Taking control of health care expenses is on the top of most people’s to-do list for 2018. The average premium increase for 2018 is 18% for Affordable Care Act (ACA) plans. So, how do you save money on health care when the costs seems to keep increasing faster than wage increases? One way is through health savings accounts.
Health savings accounts are used in conjunction with High Deductible Health Plans (HDHP) and allow savers to use their pre-tax dollars to pay for qualified health care expenses. There are three major types of medical savings accounts as defined by the IRS. The Health Savings Account (HSA) is funded through an employer and is usually part of a salary reduction agreement. The employer establishes this account and contributes toward it through payroll deductions. The employee uses the balance to pay for qualified health care costs. Money in HSA is not forfeited at the end of the year if the employee does not use it. The Health Flexible Savings Account (FSA) can be funded by the employer, employee, or any other contributor. These pre-tax dollars are not part of a salary reduction plan and can be used for approved health care expenses. Money in this account can be rolled over by one of two ways: 1) balance used in first 2.5 months of new year or 2) up to $500 rolled over to new year. The third type of savings account is the Health Reimbursement Arrangement (HRA). This account may only be contributed to by the employer and is not included in the employee’s income. The employee then uses these contributions to pay for qualified medical expenses and the unused funds can be rolled over year to year.
There are many benefits to participating in a medical savings account. One major benefit is the control it gives to employee when paying for health care. As we move to a more consumer driven health plan arrangement, the individual can make informed choices on their medical expenses. They can “shop around” to get better pricing on everything from MRIs to prescription drugs. By placing the control of the funds back in the employee’s hands, the employer also sees a cost savings. Reduction in premiums as well as administrative costs are attractive to employers as they look to set up these accounts for their workforce. The ability to set aside funds pre-tax is advantageous to the savings savvy individual. The interest earned on these accounts is also tax-free.
The federal government made adjustments to contribution limits for health savings accounts for 2018. For an individual purchasing single medical coverage, the yearly limit increased $50 from 2017 to a new total $3450. Family contribution limits also increased to $6850 for this year. Those over the age of 55 with single medical plans are now allowed to contribute $4450 and for families with the insurance provider over 55 the new limit is $7900.
Health care consumers can find ways to save money even as the cost of medical care increases. Contributing to health savings accounts benefits both the employee as well as the employer with cost savings on premiums and better informed choices on where to spend those medical dollars. The savings gained on these accounts even end up rewarding the consumer for making healthier lifestyle choices with lower out-of-pocket expenses for medical care. That’s a win-win for the healthy consumer!
Benefits of going to your annual physical include both cost savings and gaining knowledge.
Have you ever heard the proverb “Knowledge is power?” It means that knowledge is more powerful than just physical strength and with knowledge people can produce powerful results. This applies to your annual medical physical as well! The #1 goal of your annual exam is to GAIN KNOWLEDGE. Annual exams offer you and your doctor a baseline for your health as well as being key to detecting early signs of diseases and conditions.
According to Malcom Thalor, MD, “A good general exam should include a comprehensive medical history, family history, lifestyle review, problem-focused physical exam, appropriate screening and diagnostic tests and vaccinations, with time for discussion, assessment and education. And a good health care provider will always focus first and foremost on your health goals.”
Early detection of chronic diseases can save both your personal pocketbook as well as your life! By scheduling AND attending your annual physical, you are able to cut down on medical costs of undiagnosed conditions. Catching a disease early means you are able to attack it early. If you wait until you are exhibiting symptoms or have been symptomatic for a long while, then the disease may be to a stage that is costly to treat. Early detection gives you a jump start on treatments and can reduce your out of pocket expenses.
When you are prepared to speak with your Primary Care Physician (PCP), you can set the agenda for your appointment so that you get all your questions answered as well as your PCP’s questions. Here are some tips for a successful annual physical exam:
- Bring a list of medications you are currently taking—You may even take pictures of the bottles so they can see the strength and how many.
- Have a list of any symptoms you are having ready to discuss.
- Bring the results of any relevant surgeries, tests, and medical procedures
- Share a list of the names and numbers of your other doctors that you see on a regular basis.
- If you have an implanted device (insulin pump, spinal cord stimulator, etc) bring the device card with you.
- Bring a list of questions! Doctors want well informed patients leaving their office. Here are some sample questions you may want to ask:
- What vaccines do I need?
- What health screenings do I need?
- What lifestyle changes do I need to make?
- Am I on the right medications?
Becoming a well-informed patient who follows through on going to their annual exam as well as follows the advice given to them from their physician after asking good questions, will not only save your budget, but it can save your life!
