CalCPA ProtectPlus

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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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.

If You Continue to Work Past 65
For those who continue working beyond the age of 65, whether solo CPAs or in firms of fewer than 20 employees, the Group Insurance Trust strongly recommends subscribing to Medicare Parts B and D and purchasing a Medigap policy. Since Medicare will be your primary payer of claims, you will receive few if any benefits from retaining your group coverage.

However, if you are employed at a firm with more than 20 employees, the opposite generally holds true. Since your group plan qualifies as the primary payer, and thus is billed before Medicare, you should retain your group coverage. In this circumstance, you can also delay purchasing any optional Medicare and Medigap plans until you do finally retire. If your spouse has been covered on your group plan and you continue working, then for solo practitioners with ProtectPlus, the choice is simple. (continue reading…)

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…)