Healthcare Blog

Latest "Did You Know?" Posts

HSA for Retirement

Open Enrollment for 2016 healthcare plans are around the corner and we don’t want you to miss the benefits that a HSAHealth Savings Account (HSA) can offer you. An HSA is a tax-exempt trust of custodial account that can be set up to pay for future medical expenses. This type of plan is incredibly beneficial who are looking to save money for retirement and here is why.

HSA accounts allow you to put tax deductible contributions into your account up to $3,300 for an individual or $6,550 for a family. If you were 55 or older in 2014 you can add an additional 1,000 dollars to each of those numbers. The money you contribute accrues interest and the earnings are tax-free and you are able to pay for your qualifying medical expenses out of that account also tax-free. This can be a wise way for both older and younger individuals looking to invest, that know their investment capital is around the maximum contribution allowed or less. If the ability to contribute more than the maximum contribution amount you might want to look at an IRA instead.

Another great bonus to an HSA account is that the funds remain in your account year after year even if you do not use them for medical expenses that year. Once you hit retirement age you can withdraw those funds tax-free even if you are not using the funds for a medical expense. The stipulation to have an HSA is that you must be enrolled in a high deductible health plan. That said in order to take advantage of the tax breaks this plan works best if you are relatively healthy and have low medical expenses. It can also save you money on taxes if you are spending significant dollars annually on healthcare.

This year when you are looking at plans for yourself or your family make sure to ask your broker about Health Savings Accounts and if it would be a wise choice for you. Are you already familiar with HSA’s or is this something new for you?

Read the full article on U.S. News HERE

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Posted by Lauren Yeager in All Posts, Did You Know?, Health Insurance and tagged , , ,

A New Job Doesn’t Mean A Qualifying Event

When the Affordable Care Act started, health insurance enrollment was limited to a three month cycle each year. For 2016 open enrollment is November 1st, 2015- January 31st, 2016, with the first date of coverage able to start on January 1st, 2016. Any enrollment outside of that time has to be triggered by a qualifying event (QE). Although, many Americans find themselves in a rock in a hard place as they are outside of employment and believe that they can get coverage when they start their new job. Unfortunately a new job is not considered a qualifying event.

First I will explain why we now have open enrollment. Before the ACA individuals were dependent on medical underwriting for health insurance. The insurance carrier decided if the individual was qualified to purchase health insurance, and had the possibility of being denied coverage. After the passing of the ACA all policies are considered guaranteed issue, meaning that nobody has to qualify to have health insurance. If you are a living and breathing individual you now qualify. This puts a greater risk on health insurance companies as they are now insuring individuals with no prior knowledge of their health status. Open enrollment protects the health insurance companies to instill confidence that an individual will not  enroll in a policy then drop their policy as soon as they have completed their medical needs.  Thus creating a need for a Special Enrollment Period (SEP) for life events outside of the three month cycle.

qualifying event timeline
When I think of a QE I think of anything life changing like a move, marriage, baby, and a NEW JOB, but the ACA does not consider having a new job as a qualifying event. A QE gives an individual a sixty day SEP to enroll in a new plan or change their current plan. If you have ever had employee sponsored group insurance then you should be familiar with this type of enrollment, but those that haven’t could be caught off guard.

As you go into 2016 the best way to make sure you and your family are covered is to enroll within open enrollment dates. This way you can see if you are eligible for a subsidy (tax credit) to help with the cost of your health insurance and ensure that you and your family are covered. This will also remove doubt that the “qualifying event” that you were relying on to make changes to coverage or obtain new coverage from is not truly a QE.

If you do find yourself in this specific circumstance all is not lost as you can look into short term policies to cover your family, but these policies will not keep you from a tax penalty at the end of the year. If you have questions on what a qualifying event is there is a great article on HealthInsurance.org that you can read HERE.

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Posted by Lauren Yeager in All Posts, Did You Know? and tagged , , , ,

What Is A Section 105 Plan?

