Health Insurance

New IRS guidelines for employees’ family members to receive health insurance premium assistance

Posted on by McGriff Williams in Health Insurance, Human Resources |

The state of the health insurance market is constantly changing and those that are business owners or group plan administrators have seen how difficult it can be to keep up and remain compliant. We are committed to helping everyone stay informed to take good care of their employees. Most recently, as of October 11th, there were new guidelines released from the Internal Revenue Service (IRS) regarding premium tax credits for individuals that may not be the right fit on an employer-provided group health plan.

This change is intended to fix the so-called a family glitch by extending marketplace subsidies to an employee’s household members that may not have been eligible before. In the past, eligibility was determined by whether or not the premium for single group medical coverage offered to an employee was affordable. Now, it is based on whether the premium for a FAMILY group medical coverage is affordable. For example, if the family plan offered by the employer to an employee is not affordable for them, their spouse and children may be eligible to receive a subsidy and the employee can remain on the group plan.

Subsidies are determined by the Marketplace, established by the Affordable Care Act, and are based on total household income. The plans, as far as coverage, remain the same but the premium may be discounted in tiers depending on their income level. This is reevaluated every year based on their projected income and tax filings.

So what does this mean for an employer? It doesn’t change anything for the group plan administration but it does provide another option for employees’ family members to obtain health care coverage that they can afford. Because this new regulation is focused on the family members of employees, it does not change anything with mandates for large employers to offer coverage to employees or their family.

If you are an employer that offers health insurance benefits, we recommend sharing this information with your team. We are happy to help guide them through the individual health insurance market, should they choose to pursue it for their spouse and/or children. Here is a copy of this new regulation if you’re interested in reading more.

 

New HSA information released for 2022

Posted on by McGriff Williams in Health Insurance, McGriff-Williams News |

New guidelines for Health Savings Accounts in 2022 have been released and there are several ways this type of account may work to your advantage. Just like all health plans, an HSA isn’t the right fit for everyone. But for some, it can result in big savings financially and be just the plan you need.

Let’s start with what exactly an HSA is. A Health Savings Account consists of two things: a high deductible health plan purchased from a private carrier, such as Florida Blue, in which you pay a monthly premium for as well as a qualifying savings account at a bank where pre-tax contributions can be made. That account would then be where funds come from to pay for things like copays at the doctor, certain medicines, etc.
Some examples of qualified expenses that can be purchased with an HSA account are:
  •  Prescription or over the counter medications
  •  Eye glasses, contacts, solution, etc
  • Acupuncture and chiropractic care
  • Vaccinations or immunizations
  •  Dentures or dental treatment
  • Hearing aids
  • Insulin and diabetic supplies
  •  Allergy testing
  • Wheelchairs, walkers, crutches, etc
  • Sunscreen and first aid
There are limitations and guidelines to abide by with an HSA account. These can vary each year so it’s important to pay attention to them at every renewal if that’s the plan you choose. For 2021, an individual can contribute up to $3,600 of pre-tax money per year and for a family, the maximum contribution is $7,200. The out of pocket maximum is $7,000 for an individual and $14,000 per family.
Meaning, one can put $3,600 into that bank account and then use however much of it they need for health expenses. Then after $7,000 out of pocket is spent, their plan’s coverage kicks in and they pay nothing more for that calendar year.
For 2022, those limits have increased to a $3,650 contribution limit for an individual and of maximum of $7,300 for a family. The out of pocket maximum was also increased to $7,050 per individual and $14,100 for a family.
The tax-deductible contributions, tax-free interest and tax-free withdrawals for qualified medical expenses are all huge perks to an HSA plan for health care. But another big advantage is that it is 100% yours. If you get it through an employer and leave that job, you keep it. If you don’t use it, it remains there as a savings account and the contribution allowance starts back over the next year.
Again, Health Savings Accounts are not the right fit for everyone but are definitely worth exploring. And if you’re ever uncertain about a qualified expense, you can contact your carrier for clarification. It is also recommended that you always keep all receipts in the event of an audit.

 

What exactly is the American Rescue Plan of 2021?

Posted on by McGriff Williams in Health Insurance, Insurance, McGriff-Williams News |

Early in the new year of 2021, the Biden Administration implemented The American Rescue Plan (ARP) with the intent of reducing health care costs and expanding access to health insurance plans.

There are currently over 9 million Americans accessing health care through the Affordable Care Act Marketplace, which provides subsidized plans with lower premiums based on household income. Their goal is for there to be at least a few plan options available to every consumer at a monthly premium no more than 8.5% of their household income.

For example:

  • Uninsured couples earning over $70,000 annually could save more than $1,000 per month on their premium
  • A family of four making $90,000 annually will see their premiums decrease by $200 per month
  • A single individual making $19,000 annually will be able to find health insurance coverage with no monthly premium at all, saving roughly $66 per month on average

This plan also introduced an extended Open Enrollment Period that in past years ended on December 15th for the coverage to be effective the following year. For 2021, that new period was from January 15th-May 15th but has now been extended even further to August 15th and coverage can be effective on the 1st of the following month.

