A husband-wife business or a corporation with family employees might want to investigate TASC. TASC is a company that can set up a cafeteria plan for small businesses similar to the kind of plans large companies use. Utilizing their service a small business can write off health insurance expenses, medical expenses, long-term care expenses, etc. pre-tax. The annual cost is very low, but all you have to do is keep records, and at the end of year submit a summary of the records to TASC for review. A typical middle-aged husband/wife-owned business would be able to deduct, pre-tax, a lot of expenses that otherwise would not be allowed as deductions. This service has saved one couple I know more than $5000/year for many years. There are various requirements that have to be met, but for people who meet the requirements, it offers a huge tax savings. For example, imagine that a woman operates a small business. If she hires her husband to help her with the company's paperwork and pays him a salary based upon that work, they could write off $5000 in long-term care insurance expenses and $15,000 or more in health insurance, drug, and medical expenses. Depending upon their tax bracket the savings could be huge. Without a cafeteria plan, health expenses would have to be 7.5% of their income before any of those expenses could be deducted. There may be other companies that perform the same service, but this is the best one that I know about.