Have you heard the saying “the eyes are the window to your soul”? Well, did you know that your mouth is the window into what is going on with the rest of your body? Poor dental health contributes to major systemic health problems. Conversely, good dental hygiene can help improve your overall health. As a bonus, maintaining good oral health can even REDUCE your healthcare costs!
Researchers have shown us that there is a close-knit relationship between oral health and overall wellness. With over 500 types of bacteria in your mouth, it’s no surprise that when even one of those types of bacteria enter your bloodstream that a problem can arise in your body. Oral bacteria can contribute to:
- Endocarditis—This infection of the inner lining of the heart can be caused by bacteria that started in your mouth.
- Cardiovascular Disease—Heart disease as well as clogged arteries and even stroke can be traced back to oral bacteria.
- Low birth weight—Poor oral health has been linked to premature birth and low birth weight of newborns.
The healthcare costs for the diseases and conditions, like the ones listed above, can be in the tens of thousands of dollars. Untreated oral diseases can result in the need for costly emergency room visits, hospital stays, and medications, not to mention loss of work time. The pain and discomfort from infected teeth and gums can lead to poor productivity in the workplace, and even loss of income. Children with poor oral health miss school, are more prone to illness, and may require a parent to stay home from work to care for them and take them to costly dental appointments.
So, how do you prevent this nightmare of pain, disease, and increased healthcare costs? It’s simple! By following through with your routine yearly dental check ups and daily preventative care you will give your body a big boost in its general health. Check out these tips for a healthy mouth:
- Maintain a regular brushing/flossing routine—Brush and floss teeth twice daily to remove food and plaque from your teeth, and in between your teeth where bacteria thrive.
- Use the right toothbrush—When your bristles are mashed and bent, you aren’t using the best instrument for cleaning your teeth. Make sure to buy a new toothbrush every three months. If you have braces, get a toothbrush that can easily clean around the brackets on your teeth.
- Visit your dentist—Depending on your healthcare plan, visit your dentist for a check-up at least once a year. He/she will be able to look into that window to your body and keep your mouth clear of bacteria. Your dentist will also be able to alert you to problems they see as a possible warning sign to other health issues, like diabetes, that have a major impact on your overall health and healthcare costs.
- Eat a healthy diet—Staying away from sugary foods and drinks will prevent cavities and tooth decay from the acids produced when bacteria in your mouth comes in contact with sugar. Starches have a similar effect. Eating healthy will reduce your out of pocket costs of fillings, having decayed teeth pulled, and will keep you from the increased health costs of diabetes, obesity-related diseases, and other chronic conditions.
There’s truth in the saying “take care of your teeth and they will take care of you”. By instilling some of the these tips for a healthier mouth, not only will your gums and teeth be thanking you, but you may just be adding years to your life.
Fall. With it comes cooler temperatures’, falling leaves, warm seasonal scents like turkey and pumpkin pie, and Open Enrollment. It goes without saying; employees who understand the effectiveness of their benefits are much more pleased with those packages, happier with their employers, and more engaged in their work. So, as your company gears up for a new year of navigating Open Enrollment, here are a few points to keep in mind to make the process smoother for both employees and your benefits department. Bonus: it will lighten the load for both parties alike during an already stress-induced season.
Communicate Open Enrollment Using a Variety of Mediums
Advertise 2018 benefit changes to employees by using a variety of mediums. The more reminders and explanation of benefits staff members have using more than one mode of media, the more likely employees will go into Open Enrollment with more knowledge of your company’s benefit options and when they need to have these options completed for the new year.
- Consider explainer videos to simplify the amount of emails and paperwork individuals need to review come Open Enrollment time. These videos can increase the bottom line as well, eliminating the high cost of print material.
- Opt for placards placed throughout your high-traffic areas. Communicate benefit options and remind employees of Open Enrollment dates for the new year by posting in such areas as the lobby, break room and bathroom stalls.
- Choose SMS texting. Today, over 97% of individuals use text. Ninety-eight percent of those that use text open messages within the first three minutes of receiving them; 6-8 times higher than the engagement rate for email. Delivering a concise message to employees’ mobile devices creates more touch points along the Open Enrollment journey. The key, however, is making it quick so as to entice your employees to take action.
- Promote apps and in-app tools. Push notifications and apps like Remind 101 can help drive employee engagement during Open Enrollment season simply by providing short messages reminding them to enroll. Notifications like these can also be tailored to unique employee groups based on location, job level, eligibility status and more.
