Group Health Insurance
Health care reform
Health Savings Accounts (HSAs)
Individual Health Insurance
Long Term Care Insurance
Medicare related coverage
05-24-2010by Colleen King
With all the discussion around health care coverage, the cost, who’s good and who’s not, I like to see my clients get the most they can from their health insurance.
The big tip–the excitement–drum roll please…..You want to use contracted providers whenever possible. With HMO (health maintenance organization) plans you don’t really have a choice. You have to see doctors contracted with the carrier or your care isn’t covered except in case of an emergency.
PPOs, preferred provider organizations, you have the option of using providers that are or aren’t contracted. If you use a doctor, hospital, outpatient surgery center, whatever, that IS contracted with your insurance carrier you get the benefit of a contracted rate. So even if you are paying for the care, like when you haven’t met your deductible yet, you get the benefit of the contracted rate, also known as a discounted rate or negotiated rate. This can really help–I had blood work that I was billed over $400 for last year, and once the negotiated rate was applied, it cost about $100. I still had to pay the bill, but would the lab have knocked it down 75%? I think not.
So either go to the web site of your insurance company (they all have them) or call them. You can also ask the office or hospital you are going to be going to if they are contracted but be sure to specify if you have an HMO or PPO plan. Just asking ‘do you take Aetna’ won’t help if you have an HMO and they only accept PPOs.
It may seem like a little thing, but believe me, it will make a difference.
05-20-2010by Colleen King
As with most things that came out in the health care reform bill, the devil is in the details. The small business tax credit most assuredly included. I am not a tax expert by any means, but my wonderful tax guy, David Marton in Westlake Village, passed this on to me from the Kiplinger Tax Letter. And here is an article with various pieces of information you may find helpful.
So, you will get a 35% tax credit if you have 10 or fewer employees and the average yearly wages are less than $25,000. If you are a tax exempt organization, the credit is capped at 25%. And the higher the average wages, the more full time employees you have, the credit decreases. For example, the Kiplinger letter give the example that if you have 15 employees, averaging $35,000 per year, the credit goes down to 9%. And it’s gone completely if you have more than 25 full time employees or wages average more than $50,000.
And god forbid our government should stop there as far as complexity. Guess who is NOT eligible to be included in this? Partners, sole proprietors, 2% owners of S corporations and 5% owners of C corporations. On top of that, Family Members–including kids, their spouses, spouses and their parents, grand kids, parents, siblings and their spouses, nieces, nephews, aunts and uncles. I didn’t see anything about partridges in pear trees, but I bet they’re excluded too. Then there’s rules around seasonal workers, part timers, it just goes on and on.
Oh Yeah–employers must be contributing a minimum of 50% of the employee premium. Most do, but several of my clients have a fixed amount they contribute per employee, and sometimes that doesn’t calculate out to be 50%.
Then the amount of the credit you take decreases the amount of the deduction you can take for paying premiums. That makes sense, otherwise you’d be ‘collecting’ twice.
And there’s more, so I urge you to contact your tax professional to see how this works for you–or doesn’t–before you make any decisions about your benefit offerings and how they will work with the new credits. And of course, they phase out over the next few years. Probably out the time we figure it out.
Like I said, there’s a lot to this, so stay tuned....read more
05-10-2010by Colleen King
In my last article I talked about the impending herd of new graduates, high school and college, and that people are now needing to address what to do about their health insurance.
Again, If your high school grad is going to college, then of course they can stay on your group health plan if you want them to. The health care reform bill has passed, one of the FEW things that comes into effect this year is allowing overage dependents up to age 26 to stay on their parents’ plan. That is supposed to to go into effect September 23 this year, but most major carriers have said they will implement this early. But should you do it?
Check the cost of doing this–if you only have one child it might be more expensive to go that way. if you have more than one child on the group plan, usually it is the same cost regardless of the number of kids. So ask.
Other options to consider–There are short term health plans available that I refer to as ‘accident and illness’ plans. Generally they don’t cover maternity, routine care or anything pre-existing. But if someone gets sick or injured, which tends to happen in your 20s, then you are covered subject to the deductible. Because they don’t cover pre-existing conditions, the underwriting review period is very quick and these can be set up in a couple of days usually. They can either be purchased on a month to month basis for a maximum of 6 months, or if you know specifically how long you will need it you can purchase a certain number of days. It’s affordable–one carrier I use for these, in Los Angeles County a 22 year old can get a policy with a $1000 deductible for $87/month. Or if you knew you only needed one month, or 30 days, that same coverage would cost $51.30.
Or, if you’re not sure what the future holds for your new grad, no job prospects on the horizon, you would probably want to consider a regular individual health plan. Rates on these really run the gamut, so I won’t go into a lot of detail here, but for a 22 year old male, in a Northridge zip code, standard rates range from $44 – $440/month.
So there are ways to get your new grad covered; consider talking to an independent agent to sort through the best options for you.
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05-07-2010by Colleen King
May into June is such a great time for families as their kids are getting ready to graduate from high school or college. A time of pride, sense of accomplishment, it’s great. As I drive around the LA area I see the signs of upcoming graduation ceremonies and it takes me back. We won’t go into how far back.
But it’s also the time to figure out what to do about health insurance. If your high school grad is going to college, then of course they can stay on your group health plan if you want them to. But in general the landscape has changed. Many people are unemployed, or their companies have dropped their health plans. Or it is way too expensive to keep dependents on the plan. Or new grads are coming into an environment where jobs are scarce, and jobs with benefits, even more scarce.
Now that the health care reform bill has passed, one of the FEW things that comes into effect this year is allowing overage dependents up to age 26 to stay on their parents’ plan. That is supposed to to go into effect September 23 this year, but most major carriers have said they will implement this early. But should you do it?
Check the cost of doing this–if you only have one child it might be more expensive to go that way. if you have more than one child on the group plan, usually it is the same cost regardless of the number of kids. So ask. Many times it is more cost effective to go to an individual plan, but if you child has a health condition that will keep them from getting coverage, then leaving them on the plan is the way to go.
Next, some options if you decide to buy insurance on your own
A 3 minute Video on what’s happening this year because of health care reform....read more
05-03-2010by Colleen King
I saw this article title and had to look at it a couple of times. Deductible on a life insurance policy? That brought up all sorts of morbid concepts for me so I decided to read it.
Thomas Jurek, an agent in the Midwest, had an interesting article published in the Agent Sales Journal on this last December, and what he was pointing out was a different way to assess your life insurance needs and planning. His definition was that it was the difference between what a family needs and the amount they will receive at the time of the breadwinner’s death.
Most agents recommend an annual or biannual review of insurance in place. That way you can make sure there’s enough, or equally as important, do you still need all that you have? When kids have left the nest and are financially independent, a couple nearing retirement might not need as much life insurance.
Basically, the way I read this, is rather than the deductible being what you pay before insurance kicks in, this is more like what are you going to be stuck paying for, or going without, based on how much life insurance there is when the primary earner dies. For younger families with kids you have to allow for college and weddings. What assets do you have that you need to protect? Rental property? what if you lose the tenant? What do you have in savings and are you willing to deplete that if someone dies and the life insurance isn’t enough to meet your mutual obligations?
Lots of questions, and multiple answers for most scenarios. Bottom line, call an agent you trust and see where you stand. It could keep your family from having to make some really tough decisions at a difficult time.
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