AFFORDABLE [uh-fawr-duh-buhl] adj.

According to dictionary.com, affordable means, “believed to be within one’s financial means.” Obviously the politicians in Washington took this definition literally when they passed the Affordable Care Act.

According to an article in Forbes this past week, individual health insurance premiums will increase by an average of 41% across the country. Offering subsidies to a small subset of Americans to help offset substantially higher rates for everyone else doesn’t make sense.  However by this definition, all they needed to do was to make health insurance within one’s financial means.  And as of yesterday we know at least 5 have enrolled so far.

The Manhattan Institute put together an excellent interactive map that shows pre and post ObamaCare rates for each state:

Manhattan Institute – Know Your Rates

There are winners and losers in ObamaCare.

Winners: unhealthy people that were forced into expensive state pool guaranteed issue health plans that can now get any plan they choose without proof of insurability
Winners: low wage earners that qualify for expanded Medicaid or a substantial premium subsidy (and actually make it through healthcare.gov)

Losers: everyone else

I guess it all depends on what your definition of the word “Affordable” is…

Obama-Car

While talking about healthcare reform with my wife, our teenage son started asking questions. We tried to answer him in a way he could understand, but we just weren’t getting through. Health insurance is a foreign language to him. However he is dreaming about which car he will soon purchase. So we introduced ObamaCare to him by way of the Affordable Car Act… a.k.a. Obama-Car:

Obama says his reforms will include additional mandated essential health benefits AND reduce health insurance costs by $2500 per family. That’s simply impossible. That would be like requiring all 2014 cars to be either hybrid or fully electric (more energy efficient), include run-flat tires with electronic low-pressure warnings (better fuel economy), HID headlights (better night vision), GPS (less fuel wasted getting lost), and satellite radio (because it sounds good) at a lower price.

Yes, these OPTIONS are nice if you have the money to pay for them, but they should remain OPTIONS, not REQUIREMENTS.

Instead of a Chevy Cruze starting at $17,000 the new Obama-Car compliant version (such as the Chevy Volt) would be priced around $34,000.

Obama claims these new cars will only be paid in full by the “millionaires and billionaires” because anyone making less than 400% of the poverty level will have some (or all) of their car subsidized by the government.

Now let’s talk about used cars…

Let’s say you like your existing car.  As long as you owned it before March 23, 2010, you would be allowed to keep it. You cannot make any changes to it or it would no longer be “grandfathered” and you would be forced into buying a new Obama-Car next year or pay a penalty.

If it doesn’t get good enough gas mileage or include all the new Obama-Car required Overpriced Bureaucratically Authorized Mandated Add-ons (OBAMA), then you would also be penalized.

Our son is glad Obama-Car doesn’t exist. He can save his own money to purchase any car he chooses… as long as Dad (not Obama) approves of it!

Dislaimer:  This article was never meant to suggest Obama-Car legislation is needed or should ever become law.

Prepare For ObamaCare

Dear Nancy Pelosi,

After 3+ years and 20,000+ pages of additional clarifications…
WE STILL DON’T UNDERSTAND WHAT’S IN IT!

Senate Minority Leader Mitch McConnell (R-KY) points up at ObamaCare

More Employers Steer Towards Consumer-Driven Health Plans

Renewing your health insurance used to be easy. Now it seems to take all year. Your employees seem to be healthy, but your renewal rates disagree. You contact your old consulting firm. Utilization is too high…again. Emergency room visits are too frequent…again. Generic prescription substitution is too low…again. You are told to increase co-pays and raise deductibles to create the necessary “steerage” to help hold down your health care costs. The result? Double-digit premium increases…again. You are reminded of the definition of insanity: doing the same thing over and over again expecting different results.

What other options are there?

By now you’ve heard of “consumer-driven” health care plans. At this time there are two versions showing promise, Health Reimbursement Arrangements (HRA) and Health Savings Accounts (HSA). They are designed to lower health insurance costs by engaging employees to take a vested interest in their own health care expenses.

