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Common Misconceptions with Defined Contribution

There 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 …

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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 …

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10 Essential Health Benefits

When 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: Outpatient care—the kind you get without being admitted to a …

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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 in 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 …

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How does a Deductible and an Out-of-Pocket Maximum Work?

When an individual or family enrolls in healthcare they are often bombarded by insurance jargon that isn’t the easiest to understand. The health insurance world speaks a different language than what most of us are used to. So what exactly is an out of pocket maximum and how does that work with a health plan deductible? An out of pocket maximum is the most you’ll have to pay during a policy period (usually Jan 1st-Dec 31st) for health care services. Once you’ve reached your out-of-pocket maximum, your plan begins to pay 100 percent of the allowed amount for covered services. I …

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How To Shop For Health Insurance

As Open Enrollment for 2016 is fast approaching do you know what to look for when selecting your health insurance? Many Americans are unsure what they are getting when they enroll in their plan until they go to use services and realize that they are under-insured. Consumer Reports highlights three key points to go over as you select your healthcare plan. First off “What does the plan cover?” With the Affordable Care Act (ACA) each health plan must cover certain items including: maternity and newborn care, mental health and substance-abuse treatment, preventative services, and pediatric services including dental and vision care. These are …

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