Better benefits without a bigger budget, and a reason to stay.

A dental or medical practice competes for good clinical people against every other practice in the metro, and cannot always answer with a raise. Optiv Advantage gives assistants, hygienists, and front-office staff a measurable increase in take-home pay without a raise. It adds real coverage they can actually use, the kind most small practices never offer. And the practice funds all of it by recovering payroll tax it was already overpaying on every payroll run, so none of it lands as a new expense.

Book a Practice Discovery Call

$5 a week to over $100 a month

added take-home for the employee

No copay, no deductible

virtual care for the employee and family

Up to $957

employer recovery per enrolled employee per year

Competing for good people when you cannot always raise pay

Every practice in the area is chasing the same assistants, hygienists, and front-office staff, and the reason they most often give for leaving is pay that has not kept pace with the cost of living. A practice cannot always answer that with a higher wage. What it can do is put more money in the same paycheck and offer coverage most small practices do not, so a competing offer of a few dollars an hour stops being enough to pull good people away. Turnover is the consequence when it does not, and in a clinical setting that consequence is steep. A vacant seat stops production the practice can never bill back.

Pay that lags the cost of living is the top reason clinical and front-office staff leave. More take-home in the same paycheck speaks to it directly.

Most small practices offer limited or no supplemental coverage, so there is real room to stand out to a candidate weighing two offers.

When retention slips, the cost is unusually steep. A single open dental assistant role puts more than $21,000 of production at risk over its vacancy, on top of recruiting and onboarding spend.

What makes good clinical staff choose you, and stay

Assistants and front-office staff weigh two things when they compare offers: what lands in the paycheck and what the coverage actually does for them. Most small practices offer little on either front, so a practice that offers more take-home and real coverage stands out before the candidate ever walks in. The same two things keep the people already on the team from taking the next call from a recruiter. Recruiting and retention are the same lever pulled at two moments, and there is a fuller recruiting playbook for practices in the resources below.

A measurable take-home increase gives a candidate a concrete reason to choose you, and a current employee a reason to stay put.

Real coverage most small practices skip, virtual care at no copay for the whole family, signals the practice values the people who care for patients all day.

The recruiting edge and the retention edge come from the same benefit. See the recruiting playbook for practices at /resources/recruiting.

How Optiv Advantage works for a practice

Optiv Advantage uses a Section 125 structure, which means qualifying benefit premiums come out of pay before payroll tax is calculated. That lowers the wage base the practice and the team member are both taxed on. Here is where the saving becomes concrete, and how it reaches your bank account. Each pay period, whoever runs payroll drops your payroll report into a calculation engine we provide. The engine returns an updated payroll with the benefits already calculated, and it flags new hires and terminations so people are added to or removed from the plan and enrollment outreach starts on its own. Because each team member's qualifying premium is now taken out before tax, the wage base is lower, so the FICA you deposit with that payroll is smaller. You keep the difference. It is not a rebate you wait for and not a check that arrives later. It is simply a smaller FICA deposit on the very next run, which means the cash stays in your account instead of leaving it. That drop-in step is what calculates your reduced FICA each cycle. It adds about five minutes and five clicks, and everything after the drop is handled for you. That is what we mean when we say we do the work. Coverage is provided by an A-rated, state-licensed insurance carrier. Implementation and the full mechanics are covered on the How It Works page.

WORKED EXAMPLE

Take one team member who elects pre-tax premium under the plan. The practice calculates its FICA deposit on that team member's wages after the premium is taken out, not before. The result is a smaller FICA deposit for that team member on the very next payroll, and up to $957 less over the year. Across a full roster of enrolled team members, that recovery adds up to real money the practice keeps each year. The figure is illustrative. The exact amount is modeled to each practice's census and depends on participation and election levels.

What the math looks like across your workforce

Modeled on a 100-employee practice at the industry turnover rate, with a conservative reduction in line with what meaningful financial benefit programs are associated with in retention research. The turnover figures are industry data and are cited below. The Optiv savings are shown as a range. The exact figure is modeled to your census in a gated proposal.

Without Optiv Advantage

turnover at the industry rate — replacement cost spread across recruiting, onboarding, training, and lost production — no payroll tax recovered.

With Optiv Advantage

fewer replacements as retention improves — plus recovered payroll tax on every participating dollar.

Net annual value for a 100-employee practice

a range combining recovered payroll tax and reduced turnover cost — exact figure modeled to your census.

