Health, Medicare, Group Medical, Life & Dental Quotes
What decisions do I need to make during my employer’s open-enrollment period this fall?
Here are five ways to consider when selecting your 2016 options.
1. Pick the best deal in health insurance. Health-care-reform changes and ever-increasing health-care expenses are prompting most employers to boost premiums, co-payments and deductibles for their health-insurance plans in 2012. If you have several plan options, the one you picked in the past may no longer be your best choice.
It’s important to compare premiums, but you also need to add up your potential out-of-pocket costs for each plan. For example, if you take a lot of medications with high co-payments, the plan with the lowest premium may actually cost you more in the long run. Many employers are steering employees toward high-deductible health insurance policies as a way to encourage them to pay closer attention to their medical expenses. As an incentive, some are offering competitive premiums and contributing to employees’ health savings accounts, which give employees tax-free savings to use for medical expenses at any time. Many employers offer tools on their intranet sites to help you run the numbers for your plan options.
2. Spousal Coverage. If both spouses have health-insurance coverage through work, it’s important to compare the overall costs of both policies again. Some employers are charging more to cover dependents than other employers are, so you could come out ahead by switching your children from one spouse’s policy to the other’s. And if your spouse’s employer has boosted premiums significantly but your coverage has remained fairly stable, then you might do best by having the whole family — including your spouse — on your employer’s plan.
As a result of health-care reform, you can add adult children up to age 26 to your health-insurance coverage, even if they had aged off the policy in the past. And a child can be covered under your plan even if he or she doesn’t live at home, isn’t your dependent for tax purposes and is married. You need to add your child during open-enrollment season for coverage to begin the next plan year (generally January 1).
If your employer charges one rate for family coverage and you already have younger children on your policy, you might not have to pay extra to add your older child. But if your employer charges separately for each dependent, it might be cheaper to get your adult child a policy of his or her own. Healthy adults in their twenties can usually buy a policy for less than $200 a month.
3. Make the most of flexible spending accounts. FSAs can help lower your taxable income and give you tax-free funds to pay out-of-pocket medical expenses throughout the year. Starting in 2013, the maximum amount employees can stash in a medical FSA will be capped at $2,500 per year. Currently the maximum limit varies by plan, but many employers allow employees to set aside $4,000 or more in these pretax accounts for medical expenses. In light of the impending change, find out how you can make the most of your FSA in 2016.
4. Get tax-free money for child care. Many employers also let you set aside up to $5,000 in a dependent-care flexible spending account, which gives you tax-free money to use for dependent care for children under age 13. Before you sign up for your employer’s dependent-care flex plan, though, it’s important to calculate whether or not you’ll come out ahead by using the money from the FSA for those costs or claiming the child-care credit on your taxes. See FSA or Child-Care Credit? for more information about who qualifies for these benefits, how to calculate which is a better option for your family, and a strategies to help you take advantage of both the FSA and some of the child-care credit if you have two or more kids.
5. Benefit from special deals on other insurance coverage. You may also be given the choice during open-enrollment season to buy extra life insurance, disability insurance and long-term-care insurance beyond any coverage already provided by your employer. You usually have to pay for this extra coverage yourself, but you could benefit from a group discount. However, the quality of these deals can vary a lot, depending on the type of insurance.
Employers are just starting to announce their health insurance options for 2016, and you may need to make your decisions during open enrollment in the next month or two. The National Business Group on Health recently came out with its annual survey of large employers, which offers the first glimpse of the changes employees are likely to see in their health plans for 2016.
1. Higher premiums. Large employers expect their health care costs to increase by about 5% for 2016 – the same size increase they expected in 2014 and 2015. They plan to pass along some of the extra cost to employees but more of it to dependents, with employees contributing 20% of their own premiums and 24% of the premiums for dependents (higher-income employees may pay more). About one-third of the companies plan to add a surcharge for spouses who could get coverage elsewhere but don’t. But very few (only 4%) plan to exclude spouses who have similar coverage available through their own employer.
