Cloud & Associates Blog

If you’re not happy with Obama Care and are not keen on putting your health care decisions in the hands of a company that cares more about managing its profits than it does about your health, A HSA, Health Savings Account may be a good option for you.  The agents at David C. Cloud with their years of experience have compiled the newest updates and legislative action that effects health care and have put it together in a manner that explains all your options without the legal Mumble Jumble of the IRS.

There are primarily four types of Personalized Health Care Accounts.  They are commonly referred to by their initials such as HAS’s, FSA’s, MSA’s, and HRA’s.  We can consider these accounts to be various vehicles or tools to maximize our health care options and strengthen our tax advantage.  Below are the basic types of Health Savings Accounts:

• Health savings accounts (HAS’s).
• Health flexible spending arrangements  (FSAs).
  • Medical savings accounts: Archer MSAs and Medi-Care Advantage MSA’s.
  • Health reimbursement arrangements   (HRA’s)

Each of these accounts has a different set of rules and requirements along with different advantages and disadvantages.  We here at David Cloud and Associates,  highly encouraged you to  seek out professional advice when  deciding  which account is best suitable for you, as there are serious and potential tax disadvantages between each type of account.  Let’s start with the HSA, Health Savings Account.

An HSA is a pre tax account that you, the holder of the account, can contribution into.  A family member may also contribute to your account.   The amounts that you or your spouse, if filing a joint return are Tax Deductible.  Your employer may elect to make contributions to your HSA; however the amount that your employer contributes is not tax deductible on your return.  The money contributed from your employer is not considered income to you.  If a person other than a family member or individuals listed on your return contributes to your plan, there are different rules for them.  Distributions from a Health Savings Account that used to pay qualified medical expenses are not taxed or treated as personal income.

 

Here is some important legislature that applies to Health Savings Accounts.  Any medicine or drug will be a qualified medical expense only if the medicine or drug:

1.  Requires a prescription,

2.  Is available without a prescription (an over-the-counter medicine or drug) and you get a

Prescription for it

3.  Is insulin.

 

Some of the benefits of a HSA, Health Savings Account are that they allow you to claim a tax deduction for the amounts you or a family member contributed to your plan, even if you do not itemize your deductions on your tax return.  The contributions made into your HSA from your employer, including contributions that were made from a cafeteria plan in most circumstances are not treated as income to you. With an HSA, unlike some other plans, the contributions in your account are not subject to the “Use it or Lose It” clause and remain in your account year after year until you use them.  The earnings and profits made on these accounts are also tax free.

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David Cloud and Associates can guide you through this and help you establish the best account for you.  As you can see, there are many rules that apply to HSA’s, yet the benefits are great.   Stack the deck in your favor, take back a little control over your health and money and put it back where it belongs, in your hands.  Let David Cloud give you a voice and a choice in managing your family’s health care decisions.  This option allows you to keep the change in your pocket, where it belongs.

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WASHINGTON — A Democratic senator, Ron Wyden of Oregon, and a Republican member of the House, Paul D. Ryan of Wisconsin, unveiled a bipartisan plan on Wednesday to revamp Medicare and make a fixed federal contribution to the cost of coverage for each beneficiary.

The lawmakers aim to reshape the debate over the giant health insurance program by addressing concerns that have provoked fierce opposition to similar ideas in the past.

Just as important as the details of their proposal was the fact that the two were working together on an issue that both parties have exploited for political advantage.

In 2010, many Republicans won House seats — and the support of older voters — by arguing that President Obama’s health care law would damage Medicare. Democrats are hoping to retake the House by arguing that Mr. Ryan and other House Republicans are pushing for the privatization of Medicare, which they say could greatly increase costs for beneficiaries.

The new Wyden-Ryan proposal, by blurring the contrast between the parties on this issue, could make it more difficult for Democrats to win the argument.

The proposal would make major structural changes in Medicare and limit the government’s open-ended financial commitment to the program.

Under the proposal, known as premium support, Medicare would subsidize premiums charged by private insurers that care for beneficiaries under contract with the government.

Congress would establish an insurance exchange for Medicare beneficiaries. Private plans would compete with the traditional Medicare program and would have to provide benefits of the same or greater value. The federal contribution in each region would be based on the cost of the second-cheapest option, whether that was a private plan or traditional Medicare.

In addition, the growth of Medicare would be capped. In general, spending would not be allowed to increase more than the growth of the economy, plus one percentage point — a slower rate of increase than Medicare has historically experienced.