Turnover figures are industry data, cited below. Optiv savings reflect program averages and are modeled to each practice's census. Individual results vary. A 5 to 20% turnover reduction is consistent with documented outcomes when employers add meaningful financial benefit programs.

What the team member actually receives

The plan is built to be felt in the first paycheck and the first time a team member needs care. It pairs a measurable take-home increase with coverage this workforce rarely gets. Virtual Urgent Care connects the team member and family to a board-certified physician around the clock, usually in under 15 minutes, and Virtual Primary Care gives them a dedicated PCP, both with no copay and no deductible. Their Health Maintenance Benefit is included. Optiv Access pairs with the Advantage plan to bring entry-level virtual care to part-time and contingent team members, and its cost nets against the practice's payroll-tax recovery rather than adding an expense.

A measurable increase in take-home pay, modeled to the staff member's situation.

Virtual Urgent Care and Virtual Primary Care with no copay and no deductible, for the team member and their family.

Mental-health support through the EAP, which addresses the burnout cascade that follows every vacancy.

Supplemental accident, critical illness, and cancer coverage for staff who rarely receive it.

Work Shield workplace-misconduct resolution as a bundled bonus, resolving issues about 80% faster than the national average.

Indemnity payments are potentially taxable on the excess.

The value compounds with every clinical seat you keep filled

The payroll-tax recovery scales with the number of enrolled team members, and the turnover savings scale with how many stay. Across a 50, 100, or 250-employee practice, both move in the same direction and compound every year the plan is in place. Larger practices see larger recovery. The per-employee logic does not change.

50 employees

recovered payroll tax plus reduced turnover cost, modeled to census.

100 employees

a combined annual range, modeled to census.

250 employees

the same logic at greater scale, modeled to census.

Questions practice owners ask

Most small practices offer limited supplemental coverage and cannot always raise base pay to match a competing offer. Optiv Advantage adds more take-home pay in the same paycheck and virtual care at no copay for the whole family, which is coverage a candidate rarely sees from a practice this size. It gives you something concrete to put in front of a good assistant or hygienist without adding a benefits expense, because it is funded by recovering payroll tax you already overpay.

Yes. Because the qualifying premium comes out before payroll tax is figured, the team member is taxed on a smaller wage base, so more of the paycheck reaches them. The added take-home varies by pay and election, from as little as $5 a week to over $100 a month. We model the range against your actual roster before you decide anything.

The plan can pay a fixed cash benefit when a covered medical event happens. Those payments are potentially taxable on the excess above what a team member paid in, and the question of how the excess is treated for wage purposes is genuinely unsettled. We do not describe the benefit as free of tax. The full analysis is available in a gated white paper for practices that want to see it before enrolling.

The entire process only adds about five minutes and five clicks to your regular payroll. Each pay period, whoever runs payroll drops your payroll report into a calculation engine we provide. That returns an updated payroll with the benefits already calculated, and it flags new hires and terminations so people are added to or removed from the plan and enrollment outreach starts on its own. That same step is what figures your reduced FICA for the cycle, so the savings show up as a smaller FICA deposit on that run rather than a rebate you chase later. Everything after the drop, the benefit math, the enrollment, keeping every employee in line each cycle, is handled for you. That is what we mean when we say we do the work.

SOURCES

Dental Economics, 2025; DANB Salary and Satisfaction Survey. Dental assistant turnover near 28% annually; hygienists near 18%.
ADA Health Policy Institute. About 62% of dentists identify staffing as their top business concern; administrative turnover of 25 to 35%.
DANB, Financial Impact of Dental Assistants on the Dental Practice. Average at-risk revenue of more than $21,000 over the vacancy of a single dental assistant role.
ADA and U.S. Bureau of Labor Statistics wage data. Hygienist median $47.16 per hour; assistant median $23.11 per hour.
U.S. Bureau of Labor Statistics, Job Openings and Labor Turnover Survey, Table 20 (released March 2026), health care and social assistance.
Optiv Advantage program data. Employer FICA recovery of up to $957 per enrolled employee per year; employee take-home increase varies from as little as $5 a week to over $100 a month.

Know your numbers, before you make the call

The plan is engineered. The math is yours. Calculated, not recommended.

Schedule your employer ROI analysis

The Optiv Group helps employers evaluate tax-advantaged benefits strategies, payroll-linked savings opportunities, and modern coverage paths with compliance-aware plan design.

Book My Savings Analysis