Your health insurance plan does more than just protect your family’s health. It also protects your budget, by helping you manage expenses. But there are several ways to wring a bit more value from your plan…
Make sure you have the right plan. You wouldn’t use the wrong tools to accomplish a particular task, so why use the wrong health insurance plan to protect yourself and loved ones? It’s tempting to automatically re-enroll in your current plan each year, because it’s one less task to tackle. But really, you should be re-evaluating your family’s needs each year, and comparing those needs to your plan’s provisions.
Understand your plan. Upon enrollment, your health insurance company will send you a packet of information. Take the time to review this information, and hang onto it for later reference.
If you’ve met your deductible, take advantage. If, and when, you meet your deductible for the year, go ahead and schedule other screenings or procedures that you might have postponed earlier. You’ll be getting them at reduced cost now.
Use in-network providers whenever possible. Before utilizing any medical facility or doctor, check with your insurance company to be sure they’re in-network. Only use out-of-network providers when absolutely necessary.
Try mail-order prescription services. Check with your insurance provider to see if they cover mail-order prescription services. You can save money by ordering a 90-day supply of your prescriptions, rather than standing in line at a local pharmacy each month.
Consult with a medical billing advocate. Hospitals can, and do, make errors in billing. Sometimes those errors amount to thousands of dollars! When you encounter high out-of-pocket costs, consult with a medical billing advocate. Consultation is usually free, if your bill turns out to be correct. If the advocate succeeds in reducing your bill, their fee is usually about one-third to one-half of the amount saved. Your insurance company might even offer this advocacy service.
Stay in touch. Health insurance companies sometimes add special services and perks to their roster of offerings. Read any emails or snail mail they send you, and check their website frequently for updates on free screenings, wellness programs, handy apps, and more.
If you choose to offer your employees a dental care plan, providing them with a valuable health benefit is probably your primary motivation. However, when your employees take advantage of those plans, particularly preventive dental care, you also reap the benefits.
According to a study by Guardian Life Insurance Company of America, companies that encourage employees to use preventive dental care can slash the cost of group policies for their employees.
The study analyzed claims data from 2011 to 2017, and divided employers into two groups: high-preventive-utilization and low-preventive-utilization. In other words, they compared the rates at which preventive dental care was accessed by workers, between different companies.
Over the six-year period, the high-preventive-utilization group spent 39 percent more on preventive care, but 86 percent less on major and restorative dental services. This translated into a 16 percent savings on dental care, overall, as compared to the low-preventive-utilization group.
Because more than 90 percent of systemic diseases present oral signs and symptoms, routine preventive dental care also aids in early detection of many serious (non-dental) medical conditions. Therefore, accessing their preventive dental care benefits might also help your employees detect health conditions such as diabetes and heart disease. Routine dental care can even contribute to a healthy pregnancy. So, preventive dental care might also help to reduce overall expenditures on medical care, as well as the cost of sick leave and other workplace issues related to employee health.
How can you urge your employees to utilize their preventive dental benefits? First, it is important for you to thoroughly understand your dental health package. Then, you can more effectively communicate those benefits to workers, and offer incentives to encourage their use.
We’re happy to help you understand your dental health policy, so that you and your employees can reap the full benefits of it. Just give us a call and we will discuss your group plan.
When do you think you’ll retire?
Not too long ago, the most common answer was, “age 65”. That’s because 65 was once the standard age for reaching “full retirement age” according to Social Security, meaning you would access your full benefits at that point. Plus, it was – and still is – the age of Medicare eligibility.
So, a worker could reasonably assume that once he or she reached age 65, they could retire, claim their Social Security benefits, and receive healthcare through Medicare.
These days, Social Security’s full retirement age has risen to 66 for those born in 1943 or later, and to 67 for anyone born in 1960 onward. So, many people are delaying retirement at least another year or two (and sometimes longer if their retirement savings falls short of what they need). This means a lot of you are still working at age 65, when you become eligible for Medicare.
Now, here’s a funny thing: You’re actually required to enroll in Medicare when you turn 65. If you don’t, you will face higher premiums when you eventually do retire. For some people, the wait might make sense, but this definitely creates a bit of a puzzle for you.