To stay under the limit, Congress could cut payments to providers and suppliers responsible for the overspending and could increase Medicare premiums for high-income beneficiaries, the lawmakers said.

The proposal is sure to come under fire from beneficiaries and Democratic lawmakers who see themselves as the pre-eminent defenders of Medicare.

For his part, Mr. Wyden said: “Medicare is the most important fiber in the social safety net. I would never do anything to shred it, weaken it or harm it in any way. Our proposal places traditional Medicare, long supported by progressives, alongside a menu of private alternatives that provide the choice and competition long supported by conservatives.”

Unlike the Ryan budget blueprint approved by the House in April, Mr. Ryan said, the new proposal would preserve the traditional fee-for-service Medicare program as an option for all beneficiaries. “Our proposal harnesses the power of competition to address the root cause of medical inflation,” said Mr. Ryan, the chairman of the House Budget Committee.

Democrats expressed concerns about the proposal based on policy and politics. A senior Democratic Congressional aide said, “This plan gives bipartisan political cover to Ryan and other Republicans against whom we have been waging a very successful political offensive.”

 

from BigHealthReport.com

 

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A new technical analysis by Oliver Wyman estimates that the new health insurance tax in the Affordable Care Act (ACA) “will increase premiums in the insured market on average by 1.9% to 2.3% in 2014,” and by 2023 “will increase premiums 2.8% to 3.7%.”

AHIP commissioned this report as part of its ongoing effort to raise awareness about the impact the tax will have on consumers, employers and public program beneficiaries. To learn more, please visit http://www.ahipcoverage.com/premiumtax/.

This new tax on health insurance plans amounts to $8 billion in 2014, increases to $14.3 billion in 2018, and increases based on premium trend thereafter. The tax will be allocated to each insurer based on its applicable net premiums during the year. Between 2014 and 2019, the total amount assessed will be at least $73 billion.

This new analysis, Estimated Premium Impacts of Annual Fees Assessed on Health Insurance Plans, is consistent with previous analyses on how the premium tax will impact the cost of coverage:

• According to the Joint Committee on Taxation: “For those insurance premiums that are subject to the fee, we estimate that the premiums, including the tax liability, would be between 2.0 and 2.5 percent greater than they otherwise would be. You asked for an estimate of the dollar amount of price change associated with the fee on the premium for a family of four. While we have not separately estimated premiums by family size, we estimate that eliminating this fee could decrease the average family premium in 2016 by $350 to $400.”
• In a November 30, 2009 letter to Senator Bayh, the Congressional Budget Office states that “New fees would be imposed on providers of health insurance and on manufacturers and importers of medical devices.  Both of those fees would be largely passed through to consumers in the form of higher premiums for private coverage.”
• An analysis of the premium tax by former CBO director Douglas Holtz-Eakin concludes that “The anticipated impact is as much as 3 percent or nearly $5,000 per family over a decade.”

Bipartisan legislation has been introduced to repeal the new health insurance tax. This bill currently has 73 co-sponsors.

The new Oliver Wyman analysis also estimates the effect of the new tax on insurance market segments and public programs:

• Impact on individual market consumers: Increase premiums over a ten-year period for single coverage by $1,900 under the lower-end estimate and $2,400 under the higher-end estimate (for an average $2,150 increase in premiums), and for family coverage would increase by $4,500 and $5,700 (for an average $5,080 increase in premiums).
• Impact on small employers: Increase premiums over a ten-year period for single coverage by $2,400 under the lower-end estimate and $3,100 under the higher-end estimate (for an average $2,760 increase in premiums), and for family coverage would increase by $6,000 and $7,700 (for an average $6,830 increase in premiums).
• Impact on large employers: Increase premiums over a ten-year period for single coverage by $2,300 under the lower-end estimate and $2,900 under the higher-end estimate (for an average $2,610 increase in premiums), and for family coverage would increase by $6,200 and $8,000 (for an average $7,130 increase in premiums).
• Impact on Medicare Advantage beneficiaries: Increase costs $16 to $20 per member per month in 2014 and will increase to between $32 and $42 by 2023, with an average expected increase in the cost of Medicare Advantage coverage of $3,590 over ten years.
• Impact on Part D beneficiaries: Increase average premiums by $9 in 2014 and by $20 in 2023 for a total increase of $161 over ten years.
• Impact on Medicaid managed care beneficiaries: Increase the average costs of Medicaid coverage by about $1,530 per enrollee between 2014 and 2023.