2. More high-deductible health plans. Employers are continuing to try to contain rising costs by forcing employees to take more control of their health care: 83% of large employers plan to offer a consumer-directed health insurance plan in 2016 (primarily high-deductible health insurance paired with a health savings account). Half of the employers plan to offer the high-deductible plan as an option, and 33% plan to offer it as the only option. More than half contribute to employees’ HSAs, giving them tax-free money for medical expenses; some add more if you participate in a wellness program or take a health risk assessment. For more information about HSAs, see FAQs About Health Savings Accounts
https://www.mainstreet.com/article/premiums-for-employer-sponsored-health-insurance-plans-to-rise-in-2016
One of the most overlooked parts of an overall financial plan is the benefits package you receive from your employer. Making benefits decision can often be a difficult process. Most of the time, I have found that people wait until the very last day of open enrollment with their employer only to quickly check the boxes that they checked last year without any research on what may be their best options. Remember, that your compensation package from your employer should always be looked at from a total economic package point of view. This means looking at your cash compensation plus benefits plus stock options, fringe benefits, etc. If you view your compensation only from a myopic point of view such as salary, you won’t be able to really analyze what you are getting paid from your employer nor the true value of your benefits package.
One of the first decisions you will have to make upon your benefits election is to choose the type of health insurance coverage you want for the next year. It is important to note that your company may have changed health care providers, deductible, or the overall plan they use with the current health insurance carrier so compare closely when you make this election. Here are some items to consider when you select your health insurance through your employer’s benefits package.
When you find a new job and sit down to look at the benefits you may be surprised at the options that are available to you. It may seem overwhelming to consider all of the insurance that you can purchase. Do you really need all of the insurance or can you pass on some of the policies? Is it possible to be over insured? It is also important to check on your insurance to see if you qualify for better rates. Some insurance like home insurance or car insurance is a given> Learn about the other insurance options.
Health insurance is something your should have. You run the risk of financial ruin without it. Even if you are relatively healthy, if you are involved in a serious accident or suddenly develop appendicitis, you may end up owing tens of thousands of dollars in medical bills before you are done. If your employer covers you, you should take advantage of that plan, if you are self-employed you may want to consider high deductible health insurance as a money saving option. More »
Life insurance is another benefit that is offered by many employers. Generally employers will offer a basic life insurance policy equal to one year’s salary at no cost to you. You may have the option of purchasing more insurance through your benefits package. If you are single and do not have children, you may be fine relying on just the insurance provided by your employer. However, if you have responsibilities towards a spouse or children you should insure yourself to help them in the event of your death.
Disability insurance will help to cover you in the event that you are no longer able to work. This insurance will help you to pay your bills and make ends meet while you are coping with an illness or injury. This is generally good insurance to have. Short-term disability will help to cover maternity leaves and fill in the waiting period before disability insurance kicks in.
Dental insurance can help to pay for your dental checkups and other work that you need done. You need to carefully look over your policy to make sure that your dental benefits are more than the premiums you are paying. If the plan will not save you money, you may want to shop around for a dentist and look for a dental discount card to save on the cost.
Long term care insurance will help to pay the cost of care if you end up needing to be in a nursing home or an assisted living facility. Since you are young and in your twenties you may opt to wait on this insurance. A good time to get this insurance is in your late thirties, after that the rates begin to rise rapidly. If you have a condition that makes you think you will need this sooner, you should get it. If you have a family history of certain conditions such as Alzheimer’s you may consider purchasing it earlier to lock in lower premiums.
Cancer insurance may also be available to you. Unless you have a strong family history of cancer, this is one insurance that you are pretty safe not having. You should make it a priority to save money to cover the extra medical bills that may arise from this or any other serious health problem.
Definition:
Cancer insurance is a benefit that will pay you money if and when you are diagnosed with cancer. The policies vary widely, so it is important to carefully read the policy before you purchase. Some policies will be pay a designated amount once you are diagnosed with cancer. This is to help defray costs such as missed work and out of pocket expenses. Other cancer insurance is supposed to cover the amount that your insurance would not cover.
Many cancer policies are risky because they have so many exclusions and limitations. Additionally your traditional health insurance may decrease the amount it covers as a result of the cancer insurance. You should carefully examine every limitation and benefit before you sign up.
Business health insurance is a major cost of doing business, especially for small companies and mom-and-pop firms. With premiums soaring, many small business owners are asking their employees to shoulder more of the financial burden or cutting benefits entirely.
The New York-based Commonwealth Fund, an advocacy group for health care reform, says small business health insurance costs average 18 percent more than those of larger businesses. In California, health insurance costs increased 10 percent in 2006 alone, according to the California Employer Health Benefits Survey.
Those costs have proven too high for many small businesses. According to the U.S. Chamber of Commerce, more than 45 million Americans are uninsured, and approximately 60 percent of the uninsured are employed by small businesses.
