high deductible health insurance Archives

Should You Get A HSA During Open Enrollment?

Do you have a Health Savings Account (HSA)? If not, you could be missing out on some savings. HSA allows you to set aside pre-tax money to help pay for out-of-pocket medical expenses; they are particularly helpful for people with a lot of medical expenses, but they are not compatible with all health insurance plans. Before the Open Enrollment Period is over, find out how HSAs work, if you qualify for one, and if it is worth setting one up.

What Is a HSA?

pink piggy bank with stacks of money next to it — *HSAs let you to set aside a certain amount of pre-tax income to pay for healthcare needs.*

The ACA’s Open Enrollment Period runs from November 1 – January 15 this year, so now is your chance to make sure that your health insurance will work for you next year. That includes considering new ways of helping fund your healthcare expenses, like with a Health Savings Account (HSA). So how do these accounts work?

HSAs are savings accounts that allow you to set aside a certain amount of pre-tax income to pay for healthcare needs/bills. There are a few important things to note about these accounts: first, you are only eligible for a HSA if you are enrolled in a qualified high-deductible health plan. Next, there is a limit to how much you can put into these accounts each year: limits on annual HSA contributions for coverage beginning in 2022 are $3,650 for individuals and $7,300 for families. Some employers will contribute to your HSA; if they do so, you will still not be able to exceed the annual contribution limit. The money that you both contribute is pre-tax, earns tax-free interest, and will not be taxed when you withdraw it to use for qualified medical expenses.

Advantages of HSAs

Aside from being an excellent way to pay for your out-of-pocket medical expenses, HSAs have:

Tax benefits– Any money put into your plan up to the annual limit is untaxed. If you enroll in a HSA separately from an employer’s health insurance plan, your HSA contributions are tax-deductible. This means that if you put the maximum amount of $3,650 into your HSA and make $50,000 annually, you will be taxed as if you earn $46,350, which could possibly put you into a lower tax bracket. And if your account grows, you will not be taxed on the growth, nor will you be taxed if you choose to make any withdrawals for medical expenses.
Investment options– You have the ability to invest the capital of your cash account, so you can grow your untaxed funds.

Do You Qualify?

Not everyone qualifies for a HSA. In order to be eligible for one, you must: checklist with all the boxes checked and a pen on the clipboard

Be covered under a qualified high-deductible health plan (HDHP). For 2021, a HDHP is a health insurance plan with a deductible of at least $1,400 for individual coverage or $2,800 for family coverage.
Not be covered by any other medical plan.
Not be enrolled in Medicare.
Not be claimed as a dependent on someone else’s tax return.
Not be enrolled in TRICARE or covered by medical benefits from the Veterans Administration.

Is a HDHP Right For You?

As pointed out above, in order to set up a HSA, you need to first have a high-deductible health plan (HDHP), so before you decide whether a HSA is right for you, you’ll have to decide if a HDHP is also right for you. These plans are great for people who are generally healthy, and do not see the doctor often, because the deductible is so high. But in return for the high deductible, you will have low monthly premiums, so if you’re looking to save money on your monthly premiums and think you will not reach your deductible amount because you don’t go to the doctor aside from annual checkups, this might be the right type of plan for you.

HSAs are a great savings tool that will help you pay for any out-of-pocket medical expenses, but you’ll first have to consider if a HDHP is right for you and/or your family. If you are interested in a HDHP and a HSA, an EZ agent can help. We will do all the research and comparison for you and find you the plan that will best suit your needs. To compare quotes in minutes, at no cost, enter your zip code in the bar above, or to speak to an agent, call 888-350-1890.

How Much Should You Be Contributing To A Health Savings Account (HSA)?

How much money have you put into your health savings account recently? If the answer is “not much,” then you should put contributing to it at the top of your to-do list. As long as you are enrolled in a high-deductible health plan, you can put aside money on a pre-tax basis into your health savings account, or HSA, and withdraw these funds (also tax-free) to cover current and future medical expenses. The money you save also accrues tax-free interest! So the question isn’t should you be contributing to your HSA, the question is only how much.