There are significant differences between how these plans work. The employer is the owner of the HRA. The more successful HRA plans are designed to allow a portion of the unspent accounts to roll over from year to year as an incentive to the employee not to spend them. There are no requirements for which type of insurance you use with an HRA. The money that is not spent stays with the employer if an employee leaves.

The employee is the owner of their HSA. Both the employer and the employee can fund this account. HSA funds can be used to help offset all medically related expenses including a tremendous number of things that do not count towards the insurance deductible such as dental, vision, and even some over-the-counter medications. In order to establish an HSA the employee must be covered exclusively by a High Deductible Health Plan (HDHP). The federal government has placed specific guidelines for deductibles and out-of-pocket maximums for these plans to be qualified. Since these plans have a higher deductible than most co-pay plans there is usually a significant premium savings. The concept is to place the premium savings in the tax deductible HSA account and use these dollars to pay your smaller expenses at the insurance company’s negotiated PPO discount while maintaining the insurance plan for major expenses. There are now many examples of the premium savings being large enough to cover most or all of the HDHP deductible!

The HSA accounts can be opened through local banks and credit unions. As long as your HSA qualified health insurance plan is effective by December 1st 2012 you have until April 15th of the following year to deposit up to $3,100 individual or $6,250 family into an HSA account for 2012 and $3,250 individual or $6,450 family for 2013. If you are 55 or over then you can deposit an additional $1000. Account balances roll over year to year. HSAs are the only products that offer triple tax advantages; tax-deductible deposits, tax-free interest earned, and tax-free withdrawals as long as they are spent on qualified medical expenses. Since the employees own their HSA account there is a significant difference in how this money is spent. Imagine your employees all having a vested interest in not spending their health care dollars. This is why self-funded plans tend to benefit most.

The city of Iola, KS is a perfect example. They switched all of their employees to an HSA plan in 2004. Their utilization has decreased substantially which has allowed the city to deposit half of the employee’s individual deductible into their HSA account each year. Employees have embraced the new plan and are seeing their HSA not as an entitlement to be spent but as a retirement account that should be saved whenever possible. The city now has their health insurance costs in check.

The new generation of consultants will need to be focused on educating businesses and their employees offering workshops and educational tools to help employees understand how these plans work.

Otherwise you can keep your current consultant and accept your insurance premium increase… again!

(Originally printed in the Kansas City Star July 17, 2007)

Finally people are starting to get it!

Here’s another Health Savings Account success article:

Philadelphia warming to high-deductible health plans

Employees like a lower cost option… Lower health insurance premium increases… Employees saving money… This HSA thing might take off after all!

Health insurance premiums are going up again

Nationally, cost increases for employers who offer health insurance plans will average 8 to 10 percent. In the Kansas City area, employers’ 2009 costs are going up as much as nearly 30 percent.

We are heading into health insurance renewal time for many businesses.  The Kansas City Star published an article this week describing the pain being felt by local businesses.  I’m not surprised that local brokers are saying many of their clients are contemplating dropping insurance altogether due to these increases. 

Benefits enrollment time brings higher costs for health plans at work

When businesses re-allocate their healthcare dollars to purchase an HSA qualified High Deductible Health Plan (HDHP) which and put the premium savings into the employee’s Health Savings Accounts (HSA), there is a built-in shielding of the huge premium increases usually associated with health insurance renewals.

Over 95% of my clients elect HSA qualified plans.

Maybe that’s why my HSA clients don’t drop their health plans!

“The Right Way to HSA”  Seminars are being held this week Thursday October 2nd in Overland Park at 7pm and Friday October 3rd in St. Joseph at 12 noon. If you would like to see why over 6 million Americans have already made the move to HSA qualified insurance plans, please RSVP by visiting our website www.missionHSA.com or by calling our office at 913-432-2732 ext. 110.

