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Health Insurance Checklist

The health insurance Exchanges opened on October 1, but are not fully operational yet.  No one (that I can find) can say how long it will be until the Exchanges are running smoothly.  But some time in the future, you will be able to get the information you will need to make an informed decision concerning your health care if you plan to purchase your insurance through an Exchange.  Remember, it is the law that you have a health plan by January 1, 2014.  There are some exceptions to this law which we will cover in the next blog.

Here is a checklist you can use when you fill out the application which has to be filled out the day you enroll.

  1. Research your options to pare down your choices to only ones that fit your budget, cover most of the medicines you use, and whose network includes the most important providers to you.
  2. Have Social Security numbers for everyone you want on your insurance policy.
  3. Have the gross salary for your family, or just yourself, if you’re not covering anyone else.
  4. Have the list of providers you want ready.  That way you can check the drug formulary for any plan you’re considering.  Make note how much the co-pay will be for each prescription.
  5. Look at the summary of benefits for any health plan you’re considering if you haven’t done it yet.
  6. Review the details in each plan’s essential benefits.  Look for services you need, such as infertility treatment or gastric bypass, since not all states will include the same items.
  7. Know how much you can afford each month to pay a premium. 
  8. In using an Exchange, use its subsidy calculator or its insurance cost calculator.  From it, you’ll find out how much financial help you can put toward your premium costs.  This may lower your costs each month.
  9. You might be able to have insurance payments sent directly from your bank account.  If that is an option for you, have your banking information with you when you apply.  States may also take credit cards or checks. 

 

Next:  Who Won’t Have to Pay for Insurance or a Penalty?

 

Posted October 25, 2013 by Susan D. Krohn

 


How much Can You Contribute to Your Health Savings Account (HSA)?


This year, federal tax rules allow individuals to contribute up to $3,250 annually to an HSA.  Families can contribute up to $6,450.  Your employer also may contribute to your HSA, but the annual limits on deposits still apply. 

To qualify for an HSA, you must buy insurance, which will be the law as of January 1, 2014, or your employer must buy it for you, that has a deductible of $1,250 for an individual and $2,500 for a family.

That means that before your insurance company pays a dime for your care, you must have spent $1,250 out of your own pocket, assuming you bought individual coverage. 

 When the health care exchanges are fully operational, October 1, 2013, they will offer health plans which have HSA qualified products.

 HSA funds can be used for medical services not covered by the insurance policy, so HSA owners can use tax-advantaged funds to pay for their children’s braces, for example.

Posted October 20, 2013 by Susan D. Krohn


More About Health Savings Accounts (HSAs)


In order to qualify to contribute to an HSA, your high deductible health plan must meet certain criteria. 

1.)    For policies covering only you, with no family coverage, the annual health plan deductible must be at least $1,200, as of 2011. 

2.)    The maximum annual deductible and other out-of-pocket expenses cannot be more than $5,950. 

3.)    The max limit, however, doesn’t apply to expenses or deductions for out-of-network services if you plan use a network, which is the rule with health maintenance organizations (HMOs) and preferred provider organizations (PPOs).  The limits apply to in-network charges. 

4.)    For family coverage, the minimum annual deductible is $2,400 for individual plans and $11,900 for family plans.

In some cases, your high deductable health plan may provide for some preventative care without applying a deductible.  This may apply to tests, checkups, mammograms and diagnostic procedures ordered as follow-ups to routine examinations.

You can deduct from your personal income tax the amount of money you deposit in a HSA account, which is offered by banks and other financial institutions.

The growth in the account’s value is tax free.  The money you withdraw to pay for health expenses is not subject to income tax.

You can withdraw money for other uses as well.  If you are 65 or older, you pay tax on the used funds not used for health care.  If you are younger, you pay taxes and a 20 percent penalty on the amount you withdraw for nonmedical expenses

Like an individual Retirement Account, the money in the HSA is yours.  You can accumulate as much in the account as you wish. 