First, You Must Qualify For An HSA

piece of paper with checklist checked off and a blue pen on the clipboard — *In order to utilize savings for an HSA, you have to be eligible.*

Not everyone qualifies for an HSA, so in order to be eligible for one, you must:

Be covered under a qualified high-deductible health plan (HDHP). For 2020, a HDHP is a health insurance plan with a deductible of at least $1,400 for self-only coverage or $2,800 for family coverage.
Have a HDHP which meets the minimum deductible and the maximum out of pocket threshold for the year. For 2020, the out-of-pocket maximum for an HSA-qualified health plan cannot be more than $6,900 for self-only coverage or $13,800 for family coverage.
Not be covered by any other medical plan.
Not be enrolled in Medicare
Not be claimed as a dependent on someone else’s tax return
Not be enrolled in TRICARE or covered by medical benefits from the Veterans Administration

Max Out Your Contributions

The IRS places a limit on how much you can contribute to your HSA each year. In 2020, as an individual, you can put in up to $3,550, and if you have a family, you can contribute up to $7,100. If you can, you should try to max out your contribution to your HSA. The more you contribute, the more you can benefit from your HSA’s triple tax advantages:

3 full jars of coins — *If you can, max out your yearly contributions.*

Pre-tax contributions
Tax-free earnings
Tax-free withdrawals

If you’re worried about contributing too much money to your HSA, and not using up all of the funds, you should know that whatever money you do not use at the end of the year rolls over to the next year and keeps growing. In addition, any interest earned from these investments is completely tax-free, so it makes sense to contribute as much as you can. But if you cannot afford to max out your HSA you can still reap the benefits.

If You Can’t Max Out…

When it is time to decide your yearly contribution, you have to take into account how much you think you will spend on medical expenses for the year. Consider that you are responsible for paying your deductible and other out-of-pocket expenses, so try to put as much of these costs as you can into your HSA.

For example, if you have a set deductible, put that amount into your HSA. Or, if you have prescriptions that you need to purchase on a monthly basis that cost $200, contribute $2,400 (a year’s cost of the medication) into your account. That way you can enjoy the tax advantages on the money that you need to spend on that prescription drug anyway.

Consider Your Age

While you should always consider putting as much money into your HSA as you can, it may not be as important to max out your contributions if you are young and healthy. In this case, you will have fewer health care expenses than someone who is older or who has a chronic condition. But when you’re approaching retirement age, the likelihood that you will need more money for medical costs is greater. It makes more sense in this case to put as much money as you can into your HSA so that you can build interest on it, and use it tax-free for your out-of-pocket medical expenses. Taking advantage of your HSA is another way to help save your money, as well as to have spending money for any medical costs that may come up throughout the year.

If you are enrolled in a high-deductible health insurance plan, you should absolutely be utilizing your HSA. Not only are you putting money into an account that accumulates interest, but you will also be able to use it without paying taxes on it. And, because accidents or medical emergencies can happen, having a health savings account is important for helping you prepare for the unexpected.

Have questions? Need some guidance? We can help! EZ.Insure understands that insurance can be confusing, but we can go over any questions that you have and help you make an informed decision. We will go over how it all works, let you know what plans are available in your region, and offer help on how much you should contribute to your HSA if you have a high-deductible plan. And we offer all of our services for free! To view our accurate quotes within minutes, simply enter your zip code in the bar above, or to speak to an agent, call 888-350-1890.

High Deductible Health Plan? Make Sure Your Employees’ Is HSA-Qualified!

An increasing number of employers are jumping on the high deductible health plan bandwagon. In 2006, only around 6% of companies that offered healthcare plans offered High Deductible Health Plans, but in 2019 that number soared to 26%. There are definitely good reasons to consider offering one of these plans to your employees, but you do need to know that not all high deductible plans are the same. With some high deductible plans, you can offer your employees a Health Savings Account (HSA), which has tax advantages for them and for you. But first you need to make sure you’re choosing the right plan.

What Makes an HDHP HSA-Eligible?

person's hand holding a pen while checking off a checklist — *In order to offer an HSA, your high deductible health plan must meet certain criteria.*

It might seem like a small distinction, but not every high deductible plan is a High Deductible Health Plan (HDHP) with a capital “H.” The difference is that an HDHP not only has a high deductible, but it also meets certain criteria. If your plan meets this criteria then – and only then – can you offer an HSA alongside it. To be an HDHP, the plan must have:

A deductible that meets minimum requirements. A “high deductible” isn’t just a matter of opinion; each year, the IRS sets the minimum deductible amount for a plan to be considered HSA-eligible. For 2020, the deductible for an individual must be at least $1400, and for families, it must be at least $2800 for the plan to be an HSA-eligible HDHP.