Keep in mind that moving your January renewal up to December 1st can allow HSA contributions to be deducted from your 2008 taxes!

More Employers Steer Towards Consumer-Driven Health Plans

Be sure to RSVP for upcoming “The Right Way to HSA” seminars October 2nd in Overland Park, KS and October 3rd in St. Joseph, MO

Renewing your health insurance used to be easy. Now it seems to take all year. Your employees seem to be healthy, but your renewal rates disagree. You contact your old consulting firm. Utilization is too high…again. Emergency room visits are too frequent…again. Generic prescription substitution is too low…again. You are told to increase co-pays and raise deductibles to create the necessary “steerage” to help hold down your health care costs. The result? Double-digit premium increases…again. You are reminded of the definition of insanity: doing the same thing over and over again expecting different results.

What other options are there?

By now you’ve heard of “consumer-driven” health care plans. At this time there are two versions showing promise, Health Reimbursement Arrangements (HRA) and Health Savings Accounts (HSA). They are designed to lower health insurance costs by engaging employees to take a vested interest in their own health care expenses.

There are significant differences between how these plans work. The employer is the owner of the HRA. The more successful HRA plans are designed to allow a portion of the unspent accounts to roll over from year to year as an incentive to the employee not to spend them. There are no requirements for which type of insurance you use with an HRA. The money that is not spent stays with the employer if an employee leaves.

The employee is the owner of their HSA. Both the employer and the employee can fund this account. HSA funds can be used to help offset all medically related expenses including a tremendous number of things that do not count towards the insurance deductible such as dental, vision, and even some over-the-counter medications. In order to establish an HSA the employee must be covered exclusively by a High Deductible Health Plan (HDHP). The federal government has placed specific guidelines for deductibles and out-of-pocket maximums for these plans to be qualified. Since these plans have a higher deductible than most co-pay plans there is usually a significant premium savings. The concept is to place the premium savings in the tax deductible HSA account and use these dollars to pay your smaller expenses at the insurance company’s negotiated PPO discount while maintaining the insurance plan for major expenses. There are now many examples of the premium savings being large enough to cover most or all of the HDHP deductible!

The HSA accounts can be opened through local banks and credit unions. As long as your HSA qualified health insurance plan is effective by December 1st you have until April 15th to deposit up to $2,900 individual or $5800 family into an HSA account for 2008. Account balances roll over year to year. HSAs are the only products that offer triple tax advantages; tax-deductible deposits, tax-free interest earned, and tax-free withdrawals as long as they are spent on qualified medical expenses. Since the employees own their HSA account there is a significant difference in how this money is spent. Imagine your employees all having a vested interest in not spending their health care dollars. This is why self-funded plans tend to benefit most.

The city of Iola, KS is a perfect example. They switched all of their employees to an HSA plan in 2004. Their utilization has decreased substantially which has allowed the city to deposit half of the employee’s individual deductible into their HSA account each year. Employees have embraced the new plan and are seeing their HSA not as an entitlement to be spent but as a retirement account that should be saved whenever possible. The city now has their health insurance costs in check.

The new generation of consultants will need to be focused on educating businesses and their employees offering workshops and educational tools to help employees understand how these plans work.

Otherwise you can keep your current consultant and accept your insurance premium increase… again!

Top 5 Health Insurance Gotchas!

Here is a list of 5 common mistakes people make when choosing whether to renew their existing health insurance plan (accepting the enormous premium increase) or find a new plan.

Gotcha #5 – “My local hospital was in the network when I first enrolled so I’m sure it’s still on the PPO list”

Don’t bother going back and digging up your PPO (Preferred Provider Organization) directory.  That list was actually outdated the day it was printed!  Being out-of-network is similar to handing the hospital administrator your checkbook and allowing him to bill you whatever he wants.  We have seen 80% or more of the original charges be discounted because the facility was in the PPO network.  There are constant fluctuations with physicians and hospitals moving in and out of PPO networks.  Today the only way to get real-time PPO participation is to look up the network online.  Most insurance cards will show the provider network name or website.  When I travel out of town, I print a PPO network for the city I am traveling just to be safe. 

