New Tax Credit May Help Small Businesses
Small businesses may be able to claim a new credit on their 2010 tax returns if they pay employee insurance premiums in 2010.
The credit, available through the Patient Protection and Affordable Care Act, is intended to:
1.Give small employers a tax break if they pay at least half the cost of single coverage for their employees on the group health plan.
2.Encourage small employers to offer health insurance for the first time or maintain the coverage they currently have.
These frequently asked questions may be helpful. More information about the credit, including tax tips, guides and FAQs is available on the IRS website at www.irs.gov.
This link will take you to the general overview on the IRS web page IRS LINK
Use this link to determine eligibility Eligibility chart
Medicare Supplement Plan N was approved for enrollment on June 1, 2010. The plan is offered at a competative price point by Anthem BCBS and United Healthcare “AARP Branded”. They both offer plan N for around $150 a month depending on availability of discounts.
Plan N is a departure from other supplements in that is allows the physician to bill up to a max of $20 per visit. It also has a $50 emergency room copay and does not cover the part B deductible (disappointing) of $155 a year. Many seniors have been willing to give the plan a try in order to save $50 a month in premium. This has been especially true of those in plan F supplements. Plan J enrollees need to be careful as plan J is a closed plan an they will not be able to go back to it in the event they try plan N and decide they do not like it.
The most suprissing part plan N has been the low number of providers that actually bill any type of excess on the plan. Providers are allowed to bill up to $20 dollars but seem not to do so often. (That has been our limited experience so far anyway)
People switching from their current plan to Plan N do not need to pay the $155 part B deductible as it has already been met for the year. They will however be subject to the Part B deductible in 2011.
Walmart will be offering Medicare Part D Prescription drug plans for 2011. While there has not been much detail provided about the plan design, it is suggested that the plan will have a $0 copay for generic drugs and very low cost monthly premiums
Walmart will utilize small kiosks in the store staffed by representatives licensed to sell the Medicare Part D Rx plans. There are not yet many details on the plan formulary but it will be offered through Humana. Members will only be able to use the new drug card at Walmart pharmacies. The plan will be available on November 15th which is the start of the Medicare Annual Election Period which is when Medicare Eligible members may sign up for a Part D Rx plan.
AARP Supplement Changes For June 1, 2010
AARP released the new supplement changes for 2010. Plan changes and Rates are as follows…
Supplement Plan M- Will not be offered in CT for 2010 Read more
Employer Reporting Requirements
Notice of Coverage Options. Not later than March 1, 2013, employers must provide a written notice to newly-hired and current employees informing employees: 1) that healthcare exchanges are available, the services provided by the exchange, and how to contact the exchange; 2) if the employer pays less than 60% of the costs of benefits, that the employee may be eligible for a premium tax credit and a cost-sharing reduction if the employee purchases health insurance from an exchange.
Reporting Cost of Employer-Sponsored Health Coverage on W-2. Effective January 1, 2011, an employer will be required to report the aggregate value of medical benefits, dental, vision, and supplemental insurance coverage on the Form W-2 that is provided to each employee annually.
Uniform Explanation of Coverage. By March 23, 2012, group health plans and sponsors of self-insured health plans must provide participants a uniform summary of benefits and coverage. The uniform summary cannot be longer than four pages and must describe the health benefits offered under the plan, limitations on coverage, cost-sharing provisions, and any restrictions on continuation of coverage. Failure to provide this summary will result in a $1,000 fine per failure. Read more
Do You Have A Competitive Life Insurance Rate?
The old saying goes that you should keep you life insurance policy once you purchase it because it costs more as you get older. This saying is only partially true for most and can cost you thousands is you follow it. Many believe that this was simply a ploy by insurance carries to help keep business on the books and prevent people from rate shopping once they had a policy.
Small Group Employers In Connecticut May Want To Consider Alternatives
Group health insurance rates are becoming a greater burden on small employers with every renewal. Double digit rate increases have become the norm. So what can a small employer do to help off-set rate hikes?
Most employers have simply been going by the standard formula of increasing the employees contribution toward the plan premium and raising medical and Rx copays to keep things at a manageable level. More proactive groups use either HSA or HRA designs in order to offer a plan with a more substantial deductible in order to lower premiums. Such strategies are becoming more and more popular every year.
Insurance Companies are starting to roll out the plan changes for 2010 and the trend is disturbing. Much like group and individual health insurance, Medicare Advantage plans are seeing increasing trends. The difference is that the Medicare Advantage companies are increasing rates and lowering benefits at the same time.