A maximum out-of-pocket amount. Having a high deductible plan means having higher out-of-pocket expenses, but the good thing is that there is usually a limit to how much you have to fork out each year in deductibles and copays. To be an HSA-eligible HDHP, this out-of-pocket maximum must be below a certain amount. For 2020, that number is $6,900 for an individual and $13,800 for family.
No insurance coverage until the deductible is met. In order to take part in all of the advantages an HSA has to offer, you do have to give up some coverage. But don’t worry, there are some exclusions. Wellness and preventative care, which even includes things like help with weight loss and quitting smoking, as well as regular checkups and care resulting from accidents, can all be covered before the deductible is met in an HDHP with HSA.

These are the rules for offering an HSA alongside a high deductible plan, and there are also a few other rules surrounding contributing to an HSA to be aware of. In addition to being covered by an HDHP, you also cannot:

Have any other health coverage

Be enrolled in Medicare

Be claimed as a dependent on someone else’s tax return

Why Offer an HDHP with HSA?

Now that you know what makes a high deductible plan HSA-eligible, the next question is: why offer this type of plan to your employees? It all comes down to savings. Offering a healthcare plan to your employees is the right thing to do, and studies have shown that employees with healthcare are happier and more productive. But there’s no doubt that it’s expensive. Choosing a plan with a high deductible is one way to keep your costs down, because premiums on these plans are usually much lower.

Just look at this comparison: in 2019, the average employee contribution to a healthcare plan without a high deductible was around $6,200 for an individual and $14,700 for a family. For HSA-eligible HDHPs that number was around $5,200 and $14,000 respectively – a savings of $700 – $1,000.

Of course, HDHPs are not perfect. To some employees, especially lower income ones, the out-of-pocket expenses can feel like a burden. This is why it’s important to make sure the plan you choose is HSA-eligible. Having the HSA allows them to set aside money pre-tax to help pay for medical expenses that come up throughout the year; you can also help them out by contributing to their HSA (the maximum contribution allowed by both you and your employee combined is $3,550 for an individual and $7,100 for a family).

Offering an HSA alongside a HDHP (and contributing to it!) means that your employees will be more likely to enroll in your plan. It may also be the difference between them skipping out on preventative care or necessary treatments – possibly leading to poor health and more sick days in the future – and using their plan when they need it.

There’s a lot you need to know when you’re the boss. You’ve got to know your business, and also know what’s best for your employees – and sometimes that means reading up on things that aren’t your business – like health insurance. But don’t worry, you don’t have to go it alone! EZ can answer any questions you have, and can help you find the plan that works best for your employees and your business. There’s nothing we can’t answer, and we’ll never hassle you or charge you for our services. If it’s just quotes you’re after, stop by, give us a few seconds of your time, and be on your way. You’ve got enough to do! To get started with us, enter your zip code in the bar above. Or to speak with an agent directly, call 888-350-1890

Group Health Newbies: Don’t Be Caught Off-Guard When Shopping for Your Business’ Plan

If you’re a newbie shopping for group health insurance for your small business, how are you feeling about the whole process? Confident? Nervous? Confused? We get it, there’s a lot of feelings to feel when it comes to picking a plan. But we’re here to guide you, and steer you past some of the common surprises and pitfalls that may come your way.

You Might Need More Info Than You Thought

caucasian hand holding a pen filling out a survey — *Conduct an anonymous employee health survey prior to shopping, so that you know what your employees want in a plan.*

We’ll start you off with an easy one. When it comes to getting accurate quotes, you used to be able to simply provide the age ranges of employees. Now you need to have their exact date of birth, as well as the dates of birth of any spouses or dependents they want to cover. Don’t be caught fumbling around for info, make sure you’ve collected all of your data before even looking for a plan. We would suggest conducting an anonymous employee health survey prior to shopping, so that you have all of the facts at your fingertips, as well as a good idea of what your employees are looking for in a plan.

A Provider You Thought Was Covered Isn’t

A lot of people are attached to a certain doctor or healthcare provider. When choosing a plan, you need to pay close attention to the network that is offered, especially since many plans are reducing the size of their networks to cut insurance costs. You could end up with unhappy employees who are unwilling to enroll in your plan if the network is too small or if their doctor isn’t included. And if this is your second time offering insurance, pay extra close attention to any changes made to the network; plans can change from year to year, so the providers that you were sure were covered, may not be.