If you already have health insurance through your employer, it’s important to understand how Medicare will coordinate with that plan. You need to talk with your employer’s health plan administrator, to find out whether you’re required to enroll in Medicare, if your insurance will change once you enroll, and how much you’re paying for health insurance currently. Remember, since you don’t pay taxes on payroll deductions for health insurance, you need to consider the tax implications of keeping your insurance versus enrolling in Medicare.
Should you enroll in Medicare? For most people, Medicare Part A is premium-free. Your hospital expenses will be covered by your employer health care plan, and Medicare Part A would kick in as a secondary payer. In many cases this is a good idea since you might, for example, have a large deductible.
On the other hand, if your employer provides healthcare through a Health Savings Account, their contributions might stop if you enroll in Medicare. You need to investigate this issue before making a decision.
As for Medicare Part B, or doctor and inpatient coverage, the answer is not so clear. If you already have employer coverage, you might not want to enroll in Part B in order to avoid the premiums you will be charged. Part B provides only a very limited value to most people with employer-provided insurance. But if you’re self employed, or work for a small employer with less than 20 full-time employees, Medicare is likely to be the primary payer. So it might make sense to enroll.
The bottom line: It’s complicated. If you’re still working at age 65, and you’re covered by an employer’s group health insurance plan, you should seek specialized guidance when deciding whether to enroll in Medicare.
The American Heart Association has designated February as American Heart Month, and for good reason: At 17.9 million deaths per year, cardiovascular disease is the leading cause of death in the world. Many of us are under the impression that heart disease will simply “happen” to us, no matter what we do, but that simply is not true. Knowledge can empower you to take better care of your heart, to ward off cardiovascular disease or at least manage the progression if you do develop a condition.
Watch your stress level. Numerous research studies have demonstrated a clear link between stress and various health conditions, and heart disease is no exception. For example, chronic stress can lead to high blood pressure, which in turn damages your blood vessels and heart over time. So take care to manage your stress, by utilizing relaxation techniques, yoga, hobbies that help you feel calm, meditation, exercise, or anything else that helps you feel balanced.
Speaking of exercise… Do it! Exercise is one of the best ways to keep your heart healthy. The American Heart Association recommends at least 30 minutes of aerobic activity each day. Do check with your doctor first, to make sure your exercise plans are safe for your level of health. And if your knees, hips, or other joints bother you, try lower-impact activities like swimming or an elliptical machine.
Don’t smoke. Yes, you’ve heard it before, but smoking cigarettes can damage your lungs and heart over time. It’s never too late to quit! Talk to your doctor if you’re having trouble identifying a smoking cessation program that works for you.
Eat a heart-healthy diet. Three types of food are known to promote heart health: Fresh fruits and veggies, whole grains, and foods containing omega-3 fatty acids. These are the healthy unsaturated fats found in fish, nuts, and some seeds. Incorporate more of these foods into your diet, and avoid unhealthy foods that contain empty calories.
Visit your doctor regularly. An annual physical and appropriate health screenings can help you detect problems early, often while they can still be managed or even reversed. Don’t wait until you’re already very sick to seek medical care. Regular consultations with your primary physician can keep your health on a good track, and help you live a longer, happier life.
If you have questions or require assistance with your health insurance policy or any other insurance needs, please feel free to contact us at any time. We’d love to hear from you.
Each year when we file our income tax returns, we all must answer some questions about our health insurance. As you know, most taxpayers are required to enroll in a healthcare plan, or risk a penalty at tax time. So when the IRS asks about your coverage for the previous year, you might also be asked for proof of that coverage. That’s why Forms 1095-A, 1095-B, and 1095-C are used.
These forms are issued as proof of coverage each year. The Health Insurance Marketplace sends Form 1095-A to individuals and families who enrolled in a healthcare plan through them, while Form 1095-B is issued by individual health insurance companies to their own customers. If you have an employer-provided plan, then you’ll receive Form 1095-C from your company.
Which type of form you receive, and who sends it, depends upon how you receive coverage. However, it will always be one of these three forms, unless of course you don’t have health insurance at all.
When will I receive my form? The Marketplace must issue Form 1095-A by January 31. The deadline for Forms 1095-B and 1095-C (from individual insurance companies or employers) will be in early March.
Can I file my tax return before I receive my form? Those who receive health insurance through the Marketplace should wait for their Form 1095-A to arrive, before proceeding with their tax return. However, if you are expecting Form 1095-B or 1095-C, you can go ahead and file your taxes. Just answer questions about health insurance correctly. When your forms do arrive, file them with a copy of your return. In the event of an audit, you might be asked to provide proof of your health insurance coverage.