According to the report, “the potential result of these increases will be:

• “An increase in the cost of fully insured health care coverage, impacting individuals and smaller firms in particular, across both the commercial and public sectors.
• “Further incentive for employers to self-insure their health benefits coverage as a means of avoiding these fees – increasingly shifting the burden of the fees to smaller employers and individuals who continue to purchase fully insured coverage and must shoulder the cost of a statutorily fixed level of fees no matter the relative size of fully insured coverage markets.
• “Increased costs facing the Medicare Advantage and Part D programs that, following basic economic and actuarial principles, will result in increased cost-sharing and premiums for Medicare Advantage and Medicare Part D enrollees.
• “Greater pressure on state budgets to address increasing costs for Medicaid managed care plans.
• “A potential exacerbation of concerns related to ‘adverse selection’ in the individual and small group markets as younger, healthier individuals forego coverage leading to a less stable risk pool and higher premiums.”

The Oliver Wyman report also notes that the new tax assessed on health insurance plans is non-deductible for federal tax purposes. According to the analysis “this feature implies that for each dollar assessed and paid in fees, more than a dollar in additional premium amounts must be collected.”

 

Posted on November 2, 2011 by AHIP Coverage

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More than 40 percent of doctors surveyed said their patients receive more medical care than needed, due chiefly to physicians’ fear of malpractice lawsuits.

The survey of 627 members of the American Medical Association, conducted by Dr. Brenda Sirovich of the Dartmouth Institute for Health Policy and Clinical Practice and two colleagues, also found that just 6 percent believe their patients got too little care.

Three quarters of doctors surveyed said that malpractice concerns caused them to over-treat patients.

The research published in the Archives of Internal Medicine also disclosed that 62 percent of respondents believe diagnostic testing would be reduced if it did not generate revenue. Doctors are compensated for each test and procedure individually, thereby increasing their incentives for unnecessary or ineffective practices.

“Physicians seem to see that there are excesses of the medical care system,” Sirovich told National Journal. “Almost half saw it in their own practices — their own patients are getting what they describe as too much medical care.”

The researchers concluded that “malpractice reform, realignment of financial incentives, and more time with patients could remove pressure on physicians to do more than they feel is needed.”

Another study found that in 2009, more than $6.7 billion was wasted in excess healthcare spending in the primary care setting alone.

The study headed by Dr. Minal Kale, a postdoctoral fellow at Mount Sinai School of Medicine, disclosed that more than half of complete blood work ordered was unnecessary, antibiotics were overprescribed, and money was wasted on unnecessary bone density scans, urine testing, Pap tests and pediatric cough medicine prescriptions.

From NewsMax.com

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They've done it again! Just when we think we know the rules they change them. Many Americans wait until after Christmas to decide on a Medicare plan. They like to talk to their friends during the holidays to see what they think about a particular plan or policy. You cannot do that this year. Many plans receive as much as a quarter of their applicants during the last three weeks of December. You will not have the last three weeks of December to decide your coverage this year.

This year you have a longer window of enrollment than the November 15 to December 31 stretch of last year. Open enrollment runs from October 15 to December 7 this year. Someone out there has no sense of history or ironic sense of humor. The health-care overhaul calls for an earlier deadline to ensure that all new coverage begins as planned on January 1.

You should receive an annual notice telling you about any changes in your coverage for next year by September 30. Insurers will begin to market their 2012 plans on October 1. The dates are bound to catch some seniors off guard. Be proactive! If you are interested in enrolling in an Advantage Plan for 2012 start comparing plans as soon as possible. If you are considering changing plans for the first time visit the Medicare.gov to search for plans in your area.

Do not take any coverage for granted. Just because something was covered this year by no means indicates that it will be covered next year. Plans change how they cover expenses from year to year. You may find that a prescription drug that was covered last year is not covered for the new year, or you may face a big bill for a costly treatments like chemotherapy. Any changes will be laid out in the annual notice you receive from your insurer. Read it carefully!

If you miss the deadline things can get complicated. The open enrollment period, which ran from January 1 through March 31, has been eliminated and is no longer available. So, if you fail to do due diligence, the plan you are on may still be offered for 2012, but the details of the plan may change. If the plan is discontinued you may be switched to another plan or dropped into regular Medicare, which does not provide prescription drug coverage. If you enroll in a Medicare Advantage plan and wish to make a change, your only opportunity will be between January 1 and February 14. But, you will only be allowed to dis-enroll and return to original Medicare. You may also purchase a stand-alone Part D plan and a Medicare supplement if you wish. But, you will not be allowed to jump into another Medicare Advantage Plan.