Your Employee Isn’t Eligible

time sheet — *Employees are usually required to work at least 30 hours to be eligible for certain plans.*

This one might really come as a surprise. You’ve decided to offer healthcare to all of your employees, but that doesn’t mean that all of your employees are eligible. The state your business is in, your insurance company’s rules, or even the policy you choose can dictate the number of hours an employee must work to be eligible for your plan. Employees are usually required to work at least 30 hours to be eligible for certain plans; they must also satisfy a waiting period before they are covered. It could be disastrous to extend coverage to an employee who signs up, only to find out later that they were ineligible for the plan. They could end up saddled with a giant medical bill even though they thought that they had insurance.

You Need to Communicate with Your Employees – A LOT

Keeping your employees informed about their health coverage is not a courtesy, it’s an absolute must. You need to provide a Summary of Benefits Coverage (SBC) to participants and beneficiaries prior to enrollment in the plan, at renewal of the plan, within 90 days of a special enrollment period, and within 7 business days of a written request.

You also need to give each employee covered under the plan a Summary of Material Modification (SMM) when there are changes made to their health benefits. We know, that sounds like a lot of paperwork, but it’s important that you familiarize yourself with all of these notices. Remember, EZ’s agents can help you manage all of the crazy insurance admin that you have to deal with!

Prescription Drug Pricing Is Complicated!

If your employees are counting on prescription drug coverage in their group health plan, then you’re going to want to take a closer look at how your chosen plan covers medications. All drugs are priced differently, and generics cost less than brand name medications, but what you might not know is that the same drug may be priced differently by different insurance companies. The same drug might even have a different copay on different plans with the same company. Familiarizing yourself with different plans’ drug formularies can help to cut down on prescription price surprises.

One more thing that you might not have realized in regards to prescription drug coverage is that some plans now actually have a separate drug deductible. Just as with a general deductible, your employees would have to meet a set amount of drug expenses out-of-pocket before their plan would begin covering the cost of prescription medications. Again, this is where an employee health survey would help to give you an idea of what your employees need, and what you need to avoid when looking at healthcare plans.

A High Deductible Isn’t Always a Bad Thing

Yes, a high deductible can sometimes be a burden to employees, especially those with lower incomes, and you might think that if you’re providing healthcare you should avoid any plans that might pile high out-of-pocket costs onto your employees. But you might be surprised to find that some employees actually prefer these lower premium plans, especially if they rarely use medical services and are just looking for a safety net in case of emergency. This is especially true if you pay a higher percentage of their (low) premiums (meaning you’ll still be saving money), choose a plan that is HSA-eligible, and then contribute to those health savings accounts. HSAs have tax advantages for both you and your employees, and having that money put aside means that employees will be able to cover a surprise medical expense.

The list of things you need to know about healthcare plans as an employer can seem endless, and it may feel like you are constantly being surprised by some new rule or protocol. But we promise, you’ve got this! And we’re here to support you, simply contact one of EZ’s knowledgeable agents and you’ll have all the answers to your insurance questions at your fingertips. We can also sort through all of the plans on offer and get you instant, accurate quotes so you can find the best plan for your business and your employees – and we’ll do it all for free! No hassle, no obligation, and no surprises! To get started with us, enter your zip code in the bar above, or to speak to an agent, call 888-350-1890.

Catastrophic Plans Can Be Confusing, Let Us Help

The cost of health insurance is not one size fits all. If you’re healthy, under 30, and facing financial hardship, you could have some cheaper options available to you. For people in these categories, Catastrophic health insurance plans can provide essential health benefits without breaking the bank with monthly premiums. However, you should know that, while premiums on these plans are low, they have high deductibles. If you remain healthy, then your high deductible won’t be a problem, but if you have an accident or become ill, you could end up with huge medical bills. Before you decide if a catastrophic plan is right for you let’s take a look at how they work.

Who These Plans Are For

homeless person sitting outside with a black bag full of clothes — *Catastrophic plans are ideal for people dealing with hardships such as homelessness.*

Catastrophic plans are designed for individuals who are young or struggling to afford health insurance. Not everyone qualifies for these plans. They are only available to people who are:

Under 30 or are over 30 and meet the guidelines for a hardship exemption. This includes people whose plan was canceled by their insurer or small group employer.
Dealing with hardships such as homelessness, eviction, foreclosure or bankruptcy, domestic violence, or medical debt
Considered low-income and cannot afford insurance

These plans have the lowest premiums of any plans on the ACA exchanges, but they also have the highest out-of-pocket costs.These plans do not have a copayment or coinsurance and premiums will vary depending on where you live. Generally all plans have the same high deductible: deductibles were $7,900 for 2019, and they have risen to $8,150 in 2020. Once you meet your deductible, then the insurance company will pay for all covered services.