Utilize Mobile Apps and Web Portals for Open Enrollment
Now that your company has communication down pat for Open Enrollment, simplify the arduous task employees have of enrolling for the coming year by going paperless. Utilize web portals through benefit brokers and companies like ADP to eliminate the hassle of employees having to fill out paperwork both at renewal, and at the time of hire. With nearly three quarters of individuals in the United States checking their phone once an hour and 90% percent of this time is spent using one app or another as a main source of communication, mobile apps can make benefits engagement much easier due to the anywhere/anytime accessibility they offer.
The personal perks for employees are great too! Staff members with a major lifestyle event can make benefit adjustments quickly with the ease of mobile apps. Employees recognize this valuable and time-saving trend and enjoy having this information at their fingertips.
Open Enrollment season can be a stressful time but hopefully these tips will help for a smoother transition into the next year for your business. Simple things like using explainer videos, placing reminders in high traffic areas and utilizing mobile apps and text messaging can save time and stress in the long run for your employees and benefit department.
Congress approved the Health Insurance Portability and Accountability Act (HIPAA) to guard the privacy of personal medical information, and to give individuals the right to keep their health insurance coverage for pre-existing conditions in place even if they change jobs. The law has done this, providing important safeguards for patients. But it has also increased the red tape involved in medical care.
Congress passed HIPAA in August 1996, and the U.S. Department of Health and Human Services finalized standards for the electronic exchange, privacy and security of health information in 2002. The rules apply to health plans, health care clearinghouses, and to any health care provider, such as a doctor, who transmits health information in electronic form.
Congress intended HIPAA to protect individually identifiable health information. Any entity, including a physician’s office, a hospital or other health care facility, or an insurer, that deals with personal health information must follow strict rules about how to handle that information to avoid disclosing it to someone not authorized to see it. For example, Health and Human Services allows physicians and insurance companies to exchange individually identifiable health information to pay a health claim, but would not allow them to release it publicly. Penalties for violating the regulations include civil fines of up to $50,000 per violation, according to Health and Human Services.
According to Health and Human Services, the privacy rule also requires physicians, hospitals, insurers, and other health care entities to use and disclose only the minimum amount of information needed to complete the transaction or fulfill the request. As a practical matter, for example, that means a physician should not send a patient’s entire medical file to an insurer if just one page from the record will suffice to answer the insurer’s query.
In addition to protecting patients’ privacy, HIPAA also limits the ability of a new employer plan to exclude coverage for pre-existing conditions. This means a person who has health insurance coverage can change jobs — and therefore health plans — without worrying that a condition they already have, such as diabetes or asthma, would not be covered under the new health plan. This was not always the case, according to the U.S. Department of Labor. “In the past, some employers’ group health plans limited, or even denied, coverage if a new employee had such a condition before enrolling in the plan. Under HIPAA, that is not allowed,” the Department of Labor says. HIPAA also prohibits discrimination against employees and their family members based on health histories, previous claims, and genetic information, according to the Department of Labor.
HIPAA, for the first time, allowed patients the legal right to see, copy, and correct their personal medical information. It also prevented employers from accessing and using personal health information to make employment decisions. And, it enabled patients with pre-existing conditions to change jobs without worrying that their conditions would not be covered under a new employer’s health plan.
However, HIPAA’s effects have not all been positive. The regulations increased the paperwork burden for doctors considerably, according to the American Medical Association. HIPAA has spawned a mini-industry of companies and consultants who help medical professionals comply with the law’s lengthy provisions. In addition, some professionals who deal with medical paperwork have become overcautious about releasing protected information. For example, some physician’s offices now refuse to mail test results, saying patients need to pick them up in person. And some hospitals require physicians to submit written requests on their own letterhead for information on a patient’s condition, when the law allows this information to be provided by phone.
Originally Published By Livestrong.com
Insurance has become the method by which most Americans have their health-care costs paid. By paying a regular monthly bill for health insurance, the cost of expected health care events is spread out into even payments and the cost of major unexpected medical incidents is absorbed by insurance. Lack of health insurance can have a profound negative effect on personal finances.
Lack of health insurance can come about due to lack of income to pay for it, or when a breadwinner is between jobs that would otherwise provide health insurance as an employment benefit. If a major illness or accident occurs during the time a person is uninsured, it can lead swiftly to bankruptcy, reports the Oregon Public Broadcasting News. Under-insurance, that is, health insurance which is not sufficient to cover the costs of a major health incident, can also lead to bankruptcy. A study published by the American Journal of Medicine in August 2009, reported that well over 60 percent of U.S. bankruptcies filed. in 2007 were due to inability to pay medical costs. Most of these debtors had medical debts over $5,000, which represented a significant portion of their household annual income; three-quarters had health insurance insufficient to cover their bills, and one-quarter had no insurance.