Medicare Advantage Plans and VA benefits
We will explain why veterans should use $0 Medicare Advantage Plans and VA benefits .
There are a large number of Medicare eligible veterans who rely on VA facilities for their medical care and Rx coverage. Although it is not possible to put all those using VA benefits in the same category, there is a general trend with veterans in Connecticut. Most veterans go to VA doctors for routine care. They also use the VA to fill their generic prescriptions. The need for hospital or emergency care seems to be a different story as most usually tell me they prefer to go to the local hospital or emergency room.
The other trend I often see is:
They tend to have Medicare A and B benefits without either a secondary plan or Rx coverage. This can lead to out of pocket costs when the veteran needs a name brand drug or chooses to use the local hospital or emergency room. Medicare A and B leaves them with out of pocket expenses when they use non VA providers.
Individual Dental Plans in Connecticut
Purchasing an individual dental plan in Connecticut has traditionally been a difficult task. The premiums for the plans usually cost almost as much as the max annual benefit. (max benefit is usually $1,000 or $1,500 a year). Most plans have have waiting periods on basic and major services of at least 6 months. Once those waiting periods have been met the plan will pay 40% to 60% of the allowable cost. Preventative cleanings are usually covered 100% from day one but many plans only cover one per year. On top of this dentists often do not participate with many of the plans making it more difficult.
This has changes to a certain extent recently. There are now some plans available that do offer a fair premium compared to the benefits you can receive. Here are three that you may want to consider.
Ameritas- They have a variety of stand alone dental plans ranging from $25.00 to $70.00 a month. The waiting periods are reasonable for basic services and preventative dental is covered at 100% which includes X-rays. Be careful however, because at this time they only allow one preventative cleaning a year on the lower cost options.
Get a quote: https://secure.healthplan.com/agent_platypus/quote_start.php?go=true&cust_link=CUS1013121551
Aetna- Aetna offers a very affordable plan ($16 a month for individuals under 65 and $15 a month for those over 65) that covers two preventative cleanings including X-rays a year. The network has a surprising number of participating dentists as well. Be careful when asking your dentist if they accept the plan. There are a number of Aetna networks and you need to make sure they are in the one specific to your plan. The Aetna Plans are not “Stand Alone” and as a result, you must be enrolled in an Aetna Individual Medical or Medicare Advantage plan to be eligible.
Get a quote: https://www.aetna.com/iqs/aimquote.do
Golden Rule “United Health One”- This plan came out in July of 2009. The premium for the value option is $26.00 a month and the plan covers 2 preventative cleanings including X-rays. There is 80% coverage for basic services and 50% coverage for Major services (after a reasonable waiting period 3 months and 6 months) The network is adequate in most areas. This plan can be used as a stand alone option and is available to people of any age.
Get a quote: https://www.goldenrulehealth.com/Customer/QuotePages/CustZipCode.aspx?SID=bc05c0ff-2120-4705-a19b-8282fc6507a3
Medicare and Medicaid Dual Eligible Plans
Medicare and Medicaid Dual Eligible Plans: Evercare (United HealthCare) is the only Medicare/Medicaid “Dual Eligible” plan available in the Connecticut market today. WellCare was offering a dual eligible plan but it is currently not being sold due to CMS restrictions.
The Evercare plan offers some benefits to Dual Eligible people that they would not have otherwise. It helps them cut down on potential out of pocket costs associated with visiting doctors whom do not accept Medicaid. The plan also provides a small benefit ($180 a year)toward over the counter drugs which can be purchased through a catalog. Finally, the plan offers 12 round trip rides per you to the doctor which can be useful for those who have trouble making it to their doctors appointments.
Evercare carries no premium for full qualifiers and can be added or dropped at any time. Medicare enrollment time frames are not applicable other than the need for the plan to start the first of the month after the member applies.
Choosing Medicare Supplement or Medicare Advantage
Choosing Medicare Supplement or Medicare Advantage plans can be both confusing and frustrating. Many seniors simply go with a company name they are familiar with (Most commonly AARP). A plan that a relative or friend suggested or they just stay in their current plan because that is what they have always had. The end result is usually a bad choice of plan for the given situation. The reality is that there is not one “best plan” for everyone. To choose the best plan for the situation, it is important to know all the options available.
