026 [5][6]. August and September are the right time to be having this conversation, not October.
Next Steps
Adding Direct Primary Care to a benefits package is a decision with a lot of moving parts: network availability, funding structure, HSA compatibility, and how it fits alongside whatever catastrophic coverage layer you already offer. It is worth modeling against your actual renewal numbers before you commit to another year of the status quo.
At Journey Health Advisors, we help employers compare DPC, ICHRA, health sharing, and traditional group coverage side by side, with no carrier bias and no pressure toward any single product. If your renewal is coming up, now is the time to have this conversation.
Speak with an advisor at Journey Health Advisors: 1 (844) 580-6055 | journeyhealthadvisors.com/contact
Related Reading:
- What Is Direct Primary Care? A Complete Guide for Individuals and Families
- DPC Plus Health Sharing: The Layered Coverage Strategy That Could Replace Your Insurance
- Health Benefits for Small and Mid-Size Employers: Smarter, More Affordable Solutions
REFERENCES
[1] KFF. “2025 Employer Health Benefits Survey.” Kaiser Family Foundation, October 2025. https://www.kff.org/health-costs/2025-employer-health-benefits-survey/
[2] KFF Health News. “Annual Family Premiums for Employer Coverage Rise 6% in 2025, Nearing $27,000.” KFF, October 2025. https://www.kff.org/health-costs/annual-family-premiums-for-employer-coverage-rise-6-in-2025-nearing-27000-with-workers-paying-6850-toward-premiums-out-of-their-paychecks/
[3] Hint Health. “2026 Direct Primary Care Trends Report.” Hint Health / Morningstar, April 2026. https://get.hint.com/direct-primary-care-trends-2026
[4] Health Compiler. “Rise of Employer-Sponsored Direct Primary Care in 2025.” Health Compiler, November 2025. https://www.healthcompiler.com/why-2025-is-the-tipping-point-for-employer-sponsored-direct-primary-care
[5] Summit Health Benefits. “Open Enrollment 2027 Deadline: ACA Dates & Employer Guide.” Summit Health Benefits, June 2026. https://www.summithealthbenefits.com/blog/open-enrollment-employer-guide
[6] healthinsurance.org. “ACA Open Enrollment Guide.” healthinsurance.org, April 2026. https://www.healthinsurance.org/open-enrollment/
[7] American Academy of Family Physicians (AAFP). “Answers to Six Common Questions About Direct Primary Care.” AAFP In Practice Blog, October 2025. https://www.aafp.org/pubs/fpm/blogs/inpractice/entry/dpc-faqs.html
[8] SALTA DIRECT. “HSA + Direct Primary Care: What the One Big Beautiful Bill Means for Patients and Employers in 2026.” SALTA DIRECT, April 2026. https://saltadirect.com/hsa-direct-primary-care-what-the-one-big-beautiful-bill-means-for-patients-and-employers-in-2026/
Journey Health Advisors | journeyhealthadvisors.com | 1 (844) 580-6055 8810 Blakeney Professional Drive, Suite 100, Charlotte, NC 28277