NEXT: Contribution Limits to your HSA



Posted October 14, 2013 by Susan D. Krohn



How Health Saving Accounts (HSAs) Work

If you are self employed or you do not have access for a workplace health plan, in order to make health insurance affordable, you need to set a sky high deductable.  And to make matters more painful, you get taxed on the money you save to pay for medical expenses that you have to pay for out of your own pocket.

As of June, 2013, 9.1M people have Health Saving Accounts.

So what is an HSA?

HSA/Health Spending Account: this is tax-exempt money you put into a savings account and you can carry it over year to year.

The health savings account (HSA) allows you to defer taxes on any money you contribute, in order to cover-out-of-pocket medical expenses.  There is a catch:  to quality for an HSA, you must first own a qualified high-deductible health plan (HDHP).

HDHP’s are major medical policies with higher deductibles than normally found in regular medical plans.  These plans aren’t designed to provide full coverage for every sniffle or stubbed toe.  Instead these plans are designed to keep premiums low by restricting coverage to major medical events, like a severally broken leg.  You are personally responsible for say a visit to a doctor because of a fever and sore throat.

The money you contribute to a HAS accumulates from year to year, adding up to a medical savings account, the size depending on the amount of your medical usage.  These accounts are particularly attractive the closer to retirement you get.  It is a tax deferred method of saving for your retirement medical expenses with untaxed dollars.

To qualify for an HAS, you must:

1.)    Own a high-deductible health plan

2.)    You must not be covered by any other health plan

3.)    You must not be enrolled in Medicare

4.)    You must not be claimed as a dependent on someone else’s tax return.

NEXT:  More about HSAs



Posted October 6, 2013 by Susan D. Krohn



Federal Subsides:  How You Can Get Help with Your Healthcare

Under the Affordable Care Act (ACA), if you purchase insurance through a health care exchange, you could be eligible for subsidies for health insurance premiums and cost sharing if your income is less than 400 percent of the federal poverty level (FPL). 

For example, if you have an income of $89,000 and a family of four, you could be eligible for help. 

 If you get insurance through your employer, you can still get subsidized coverage in an Exchange if your premiums are unaffordable (more than 9.5% of your household income) or if the plan is inadequate (pays less than 60% of the cost of covered benefits).

The ACA provides two forms of subsidies to help pay for health insurance.

1.)    A monthly premium assistance tax credit will lower the premium amount you and your family must pay. 

2.)    Cost-sharing assistance will limit your maximum out-of-picket costs, and for some, it will also reduce other cost-sharing requirements (i.e., deductibles, coinsurance, co-payments.)

The premium assistance subsidy reduces the amount that you and your family pay for insurance coverage by providing a tax credit.  The subsidies are only available through the state/federal Exchange. 

Subsidies are determined on a sliding scale, based on your income, so that if you are at the lower end of the income scale, you will get the most help.  The subsidy is based on the premium for the second lowest cost sliver plan available in an Exchange. 

If you want a more expensive or higher tier plan (i.e., gold or platinum) you must pay the difference.

Everyone who buys coverage through an Exchange will have a cap on their total out-of-pocket spending, including deductibles, co-pays and co-insurance.  These limits are based on the out-of-pocket limits that apply to high-deductible plans used with Health Savings Accounts (HSAs).

 If you have an income under 400 percent of the federal poverty level, you will get subsidies to lower those caps based on your income. 

 While this is all very confusing, the Exchange will help you navigate the ins and outs of getting the right insurance for you and your family and will assist you with any help you may quality for.

 

NEXT:  How Health Saving Accounts Work

Posted September 24, 2013 by Susan D. Krohn




When Will the Exchanges Be Open for Business?


Although the health insurance exchanges are officially slated to open on October 1, 2013, you can open your own personal “Obamacare” account now, but you’ll have to wait eight weeks before you can actually check out insurance plans and can enroll.

Health and Human Services (HHS) Secretary Kathleen Sebelius said consumers can now go online to healthcare.gov and create personal accounts by establishing a username and password.  Serious shopping will have to wait until sometime in September, when details on insurance plans and premiums offered in local areas will become available through the new online marketplace.

