Health Care News

Health Savings Accounts (HSA) changes for 2014

A HSA is a tax-advantaged medical savings account that is available to American tax payers who are concurrently enrolled in a high deductible health plan (HDHP).[1]  Deposi... Read more

A HSA is a tax-advantaged medical savings account that is available to American tax payers who are concurrently enrolled in a high deductible health plan (HDHP).[1]  Deposits into these accounts are not subject to payroll taxes and can be withdrawn without penalty for any qualifying medical expense.  They also have a distinct advantage over Flexible Spending Accounts (FSA) because any deposits will accumulate and roll over year to year, where FSA’s require you use the funds that calendar year – the “use it, or lose it” approach.

Employers and individuals can contribute to these personally owned savings accounts and the IRS adjusts maximum contribution limits pretty much annually, with the exception of 2011 (program started under the Bush Administration in 2004).

With health care reform there was some speculation that HSA’s would be going away – that’s not the case.  They are here to stay!  However, there are a handful of characteristics of these accounts for 2014 that need to be noted.

2014 contribution limits (employer and individual combined)[2]

·         Maximum contribution limit for individuals - $3,300

·         Maximum contribution limit for families - $6,500

·         Age 55 catch-up contributions - $1,000

Minimum HDHP limits

·         Minimum deductible for self-only coverage - $1,250

·         Minimum deductible for family coverage - $2,500

·         Maximum out-of-pocket expenses for individual - $6,350

·         Maximum out-of-pocket expenses for family - $12,700

Coverage of Adult Children

While the Affordable Care Act has allowed parents to keep their children on their health policies up to age 26, the IRS has not changed their definition of dependent coverage.  If an account holder can’t claim a child as a dependent on their tax returns, then they can’t spend HSA funds on the child.  The child is qualified if:

·         Has the same principal place of abode as the covered employee for more than one-half               of the taxable year

·         Has not provided more than one-half of his/her own support during the taxable year

·         Is not yet 19 (or, if a student, not yet 24) at the end of the tax year or is permanently and                 totally disabled



[1] "Health Savings Accounts". Health401k.com. October 2013

[2] Miller, Stephen. “For 2014, Higher Limits for HSA Contributions, Out-of-Pocket Expenses.” www.shrm.org. October 2013

 

 

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HSA Contribution Limits for 2015

Maximum contribution limits for 2015 are (these contributions are 100% tax deductible from gross income): Individual - $3350 Family - $6650 Also, in 2015 ... Read more

Maximum contribution limits for 2015 are (these contributions are 100% tax deductible from gross income):

Individual - $3350

Family - $6650

Also, in 2015 the minimum deductible amount has changed to $1,300 for self-only and $2,600 for a family.  The maximum out of pocket experienced a bit of a bump from 2014 to $6,450 for self-only and  $12,900 for a family.

For those 55 and older, you may make an additional contribution of $1000.

For a lot of great information on HSA's, visit www.hsacenter.com.

 

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IRS approves 2013 HSA contributions

HSA stands for 'Health Savings Account' which are tax-exempt accounts that help people save money for eligible medical expenses. In order to qualify for an HSA, the policyh... Read more

HSA stands for 'Health Savings Account' which are tax-exempt accounts that help people save money for eligible medical expenses. In order to qualify for an HSA, the policyholder must be enrolled in an HSA-qualified high deductible health plan, and must not be covered by any other health insurance or Medicare, and cannot be claimed as a dependent on someone else’s tax return

2013 HSA contribution limits: 

  • Individuals (self-only coverage) - $3,250 (up $150 from 2012 - $3,100)
  • Family coverage - $6,450 (up $200 from 2012 - $6,250)

For more information about HSA health plans, please call our office at 360-464-1622.

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Obamacare non-compliant plan revisions

Last November, President Obama announced a revision to the ACA where individuals could extend their non-compliant plans for an additional year in an effort to ease tensions... Read more

Last November, President Obama announced a revision to the ACA where individuals could extend their non-compliant plans for an additional year in an effort to ease tensions and transitions into new programs that went live year start, 2014.  Specifically, ones that had been recently cancelled by insurance carriers due to being non-Obamacare-Compliant.  The decision to enact this extension was left to individual state insurance commissioner offices as well as health insurers.