Lack of health insurance can lead to a breadwinner's death, further causing the most severe reduction on household income. According to a Harvard Medical School study reported by Reuters news, about 45,000 people in the United States die each year due to lack of health insurance. Thus, people who could otherwise serve as breadwinners or care-givers are removed from being able to do so. The Urban Institute points out that people lacking health insurance create the significant economic impact of reduced personal earnings, because poorer health means less productive work years and more time off work due to illness or injuries during those working years.
Beginning January 1, 2014, most people will be required to maintain health insurance, and individuals who do not obtain health insurance will have to pay a penalty under the federal Patient Protection and Affordable Care Act of 2010. The insurance requirement penalty provision exempts people with income below the poverty level, as well as those in jail, members of registered Indian tribes, those whose religious tenets preclude health insurance, and individuals for whom essential health insurance coverage cost for one month would exceed 8 percent of their household gross income for the year. People who do not meet one of these exemptions, but who decline to purchase health insurance, may be penalized up to $95 in 2014, $350 in 2015, $750 in 2016, and $750 plus a cost of living increase for subsequent years. According to SmartMoney, the penalty provision is likely to have the strongest impact on the personal finances of younger, unmarried consumers. Although the statute exempts the poorest people from its provisions, the penalty for failure to have health insurance will negatively impact the personal finances of those to whom it applies.
By Cindy Hill
Originally Published By LiveStrong.com
Most health insurance plans cover emergency treatment, hospital stays and medical exams. If you are injured in an accident, your health insurance plan might not pay for all the incurred medical expenses. Supplemental accident insurance coverage pays cash benefits for illnesses or injuries caused by an accident, including fractures and physical therapy. The coverage is designed to help alleviate the burden of unexpected costs. Depending on how the policy is paid, the payouts may be classified as taxable income.
Accident insurance coverage generally covers death or injuries caused by accidents on or off the job. There are a variety of coverage options available. Some employers offer the accidental coverage as a voluntary supplemental plan. You can also purchase private accident insurance to protect yourself if the coverage is not offered through your employer.
According to the IRS, if you paid the premiums on an accident or health insurance policy, the benefits are not taxable. Payouts from an insurance policy taken out through the employer are not taxed if you paid the premiums with after-tax dollars. If you pay the premiums of an accident insurance plan through a cafeteria plan, the premium was not included as taxable income and is considered paid by the employer and therefore the benefits are taxable.
Accidental insurance payouts are taxable if the employer paid for the insurance plan. If you paid for an accidental insurance plan through the employer using pre-tax dollars, your benefits are taxable income. Any benefits received from your employer while injured are considered salary or wages and taxable as ordinary income. Additional taxable disability benefits include income from a welfare fund, state sickness or disability fund and association of employers or employees.
Report any taxable insurance payouts as wages, salaries, tips, etc., on your taxes. If you are suffering a long-term disability and receive taxable benefits, avoid a hefty tax bill by submitting a Form W-4S, Request for Federal Income Tax Withholding From Sick Pay, to the insurance company.
By Jeannine Mancini, Originally Published By LiveStrong
A fixed indemnity health plan pays a specific amount of cash for certain health-related events (for example, $40 per office visit or $100 per hospital day). The amount paid is neither related to the medical expense incurred, nor coordinated with other health coverage. Further, a fixed indemnity health plan is considered an “excepted benefit.”
Under HIPAA, fixed dollar indemnity policies are excepted benefits if they are offered as “independent, non-coordinated benefits.” Under the Patient Protection and Affordable Care Act (ACA), excepted benefits are not subject to the ACA’s health insurance requirements or prohibitions (for example, annual and lifetime dollar limits, out-of-pocket limits, requiring individual and small-group policies to cover ten essential health benefits, etc.). This means that excepted benefit policies can exclude preexisting conditions, can have dollar limits, and do not legally have to guarantee renewal when the coverage is cancelled.
Further, under the ACA, excepted benefits are not minimum essential coverage so a large employer cannot comply with its employer shared responsibility obligations by offering only fixed indemnity coverage to its full-time employees.
Some examples of fixed indemnity health plans are AFLAC or similar coverage, or cancer insurance policies.