The congressional Government Accountability Office and Treasury’s inspector general for the IRS have been among the nonpartisan oversight organizations warning of possible delays with the rollout of the law, so President’s Obama’s administration is pleased with the progress that has been made.

The new personal account feature unveiled Monday, August 4, will be available just in English for the time being.  HHS said personal accounts will be coming soon to the Spanish-language marketplace at cuidadodesalud.gov.

The new online insurance marketplaces will be geared to people who don’t have coverage through their jobs, most of whom will be eligible for tax credits to help pay their premiums.  Insurance benefits take effect Jan. 1, 2014, which is the date most Americans will have to have health insurance or face fines.  Insurers will not be able to turn anyone away regardless of a prior or ongoing medical condition.

In order to quality for government subsidies to help you fund your insurance plan, you have to enroll through a state or federal health insurance exchange. 

NEXT:  Federal Subsides:  Helping You Afford Health Care


Posted September 5, 2013 by Susan D. Krohn


What In the Heck Is a Health Exchange?


There has been great deal of talk about health insurance exchanges, but apparently few of us understand what an exchange is.  According to a recent poll by Healthcare Exchange, 3% of those pooled said they understand the definition of an exchange and how to enroll in an exchange.  97% of Americans do not.

So if you don’t understand what a health insurance exchange is, what it does and how to work with one, you’re in good company.

The official definition is health insurance exchanges are entities for buying and selling individual health insurance policies.  The goal:  to provide an easier way to shop for insurance and provide a competitive marketplace for you as an individual if you do not get insurance through your employer.  All the insurance plans will be listed for you in one place so you can easily compare prices, benefits, etc.

The states can elect to build a fully state-based exchange, enter into a state-federal partnership exchange, or default into federally-facilitated exchanges which are not yet formed.  October 1, 2013 is the target date to have the exchanges up and running.  Both Louisiana and Texas have elected to default in to federally-facilitated exchanges.  There are private exchanges and we’ll talk about those later. 

Have you ever shopped for the best travel deals on Internet?  The exchanges are being compared to websites such as Travelocity or Orbitz:  they will help you hunt for the best deal.  You’ll be able to search for and shop for the best plan for you from a menu of options in one place.   If you do not have Internet, there will be other options to work with the exchanges. 

Exchanges will also help administer health insurance subsidies if you quality for help and will help you enroll in private health insurance, Medicaid and the Children’s Health Insurance program.

No one will be required to purchase health insurance through an exchange, though subsidies will only be available for plans sold through the exchange.  If you would prefer to buy your insurance through an insurance agent, you can do so.  If not, you’ll be able to purchase insurance in a matter of minutes on the exchange’s website.  

Some good news for many of us is that plans cannot refuse to sell you a policy and they all must comply with the new consumer protections.

Next:  There’s More to Know about Health Exchanges

 


Posted August 7, 2013 by Susan D. Krohn

 



What Do You Know About the 2010 Affordable Care Act?


Are you confused about the Patient Protection and Affordable Care Act (ACA)?  Yes, not only is it an unusually large and unwieldy law (17,000 pages), but there are a great many lose ends that need to be tied down.

The law is designed to provide affordable, quality health care to all Americans and to reduce the overall cost of health care.  While some provisions of the law have already taken effect, many more provisions will be implemented in the coming years. 

Of course nothing is ever simple, and a great deal of confusion exists in terms of what the act does, what it doesn’t do and the timeline for enacting the provisions.  Congress is continuing the debate on various issues while the Obama administration is working on clarifying the law and implementing the mandates.  In the coming blog entries we will be working to keep you informed and up to date as to what to expect regarding health insurance.