Washington State decided that allowing cancelled health plans “was not in the best interest of the (Washington) health insurance market and would ultimately harm consumers.” [1]

On Wednesday, March 5th, the Obama administration announced that individuals could once again extend these non-compliant plans by an additional two years.  However, this announcement does not affect Washington, as the first extension was not granted  - these plans no longer exist in the state.

Like Washington, several states decided against extending non-compliant plans.  Reasons cited include instability of the market, reduction of benefits and mostly, it would have been a costly maneuver to add these plans back into the framework.  



[1] www.insurance.wa.gov “President Obama’s decision to extend non-compliant health plans does not apply to Washington state” March 6, 2014

 

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Obamacare Poll Findings

Kaiser Family Foundation’s latest Health Tracking Poll,[1] released September 28th, delves into the public’s uncertainty pertaining to open enrollment and introduction of t... Read more

Kaiser Family Foundation’s latest Health Tracking Poll,[1] released September 28th, delves into the public’s uncertainty pertaining to open enrollment and introduction of the Affordable Care Act’s most prevalent features.  Most Americans are primarily concerned with how much the law will cost them, as well as the fundamentals on how the law actually works.  Over 1500 people were surveyed, with the sample size consisting of a well-balanced mixture of democrats, republicans, insured and uninsured Americans.

Let’s dive into that primary concern of how much health care is going to cost you and who is going to pay for it with the new ACA provisions.  Having health insurance will be required for almost all Americans as of January 1st, 2014.  There are four different ways you can obtain coverage:

1.       Your Employer

      2.       The Government

      3.       Buy your own

      4.       None

More than half of all Americans have health insurance through their employers.  If this is the case, then for you, nothing changes.  You’ll continue going to work and your employer will continue paying your premiums.  We are going to see some employers drop health insurance from their benefits package and others add it.  There are several moving parts regarding penalties and requirements placed on businesses that will affect their decision to provide or not provide health insurance to their employees.

For others, the Government will be stepping into help people purchase health insurance.  States have set-up exchanges (think of it as a marketplace) to go compare, shop and purchase insurance.  Within these exchanges you may find you qualify for fully subsidized insurance.  Medicaid programs have been expanded in the sense that now more people will qualify.  This program is fully funded by the Feds.  If you qualify, your coverage is free!

Now, there are a handful of folks who are not required to purchase health insurance – those include the incarcerated, undocumented immigrants, member of an Indian tribe, member of a religion opposed to benefits from a health insurance policy, family income below a certain threshold or if you would still have to pay 8% of your income for health insurance - after taking into account any employer contributions or tax credits.  For everybody else, you will have to buy your own insurance!   This may seem daunting – however, there are additional tax credits and cost-sharing subsidies you may qualify for (e.g., an individual WA resident making less than $46,000/year, or family of four making up to $94,000/year).  To see if you qualify, see visit our cost-estimate calculator at wa-exchange.com.

Furthermore, the exchanges are open now!  In fact, as indicated by the findings of the Kaiser poll, a large majority (85%) of the public still don’t know they can begin shopping today for coverage that begins January 1st .

Open enrollment runs now-March 31, 2014.  For more information, take advantage of your local resources by contacting the Washington Health Insurance Exchange, in Tumwater, at 360-464-1622.


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<!--[if !supportFootnotes]-->[1]<!--[endif]--> Kaiser Family Foundation,Kaiser Health Tracking Poll: September 2013, 2013, www.kff.org (October 2013).

 

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Pharmacy costs make our premiums higher

Have you ever compared the actual costs of your prescription drugs from one pharmacy to the next? What you may find might shock you. Unfortunately, those differences don't mat... Read more

Have you ever compared the actual costs of your prescription drugs from one pharmacy to the next? What you may find might shock you. Unfortunately, those differences don't matter to most of us who just pay a copay for our Rx. We just simply go to the closest pharmacy to our work, or the one on the way home.

