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Friday, April 27, the Internal Revenue Service (IRS) announced that the 2018 annual contribution limit to Health Savings Accounts (HSAs) for persons with family coverage under a qualifying High Deductible Health Plan (HDHP) is restored to $6,900. The single-coverage limit of $3,450 is not affected.

This is the final word on what has been an unusual back-and-forth saga. The 2018 family limit of $6,900 had been announced in May 2017. Following passage of the Tax Cuts and Jobs Act in December 2017, however, the IRS was required to modify the methodology used in determining annual inflation-adjusted benefit limits. On March 5, 2018, the IRS announced the 2018 family limit was reduced by $50, retroactively, from $6,900 to $6,850. Since the 2018 tax year was already in progress, this small change was going to require HSA trustees and recordkeepers to implement not-so-small fixes to their systems. The IRS has listened to appeals from the industry, and now is providing relief by reinstating the original 2018 family limit of $6,900.

Employers that offer HSAs to their workers will receive information from their HSA administrator or trustee regarding any updates needed in their payroll files, systems, and employee communications. Note that some administrators had held off making changes after the IRS announcement in March, with the hopes that the IRS would change its position and restore the original limit. So employers will need to consider their specific case with their administrator to determine what steps are needed now.

HSA Summary

An HSA is a tax-exempt savings account employees can use to pay for qualified health expenses. To be eligible to contribute to an HSA, an employee:

  • Must be covered by a qualified high deductible health plan (HDHP);
  • Must not have any disqualifying health coverage (called “impermissible non-HDHP coverage”);
  • Must not be enrolled in Medicare; and
  • May not be claimed as a dependent on someone else’s tax return.

HSA 2018 Limits

Limits apply to HSAs based on whether an individual has self-only or family coverage under the qualifying HDHP.

2018 HSA contribution limit:

  • Single: $3,450
  • Family: $6,900
  • Catch-up contributions for those age 55 and older remains at $1,000

2018 HDHP minimum deductible (not applicable to preventive services):

  • Single: $1,350
  • Family: $2,700

2018 HDHP maximum out-of-pocket limit:

  • Single: $6,650
  • Family: $13,300*

*If the HDHP is a nongrandfathered plan, a per-person limit of $7,350 also will apply due to the ACA’s cost-sharing provision for essential health benefits.

 

Originally posted on thinkHR.com

As the costs of health care soar, many consumers are looking for ways to control their medical spending. Also, with the rise of enrollment in high deductible health plans, consumers are paying for more health care out-of-pocket. From medical savings accounts to discount plans for prescriptions, patients are growing increasingly conscious of prices for their healthcare needs. Price shopping procedures and providers allows you to compare prices so that you are getting the best value for your care.

Why do you need to look beyond your nearby and familiar providers and locations for healthcare? Here’s a hypothetical example: Chris is a 45-year old male in good physical health. During his last check-up he mentions to his doctor that he’s had some recent shortness of breath and has been more tired as of late. His doctor orders an EKG to rule out any problems. If Chris went to his local hospital for this procedure, it would cost $1150. He instead looks online and shops around to find other providers in his area and finds he can get the same procedure for $450 at a nearby imaging center. His potential savings is $700 simply by researching locations.

So where do you start when shopping around for your health care?  A good place to begin is by researching your health plan online. Insurance companies will post cost estimates based on facility, physician, and type of procedure. Keep in mind that these are just estimates and may vary based on what coverage you are enrolled in. Another way to shop is by checking out websites that have compiled thousands of claims information for various procedures and locations to give an estimate of costs. However, deciphering whether a site is reporting estimates based on the “medical sticker price” of charges or rates for private insurance plans or Medicare is difficult.  There are huge differences in prices at different providers for the exact same procedure. This is because contracts between insurance agencies and providers vary based on negotiated amounts. This makes it hard to get consistent pricing information.

Check out these sites that do a great job comparing apples to apples for providers:

  • Healthcare Blue Book
    • What Kelly Blue Book is to cars, Healthcare Blue Book is to medical pricing
  • New Choice Health
    • Reports on pricing of medical procedures, providers, quality of facilities, and customer feedback for healthcare in all 50 states
  • The Leapfrog Group
    • Publishes data on hospitals so patients can compare facilities and costs for treatments and procedures

After compiling all the information on prices and procedures, you can still call and negotiate costs with the location of your care. Fair Health Consumer has tips on how to negotiate with providers and plan for your healthcare needs.

Knowledge is POWER and when you spend time researching and comparing healthcare costs, you are empowering yourself!  Exercising due diligence to plan for you and your family’s medical needs will save you money and give you confidence in your decisions for care.

Many employee benefit limits are automatically adjusted each year for inflation (this is often referred to as an “indexed” limit). UBA offers a quick reference chart showing the 2017 cost of living adjustments for health and Section 125 plans, qualified plans, Social Security/Medicare withholding, compensation amounts and more. This at-a-glance resource is a valuable desk tool for employers and HR practitioners.

Here’s a snapshot of a section of the 2017 health plan limits; be sure to request the complete chart from a UBA Partner.

