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Healthcare
Financial management and accounting solutions for healthcare businesses
Optometry Practice Bookkeeping: Medical vs. Vision Billing, Inventory, and Practice-Value KPIs
Independent optometry practices earn from five distinct profit centers — routine vision plans, medical insurance, frames, lenses, and contact lenses — each with different margins and billing pathways. This guide shows how to build a chart of accounts that separates VSP/EyeMed routine revenue from medical billing, capitalize frame inventory, treat contact lens supplies as deferred revenue under ASC 606, and surface the KPIs (revenue per exam, optical capture rate, normalized EBITDA) that lenders and acquirers ask about.
VEBAs Explained: How Employers Pre-Fund Tax-Free Welfare Benefits
A VEBA is a Section 501(c)(9) trust that lets employers pre-fund tax-free health and welfare benefits, but Sections 419 and 419A cap the deduction and Section 4976 imposes a 100% excise tax on reversions. Here is how a legitimate plan differs from an IRS-listed tax shelter.
Section 105(h): The Self-Insured Health Plan Rule That Can Quietly Tax Your Best People
Section 105(h) requires self-insured health plans, including ICHRAs and HRAs, to pass an eligibility test and a benefits test each year. Fail, and a portion of a highly compensated individual's reimbursements becomes taxable W-2 income — calculated as the excess reimbursement.
Section 119 Meals and Lodging for the Convenience of the Employer: How Hospitality, Hospital, and Caretaker Employers Keep On-Premises Housing and Cafeteria Meals Out of Wages
Section 119 lets employers exclude on-premises meals and required-residence lodging from employee wages, with no FICA and no income tax withholding. This guide walks through the convenience-of-the-employer test, the "more than half" safe harbor, qualified campus lodging, the Kowalski cash rule, and what the 2026 Section 274(o) deduction sunset does and does not change.
Section 119: How Employers Give Workers Tax-Free Meals and Housing on the Business Premises
Section 119 lets employers furnish meals and lodging tax-free when they are on the business premises and for the employer's convenience — and lodging must also be a condition of employment. Qualifying value is also excluded from FICA and FUTA wages.
ABLE Accounts in 2026: How Section 529A Lets People With Disabilities Save $19,000 a Year Tax-Free Without Losing SSI or Medicaid
A 2026 guide to ABLE accounts under IRC Section 529A — the new age-46 eligibility cutoff that makes 6 million more Americans (including 1 million veterans) eligible, the $19,000 annual contribution cap, the $100,000 SSI shelter, the unlimited Medicaid shelter, qualified disability expenses, the ABLE to Work multiplier up to $34,650, and how to avoid Medicaid clawback at death.
Form 1095-C and Section 4980H: 2026 ACA Employer Penalties and Safe Harbors
For 2026, ALEs face a $3,340 per-employee 4980H(a) penalty and a $5,010 per-employee 4980H(b) penalty, with affordability set at 9.96 percent of pay. This guide covers the FPL, W-2, and rate-of-pay safe harbors, line-by-line Form 1095-C coding, and the errors that drive Letter 226-J assessments.
Form 8889 in 2026: HSA Reporting Without Triggering the 6%, 10%, or 20% Penalty
A 2026 walkthrough of Form 8889 — HSA contribution limits ($4,400 self-only, $8,750 family), the triple tax advantage, the last-month rule's 13-month testing period, the Medicare six-month retroactive enrollment trap, and the six most common filing mistakes that trigger the 6% excess-contribution excise tax, 10% recapture, or 20% non-qualified-distribution penalty.
HSA vs FSA vs HRA in 2026: Stack a Limited-Purpose FSA With Your HSA and Beat the Use-It-or-Lose-It Trap
2026 rules for HSAs, FSAs, and HRAs — contribution limits, who owns each account, when each one wins, how to stack a Limited-Purpose FSA with an HSA without breaking eligibility, and how employees and employers avoid forfeitures.
HSA vs FSA vs HRA in 2026: The Practical Playbook for Picking, Stacking, and Not Forfeiting Your Health Dollars
A 2026 walk-through of HSA, FSA, and HRA rules with the new contribution limits, the limited-purpose FSA stack that adds up to $7,800 of pre-tax room, and how small employers can use ICHRA and QSEHRA to compete with corporate benefits.
Section 4960: The 21% Excise Tax on Nonprofit Executive Pay After OBBBA's 2026 Expansion
Section 4960 imposes a 21% excise tax when a tax-exempt organization pays a covered employee more than $1 million. The 2025 OBBBA expansion redefines "covered employee" as anyone employed since 2017, widening the tax base for hospitals, universities, and foundations filing Form 4720 in 2026.
Section 7702B Long-Term Care Insurance: Deduct Premiums, Trade Old Policies, and Keep the Estate Intact
Section 7702B defines tax-qualified long-term care insurance — age-indexed premium deductions up to $6,200 per person in 2026, tax-free benefits under the per diem cap, Section 1035 exchanges from old life or annuity contracts, and hybrid life-LTC structures for aging owners and retirees.