r/Nanny•
RambunctiousCat

Healthcare stipend

Advice Needed

VHCOL city.

What are other HNW households doing for their nannies regarding health insurance come January when the ACA credits expire?

We currently pay our nanny a $350 healthcare stipend each month on top of her regular hourly rate (all on the books). All-in she makes about 85K yearly pre-tax (plus bonuses which we pay off the books) and has nobody else in her household, so I believe she will not qualify for any credits any longer.

Should we raise her healthcare stipend? If so, by how much? We also previously just paid out the stipend as regular W2 income on each paycheck rather than through a QSEHRA. Do any families/nannies out there use a QSEHRA and is it worth it?

Posted Dec 29, 2025, 6:33 PM UTC

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