Can I request a copy of my form? If you don’t receive your form, or if you’ve lost your copy, you can indeed request another one. However, you must call your insurance carrier directly to request a copy from them. Because of privacy rules, we unfortunately cannot obtain these tax forms for you.
If we can answer any other questions about your health insurance coverage, please do call us right away.
Open Enrollment for health insurance began on November 7, and will end on January 31, 2018. So, you still have plenty of time to make changes to your current healthcare plan (or finally enroll in one), but with the holidays looming we’re all getting busy. You might be wondering what will happen if you procrastinate or forget to take action during Open Enrollment.
If you currently have a health insurance plan… You will be automatically re-enrolled in that same plan, if you don’t make a decision otherwise. That could be convenient, but since your premiums will likely change, you would be wise to comparison shop before the deadline.
If you currently receive a subsidy to aid with the cost of your premiums, you need to update your income information so that your subsidy can be calculated correctly.
If you don’t have health insurance at all… For now, the Individual Mandate part of the Affordable Care Act does stand. If you fail to carry health insurance, you might face a penalty on your 2018 tax return, in the amount of 695 dollars per uncovered adult or 2.5 percent of household income (whichever is higher). Yes, some of the tax plans set currently set forth in Congress seek to do away with that penalty, but those bills have not passed at this time.
If you change your mind… Let’s say, for some reason, that you choose not to enroll in health insurance at this time. If you change your mind after January 31, you can’t enroll in a policy until Open Enrollment next November (and the plan wouldn’t take effect until January 1, 2019).
There are some exceptions to this rule, called Qualifying Life Events. If your household adds a member (a new child), if you get married or divorced, or if your income changes, you might be eligible to enroll in health insurance outside of the Open Enrollment period. There are a few other, less common, qualifying life events as well. You can always contact us throughout the year to inquire about your situation, but there are no guarantees. If you want health insurance in 2018, your best bet is to sign up now.
PLEASE NOTE: If you are a Medicare recipient, your Annual Enrollment Period has already ended and if you feel that you need to make changes, contact us directly for assistance. We’ll do our best to help you.
If you’ve been watching the news this year, you know that healthcare has remained a hot topic in Washington, DC. Congress and President Trump batted around several ideas that would repeal or vastly roll back provisions within the Affordable Care Act, but finally called it quits when a consensus could not be reached.
For now, lawmakers have abandoned the idea of a total repeal and/or replacement of the healthcare law. That means many of the provisions included within the ACA, which were delayed and gradually implemented, will continue to take effect throughout the country.
One of those provisions is the employer mandate, which requires many small and midsize businesses to provide their employees with a qualifying health insurance plan. The rule has been in place already, of course, but the IRS needed time to build its compliance systems. Therefore, the requirement wasn’t exactly enforced until those systems were complete…. But now, the IRS has announced that they are beginning to notify employers who failed to comply with the law in 2015.
Under the employer mandate, businesses which employ more than 50 full-time workers must provide them a group health insurance plan which meets requirements set forth under the ACA. Those who failed to comply will face steep tax penalties. Since the first batch of letters addresses businesses that failed to comply with the law in 2015, we can assume the IRS will continue to catch up with those who failed to comply in 2016, and so on.
Congress continues to debate various other tax issues, as both the House and Senate are putting together bills to revise the income tax structure. But so far, the employer mandate has not been mentioned within those bills (the Senate bill effectively reverses the individual mandate, by doing away with tax penalties for individuals who do not enroll in health insurance, but this will not affect employers).
So for now, the employer mandate stands, and it will be enforced. If your business is growing and you are approaching the 50-worker threshold, it is time to evaluate your group health insurance options. Give us a call, and we will help you identify your options and select a plan that is right for your business.
Protecting your assets is one of your most important considerations as a business owner. Since your employees are your greatest asset, you have carefully crafted a package of benefits to help both them and your company succeed.
However, with today’s health insurance plans often subject to such high deductibles, you would be right to wonder just how protected your employees really are. Would they be able to meet that deductible, in the event of an unexpected and costly accident? Or would the gap between their insurance coverage, and what they can actually afford to pay out of pocket, create an extra burden at the worst time?