2017 health plan limits

Originally published by www.ubabenefits.com

 

On October 3, 2016, federal officials posted the 2016 Transitional Reinsurance Program Annual Enrollment Contributions Form that health insurers and self-funded plan sponsors (employers) will use to make required payments under the Transitional Reinsurance Program (TRP). The 2016 report is due no later than November 15, 2016.

Background

The Affordable Care Act (ACA) prohibits insurers from rejecting applicants based on their health status or pre-existing conditions. To spread the financial risk of this change across insurance markets, the ACA also established the Transitional Reinsurance Program (TRP). The program raises revenue to help fund high-risk insurance pools by imposing a mandatory contribution on health insurers and employers with self-funded health plans (contributing entities). Contributions are collected annually for each calendar year from 2014 through 2016.

For 2016, the reinsurance contribution amount is $27 per plan enrollee per year. (The 2014 amount was $63 and the 2015 amount was $44.)

Self-Funded Health Plans

Insurers and health maintenance organizations (HMOs) are responsible for reporting and paying the reinsurance contribution for insured plans. The employer policyholder does not have any duties under the TRP for any group insurance plans.

For self-funded health plans, however, the plan sponsor (employer) is responsible for reporting its enrollment count and paying the appropriate contribution. Although a third-party administrator may handle duties on behalf of the self-funded plan, the employer as plan sponsor remains responsible for accuracy and timeliness.

The reinsurance contribution applies only to health plans that provide minimum value. To confirm whether a particular plan provides minimum value, refer to the plan’s Summary of Benefits and Coverage (SBC). Minimum value plans typically are major medical and HMO plans that provide benefits covering at least 60 percent of allowable costs.

The reinsurance contribution does not apply to the following plans:

  • Stand-alone dental and/or vision plans.
  • Carve-out prescription drug plans.
  • Health flexible spending accounts (FSAs).
  • Integrated health reimbursement arrangements (HRAs).
  • Health savings accounts (HSAs).

Exception for Certain Self-Funded Self-Administered Plans

For 2015 and 2016 only, group health plans that are both self-funded and self-administered are exempt from the reinsurance contribution requirement. Plans that do not use a third-party administrator for “core administrative functions,” such as claims processing or adjudication or plan enrollment, may qualify for the exception. The majority of self-funded, self-administered plans are union trust plans, so this exception is not widely available outside of the multi-employer plan environment.

Enrollment and Contribution Submission Form

Contributing entities must register on www.pay.gov. (Entities that created a Pay.gov account for earlier years may use the account this year.) Once registered, the contributing entity will use the online form to enter their identifying information and 2016 enrollment counts.(If reporting for four or more entities, supporting documentation also is required.) Access the 2016 form directly at 2016 Transitional Reinsurance Program Annual Enrollment Contributions Form or by going to www.pay.gov, then searching for “2016 ACA Transitional Reinsurance.”

The form automatically calculates the plan’s required annual reinsurance contribution based on the enrollment count. To complete the form, entities also must enter payment information (e.g., bank account info) and schedule their payment dates(s). The two payment schedule options are to pay the total contribution by January 17, 2017, or to pay in two installments by January 17, 2017 and November 15, 2017.

Several different methods are allowed to determine the plan’s enrollment count:

  • Actual count method.
  • Snapshot method.
  • Form 5500 method.

These three methods are similar to the methods used to determine the Patient-Centered Outcomes Research Institute (PCORI) fee. For the reinsurance contribution, however, the actual count and snapshot count methods are based on enrollment in the first nine months of the calendar year, regardless of when the health plan year begins and ends.

Employers may use Employee Retirement Income Security Act (ERISA) plan assets (e.g., employee contributions) to pay some or all of the plan’s reinsurance contribution.

Key Dates for 2016 Reinsurance Contribution

  • By November 15, 2016, submit enrollment count and schedule payment date(s).
  • By January 17, 2017, remit 2016 contribution:
    • If paying 2016 amount in single installment: $27 per covered life.
    • If paying in two installments: $21.60 per covered life.
  • By November 15, 2017, remit 2016 contribution (second installment, if any): $5.40 per covered life.

More Information

For step-by-step instructions to complete the 2016 Form, register on the CMS REGTAP page, and then search for “2016 Reinsurance Contributions.”. This web-based training was developed by the Centers for Medicare & Medicaid Services (CMS), the federal agency responsible for the TRP, to assist contributing entities. CMS also will respond to specific questions sent to ReinsuranceContributions@cms.hhs.gov.

Entities are encouraged to allow enough time to review the training site and understand the requirements. Entities that made reinsurance contributions for 2015 are familiar with the process. Entities that are responsible for the first time this year should not wait until November to begin preparing their submission. Also, if reporting for four or more entities, supporting documentation will be required and must be submitted using specific file formats.

Employers, brokers, and other interested parties may access the web-based training site at https://www.regtap.info/index.php.

The deadline for contributing entities to complete the 2016 form is November 15, 2016.

Originally published by www.thinkhr.com

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- San Francisco, Non-profit organization

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