Understanding the FMS Models: Bill Payer, Co-Employer, and Sole Employer

When families join the Self-Determination Program, one of the first decisions they face is choosing an FMS model. This choice determines how responsibilities are divided between the participant (or their representative) and the FMS. Each model offers different levels of flexibility, control, and responsibility. At Sentinel Four, we support families by walking through each option carefully, so you can select the model that best fits your needs and comfort level.

Co-Employer Model

The Co-Employer model is the most common and often the most practical choice. In this setup, you (the participant or family) and Sentinel Four share responsibility as co-employers of your staff. You choose and direct your employees, but Sentinel Four takes care of payroll, withholdings, workers’ compensation, and other employer-related compliance. This protects you from the liability of running payroll yourself, while giving you the freedom to recruit, hire, and supervise the staff who support you. The trade-off is that you must understand the true cost of employment (wages + employer burden) and stay engaged with scheduling and management of your team. For most families, this model strikes the right balance between control and protection.

Sole Employer Model

The Sole Employer model offers the highest level of independence. Under this model, the participant (or their representative) is the legal employer of record. Sentinel Four's responsibilities remain nearly identical as the co-employer model, where we take care of payroll and other employer-related compliance. The key difference is that you may choose to secure your own workers’ compensation insurance or use Sentinel Four’s resources for coverage. This model is most often utilized when participants hire staff who provide advanced skilled nursing or other specialized supports where additional flexibility in coverage is needed.

Bill Payer Model

In this arrangement, Sentinel Four acts primarily as a financial administrator. We pay invoices, track spending against your budget, and provide reporting to you and your regional center. However, we do not handle payroll or employer responsibilities. That means participants cannot hire individual staff as employees under this model — they can only use vendors or agencies who are already set up to provide services. This option is simpler and works best for families who do not plan to hire their own staff, but instead prefer to contract with established service providers.

Managing Budgets With Accuracy and Accountability

$71M+
Managed Budgets

Bills paid on time, families supported without delays.