The ARP is reevaluating the level of subsidy that Americans qualify for based on their income. Those with new or existing Marketplace plans can visit www.healthcare.gov or call the Marketplace directly to confirm whether or not their tax credit will be increased, resulting in lower out of pocket monthly premium responsibility for the insured. You can also wait until you file your 2021 taxes next year to get the additional premium tax credit amount. However, it is recommended that you update your application and review your plan options during the allotted period up until August 15th.

There is something to keep in mind regarding coverage if you change plans during this time. It is important to consider the new plan’s deductible as it’ll likely start over. If you change plans or add a new household member, any out-of-pocket costs you already paid on your current 2021 Marketplace plan probably won’t count a towards your new deductible, even if you stay with the same insurance company.

These are variables that a licensed agent or Marketplace representative can discuss as they pertain to specific situations. The website again for resources regarding the Affordable Care Act is www.healthcare.gov.

How much does Medicare cost?

Posted on by McGriff Williams in Health Insurance, McGriff-Williams News, Medicare |

The cost of Medicare can seem confusing but it’s really quite simple. Because it is very case-by-case for each individual’s situation, this is a very brief guide to reference Medicare premiums in 2021. Part A, which is for hospital coverage, has $0 premium regardless of who is qualifying or what their income and employment status is. Part B, however, is determined by income level and how taxes are filed. This chart shows the different brackets for each and the current premiums for 2021.

File Individual Tax Return File Joint Tax Return File Married & Separate Returns 2021 Monthly Premium
$88k or less $176k or less $88k or less $148.50
$88k – $111k $176k – $222k N/A $207.90
$111k – $138k $222k – $276k N/A $297.00
$138k – $165k $276k – $330k N/A $386.10
$165k – $500k $330k – $750k $88k – $412k $475.20
$500k or above $750k or above $412k or above $504.90

 

This chart is specific to Florida Blue’s current Advantage Plan and Plan G supplement but may also be helpful to show the estimated cost of both routes you can go if purchasing additional coverage to Parts A and B.

ADVANTAGE PLAN SUPPLEMENT
Medical Coverage Medical Coverage
Monthly Premium: $47.90 Monthly Premium: $180.60 (Plan G at age 65)
Part A: $0 Part A: $0
Part B: contingent on income (see above) Part B: contingent on income (see above)
Prescription Drug Coverage Standalone Part D
Monthly Premium: included in plan Monthly Premium: $73.70
Deductible: $250 Deductible: $405

 

MONTHLY TOTAL
ADVANTAGE PLAN

$47.90 (+ Part B)

 SUPPLEMENT

$254.30 (+ Part B)
Includes copays & coinsurance.

Out of pocket max: $6,500 in network/$10,000 out of network

 Part B deductible ($203) must be met.

No copays or coinsurance.

 

New Executive Order for Health Insurance Special Enrollment Period

Posted on by McGriff Williams in Health Insurance, McGriff-Williams News |

On January 28, 2021, President Biden signed an Executive Order directing the Department of Health and Human Services (HHS) to open healthcare.gov for a three month special enrollment period (SEP).

Usually, the Open Enrollment Period for new health insurance or changes to a current plan is from November 15-December 15 of every year for the following year’s coverage. In the past, if you needed new coverage or changes made outside of that time frame, you would have to qualify by having a life event such as marriage, divorce, birth, adoption, loss of employer-provided coverage, etc.

This Period for 2021 is from February 15-May 15 to provide an additional opportunity for uninsured and underinsured Americans to enroll in coverage in the face of the COVID-19 pandemic. Coverage would be available as soon as the 1st of the following month. This applies to both subsidized plans (with premium assistance based on income qualifications) in the Marketplace and non-subsidized plans that are considered Off-Marketplace.

According to Florida Blue, here are a few tips if you are in the market for new health insurance or to make changes to what you currently have:

  • Starting February 15, consumers seeking to take advantage of this SEP can find out if they are eligible by visiting healthcare.gov or speak with an agent. The application process and plan selection can either be done online or through an agent as well.
  • Consumers who are eligible and enroll under this SEP will be able to select a plan with coverage that starts prospectively the first of the month after plan selection. Consumers will have 30 days after they submit their application to choose a plan.
  • Current enrollees will be able to change to any available plan in their area without restriction to the same level of coverage as their current plan. In order to use this SEP, current enrollees will need to go through their application and make any changes if needed to their current information and submit their application in order to receive an updated eligibility result that provides the SEP before continuing on to enrollment.
  • Consumers won’t need to provide any documentation of a qualifying event (e.g., loss of a job or birth of a child), which is typically required for SEP eligibility.

HHS has published a fact sheet here: https://www.hhs.gov/about/news/2021/01/28/hhs-announces-marketplace-special-enrollment-period-for-covid-19-public-health-emergency.html providing additional details on implementing the healthcare.gov SEP as well as an CMS fact sheet here: https://www.cms.gov/newsroom/fact-sheets/2021-special-enrollment-period-response-covid-19-emergency with more technical details.