1099 CRNA vs. W2 CRNA—Weighing the Pros and Cons

If you’re starting your anesthesiology career or looking to make a career pivot, it’s a great opportunity to explore whether you want to take a 1099 or W2 position. 

While W2 employment offers stability and traditional benefits, going the 1099 route can appeal to many CRNAs as well. 

Each path has its own unique advantages and challenges. Here are some items what to consider when weighing W2 CRNA roles vs 1099 CRNA roles: 

First, what does being a W2 actually entail? 

Many CRNAs are familiar with and prefer being a W2 employee because of their previous work history and the stability that comes along with it. And as a W2 employee, you can work directly for a hospital, ASC, endoscopy center or anesthesia practice management group.  

What are the pros of being a W2 CRNA? 

Simpler Tax Filing: Taxes are withheld by your employer, making end-of-year tax filing simpler. Your employer handles all calculations and payments based on your inputs on the W9. 

Shared Medicare and Social Security Costs: Your employers pay half of your Medicare and Social Security taxes, and it is automatically reflected on your pay stub. 

Employer-sponsored Benefits: Health insurance, retirement plans, malpractice insurance, and life and disability insurance are typically offered and provided by your employer for you and your family in varying degrees. 

Legal Protections: State employment laws offer protections that may not be available to independent contractors. 

What are the cons of being a W2 CRNA? 

Limited Tax Deductions: CRNAs typically cannot deduct business expenses as a W2 employee like a 1099 CRNA can. 

Job Mobility: Changing jobs can be more challenging since your benefits are tied to your current employer. Vesting periods could hurt retirement funds and benefits enrollment can be time consuming—and gaps in coverage is possible if not careful. 

Potentially Lower Pay: W2 employees often earn slightly less than their 1099 counterparts because their employer usually helps match retirement contributes and usually offers other fringe benefits and perks towards total compensation. 

Autonomy: Depending on the employer, W2 employees might have less autonomy in their roles due to the employee-employer relationship. 

What does a 1099 CRNA role entail? 

"1099" is slang for independent contractors, referencing the IRS form used to report their income. Independent contractors are self-employed, an employee-employer relationship cannot exist, and the IRS has a 20-factor test to help determine the correct contract status. Many independent contractor CRNAs establish small businesses, like an LLC, PLLC, S Corp, or APMC, depending on state laws, for tax and liability purposes. 

What are the pros of being a 1099 CRNA?

Higher Pay: 1099 CRNA roles often have higher pay rates due to demand for temporary CRNA services and because their employer is not also helping cover additional costs towards benefits.  

Autonomy: Because you own your business, you have greater control over where and when you work, your business decisions, and career trajectory.  

Tax Deductions: More aggressive tax deductions are possible, including work travel, professional development, liability insurance, continuing education, home office expenses, and equipment purchases. 

Retirement Savings: Independent contractors can save significantly more for retirement each year. 

Flexibility: With your own malpractice policy, picking up extra locum tenens work is easier. And many CRNAs appreciate the mobility and marketability of being able to take on a new contract without being tied down.  

Dual Income Potential: With that flexibility, CRNAs looking for financial freedom can pick up passive income opportunities, such as real estate investments, owning short-term rental properties, becoming healthcare influencers, or becoming an entrepreneur and opening up their own business, like a med spa.  

What are the cons of being a 1099 CRNA? 

Self-Managed Taxes: Taxes are not withheld, and independent contractors must handle their own tax calculations and payments. Plus, filing taxes for your own business is more complicated, so many CRNAs hire financial planners and tax accountants to help them navigate the process. Also, they must pay self-employment taxes as well since there is no employer paying for half of Social Security and Medicare taxes. 

Having to Find Your Own Benefits: 1099 CRNAs must shop for their own health insurance and work towards their own retirement planning strategy. And since they are not part of a group plan, premiums can be significantly more expensive. Plus, there is no employer match contribution towards a retirement account.  

Limited Legal Protections: There are fewer legal protections, and typically no employer-provided malpractice or workers' compensation coverage. 

Ultimately, the best choice depends on your personal and professional priorities. If you are interested in 1099 or W2 positions with Essential Anesthesia Management, check out our latest openings here.  

And know that if you plan to pursue the 1099 route, unlike other anesthesia practice management organizations, we allow our independent contractors to be just that—independent—while giving them access to over 30 supplemental perks specifically designed for 1099s: 

• Group life insurance  

• Medical, vision, and dental insurance plans that you’d expect of large Fortune 500 company group plans 

• Short-term and long-term disability  

• Financial planning resources 

• Mortgage planning resources 

• Well-being app with free and/or minimal cost benefits like pet insurance, debt counseling, roadside assistance, telehealth, and more 

  
  
  
  

If you’re interested in learning more about our contract anesthesia positions, apply today and chat with one of our recruiters.