When we pay a copay for our Rx, then we really have no idea of what the actual costs are. But we should, because those costs are being passed on to our insurance carrier which will ultimately affect our future premiums.

Many health insurance companies are changing their Rx coverage from co-pays, to co-insurance. Instead of paying $20 for that brand name drug, the cost would be 30%. The point is to give an incentive to policy holders to shop the local pharmacies, and talk to their doctor about lowering their prescription costs.

Prescription drug costs make up over 1/3rd of total claims costs. To save the insurance company and yourself money, always talk to your physician about generic medications, as well as alternatives that may provide the same results, and provide you a lower copay.

Understanding and being aware of the actual cost of our prescriptions is something we can all do to help reduce the spiraling cost of health care.

Regence BlueShield has a helpful website for looking up drugs and their alternatives. Another tip: switch to mail order if you have a chronic condition. Many health plans have a mail order program that will give you 3 months supply for 2 months copay.

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Premera Cyberattack

Premera and their family of companies have been the target of a sophisticated cyberattack, which may have compromised the personal information (including name, date of birt... Read more

Premera and their family of companies have been the target of a sophisticated cyberattack, which may have compromised the personal information (including name, date of birth, address, telephone number, email address, social security number, medical claims information and bank account information) of anyone enrolled in a Premera plan (individual or group) since 2002. The attack occurred in May of 2014. In an effort to make sure all of our clients know of this attack and take the necessary precautions, please review the following information.

At this point Premera has not found any evidence that any of the information accessed has been tampered with or extracted, however, they are offering two years of free credit monitoring and identity theft protection to anyone who may have been affected by this breach. To access that protection, please go to the following link: www.premeraupdate.com.

Excerpt from Premera’s press release:

We recognize this issue can be frustrating and we are taking steps to protect you. We are beginning to mail letters to affected individuals today, March 17, 2015. We are providing two years of free credit monitoring and identity theft protection services through Experian to affected individuals. We also have established a dedicated call center for our members and other affected individuals to contact.

You can access the full press release from Premera at www.premeraupdate.com. You can also contact Premera on this dedicated number (1-800-768-5817), setup specifically for questions relating to this issue.

Please feel free to contact our office if you have any questions, however, we encourage you to visit www.premeraupdate.com, which has the most up to date information as well as a very helpful FAQ page.

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Preventive Servies

Health insurance has completely shifted modes over the past few years, with the help of a major provision of the ACA - private carriers are now covering recommended prevent... Read more

Health insurance has completely shifted modes over the past few years, with the help of a major provision of the ACA - private carriers are now covering recommended preventative services with little or no patient cost-sharing.

Evidence has shown that preventative screenings and exams have saved lives and allowed patients to detect and manage illnesses more effectively.

These preventive measures have been broken into 4 different categories: 

I.                    Evidence-based screening and counseling - screening for cholesterol, obesity, various cancers, HIV, drug and tobacco use and others

II.                  Routine Immunizations – including but not limited to, influenza, meningitis, tetanus, HPV, hepatitis A and B, measles, etc .

III.                Preventive Services for Children and Youth – immunization and screening services for both behavioral and developmental assessment.

IV.                Preventive Services for Women – well-women screenings, contraceptives and related services, breastfeeding support and supplies, etc.

For a comprehensive list of covered services for both adults and children, see the tables put together by Kaiser Family Foundation.  As always, consult with your carrier about their preventative and wellness programs.

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Seattle Children's hospital files suit with the Office of Insurance Commisioner

October 4th, 2013 – This past week Washington residents began buying health insurance through Washington Healthplanfinder, the state’s new online health insurance marketpla... Read more

October 4th, 2013 – This past week Washington residents began buying health insurance through Washington Healthplanfinder, the state’s new online health insurance marketplace.  There are seven insurers in King County offering health plans through the exchange.  Of those seven, only Group Health Cooperative and Community Health plan of Washington currently include Seattle Children’s Hospital in their provider network.  As a result, Seattle Children’s Hospital, has filed suit with the Office of Insurance Commissioner citing the “failure to ensure adequate network coverage.”

