> ## Documentation Index
> Fetch the complete documentation index at: https://www.practiceownersguide.com/llms.txt
> Use this file to discover all available pages before exploring further.

# Payroll, benefits, and retirement

> Standing up payroll correctly, the benefits that matter for hiring, and the retirement plan decision with its year-end deadlines.

## Payroll

Use a payroll provider (Gusto, ADP, Paychex, or your PEO) from the first hire;
manual payroll is where tax penalties come from. Setup needs your EIN, state
withholding and unemployment accounts ([registrations](/guides/licenses-and-permits)),
workers' comp policy, and each hire's I-9 and W-4. If you took the
[S-corp election](/guides/entity-tax-basics), your own reasonable salary runs
through payroll too. Multi-entity structures run payroll per entity: clinical
staff in the PC, business staff in the MSO
([why](/guides/own-a-practice-without-a-license)).

## Benefits

In a tight clinical labor market, benefits are recruiting. Rough order of
impact: health insurance (small-group plan or an ICHRA reimbursing individual
plans), retirement with a match, PTO policy in writing, then dental/vision
and the rest. For clinicians, CE allowance, license and DEA fees, and
malpractice with clear [tail terms](/guides/malpractice-and-insurance) are
expected parts of the package.

## Retirement

| Plan                  | Fits                           | Notes                                                             |
| --------------------- | ------------------------------ | ----------------------------------------------------------------- |
| SEP IRA               | Solo or owner-only early years | Easy, but contributions scale to staff equally once you have them |
| SIMPLE IRA            | Small teams, low cost          | Lower limits; cheap match rules                                   |
| 401(k) safe harbor    | The standard practice plan     | Owner maxes contributions; mandatory match buys out of testing    |
| Cash balance + 401(k) | High-income owners late-career | Six-figure deductible contributions; actuary required             |

Deadlines matter: a new 401(k) generally must exist by year-end (safe harbor
setups have fall deadlines) to shelter that year's income. Put the decision
on the calendar in Q3, not December.

## Related

* [Hiring: W-2 vs. 1099](/guides/hiring-w2-vs-1099)
* [PC vs. PLLC, and the S-corp election](/guides/entity-tax-basics)
* [Malpractice and business insurance](/guides/malpractice-and-insurance)
* [Bookkeeping and the tax calendar](/guides/bookkeeping-and-tax-calendar)