Health insurance When the Affordable Care Act (ACA) was passed there was a lot of confusion on what companies could or could not pay for when it came to individuals health insurance plans. As employer sponsored health plan prices continue to rise companies needed another option. A section 105 plan enables employers to reimburse employees tax-free for their own individual health plan.

According to Zane Benefits, “Section 105 plans are a tax-advantaged employee benefit as outlined in the Internal Revenue Code section 105.” For an employer this means, reimbursements are tax-deductible and payroll taxes (FICA/FUTA) are lowered. This option is much better than offering employees a taxable raise that end up costing the company more to compensate for the taxes.  This ends up saving money for both employees and business owners, making it the perfect solution for small business health insurance.

As an employer there could be worry that an employee is taking advantage of the section 105 plan because the company no longer has knowledge of the health plans chosen by employees. With this type of plan an employee may only be reimbursed if they provide proof of their premium payment. Then the employee is reimbursed up to a set amount by the employer. This still gives control to the employer allowing them to decide what the money is spent on.

A section 105 plan is also tax free for the employee. As an employee enrolls in a qualified ACA health plan they are then no longer subject to the tax penalty at the end of the year for not having health insurance. Moreover they are paying for part or all of their health plan premium from the reimbursable funds given to them by their employer.

Do you have any other questions on sections 105 plans? Let us know and we would be happy to answer them.

Read the full article on Zane Benefits HERE

 

 

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Posted by Lauren Yeager in All Posts, Did You Know?, Health Insurance and tagged , , ,

Less Than A Month Away For A January 1st Enrollment Date

There is less than a month left for a January 1st start date so don’t miss out on the December 15th enrollment deadline. If you are someone that understands health insurance plans backwards and forwards then you are way ahead of the game, but many Americans do not understand the other language that is “health insurance.” I encourage you to reach out to a broker that is well versed on the language and let the help you understand.

Once you enroll in a health plan during Open Enrollment for 2016 you are locked into that plan for the entire calendar year unless you have a qualifying even like a birth, marriage, or major move. open enrollmentOpen Enrollment goes through January 31st this year.  The important deadlines and dates to remember are:

November 1st, 2015: First day to enroll in a health plan for a January 1st, 2016 start date.

December 15th, 2015: Last day to enroll in a health plan for a January 1st, 2016 start date.

January 1st, 2016: First day of coverage for those that enrolled in health plans from November 1st, 2015-December 15th, 2015

January 15th, 2016: Last day to enroll in a health plan for a February 1st, 2016 start date.

January 16th-January 31st: Enrollment days for a March 1st, 2016 start date.

January 31st: The last day to enroll in a health plan for 2016 without a qualifying event.

Check the HealthCare.gov website HERE for all dates, deadlines, and news for Health Plans.

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Posted by Lauren Yeager in All Posts, Did You Know?, Health Insurance, In The News and tagged , , , ,

How are Health Insurance Subsidies Determined?

Each year during open enrollment individuals are able to see if they are eligible for health insurance subsidies to help supplement their health care costs. The determinations are based on projected adjusted gross income (AGI) for the year compared to the cost of the second lowest silver plan in an individuals state of residence. These two factors along with how many individuals are in the household will determine eligibility to receive assistance.

The only way to receive assistance is to enroll in either your state based exchange or on Healthcare.gov. Documents are required to verify the income that you are claiming is in fact correct. If you qualify for an Advanced Premium Tax Credit (APTC) you may choose how much advance credit to apply to your premiums each month, up to a maximum amount. If you choose to only take a portion of the advanced credit allowed you’ll get the difference as a refundable credit when you file your federal income taxes.

Currently health insurance carriers are submitting their rates for 2016. The rates will either be approved or rejected by the administration and the second lowest silver plan rates will be determined for each geographical area. When receiving a subsidy you have to make sure to report any changes to your circumstance that may change your subsidy eligibility. This will prevent paying a tax penalty at the end of the year. Did you receive a tax subsidy last year? How was your experience with enrollment?