Who They Are Not For

weekly pill container filled with pills in it with Tuesday tab open. — *If you are unhealthy with a condition, then these plans are not right for you.*

Do you see the doctor often? Do you need a lot of coverage? Do you plan on starting a family in the next year? If you answered yes to any of these questions, then a catastrophic plan is probably not the best choice for you. Because of their high deductibles, these plans are not for people who have health conditions that need constant attention. In this case, you will probably want to look for a plan with a lower deductible, even if it means a higher premium.

If you are over 30 or do not qualify for a hardship, then you can look into getting a Bronze level plan on the ACA Marketplace. These plans are very similar to Catastrophic plans, but with slightly higher premiums and without the same qualification requirements of Catastrophic plans. Even if your income isn’t low enough for a Catastrophic plan, you may still be able to get subsidies for a Bronze plan.

Just The Essentials

Catastrophic plans must include all of the ACA’s benefits, and include some free preventive care. These plans cover:

Outpatient services
Catastrophic plans cover the 10 essential benefits such as lab work.
Emergency services
Hospitalization
Pregnancy, maternity, and newborn care
Mental health and substance use disorder services, including behavioral health treatment
Prescription drugs
Rehabilitative and habilitative services and devices
Lab work
Preventive and wellness services, and chronic disease management
Pediatric services, including oral and vision care

Catastrophic plans aren’t for everyone. If you’re unsure what plan is right for you, come to EZ.Insure for help. We understand how intricate the insurance world is, and because we have been in the industry for over 10 years, we can offer you free expert advice on which direction you should go in. To get free quotes, enter your zip code in the bar above, or to speak directly to one of our experienced agents, call 888-350-1890.

Making The Most Of Your High Deductible Health Plan

High deductible health plans are rising in popularity, with more companies offering them and even more people purchasing them individually. These plans definitely have benefits, like their lower premiums, and they can be great for healthy people on a budget. On the other hand the high deductibles of these plans can be a problem, because going to the doctor or hospital can mean being stuck with a big bill. Or knowing you have a high deductible to meet might make you think twice about seeking care, and you might end up ignoring symptoms until things get worse. However, there are ways to make the most of your high deductible health plan while getting the care you need and saving money.

Utilize Your Freebies

Under the ACA, all insurance plans must provide coverage for some preventive health services with no out-of-pocket costs- this applies to high deductible health plans. These free preventive services will not have a copay and do not count towards your deductible. You can expect to get free vaccines, cholesterol and blood pressure screenings, birth control, and some cancer screenings such as mammograms and colonoscopies.

Check with your insurance plan’s details and be sure to stay in-network to avoid unexpected costs; these services are free but you still have to stay within your plan’s network.

Ask For Discount

If you are sick and need to seek treatment, but are worried about a high medical bill, ask your provider if they offer any discounts. Some doctors’ offices will offer a discount if you pay with cash, or you can ask your doctor for a discount on a service that you will have to pay for entirely out-of-pocket. If they do not offer any discounts, then ask if they offer payment plans so you can avoid medical debt.

black silhouette of a piggy bank with a gold dollar sign in the middle — *HSA accounts have triple tax advantages which can help you save money for medical expenses.*

Triple Tax Advantages With HSA

One of the major benefits of having a high deductible health insurance plan is the ability to have a health savings account (HSA) alongside it. HSAs allow you to put money aside, pre-tax, to help you pay for qualified medical expenses. These accounts offer a triple tax advantage because:

Contributions are tax-deductible
Contributions roll over and can continue to grow tax-free into the following year
Withdrawals are not taxed if you use them for qualified medical expenses.

Take note that unqualified expenses incur a 20% penalty.

Stay In Network

This is said a lot, but it is worth repeating. In order to avoid major out-of-pocket expenses, you must stay within your plan’s network. When you have a high deductible plan, it is especially important to stay within the network to avoid extra charges. Only in-network services will count towards meeting your deductible; any care you get outside of your network will not count. Make sure to double check with your insurance company and doctor’s office that any specialists you are referred to are in your plan’s network.

Do you have a high deductible health insurance plan? Are you considering one? If you are in need of help, EZ.Insure is here for you. We provide accurate quotes on all plans in your area, and our trained agents will go over each plan and will find one that fits your needs and budget. To get free quotes, simply enter your zip code in the bar above, or to speak to an agent, call 888-350-1890.

Tag: high deductible health insurance