The goal of the new deadline is to prevent coverage problems arising from late December enrollment decisions. But it could be a real headache if you are not on top of your game! You can rest assured, however, that the expert staff at David C. Cloud and Associates is on top of the game for you! We will be glad to assist you with any questions concerning your Medicare options. Just click on the Contact Us link above, or call us to discuss your specific situation and questions. Tags: Untagged

Planning on going out of the country? Plan on taking some friends along? Need Medical Insurance?

IMG, a leader in the international health insurance market, has just announced two new plans for those planning short hops or longer stays out of the country. Coverage is available for groups of 5 or more and is available by the day, from 5 days up to as long as 3 years (2 under the Green plan) if three months is initially purchased.

Patriot Platinum Group provides protection for groups of international travelers who want to obtain the maximum coverage available.  A wide range of deductibles up, to $25,000, is available. The plan provides up to $8,000,000 of coverage and covers some recurrences of pre-existing conditions.  This plan provides extended services handled by a dedicated service team and access to board-certified physicians, licensed psychologists, pharmacist, dentists, dieticians and trainers to assist with any routine health related questions you have.  In-patient and out-patient medical expenses can be covered and plans are available for U.S. citizens traveling outside the U.S. as well as non-U.S. citizens traveling outside their home country. Patriot Platinum Group is designed for groups of executives, families and individuals who want first-class medical coverage.

Are you feeling particularly adventurous? Wanta go jungle zip lining, wildlife safari, or cavern tubing? Patriot Green Group is designed for groups of 5 or more environmentally consious travelers. The plan includes an Eco Sports Rider covering the bold and courageous.  Maximum coverage limits range from $50,000 to $2,000,000 and deductible options run up to $2,500. The plan is renewable up to 24 months. The Green plan also includes an additional benefit allowing insureds the opportunity to donate $5,000 in the event of  Accidental Death and Dismemberment to an environmental organization that positively impacts global conservation. Donations can be made to offset carbon footprint.  Coverage is available from five days up to two years for U.S. citizens traveling outside the U.S. and for non-U.S. citizens traveling outside their home country. The Patriot Green Group is especially designed for Green organizations, student groups and Individuals and families.

Both plans offer trip cancellation, travel delay, and baggage delay benefits and pharmacy discount savings. Each also provides freedom to seek treatment with hospital or doctor of your choice. Insureds can save their out-of-pocket costs in the U.S. by using the Preferred Provider Organization.  IMG's exclusive International Provider Access(SM) (IPA) includes more than 17,000 providers.

 

Both of these plans are available to you NOW  by clicking here! Summer is almost over but your access to safe healthy travel has just begun.

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There are several reasons why a lot of people refuse or neglect to purchase health care insurance. Some would say they do not need it, while others think that it is too expensive to invest in something you won't be able to use anyway. Either way, it all boils down to money and the cost involved with purchasing an insurance plan. Indeed, a lot of people today simply cannot afford health insurance cost, which causes them to neglect an important part of their health security for the future.

Here is a fact that every citizen needs to know; regardless of where in the US you might be, obtaining health insurance is a must. If you do not purchase health insurance coverage, then your health and financial stability may be at risk. You can even exhaust personal savings to cover medical costs, in case anything happens with your medical or health condition. Therefore, it is important to review various health insurance plans, programs and carriers. It is also important to review premium rates, while trying to secure low cost health insurance premiums.

What is the Average Cost of Health Insurance?

There are a several factors that determine premium rates and health insurance cost. This includes age, weight, medical history, and whether you smoke or not. While it is difficult to effectively pinpoint the average cost of a health insurance policy, you can always monitor policy and premium rate changes. These are important facets, and often deciding factors when looking to buy low cost health insurance. Health insurance polices, however, can be comprehensive and intricate. Therefore, it is important to evaluate each option carefully, before making a worthwhile decision.

In 2008, statistics showed that the average health insurance premium for individuals was $4,700 per year. Thus, a family of four was expected to spend approximately $17,700 per year on health insurance alone. This is staggering data that explains why a lot of Atlanta residents, and in the nation in general, have opted not to purchase health insurance. Most of the policyholders, however, were still able to acquire insurance as part of company provided plans. This made insurance premiums more affordable and a lot more manageable. In addition, a health care policy obtained through a company, is significantly cost-efficient than private plans.