The Kaiser Family Foundation provides a calculator to see if you are eligible for a subsidy, but is currently set with 2015 premium rates until the 2016 second lowest silver plan rates are determined. Remember Open Enrollment Starts November 1st. Check to see if you are eligible to receive assistance HERE

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Posted by Lauren Yeager in All Posts, Did You Know?, Health Insurance and tagged , , , , ,

The Benefit of an HSA and Being Over 65

We covered in previous posts what a Health Savings Account is and how they can be beneficial. One of those benefits is the abilityHSA earnings to pull money out of your HSA account once you reach the age of 65 as tax-free dollars even if you are not using it for healthcare expenses. This enables individuals to use their HSA as a part of a retirement plan. You pay into your HSA account each year and accumulate funds that earn interest. If you build upon that at age 65 that money can be used for expenses other than healthcare, and withdraws are still tax-free.

As of 2015 you can contribute up to $3,350 for an individual and $6,650 for a family annually. If you are over 55 there is a provision allowing an additional 1,000 to be contributed. You must complete contributions for the fiscal year by April 15th of the following year. HSA funds are able to be carried over year after year without any limits.

Take a look at the earning potential that an HSA provides in the graph, and see how beneficial contributions can be. Medical Mutual has a great fact sheet for HSA’s that you can read HERE.

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Posted by Lauren Yeager in All Posts, Did You Know?, Health Insurance and tagged , , ,

Common Misconceptions with Defined Contribution

QuestionThere are common misconceptions with defined contribution plans as to their legality and how to set them up to comply with regulations. One of the common questions comes from understanding that the employer is not directly paying for an employee’s individual health insurance. When a company sets up a defined contribution plan it must be compliant with IRS, ERISA, HIPPA, and ACA guidelines. We typically recommend using an administrator when setting up these plans. So why do you need to set up a formal plan to be in compliance versus giving the employee funds directly?

To maintain compliance employers aren’t involved in the employee’s decision to choose their individual health policy, the employer does not directly pay for the insurance premium, and the employer is not involved in any communication between the individual and the insurance company. When following the above guidelines it allows the employer to contribute to an individual health insurance plan maintaining compliance with federal law.

In a defined contribution plan employers are able to give employees different contributions based on their class or position within the company. This class can be based on job categories, geographic location, part-time or full-time status, etc. A class must treat all employees equally, to avoid discrimination. These classes are defined by the employer in an ERISA plan document before the defined contribution plan is put into place.

We have found Zane Benefits is one of the best at administering defined contribution plans. Zane offers a FAQ sheet on their website HERE. For more common misconceptions and answers visit their website. What are some of your biggest questions when it comes to Defined Contribution?

 

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Posted by Lauren Yeager in All Posts, Did You Know?, Health Insurance, In The News, Small Business and tagged , , , ,

Open Enrollment Starts Today

Open Enrollment is here for 2016 health plans. According to an article on The Street, individuals spend less than 30 minutes researching their benefits. If you are someone that understands health insurance plans backwards and forwards this sounds like a decent amount of time to spend, but many Americans do not understand the other language that is “health insurance.” This kind of care less response to choosing something incredibly important could have a huge impact when you find yourself filing claims for a medical procedure that you weren’t expecting.

Once you enroll in a health plan during Open Enrollment for 2016 you are locked into that plan for the entire calendar year unless you have a qualifying even like a birth, marriage, or major move. open enrollmentOpen Enrollment goes through January 31st this year.  The important deadlines and dates to remember are:

November 1st, 2015: First day to enroll in a health plan for a January 1st, 2016 start date.

December 15th, 2015: Last day to enroll in a health plan for a January 1st, 2016 start date.

January 1st, 2016: First day of coverage for those that enrolled in health plans from November 1st, 2015-December 15th, 2015

January 15th, 2016: Last day to enroll in a health plan for a February 1st, 2016 start date.

January 16th-January 31st: Enrollment days for a March 1st, 2016 start date.

January 31st: The last day to enroll in a health plan for 2016 without a qualifying event.