Recently, the IRS released a Memorandum on the tax treatment of benefits paid by fixed indemnity health plans that addresses two questions:
- Are payments to an employee under an employer-provided fixed indemnity health plan excludible from the employee’s income under Internal Revenue Code §105?
- Are payments to an employee under an employer-provided fixed indemnity health plan excludible from the employee’s income under Internal Revenue Code §105 if the payments are made by salary reduction through a §125 cafeteria plan?
By Danielle Capilla, Originally Published By United Benefit Advisors
Our Firm is making a big push to provide compliance assessments for our clients and using them as a marketing tool with prospects. Since the U.S. Department of Labor (DOL) began its Health Benefits Security Project in October 2012, there has been increased scrutiny. While none of our clients have been audited yet, we expect it is only a matter of time and we want to make sure they are prepared.
We knew most fully-insured groups did not have a Summary Plan Description (SPD) for their health and welfare plans, but we have been surprised by some of the other things that were missing. Here are the top five compliance surprises we found.
- COBRA Initial Notice. The initial notice is a core piece of compliance with the Consolidated Omnibus Budget and Reconciliation Act (COBRA) and we have been very surprised by how many clients are not distributing this notice. Our clients using a third-party administrator (TPA), or self-administering COBRA, are doing a good job of sending out the required letters after qualifying events. However, we have found that many clients are not distributing the required COBRA initial notice to new enrollees. The DOL has recently updated the COBRA model notices with expiration dates of December 31, 2019. We are trying to get our clients to update their notices and, if they haven’t consistently distributed the initial notice to all participants, to send it out to everyone now and document how it was sent and to whom.
- Prescription Drug Plan Reporting to CMS. To comply with the Medicare Prescription Drug Improvement and Modernization Act, passed in 2003, employer groups offering prescription benefits to Medicare-eligible individuals need to take two actions each year. The first is an annual report on the Centers for Medicare & Medicaid Services (CMS) website regarding whether the prescription drug plan offered by the group is creditable or non-creditable. The second is distributing a notice annually to Medicare-eligible plan members prior to the October 15 beginning of Medicare open enrollment, disclosing whether the prescription coverage is creditable or non-creditable. We have found that the vast majority (but not 100 percent) of our clients are complying with the second requirement by annually distributing notices to employees. Many clients are not complying with the first requirement and do not go to the CMS website annually to update their information. The annual notice on the CMS website must be made within:
- 60 days after the beginning of the plan year,
- 30 days after the termination of the prescription drug plan, or
- 30 days after any change in the creditability status of the prescription drug plan.
- ACA Notice of Exchange Rights. The Patient Protection and Affordable Care Act (ACA) required that, starting in September 2013, all employers subject to the Fair Labor Standards Act (FLSA) distribute written notices to all employees regarding the state exchanges, eligibility for coverage through the employer, and whether the coverage was qualifying coverage. This notice was to be given to all employees at that time and to all new hires within 14 days of their date of hire. We have found many groups have not included this notice in the information they routinely give to new hires. The DOL has acknowledged that there are no penalties for not distributing the notice, but since it is so easy to comply, why take the chance in case of an audit?
- USERRA Notices. The Uniformed Services Employment and Reemployment Rights Act (USERRA) protects the job rights of individuals who voluntarily or involuntarily leave employment for military service or service in the National Disaster Medical System. USERRA also prohibits employers from discriminating against past and present members of the uniformed services. Employers are required to provide a notice of the rights, benefits and obligations under USERRA. Many employers meet the obligation by posting the DOL’s “Your Rights Under USERRA” poster, or including text in their employee handbook. However, even though USERRA has been around since 1994, we are finding many employers are not providing this information.
- Section 79. Internal Revenue Code Section 79 provides regulations for the taxation of employer-provided life insurance. This code has been around since 1964, and while there have been some changes, the basics have been in place for many years. Despite the length of time it has been in place, we have found a number of groups that are not calculating the imputed income. In essence, if an employer provides more than $50,000 in life insurance, then the employee should be paying tax on the excess coverage based on the IRS’s age rated table 2-2. With many employers outsourcing their payroll or using software programs for payroll, calculating the imputed income usually only takes a couple of mouse clicks. However, we have been surprised by how many employers are not complying with this part of the Internal Revenue Code, and are therefore putting their employees’ beneficiaries at risk.
There have been other surprises through this process, but these are a few of the more striking examples. The feedback we received from our compliance assessments has been overwhelmingly positive. Groups don’t always like to change their processes, but they do appreciate knowing what needs to be done.
By Bob Bentley, Originally Published By United Benefit Advisors