Gotcha #4 – “I’ve had the same insurance company for my auto, home, and life.  They have always paid well so their health insurance should be fine also.”

We all know the jack-of-all-trades story line.  Just because their auto insurance paid for your fender bender doesn’t mean their health insurance will cover a $940 per week prescription drug to fight cancer.  You should search for an independent health insurance agent that represents many different insurance companies and is familiar with the pre-existing condition limitations and underwriting criteria.  It is difficult for an insurance agent that offers many different lines of insurance to remain up-to-date with the changing health insurance landscape.

Gotcha #3 – “A guy I work with recommended this company.  He’s had them for years.”

Ask your friend if he has had any claims, and if so, how big were they.  There are many inferior health insurance plans being renewed year after year simply because the insured has never had any real large claim experience.  If they are limited benefit plans they have internal limitations that can have severe consequences.  Some common health insurance policy limitations are annual maximums for prescription drugs or outpatient treatment (some “saver” plans exclude these altogether!) and daily maximums for chemotherapy, hospital room charges & intensive care.  I recommend comprehensive major medical plans that include inpatient, outpatient, physician visits, and outpatient prescription drug coverage.  These should all count together towards a large lifetime maximum of at least $2 million (I personally own a $5 million plan).

Gotcha #2 – “My employer group plan has got to be better and less expensive than an individual health insurance policy.”

Not so fast!  That depends on how much your employer contributes.  Since group health insurance plans require the employer to pay at least half of the employee’s health insurance cost, it is very rare for an employee to be able to purchase an individual plan on their own for less.  The additional family members are a different story.  Most employers pay little or none of the additional family monthly premium.  We often see healthy families paying $500 to $900 per month to get a spouse and/or children covered on the group plan.  With HSA qualified plans (Wow!  This is the first time I mentioned Health Savings Accounts this whole post!), we can sometimes cut this cost in half leaving the other half to deposit in the HSA.  This premium savings can be enough to fully fund the family out-of-pocket maximum within 12 to 24 months! 

Gotcha #1 – “The plan with the lowest deductible and lowest co-pays is the best plan!”

If your family had to choose between 2 plans from the same insurance company using the same PPO network, the first plan has a $0 deductible 80/20 co-insurance plan with co-pays for physician visits and prescription drugs at monthly cost of $900, the second plan is an HSA qualified plan with a family calendar year deductible of $5000 and 100% co-insurance that includes all physician visits, prescription drugs, inpatient and outpatient hospital charges at a monthly cost of $450 per month, which would you choose? 

Let’s do the math:  $900 – $450 = $450 per month premium savings x 12 months = $5400 in premium savings to offset a true “out-of-pocket maximum” of $5000 for the HSA qualified plan.  Tough decision here… With the $900 per month plan, you still have to come up with additional money out of your pocket to pay the co-pays and co-insurance.  With the HSA plan, you would have the entire deductible available in your HSA within the first year.   You should still allocate $900 per month for your health care, but give $450 per month to the insurance company and put the other $450 into your HSA account.   You get a tax deduction for every dollar you deposit.  It pays you interest tax free.  Withdrawals can be made at any time tax free for eligible medical expenses.  There is no other savings vehicle that is tax free at both ends.

The beauty of an HSA is that if you don’t spend your HSA dollars, YOU KEEP IT!  Unspent balances roll over year to year (not like an FSA or section 125 which are use-it-or-lose-it). 

Just how much money could you be saving with an HSA qualified plan?  Now you can find out!  We utilize unique technology that allows real-time highly competitive HSA qualified health insurance quoting and enrolling online.
  
The ultimate “Gotcha” is paying too much for health insurance.

 

Do the math…

Get an HSA!