In 2006, the average monthly cost for health insurance for small group plans, which are largely used by small businesses, was $311 per month, according to a survey by America’s Health Insurance Plans, a trade group representing health insurance companies. The average premium for a family of four was $814 per month, the association reported.
Small business health insurance may take a huge chunk out of your revenue, but benefits often attract better employees and help retain existing workers. Satisfied, healthy employees are more likely to help your business grow. If you’re struggling to provide health insurance, here are some tips that could reduce your small business health insurance costs.
1. Keep employees healthy. Motorola Inc., for example, has instituted a comprehensive wellness program that includes disease management for afflictions such as asthma and diabetes, as well as offering flu shots, cancer screenings, smoking-cessation sessions and a round-the-clock phone line staffed by nurses. The company found that for every dollar it invested, it saved $3.93, according to a 2003 report by the U.S. Department of Health and Human Services report, “Prevention Makes Common Cents.” Likewise, heavy machinery manufacturer Caterpillar estimates that its wellness program will save the company $700 million by 2015.
Such wellness programs don’t just keep company accountants happy. They’re also popular with workers. Pharmaceutical giant Pfizer Inc. found that 85 percent of its employees in its New York offices participated in at least one wellness program, and that 80 percent used on-site facilities such as fitness centers or physical therapy, according to the HHS report.
2. Reduce coverage. Cutting coverage or asking your employees to contribute more to the plan is a logical step to reducing small business health insurance costs. The downside of this strategy is that it will likely prove unpopular with workers.
It’s fairly common for businesses to exclude dental and vision insurance, but talk to your employees to see what they want covered. They might opt for having dental and vision insurance and a health savings account, for example.
3. Consider health savings accounts. Health savings accounts are an increasingly popular option for owners of small businesses. These tax-exempt accounts, which are used to pay for certain medical expenses, could reduce your small business health insurance costs while giving your employees tax breaks.
You must have a high-deductible health insurance plan to establish a health savings account. For example, in 2007 the minimum deduction for individuals is $1,100; for families, it is $2,200.
That means that you or your employees would have to pay $1,100 out of your own pockets for health care expenses such as doctors’ visits or prescriptions before you are reimbursed by the insurance company.
But there are benefits: In 2007, employers, workers, and their families can contribute tax-free up to $2,850 for individual health savings accounts or $5,650 for family accounts. These funds can only be used to cover health care costs, and employees can take their accounts with them if they leave. The funds generally do not expire.
Contributions and withdrawals are both tax-free, and individuals can claim tax deductions on their 1040 forms – meaning employees don’t need to itemize to get the tax break. Employer contributions are also tax-deductible for business owners but are not required. Individuals can also set up health savings accounts.
To establish or participate in a health savings account, your only comprehensive health insurance can be the high-deductible health insurance plan and they must be offered to all employees.
Health savings accounts benefit healthy employees who do not regularly see doctors. You or your employees can, however, have health insurance that specifically covers ailments, including certain diseases or illnesses, accidents, dental and vision care.
4. Join a group. Small group health insurance plans cover between two and 50 employees, although there are “group of one” insurance plans for the self-employed that offer similar benefits.
The larger your group, the lower your premiums will be. According to the America’s Health Insurance Plans 2006 survey, 80 percent of small groups polled had 10 or fewer employees in their health insurance plans, and the average monthly premiums for individuals was $330. Firms with between 26 and 50 employees paid $287 a month for single premiums.
If your business has fewer than 10 employees, you can still partner with other businesses or individuals and expand your group plan. Note that health care laws are governed by the states, so you’ll want to partner with people in your state.
5. Shop around. Health insurance is a huge business, so shopping around for different providers could reduce your small business health insurance costs. Start by searching the Internet and also ask other owners of small businesses what they pay for health insurance. Insurance agents will charge fees, but you’ll save time and they can investigate health insurance plans for you. The National Federation of Independent Businesses partnered with eHealthInsurance, a national health insurance agency that gives you several quotes online.
As a small business owner, you may be thinking about providing group employee benefits for your employees. There are many “benefits” (no pun intended) to providing this kind of service for your employees. There are many different insurance companies with many different programs. Generally speaking, there are six types of benefits you should at least consider when selecting which to include in your package.
1) Health Insurance: Health insurance protects against the risk of medical expenses. There are many health insurance companies with many different types of programs and options. It is best to do some research to see which insurance company is best for your company and employee’s needs. Two very popular insurance programs are HMOs and PPOs.