Factors Affecting Health Insurance Cost

When searching for low cost health insurance, it is important to understand your options and choices. There are even factors that can affect your ability to modify existing coverage. Insurance companies are utilizing a number of factors to come up with premium rates for each policy. However, there are some basic factors that are obvious to begin with. For instance, the age of the policyholder and current health condition are important factors. Apparently, an older person with a diagnosed health condition; will pay higher premiums than middle-aged policyholders with good health. Based on this alone, you should be able to determine the algorithms used by insurance providers when determining premium rates.

Other risk factors are also taken into consideration when determining health insurance premium rates. This is why clients are required to submit medical reports for review and assessment. After careful review, the company utilizes this information to determine premium rates and policy plans. Policyholders at a greater risk of developing certain conditions are most likely to assess higher premiums. For customers with good to great health, they are sure to have lower premiums. Therefore, is very important to take care of your health at all times. This is especially true if you want to reap the benefits of low cost health insurance.

As the cost of health insurance continues to soar, several customers have seen hikes in insurance premiums. With the current fiscal crisis, this makes health insurance even more expensive. Therefore, understanding your choices and options is simply paramount. Not only can you lower your health insurance costs, you can also protect your family's health for the future. With so many options available, there is no need to pay outrageous premiums for health insurance coverage. You can also work with insurance agents to lower the cost of health insurance policies. This can be done by modifying coverage, replacing policies, or by simply getting in better shape. If you value your health, contact an insurance agent and secure your future now! Tags: Untagged

There appears to be a major disconnect between perception and reality concerning the cost of health care in America. The perception is that Americans have a right to have access to free healthcare. The reality is that someone has to pay for it.

This disconnect can best be demonstrated in a conversation I had with a young man several years back. I needed a tree removed so I made a few calls. A conversation ensued with one of the vendors concerning healthcare.  It was his contention that everyone should have free healthcare. When I asked him who would pay for it he replied, "The government!"  As the conversation continued he seemed to have no concept of the fact that the government gets its money from taxing the people. When I suggested paying his $1000 invoice by giving him $300 and sending $700 to the government to pay for his health care he walked away bewildered mumbling something derogatory about my IQ.

In recent weeks new guidelines were announced by the U.S. Department of Health and Human Services (HHS) that will ensure women receive preventive health services at no additional cost. Women's preventive health care - such as mammograms, screenings for cervical cancer, prenatal care, and other services including approved contraceptive methods, and sterilization procedures must be covered and plans can no longer charge a patient a copayment, coinsurance or deductible for these services when they are delivered by a network provider. 

The common theme among most of the proponents of this plan is that, because of cost, most Americans use preventive services at about half the recommended rate. Cost sharing (including copayments, co-insurance, and deductibles) reduces the likelihood that preventive services will be used. Eliminating cost sharing will enable early screening, detection, and treatment thereby, reducing chronic diseases which account for most of the nation's health spending. This all sounds very nice, until we get to the next question! Who is going to pay for these extra services?

Health insurance is the normal method of payment for these services.   AHIP is the national trade association representing the health insurance industry. Recently, AHIP President and CEO Karen Ignagni made a great point when she observes that the recent guidelines  "…increase the number of unnecessary physician office visits and raise the cost of coverage."  She continues that the recent guidelines "… encourage consumers to obtain a prescription for routine supplies that are currently purchased over-the-counter." All of this she says "will significantly impact the affordability of coverage and the cost to taxpayers." 

So, get ready to pay more.  And when the Affordable Care Act (which is not!) forces your health insurance company into bankruptcy, be prepared to send $.70 of every dollar you earn to "The Government" to pay for someone else's birth control pill! And that will be a bitter pill to swallow! Tags: Untagged

People who have health insurance are protected against unexpected high health care bills. They are usually more likely to receive appropriate health care when needed. Having adequate health insurance is also associated with improved health outcomes so employees with health insurance are usually more productive employees. However, more Georgians are going without employer provided health care than ever before.

The nationwide trend in insurance enrollment rates has been on the decline for a number of years. As employers have faced increasing cost they have had to increase employee share of premium cost. And while employees have seen a decline in real income they have become more price conscious. Over the last decade the number of Georgia residents who have health insurance through their employer has fallen to about 60%. The problem is more pronounced in Georgia due to the higher numbers of small employers. Only 37% of Georgia employers with 50 or fewer employees currently offer health insurance.

The 2010 Health Care Law is supposed to help alleviate the problem of Americans having to do without health insurance coverage. While the debate continues individuals and families must have a way to secure affordable health insurance. Cloud and Associates has been serving the Atlanta area since 1980. While you can get your insurance quote online, a single phone call to our knowledgeable staff can help you find the right policy for your situation. Call us today. Tags: Untagged