Should Travel Nurses Sign with a Travel Nursing Agency or be an Independent Contractor?

Do travel nurses have to sign with a travel nursing agency in order to travel nurse? No. The reality is that nurses who want to travel can sign up with a travel nursing agency, or in some cases (but very few) become an independent contractor or 1099 travel nurse. But why would travel nurses choose to be independent contractors, and which option is more advantageous?

Let’s not beat around the bush – recruiters are paid a rate by the hospital for your services. Some travel nurses may wonder why their agency is taking a cut of their bill rate. After all, it’s the nurses who are performing expert services and saving lives.

Take this comment in particular from a frustrated nurse exploring the subject at AllNurses.com:

“They (recruiters) sit behind the comfort of their desks and phones and get a percentage of the bill rate for what they charge for my expert services.”

Of course we don’t know which agency this nurse worked with, so we can’t speak to any specifics. But the gist of this complaint is that recruiters are simply raking in money from the efforts of travel nurses. And that’s not very accurate, because recruiters and their agencies are responsible for a lot of things.

Could nurses make more money on their own, sans agency? It’s possible. But there is a lot more involved in recruitment than sitting behind a desk and answering phones, and once you see everything independent contractors are responsible for – besides nursing – you may find more value in travel nursing agencies.

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INDEPENDENT CONTRACTOR TO-DO LIST

Is going rogue really a better option? That depends on how much extracurricular activity you’re interested in beyond nursing. The following is what independent contractors are responsible for in lieu of working with a travel nursing agency:

TAXES

How do taxes work for an independent contractor? As an independent contractor, you will need to handle your own federal, state and local taxes. This gets even trickier when you’re constantly on the move every 13 weeks. And your tax situation would change based on whether you’re taking per diem or company housing. Depending on the costs, you may want to request higher travel nursing pay or an hourly rate.

Independent contractors also pay the self-employment tax, which accounts for the Social Security and Medicare taxes their agency would usually pay. They are required to file quarterly estimated tax payments on IRS form 1040-ES and annual tax returns.

If you’re too busy to account for all of these tasks and pay taxes quarterly, you may feel more comfortable letting your agency deal with this.

HOUSING

Speaking of housing, independent contractors are obviously on their own. Finding housing – especially housing that fits your budget – can be time-consuming and cumbersome. A good travel nursing agency is going to help you locate housing, whether you choose their housing services or per diem. But this is not universal. HCTN is proudly one of the few agencies who will still help you find housing if you choose per diem instead.

Then there are bills and utilities. Most good agencies can shave some of these expenses off and automate them for you, provided you take their company housing. There are different benefits to both company housing and per diem, and for more information on the two, click here. But the point is that without a travel nursing agency, you’re on your own to figure out which makes the most sense for your situation.

INSURANCE

Independent contractors must also secure their own insurance, both health and liability. If you’ve ever browsed the healthcare marketplace, you’ll notice insurance rates are a lot higher without a group. Add that expense alongside your liability insurance, and you can expect a sizable chunk of your check devoted to insurance alone every month. Any good travel nursing agency will provide affordable first-day health insurance and liability insurance.

FINDING A JOB

Independent contractors are responsible for finding their next assignment as well. That means taking the extra time to both track down and contact the appropriate people at any hospital that interests you and doing so every 10-11 weeks.

As an independent contractor, you will also most likely need to cover compliance and credentialing costs on your own. This can include costs such as background checks, drug screening, occupational health physicals, and necessary blood work. Also consider licensing fees and cost of online competency testing. These costs can add up after a while, especially if you are changing healthcare facilities every few months. Some third party companies offer memberships, but this often comes at a higher cost than what travel nursing agencies pay.

On the other hand, if you work with a travel nursing agency, most (if not all) of these compliance costs will be covered. Recruiters have already established the relationships necessary for finding your next assignment. With a recruiter, your next assignment is just a phone call away.

BILLING, PAY

Getting paid is also a lot easier when you contract with an agency. Independent contractors are responsible for both billing and collections. That means you’ll spend time billing the hospital for hours worked, and waiting for your invoice to be paid. Are you confident hospitals are paying their invoices immediately? It’s not uncommon for hospitals to take 60-90 days to pay.

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FOR MOST TRAVEL NURSES, AGENCY JUST MAKES SENSE

After considering everything an agency is responsible for, an agency’s value-add is significant. For travel nurses, it’s hectic enough just getting to know a different hospital every 13 weeks. Having to juggle literally everything else involved with your employment, outside of nursing, is inconvenient and most nurses won’t mind deferring these tasks to an agency.

From the perspective of a travel agency, it’s very simple: we win when you win. The better an agency performs, the happier travel nurses are. And the happier travel nurses are, the better they perform. The relationship is reciprocal.

Furthermore, the vast majority of registered nurses and healthcare professionals simply don’t qualify under the IRS definition of an independent contractor. See the IRS’ definition for what it means to be an independent contractor:

You are not an independent contractor if you perform services that can be controlled by an employer (what will be done and how it will be done). This applies even if you are given freedom of action. What matters is that the employer has the legal right to control the details of how the services are performed.

But we don’t want to discourage anyone from being their own business owner. If you’re up to it, you should visit the National Nurses in Business (NNBA) website for some great resources on getting started as an independent contractor.

What Is a 1099 Travel Nurse?

Are travel nurses 1099 employees? Yes. A 1099 nurse is the same as an independent contractor nurse. As a 1099 nurse, you are responsible for calculating and paying taxes and self employment tax based on your taxable income. Healthcare systems or travel nursing agencies do not offer you benefits because you are a contract employee. Meaning you will need to search for medical and dental insurance, as well as open potential retirement accounts for savings. You will need to track work related expenses, such as the cost of malpractice insurance, or professional fees, for tax purposes. You will need to also account for any other job related expenses or additional costs, as they may be tax deductible depending on your tax home or state. Also, as mentioned before, you will need to account for compliance costs, such as background checks, drug screening, and required occupational health assessments.

What’s the Difference between W2 and 1099 Travel Nurses?

Let’s review a few key differences between W2 and 1099 travel nurses. If you are a W2 travel nurse, you are typically employed through a travel nurse staffing agency and will receive a modest base pay, you will receive your wages directly from the travel agency. This is where the company calculates and automatically deducts travel nurse taxes, which can include state and federal income tax, from your paycheck. Some agencies may also provide the ability to contribute to a retirement account. 

As a 1099 nurse, you are not employed by a travel nursing agency. You will receive your entire gross income without any tax deductions directly from the hospital. Therefore, when it becomes tax time, you will need to calculate and pay your own taxes to the IRS. You can choose to pay yearly or quarterly taxes. As we mentioned before, you will also need to seek your own health insurance coverage.

FINDING YOUR OPTIMAL AGENCY

If you’re ready to let an agency handle all of the above, then you have options. Virtually every travel nursing agency offers different benefits. The truth is that of the some 340 travel nursing agencies in the US alone, it’s vital that travel nurses seek agencies that offer a complete package that best fits their unique needs. You'll be comparing the multiple job offers you receive, not job listings, when you travel with us. Get started today in On Demand.