2) Vision Plans: Usually offered as an addition to a general health insurance plan, but can be purchased stand alone, vision plans provide reimbursement for vision services. This insurance would be used when visiting an optometrist or ophthalmologist for services such as eye exams, eye glasses or contact lenses.
3) Dental Coverage: Generally offered in addition to a general health insurance plan, dental insurance provides individuals with insurance for dental care. Dental plans vary, but generally speaking they cover (partially or in total): basic cleanings, fillings, x-rays, periodontics, endodontics. Some plans may even cover parts of oral surgery, crowns, implants or dentures. Some carriers offer HMO and PPO dental options.
4) Group Life: Life Insurance can be purchased on the group with a set limit for the group or set limits by job/class. The coverage is term, is reasonably priced and is available while the individual is employed by the company. While a Group Life program can be purchased stand alone, most employers will combine as part of the overall benefits package.
5) 401K : 401K plans are a great way for employers and the owners to provide a vehicle to create a retirement income pool. Individuals contribute a percentage of pre-tax income into a qualified plan while they are working and later receive funds from the plan upon their retirement. The investment income accumulates tax free and the recipient pays income taxes as the funds are distributed, usually at a lower rate. Individuals can start withdrawals without penalty upon turning 59 ½. Many employers will provide a matching contribution based on a formula that may include company profitability.
6) Disability (Short and Long Term): this type of insurance protects those who become disabled and are unable to work. Short-term disability insurance generally pays a percentage of a disabled employee’s salary for a certain amount of time after a short waiting period of 7-14 days. Each state has different guidelines and rules regarding short-term disability; some states require benefits be provided for up to 26 weeks. Long-term disability insurance is more popular among employers. If an employee is unable to work for a long period of time due to disability, this coverage will pay a part of the employee’s salary. The amount of money that an individual will receive often depends on their position and how much coverage their company provides. Many employers will provide both STD and LTD as complimentary products.
The Consolidated Omnibus Budget Reconciliation Act (COBRA) was established in 1986 and is also known as continuation coverage. COBRA allows qualifying individuals who lose their group health coverage due to certain events like termination of employment to continue their coverage temporarily. Generally under COBRA individuals must pay the full cost of the coverage and a two percent administrative charge. Certain employers may subsidize COBRA fees, but they are not required to do so. As a result, continuing health insurance coverage through COBRA can be costly.
Employers are required to provide general information about COBRA coverage when hiring new employees. When a worker is no longer eligible for health coverage through the employer’s insurance plan, the employer must notify the worker of his or her rights to COBRA benefits. These rights may also be extended to the employee’s spouse and dependent children.
Events that may make you or your family members eligible for COBRA may include:
The Affordable Care Act, also known as Obamacare, requires insurers to sell health insurance to virtually everyone (often called “guaranteed issue”) regardless of health status. As a result, individuals with a pre-existing condition need not enroll in COBRA in order to have healthcare coverage after leaving a job. However, the mandates of the Affordable Care Act do not go into effect until 2014.
Even after the Affordable Care Act goes into effect, individuals may elect to enroll in COBRA since the benefits under their old group health insurance plan may be better than the health plans provided under ACA.
Individuals can find healthcare coverage as an alternative to COBRA:
The Obama administration will not penalize businesses that do not provide health insurance in 2014, the Treasury Department announced Tuesday.
Instead, it will delay enforcement of a major Affordable Care Act requirement that all employers with more than 50 employees provide coverage to their workers until 2015.
(Photo by Jessica Rinaldi/Reuters)
The administration said it would postpone the provision after hearing significant concerns from employers about the challenges of implementing it.
“We have heard concerns about the complexity of the requirements and the need for more time to implement them effectively,” Mark Mazur, Assistant Secretary for Tax Policy, wrote in a late Tuesday blog post. “We recognize that the vast majority of businesses that will need to do this reporting already provide health insurance to their workers, and we want to make sure it is easy for others to do so.”
The Affordable Care Act requires all employers with more than 50 full-time workers provide health insurance or pay steep fines. That policy had raised concerns about companies downsizing their workforce or cutting workers’ hours in order to dodge the new mandate.
In delaying the enforcement of that rule, the White House sidesteps those challenges for one year. It is also the second significant interruption for the Affordable Care Act, following a one-year delay on key functions of the small business insurance marketplaces.
Together, the moves could draw criticism that the administration will not be able to put into effect its signature legislative accomplishment on schedule.
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