CalCPA ProtectPlus

The following information is from IRS.gov and is very beneficial to those who have an HSA account.

You may enjoy several benefits from having an HSA. Here are some of the benefits:

• You can claim a tax deduction for contributions you, or someone other than your employer, make to your HSA even if you do not itemize your deductions on Form 1040.
• Contributions to your HSA made by your employer (including contributions made through a cafeteria plan) may be excluded from your gross income.
• The contributions remain in your account from year to year until you use them.
• The interest or other earnings on the assets in the account are tax free.
• Distributions may be tax free if you pay qualified medical expenses. See qualified medical expenses below.
• An HSA is “portable” so it stays with you if you change employers or leave the work force.

Qualified medical expenses.  Qualified medical expenses are those expenses that would generally qualify for the medical and dental expenses deduction. However, even though non-prescription medicines (other than insulin) do not qualify for the medical and dental expenses deduction, they do qualify as expenses for HSA purposes. (continue reading…)

You forgot where to send your payment?
Payments for medical, dental, vision, group life and group long-term disability plans should be sent to:

CalCPA Group Insurance Trust
P.O. Box 512516
Los Angeles, CA 90051-0516

Payments for individual life and individual disability should be sent to:

Banyan Administrators, LLC – Managers for the CalCPA ProtectPlus Programs.
P.O. Box 512516
Los Angeles, CA 90051-0516

If you’re looking ahead toward a big birthday this year—one of those marked by a round number, a party, and jokes about getting older—then among the surprises that may await you is an increase in your health insurance rates.

This unwelcome gift—in addition to the seemingly inevitable yearly rate increase that everyone gets—comes in the form of a higher premium and marks your status in having moved to another age rate band.

You’re probably aware that older people pay more for their health insurance and younger people less, and you may have already experienced such an increase.

Nevertheless, in these lean times, its not something you want to come as a surprise. “Happy birthday! Blow out the candles! Your premium just went up $100 a month!” ProtectPlus uses a range of age bands that are common in health insurance plans:

• under 30
• 30–39
• 40–49
• 50–54
• 55–60
• 60–64
• 65 and older

If you’re with another insurer, you should check to see where the bands fall on your policy. You can’t avoid getting older, of course, but if a higher premium will create a financial burden, you can switch to a less expensive plan during open enrollment (November 2 to December 31). Otherwise, you will have to live with the higher rates for your newly attained age until the next year.

Keep in mind that the rates for your spouse and dependents are dependent on your age band, so their big birthdays don’t count in terms of premiums. You can celebrate as you see fit, and not have to worry about higher rates on their birthdays.

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You can simply call Anthem Blue Cross customer service at 888-209-7847 or login to Anthem Blue Cross and click on Search for a Provider outside of California.

This article was originally published on CNN.com

By Elizabeth Cohen
CNN Senior Medical Correspondent

(CNN) — Next week, the long-awaited H1N1 vaccine is expected to arrive. At least three of the four vaccine makers have begun shipping their products to undisclosed distribution centers.

There are two types of the vaccine available: the flu shot, an inactivated vaccine containing fragments of killed influenza virus, and a nasal spray, which is made using a weakened live flu virus. The nasal spray will most likely be the first to be widely distributed, however certain groups, including pregnant women, young children and people with compromised immune systems, cannot receive the nasal spray.

So far officials of the National Institutes of Health say that in clinical trials they’ve seen no serious side effects and that study subjects who have been immunized have generated a good response.

The Centers for Disease Control and Prevention recommends the vaccine for certain high-priority groups because they are more likely to have serious complications if they develop swine flu. These groups include: pregnant women; caregivers and household contacts of children younger than 6 months; everyone between the ages of 6 months and 24 years; and people ages 25 to 64 with existing health problems.

Even people who are not in these groups can get the vaccine. But now the vaccine is almost here, the question is, “Do you want it?” We looked through our Empowered Patient inbox and it turns out that many of our readers still have questions. We consulted a team of experts to get their answers, which are edited for brevity and clarity.

When can I expect the H1N1 vaccine to be available where I live?

While the first supplies of the H1N1 vaccine are due out next week, that doesn’t necessarily mean it will be available in your city. Since only 6 million to 7 million doses are expected next week, you might have to look around for it at the beginning. However, federal health authorities have stressed that within the next few months there will be plenty of vaccine to go around; 75 million doses will be produced before the end of the year.

Where can I find the vaccine when it comes out?

Check with your doctor, your children’s school and your local public health department. Right now there’s no central list of locations where swine flu vaccine will be offered, but the Department of Health and Human Services plans on putting information on Flu.gov as soon as possible.