Here is a quick overview of the options available to Connecticut residents and the strengths and weaknesses of each…..
Medicare Supplement Plans:
Medicare Supplement plans are secondary plans you can purchase from a private insurance company to help cover the gaps in Medicare part A and B. In all states, the plans offer standard benefits. Plans provide different levels of coverage. This depends on which plan you choose. The plan benefits cannot change. This means any company that offers a plan must offer the exact same benefits. For Example Plan N with Anthem BCBS is exactly the same as Plan N with AARP (United HealthCare). The only difference is the rate that the private company charges for them. Please keep in mind, the rate can vary greatly. One company in CT charges $184.00 a month for plan J while another charges over $300.00 for the exact same plan.
Supplement plans are best for a person who uses a high volume of health care services. Supplement plans tend to be costly but have very little out of pocket expense. If someone is consistently receiving a high volume of medical services, it may be wise to look at a supplement. It may also be wise to use a supplement as some doctors that will not accept Medicare Advantage plans. In such a case, a Medicare supplement plan will provide coverage when an Advantage plan will not.
If you are in the market for a supplement plan it goes without saying that AARP should be considered.
They currently have the best rates available. If you are considering plan F, you should purchase plan J instead. Plan J cost less, has all the benefits of F and some additional benefits as well.
The drawback to a supplement in the monthly premium cost compared to the premiums of Medicare Advantage plans. Also, supplements do not come with Rx coverage which must be purchased separately if it is needed. If you are not a high volume user of medical services, it is warranted to look at the available Medicare Advantage plans.
One last thing to mention with supplements is that some people are simply more comfortable with them. For some seniors the most important thing is to be able to see any doctor and not worry about copays or anything associated with managed care. The person who feels this way may be willing to pay the extra monthly premium for this luxury.
Medicare Advantage Plans:
Medicare Advantage Plans are a low cost way to for seniors to obtain health care coverage. Advantage plans provide benefits equivalent to Medicare Part A and B with most plans providing additional benefits beyond what is covered by A and B. The plans can come with or without Rx coverage build into the plan design. Medicare advantage plan administer your benefits instead of Medicare Part A and Part B which makes the plan primary. Premiums range from $0 monthly premium to $179.00 month premium depending on the plan selected.
Medicare Advantage Plans do have some drawbacks compared to supplements such as the fact that you need to stay in network in most cases (There are PPO plans with out of network benefits) There are also copays associates with services. The higher premium plans have very low or no copays for many services but the lower premium plans ($0 premium) tend to have more out of pocket costs on things such as hospitalization)
Here is a breakdown of the plans available in Connecticut for 2009….
AARP Medicare Complete:
Positives– $0 monthly copay, Rx coverage build in with Medical, very low copays to primary doctors and specialists and out of network coverage.
Negatives– The network can have a lack of physicians in network in certain parts of the state, New Milford and some other key hospitals are not participating and the hospital copay is stiff at $225 a day for a total of 17 days.
Aetna Golden Medicare:
Positives-The Golden Medicare plans offer a national network which is nice for people who travel out of the Connecticut area. The Physician and hospital network is now one of the largest in Connecticut. The $59 plan is the lowest cost plan on the market that still covers Inpatient hospitalization at 100%. There are a number of different plans to choose from including PPO options that provide out of network coverage, the $0 premium plan offers strong benefits compared to the rest of the $0 premium plans in the market.
Negatives-Some drugs fall into the 4th tier when they are only 2nd tier with other plans.
HealthNet:
Positives- Strong provider network, many high dollar drugs are on the 2nd tier.
Negatives-At current premium levels, the benefits are not competitive with other carriers in the Connecticut market. The Navy plan has weak benefits ($150 copay for 5 days inpatient hospital) for the high premium charged ($179.00)
Evercare (Secure Horizons/United Health):
Positives-$0 premium plans with low physician copays and Rx coverage, Chronic conditions plans coverage more conditions than any other in the state, only Dual Eligible Plan (Medicare and Medicaid) offered in CT market.
Negatives- High out of pocket costs for inpatient hospitalization, weak network can be difficult to deal with from an administrative standpoint, weak out of network benefits compared to AARP Medicare Complete
Be cautious of anyone who is only able to sell one or two of the companies listed above. If they only offer a few plans, they may not know everything available that could best fit your needs. Find someone who has the ability to work with all plans available in Connecticut in order to see all of the choices. Although there are a number of plans available, each person has their own needs.
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