The issue here is two-fold.  A – When families enroll in one of the plans they may not realize that the pediatric hospital is not in their network of providers.  B) – Families that enroll in those plans that exclude Seattle Children’s Hospital could be subject to significantly higher cost-sharing amounts if they choose to seek care there.

As Dr. Sandy Melzer, the hospital’s Senior Vice President and Chief Strategy Officer explains, “The higher cost-sharing could seriously disrupt care for families currently receiving services at Children’s and could delay new patients from getting the specialized care.”[1]

Insurers are tasked with trying to find a delicate balance between an adequate network of providers and the market demand for affordable health insurance.  One of the re-surfacing concerns of the Affordable Care Act, affectionately known as Obamacare, is that the new plans sold through the exchanges will have a very narrow network of providers - this lawsuit underscores that notion.

“Children’s hospitals tend to have more expensive cost structures because of the complex needs of their patients,” said Jim Kaufman, Vice President of Public Policy for the Children’s Hospital Association. [2]

While there are new affordable options for Washingtonians seeking insurance through Healthplanfinder, there are issues developing regarding the narrow network of providers included in those plans as well as limited options for those who don’t qualify for government subsidies.

However, there are other resources available to ensure that individuals can obtain plans that include the providers they seek.  Individuals who visit wa-exchange.com will have access to four additional plans (not available on wahealthplanfinder.org) that are more comprehensive and in fact do cover Children’s Hospital, including Regence BlueShield, Moda Health, Assurant Health and Group Health Options.


[1] Landa, Amy Snow. “Seattle Hospital sues State over Exclusion from Exchange Plan Networks.” Seattle Times [Seattle] www.seattletimes.com. October 7, 2013.

[2] Carlson, Joe. “Seattle Children’s sues after exchange plans fail to include it in network.” www.modernhealthcare.com. October 8, 2013.

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Vernon Interview on KMAS News Radio

Vernon was on KMAS's Day Break program on Friday October 11, 2013 to discuss health care reform in length.  Click the icon below to listen to the interview.  Enjoy!  ... Read more

Vernon was on KMAS's Day Break program on Friday October 11, 2013 to discuss health care reform in length.  Click the icon below to listen to the interview.  Enjoy! 

 

 

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What you need to know about ACA

As you’ve probably heard, there are a lot of changes coming to our nation’s health care system as a result of the Affordable Care Act (ACA). As someone who buys your own he... Read more

As you’ve probably heard, there are a lot of changes coming to our nation’s health care system as a result of the Affordable Care Act (ACA). As someone who buys your own health insurance, the ACA changes will impact you and your policy choices for 2014. I want to be sure you are aware of the upcoming changes and important decisions you will need to make.

 

Here's what you need to know:

- Coverage is guaranteed – insurers cannot deny an application for age or pre-existing condition.

- How much you pay for health insurance cannot be based on your health status.

- Nearly everyone is required to have insurance or pay a penalty to the U.S. government.

- Health insurers are required to provide a comprehensive package of benefits (called Essential Health Benefits) in every policy, which may include more benefits than you have now.

- Some of the more affordable types of coverage – like those with very high deductibles – will be eliminated and replaced with plans that offer more extensive services, but also will cost more.

- Many people will qualify for federal tax credits to subsidize premium costs if they purchase their plan through the exchange.

- Starting Oct. 1, 2013 you can review and compare policies from different insurers through the new State Exchange on our website wa-exchange.com (website will be up and running by Oct 1)

- Only health insurance purchased through the exchange qualifies for the tax credit.

All health insurance companies will be required to update policies for people who buy their own coverage to include benefits required by the ACA. Each carrier has developed new health insurance policies to replace their current policies.

You will receive a letter from your insurance company around September with specific information about your policy options and costs for 2014.  If you do nothing, your insurance carrier will automatically move you to the closest new health plan comparable to your current coverage.

As always, you can call me at 360-464-1622 to discuss ALL of your options to ensure you are on the best coverage to meet your needs and paying the lowest cost.

Please put a reminder on your calendar to call me in November to discuss your plan changes going into 2014.

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