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.
Are you an employer, providing group health benefits that offers prescription drug coverage? Are any of your employees aged 65 or older, or are any of their dependents disabled? Do you provide group healthcare benefits to retired employees, aged 65 or older? Are any former employees disabled, or on COBRA coverage?
Okay, you need to pay very close attention to this notice.
According to the Medicare Modernization Act, you must notify your Medicare-eligible employees, by October 15, as to whether their prescription drug coverage is “creditable coverage”. This rule applies to both employees who are eligible for Medicare, as well as their dependents, if any.
So, who is “Medicare eligible”? We all become eligible for Medicare when we turn 65, so this notice applies to any of your employees who are currently age 65 or older.
What is “creditable coverage”? It means that a particular healthcare plan is expected to pay (on average) at least as much as standard Medicare Part D coverage. This allows your Medicare-eligible employee to make a decision as to whether enrolling in a Part D plan might benefit them.
If your employee has a lapse in “creditable” prescription drug coverage after turning 65, that lasts for more 63 days or longer, he or she could be penalized. They will also have to wait until the following October (the Annual Election Period) to join a Part D plan. So, your employees who are eligible for Part D really need to know whether their current coverage is creditable or not. This way they can make a decision regarding Part D coverage, without incurring a late enrollment penalty.
You also must notify CMS. You must also notify the Centers for Medicare and Medicaid Coverage (CMS) that you have sent these Part D notices to your employees. This notice is due within 60 days of the start of the plan year… So you don’t have to send it now, but it might be better to get it out of the way quickly, before end-of-year business distracts you.
So, on that note, give us a call if you have questions about this Part D notice. We can help you understand what you need to do, so that you can comply adequately with the law. Remember, you must send this notice by October 15.
Business managers must navigate a myriad of legal and personnel hurdles, ranging from health insurance regulations to sick leave to various employee relations quandaries. It’s en enormous job for one person, or even several people, to handle efficiently. Missteps can have disastrous consequences, but legal jargon can be confusing and time-consuming to interpret. What if you could outsource that work to a team of experts, who already specialize in these topics?
As part of our continued dedication to helping your business succeed, we offer unlimited HR services. Are you taking full advantage of this opportunity? Or would you like to learn more about it? Read on to discover how our HR professionals can help streamline your own services.
Consulting. Have a human resources question? You can access expert help right away, either online or over the phone. You can even use our Ticket Tracker feature to learn when your questions will be answered.
Free training sessions. Each quarter, you can opt in to a free interactive webinar that will teach you appropriate prevention strategies and legal practices for dealing with sexual harassment cases, as well as racial and ability-based discrimination.
Customizable documents. Our team can create and update your employee handbooks, employee descriptions, form letters, and more.
Compliance. One-on-one consultations with our HR Pros help to ensure that your business is legally compliant and protected.
Live Chat. Not sure what you need? Just live chat with our HR Concierge, to identify the HR tools you need. Then the Concierge will connect you with the appropriate member of our service team.
We’re proud of our HR Pros team for a reason: 98 percent of our clients said they would recommend our services to others! To learn more about how the service works, and the numerous different ways we could help you, give us a call and we’ll be happy to answer your questions.
As summer comes to a close, things are firing on all cylinders in the health insurance world. We’re getting ready to serve you during this year’s enrollment periods. Health insurance enrollment is one of the most important aspects of your financial life, but we know it’s also a bit stressful. This brief guide should help you determine your next steps.
Health Insurance Open Enrollment…
Open Enrollment for all health insurance plans (except for Medicare) begins November 1 and lasts until January 31, 2018. It’s important to note this year’s more brief enrollment period. Make any necessary changes by January 31st.
From now until November 1, gather your medical bills and evaluate the past year’s spending. Would it make sense to switch to a lower-deductible, higher-premium plan – or vice versa?
Also watch for notices from your health insurance company. They will tell you if, and more importantly how, your current plan is changing. You might even wish to speak to your primary care physician about your coverage limits, so that you can decide whether a new healthcare plan might be a better fit for your needs. Then give us a call so we can help you compare policies.
If you’re enrolled in a Covered California plan…
Even if you want to keep your current plan, you still need to log into the system and update your household and financial information. You need to do this so that your subsidy, if you receive one, can be calculated correctly.
If you’re on Medicare…
Your Annual Election Period runs from October 15 to December 7. During this time you can drop a plan, add a plan, or switch from one plan into another. Changes take effect on January 1.
You can make some changes between January 1 and February 14. If you change your mind about a Medicare Advantage plan, you can drop it and go back to Original Medicare during this time. If you do go back to Original Medicare, you can add a Part D plan during this period.
Late enrollment starts January 1 and lasts until March 31. If you forgot to sign up for Medicare during your original eligibility period when you turned 65, you can do that now. Keep in mind that you might be charged a late penalty, and coverage won’t start until July 1.
If you decide to keep your current Medicare plan(s), you don’t have to do anything at all. They will automatically renew, although your premiums or coverage might change. Watch your mail for notices from Medicare, detailing these changes.
It would be nearly impossible to avoid the news facing the health insurance world right now. As Congress continues to debate the merits and drawbacks of various replacements, the Affordable Care Act stands… But that doesn’t mean that things will continue exactly as they have been.
For one thing, there is no guarantee that the federal government will continue to fund subsidies that help to pay for premiums. That leaves our state lawmakers deciding what to do about the cost of health insurance plans offered through Covered California. Not only are premiums set to rise about 12.5 percent next year; California lawmakers are considering a 12.4 “CSR surcharge” to silver-level plans on top of that, if the federal government fails to fund subsidies next year.
The uncertainty is impacting health insurance providers as well. Anthem Blue Cross has just announced that they will pull out of much of California’s market, remaining only in Santa Clara County, parts of Northern California, and the Central Valley. About 153,000 Anthem customers, or nearly 10 percent of those enrolled in a health care plan through Covered California, will lose their provider. Luckily, for now most will still be able to choose from at least three other providers, depending upon their geographic area.
It’s not just happening in California. All over the nation, insurers are forced to reconsider their participation in the Affordable Care Act exchanges, or issue significant rate hikes.
It’s clear that Covered California and other states’ exchanges are facing some turmoil. In the meantime, remember that you don’t have to purchase your coverage through the exchange. If you’re one of the ten percent who will be affected by Anthem’s exit, or you just want to compare rates for the 2018 coverage year, we can help you decide if purchasing a plan on the private market would be right for you.