For more answers to questions, continue this story at CNN.com

Not getting the daily “coffee fix” would be like death to some of us.  Unfortunately drinking coffee, tea or smoking cigarettes can cause relentless stains on our teeth.  If you don’t have time to brush, an easy way to fight stains is by biting into a juicy apple!

According to Beauty and Personality Grooming, “the mildly acidic and astringent quality of apples cleanses and brightens your teeth. Chewing foods like apples, celery, sugarcane and carrots, actually help scrub away stubborn stains over time.”

Our group plans require that you work a minimum of 20 hours per week in order to maintain your coverage. If you plan to retire before your 65th birthday (Medicare eligible age) you will not be eligible for coverage. You may be eligible for COBRA and/or CalCOBRA coverage depending on the size of your firm. Please contact Seabury & Smith at 800 824-1154 to discuss your options.

Medicare Secondary Payer (MSP) Reporting May 2009 Update, see UPDATES post for more information.

FREQUENTLY ASKED QUESTIONS

Q: What’s changing?
A: Section 111 of the Medicare, Medicaid and SCHIP Extension Act of 2007 replaces the voluntary data exchange agreement (VDEA) in which Anthem Blue Cross (Anthem) currently participates. Section 111 removes the voluntary label associated with the VDEA by requiring participation via the MSP reporting initiative. Mandatory participation for group health plan (GHP) enrollees coupled with requirements for social security numbers (SSN), group tax identification numbers (TIN), employer group size and penalties for noncompliance comprise the majority of the mandate.

Q: What is “MSP”?
A: “MSP” refers to “Medicare Secondary Payer.” According to Medicare law, there are situations in which another payer — primarily an insurance company or self-funded group health plan — must pay first (primary) for services rendered to a Medicare beneficiary before Medicare pays as “secondary”. The purpose of the law is to save Medicare money, since it will enable the Centers for Medicare and Medicaid Services (CMS) to pay claims accurately the first time by determining primary versus secondary payer responsibilities. When Medicare is “secondary payer,” it will only pay after the member’s “primary” payment has been exhausted or if it does not exist. (continue reading…)

It’s as easy as 1,2,3.

1. Provide a written request including; the employee’s name, the plan(s) from which the employee should be terminated, the reason why, and the effective date.
2. Sign, date and include your title.
3. Fax your written request to Seabury & Smith @ 800-682-8787

If you want to find out if your doctor, or hospital is a participating provider, or you want to find a participating provider in your area.
You can use the Search for a Provider feature on the CPA ProtectPlus.com website or, login to Anthem Blue Cross. Then click on Search for a Provider.

Now that it’s summer, it’s important to be sure to protect your skin from the intense rays of the sun.

The Skin Cancer Foundation recommends, “everyone should see a dermatologist once a year. Spring is a great time to go, to get advice on sun protection and to have your skin examined before the beach weather begins.”

The following are a list of questions that you should ask yourself, and possibly even discuss with your physician:

What Is My Skin Type?

Your skin type, which depends on the amount of natural protection your skin provides you, is a key factor when determining your risk of developing skin cancer.  If you don’t know your own skin type, check out [this] skin type guide.

What Is My Risk for Skin Cancer?

Family history, childhood sun exposure, personal skin cancer history and other factors all play a part in determining your overall risk.  If you’re not familiar with your family’s medical history, consider contacting family members to find out if there is a history of melanoma in your family tree.

Do I Need to Examine My Own Skin?

A monthly skin check is a crucial part of skin cancer early detection, although it should not replace a yearly professional skin exam. You want to be as thorough as possible, so follow [this] step-by-step guide.

What Should I Look For?

There are three major types of skin cancer – basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and melanoma. Each has different symptoms, and pose different risks. Recognize warning signs of BCC, SCC and melanoma.

You may view your EOBs, your contract benefits, and search for in-network providers by accessing member services on the Anthem Blue Cross website. Login to Anthem Blue Cross.

Approximately 3 months before your 65th birthday you will receive a letter from Seabury & Smith outlining your options. ProtectPlus is not a Medicare supplement and in most cases we do not recommend maintaining your ProtectPlus coverage once you are eligible for Medicare.

However, factors that may affect your decision include: the size of your firm, whether or not you have a younger spouse and/or dependent children and when you plan to retire. You may contact Seabury & Smith at 800 824-1154 to discuss your options.

Recap of first three.

1. You can’t open an HSA without subscribing to a high deductible healthcare plan (HDHP), but you can subscribe to an HDHP without opening an HSA.

2.Before deciding on an institution to act as trustee or custodian, research your investment options and the account fees.

3. As an employee, when comparing an HDHP with traditional copay plans, consider the amount your employer will contribute to your HSA.

4. Those over 65 who qualify for Medicare may not open an HSA, but there are several incentives for those in their 50s or early 60s to at least consider an HDHP/HSA option.