Voluntary accident insurance is designed to help bridge that gap. It also complements disability insurance, which can provide a portion of lost income during time off work, but often is not sufficient to address the high medical bills that come along with a serious injury.
Accident insurance will provide a cash payout in the event of certain types of injury. The payout will vary, according to two basic factors:
- Type of injury – such as broken bones, head injuries, burns, lacerations, eye injuries, and so on
- Specific treatment required during and after the event – such as ambulance rides, X-rays, surgery, hospitalization, and various types of follow-up care
Voluntary accident insurance can cover your employees, as well as their family members, depending upon the type of policy selected. This could prove to be an invaluable benefit for those with children, in particular. We all know how unpredictable kids can be!
You might be surprised at the affordability of a voluntary accident insurance policy. With low premiums and a solid benefits package, you can provide additional protection to your employees at a minimal cost to your bottom line. Give us a call to learn more, and we can help you decide if an accident insurance plan is right for your company and your workers.
As you probably know, Open Enrollment for health insurance plans began on November 1. During this time, you are evaluating this year’s healthcare expenditures, comparing your needs to your plan’s offerings, and making a decision to either stick with your current plan or switch to a new one.
Not to add another chore to your to-do list, but there is one other important detail you should address at this time. While you’re evaluating your needs and budget anyway, why not investigate dental and vision insurance options?
Your eyes and teeth might be small parts of your body, but their functioning greatly impact your overall health. Problems like gum disease or infections within teeth can weaken your overall immune system, and vision problems can lead to safety issues while working and driving. Plus, many chronic diseases are first noticed by a dental or optometrist.
Without dental insurance, a routine exam (including x-rays and cleaning) costs and average of 288 dollars. You could also face average prices for emergency services, such as:
- 50 to 150 dollars per filling
- 75 to 300 dollars for non-surgical extractions
- 328 dollars for crowns
- 120 dollars for simple root canals (more for complicated cases)
- Costs can increase significantly depending upon complicating factors
As for vision care, the average cost of an eye exam is 154 dollars… But with insurance, you would only owe a co-pay (average of 15 dollars). Costs of eyeglasses or contact lenses can vary, but you will generally earn a significant discount through your vision insurance plan.
Some general health insurance plans offer dental and vision coverage, but most often you will need to enroll in these plans separately. There might even be a “package” available, that rolls health, dental, and vision insurance into one plan and premium.
To receive a free quote for vision and dental insurance, click here or give us a call. We will be happy to help you evaluate your needs and identify plans that could save you money on dental and vision care.
Throughout most of 2017 we all watched anxiously as Congress and President Trump debated different methods of repealing or replacing the Affordable Care Act. Now October has arrived, a repeal plan never passed, there is no replacement, and Open Enrollment looms next month. The Affordable Care Act stands for now.
But that doesn’t mean a lack of changes to the industry. The following events were already scheduled to occur, and so far it looks like everything will proceed as expected.
Rates for children will change. Currently, a family plan covers you, your spouse, and all of your children (up to age 26). The premiums were the same no matter if your child was a newborn or 20 years old.
In 2018, premiums will be based upon a family with children age 0 to 14. If you have children age 15 and up, premiums will be rated based on their ages, and might rise between 20 and 40 percent.
A new tax hits insurance carriers. The Health Insurance Tax (HIT) was included in the Affordable Care Act as a form of “sales tax” on premiums, but Congress opted to delay it until 2018. Now, with 2018 rapidly approaching, health insurance providers will have to decide how to account for the tax. A 4-6% HIT on insurance plans sold.
Many experts have estimated that the cost will be passed along to consumers, with the average cost of a family insurance plan increasing by 5,000 to 7,000 dollars over the next decade. Premiums for individuals may increase by over 2,000 dollars per year.
New Medicare ID cards will be distributed. These cards will no longer display your Social Security number, due to concerns over theft and fraud related to widespread use of these numbers. You will now be issued a Medicare Beneficiary Identifier (MBI) number. Your new card will be mailed to you automatically, so be very wary of anyone who calls and offers to “help” process your card. Fraudsters are sure to take advantage of the change, and attempt to gain access to your Social Security number via fraudulent calls or emails.
We will continue to keep you updated on changes to the insurance industry. Remember that you can always call us with any questions or concerns, and we will help you determine which (and how) changes might affect you.