  1. Starting in 2014. The ACA requires nearly all U.S. citizens and legal residents to have health insurance.  The Obama administration recently announced it would give businesses with more than 50 employees another year to comply with the requirements of the law.  The House of Representatives passed a bill on July 17 that delays the individual mandate—the requirement on individuals to buy health insurance, but this bill would need to pass the Senate also.  President Obama has threatened to veto the bill.
  2. You can get insurance. You will be able to enroll in some form of insurance coverage, regardless of your age, gender, or health status that may have made it hard to get insurance before.
  3. You can get help paying for it.  An online calculator tool is slated to be available starting October 1 to help you determine whether your income qualifies you for a government subsidy to buy insurance.
  4. You won’t be turned down because of a pre-existing condition.  Currently, it can be difficult to buy insurance if you are already ill.  But in 2014, you’re eligible for insurance even if you have a pre-existing health condition.
  5. You can cover children on your plan up to age 26.  Before the new law, most insurance plans covered only adult children who were full-time students, lived with their parents, were disabled, or considered a dependent for tax purposes.  In 2014, all young adults can stay on their parents’ plan until age 26.

As of this time, even though the business mandate has been moved to 2015 and the reprieve for individual mandates is being debated, other key parts of the law, including forming health exchanges where individuals can buy insurance, are being implemented. 

Coming:  What are health insurance exchanges and how do you buy insurance from them?



Posted July 23rd, 2013 by Susan D. Krohn



 

How to Guarantee You Will Not Get a Job Offer, Part 2

So, you have made it past the first killer question and the interview is going well when your interviewer asks Killer Question #2: What is your greatest on the job weakness?  Ouch.

 

Throughout the years I’ve heard some truly inappropriate answers, such as:

  1. I hated my last job so much I don’t know what I didn’t do well.
  2. Even though I’m in accounting I’m not good with math. 
  3. Getting to work on time. I try but…   
  4. Working with people.  The constant questions they ask drive me crazy.
  5. I love online shopping and sometimes I don’t get my work done.

 

These are definitely not the types of answers that the interviewer is looking for. Although they want you to be honest about your greatest weakness at work, they are more interested in how you handle this weakness. Be prepared when this question is asked. Try answering with something like, “I don’t feel like I’m as proficient in XYZ software as I would like to be, but if I secure a position where I’ll be using it a great deal, I plan on getting some extra training.”

 

As an interviewer, if a candidate tells me they can’t think of any weaknesses, it tells me that the candidate is lying or has not given enough thought or preparation to the interview. Nobody is perfect at work; we all have areas that can be improved upon. Remember, the interviewer is looking for self-awareness, initiative and the ability to look into the future and develop the skills necessary to not only improve job performance but to advance! 

 

Give some thought to how you would answer “Killer Question #2” before your next interview.  What is your greatest on the job weakness?  What do you plan to do about it?

 

Posted July 19th, 2013 by Susan D. Krohn



How to Guarantee You Will Not Get a Job Offer

 

After sending your resume out to what seems like scores of companies, you finally get a call for an interview.  You are dressed, your have your directions, you are prepared to nail the interview.  During the interview everything is going along so great until…

There are two questions that can kill the best interview if they are not handled well.  Question #1.)  So, tell me, what do you see yourself doing in the next five years?  

Remember, you are interviewing to get a job offer from a certain company and industry.   1.  Who knows what you’ll be doing in five years?  2.)  The interview didn’t ask what you want to be doing in five years.  That’s a completely different question and one that will quickly sink your boat if you insist and telling the interviewer your preferences such as, I’d like to retire and be a full time mom; I’d like to start my own business; I’d like to work in an industry where I could use my degree and one of my favorite answers, I’d like to have your job.

If you’re interviewing for say an accounting position, your answer should include your wish to stay in accounting, even if you want to start your own landscaping business one day.  Where do you see yourself in five years?  You want to be working for a company that values enterprising employees who work to learn new skills and who if there is no clear advancement will still award more responsibility and trust.  Companies want to hear that you are willing to do what it takes to get the job done, that you are a team player and that you are excited about the prospects this job has to offer.  They want employees who are going to be long term and want the job.

Take some time to think about how you are going to answer this question so that you are prepared to impress the interviewer.  It will be worth the time and effort!

Look for Killer Question #2 next week!

Posted on July 10, 2013, by Susan D. Krohn