While,  for instance, there are limits on the amount of tax-deductible contributions that can be made to an HSA in any year, those over 55 may also make specified “catch up” contributions. Once you turn 65 and are covered by Medicare you may no longer make contributions, but you can continue to draw from your account tax-free for out-of-pocket health expenses.

In addition, you can use your account to pay Medicare premiums, deductibles, copays, and coinsurance under any part of Medicare. If you have retiree health benefits through your former employer, you can also use your account to pay for your share of retiree medical insurance premiums. You can also use your account to pay long-term care premiums, though you may not use HSA funds to purchase a “Medigap” policy.

5. California has recently extended state tax deductions to parallel federal exemptions.

This means that employee contributions to HSAs, and distributions made from these accounts to pay for medical-related expenses, are California income tax deductible. In addition,employer contributions will not be added to an employee’s California taxable income.

6. Finally, a word of caution for those who are shopping for an HDHP policy: while a policy may be attractive for its low premiums, be sure that it comes with a good preferred provider network.

If not, you can be hit with large bills for routine medical procedures, and because of the high deductibles, your out-of-pocket expenses can be very high indeed. In such instances, the advantages ofan HSA may evaporate.

Widely publicized before they were available, Health Savings Accounts (HSAs) are quickly becoming an accepted health insurance option.

We recently introduced a new HSA, Protect 2500, once you meet the plan deductible, the plan pays 100% of in-network, eligible expenses.

Consider these guidelines whether you’re interested in an HSA for yourself, an alternative plan for employees, or when consulting clients on how an HSA might serve them.

1. You can’t open an HSA without subscribing to a high deductible healthcare plan (HDHP), but you can subscribe to an HDHP without opening an HSA.

The Medicare Prescription Drug, Improvement and Modernization Act of 2003 stipulated that HSAs were created to allow individuals to pay for qualified medical expenses with pre-tax dollars in conjunction with specially designed HDHPs. Getting HDHP coverage without opening an HSA is possible. However, keep in mind that this option fails to take advantage of HSA tax benefits while exposing subscribers to the risk of paying the very high deductibles out of ordinary savings should they need expensive medical treatment. (continue reading…)

If your firm is splitting up, those CPAs who are covered under the ProtectPlus plans and are starting new firms, can carry their coverage with them to their new firm. The new firm(s) will need to complete a new subscription agreement. Please call Seabury & Smith for instructions at 800 824-1154.

Claims Procedures

Whether you have received treatment abroad in a hospital, clinic or doctor’s office, or filled a prescription, be sure to save your receipts. Also, try to get the doctor’s, or hospital’s, write-up in English. Anthem Blue Cross provides translation services, but having information about your treatment in English will speed your claim.

In addition, if you pay by credit card, the billing will be in dollars, making the process of reimbursement both simpler and at a better exchange rate.

Similar procedures apply for Delta Dental as well, plus Delta will make allowances for out-of-network treatment when abroad. When you return home, you can use the standard claims forms to get reimbursed.

If you need information regarding a claim submitted about your ProtectPlus coverage, simply contact Seabury & Smith at 800 824-1154. If you have received an Explanation of Benefits (EOB) from Anthem Blue Cross, please have that information available when you call.

It’s a haunting fear that most of us share in one form or another: You step off the curb in a foreign city, trip, and a sharp pain shoots up from your ankle. It might be broken. In another version, you’re enjoying a Caribbean cruise, and suddenly you have a high fever and feel nauseated. It could be something you ate or the flu, or it might be appendicitis. There are other scenarios too: you leave your carry-on bag with your prescription medicines in the taxi in Melbourne, or you crack a tooth chewing the ice in your drink in Puerto Vallarta.

All these scenarios share a common element—you’re abroad and you need medical help. Fortunately, friendly people guide you to the help you need. In addition, you are able to pay your bills with a credit card or a pile of traveler’s checks, or you arrange a wire transfer of funds from your bank. But now, you have a whole new set of concerns and questions: (continue reading…)

The ever growing number of prescription drugs on the market, combined with a greater popularity of herbal remedies and an increased use of over-the-counter medications, has produced, in addition to better health, a rising danger of harmful interactions. While warnings abound— “Avoid alcohol while taking this medicine” or “Stop taking this medication if …”—the prevalence and complexity of the problem demands that consumers take extra precautions when beginning a new prescription or trying a new supplement.

In some instances, drugs prescribed for unrelated medical conditions may be incompatible, either canceling the beneficial effects of one or both, or creating potentially dangerous side effects. Researchers recently found that Tamiflu, an anti-viral drug considered to be a major tool in fighting a flu epidemic, is rendered ineffective by the anti-clotting drug Plavix. (continue reading…)