In a recent Aflac survey it was found that many people would rather complete tedious chores than research benefits with 38% who would rather clean out their email inbox, 23% would rather clean their toiled, 21% would rather pull weeds, 18% would rather do their taxes, and 12% would rather have a dental cavity filled. These tasks are ones that nobody in their right mind would sign up to do, but in comparison to choosing a health plan people chose that over their health plans. If choosing a health plan is that daunting to you then it’s encouraged to seek out a broker that has familiarized themselves with the ins and outs of health plans. Moreover they can break down the “health insurance language” into plain English allowing you to shop your health plan with understanding.

If you have had issues this year with your health carrier or your health plan make sure this year open enrollment is easier and seek out somebody whose job it is to understand each plan and what, who and how much it covers.

Read the full article on The Street HERE

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Posted by Lauren Yeager in All Posts, Did You Know?, Health Insurance and tagged , , , ,

10 Essential Health Benefits

Health BenefitsWhen the Affordable Care Act (ACA) was passed there were certain requirements placed on health plans guaranteeing health benefits. Going into the 2016 open enrollment all plans will be ACA compliant within this upcoming year. Currently there are still plans out there that are “pre-ACA” which an individual or family would have enrolled in before the ACA was passed and continued coverage through 2015.

With ACA compliant plans there are 10 essential health benefits that are included under each plan that you may not know about. Here’s the list from HealthCare.gov:

  1. Outpatient care—the kind you get without being admitted to a hospital
  2. Trips to the emergency room
  3. Treatment in the hospital for inpatient care
  4. Care before and after your baby is born
  5. Mental health and substance use disorder services: This includes behavioral health treatment, counseling, and psychotherapy
  6. Your prescription drugs
  7. Services and devices to help you recover if you are injured, or have a disability or chronic condition. This includes physical and occupational therapy, speech-language pathology, psychiatric rehabilitation, and more.
  8. Your lab tests
  9. Preventive services including counseling, screenings, and vaccines to keep you healthy and care for managing a chronic disease.
  10. Pediatric services: This includes dental care and vision care for kids

It’s good to inform yourself of what’s included on your plan as these preventative services are to be gives without charging a copayment or coinsurance even if you have not met your deductible.

To see a list of preventative healthcare for ADULTS click HERE

To see a list of preventative healthcare for WOMEN click HERE

To see a list of preventative healthcare for CHILDREN click HERE

Did you know that your Affordable Care Act compliant plan included the above? If you did, are you taking advantage of all of your benefits? If you didn’t, will you start taking advantage of them now?

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Posted by Lauren Yeager in All Posts, Did You Know?, Health Insurance and tagged , , , ,

Open Enrollment for 2016 is Fast Approaching

Often times people are not informed of the new regulations that govern the ACA and the main issue we have seen is Open Enrollment. Open Enrollment is a window of time that allows individuals to enroll in health plans for the following year. This is the only time that individuals are allowed to enroll Open Enrollmentin a plan for the following year unless they have a qualifying event during the years time frame. Many people believe that they can simply enroll in a health plan at any given time and be safe from a tax penalty, but that is not the case.

For 2016 you can enroll starting November 1st 2015 until January 31st 2016. To avoid a tax penalty you must have coverage for nine months out of the year. You must plan ahead to enroll in coverage as you will not be able to obtain coverage outside of the open enrollment period unless you have a qualifying event. You can see if you qualify with a life event HERE.

Choosing a health plan can be extremely stressful if you don’t know exactly what you are looking for in coverage. We highly recommend using a broker to help you understand the plan that you are choosing. This way taking an in depth look at plan options leaves you feeling more confident in your choice knowing you made a well informed decision. We say this due to another simple misunderstanding. Once you have chosen your health plan during open enrollment you can’t change that plan unless you have a qualifying life event or during the next years open enrollment.

Given these common misconceptions we hope you go into the quickly approaching open enrollment period confident with the choices you will be making for yourself and your family. Were you happy with the health plan you chose for 2015? Did you use a broker or enroll on your own in 2015? Answer those questions and if you have more feel free to ask!

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Posted by Lauren Yeager in All Posts, Did You Know?, Health Insurance and tagged , , , , , ,