Life Insurance Does A Lot More Than You May Realize

Talking about life insurance can be an uncomfortable topic for most of us. We all go to bed each night and assume that we will wake up the next morning as we always have. We all plan for vacations months in advance with the assumption that we will be there. We live our lives almost as if we will live forever. At the same time, every night on the evening news we hear about tragic stories within our local communities such as car accidents and violent crimes. We also hear stories of chronic health related illnesses, many of which are on the rise. And yet, only 51% of Americans have life insurance. Here is a look at why so many Americans and, more specifically, their families are unprotected:   43 % say that life insurance is too expensive. 31 % say that coverage is a low priority compared to other expenses. 14 % say they never thought about life insurance and don’t know much about it. 12 % don’t know where to start. 8 % note they don’t have time to research/learn about/explore their options. 6 % say that life insurance is too complicated. 5 % say the product is too stressful.   What do these numbers tell us? Well, they tell us that most of the uninsured are uninsured simply due to lack of knowledge and/or confusion about life insurance. If they only knew that life insurance is so much simpler than the health insurance that they must deal with every week. Very few Americans look to life insurance to fund expenses beyond simply replacing the income of a departed...

ACA Reporting Requirements

Applicable Large Employers (ALEs) must report information to the IRS regarding the health care coverage offered to full-time employees and full-time equivalent employees (FT/FTE). Once you’ve collected all the necessary information from your workforce, you must complete the three documents required for ACA compliance: the 1094-C, 1095-C, and the Written Statement to each employee. Form 1094-C Employer Transmittal Accounts for each of the following, per 2015 calendar month: Full-time employees Total headcount Whether Minimum Essential Coverage was offered Whether an applicable 4980H “Safe Harbor” was used Deadline for documents to be mailed: February 29, 2016 Deadline for document to be transmitted digitally: March 21, 2016 Form 1095-C Employee Statement Accounts for each of the following, per 2015 calendar month: Proof of offer of coverage (with code) Employee’s share of the lowest cost monthly premium Whether an applicable 4980H “Safe Harbor” was used Deadline for documents to be mailed: February 29, 2016 Deadline for document to be transmitted digitally: March 21, 2016 Written Statement of Each Covered Employee The employer’s name, address, and contact information The information for the employee on the return being filed Deadline for Statement Sent to Employee: January 31,...

4 Things to Know About the Affordable Care Act

The ACA is designed to reduce healthcare costs, expand coverage for the uninsured, and increase quality of care for people. The ACA can be confusing, making it difficult for many businesses to comply with the law’s requirements. In 2016, almost all businesses will be required to comply. To avoid hefty fines, here are four things to know about the requirements so you can remain compliant and penalty free in 2016: Are you an Applicable Large Employer (ALE)? If so, your business is subject to ACA requirements! To be considered an ALE, your company has to have 50+ full-time employees and full-time equivalent employees (FT/FTE). Calculating your total number of employees is difficult. That’s because the ACA classifies “full time” employment as 30 hours a week of work or more. Make sure to include both full-time employees as well as those who work the equivalent of full-time hours. Your business must offer “affordable” health insurance of “minimum value” to your employees: “Affordable” Health Insurance is less than 9.5% of annual household income. You can calculate the 9.5% from employees’ W2 wages, hourly pay rate, or the Federal Poverty Level for an individual. “Minimum Value” means employer-sponsored health plans must be designed to pay at least 60% of the total cost of medical services. You need to submit three key documents to guarantee compliance. If you’re an ALE, collected all the necessary info from your workforce, and made the necessary calculations, then it’s time to complete the three documents required for ACA compliance: the 1094-C, 1095-C, and the Written Statement to each...

AB339 Could Bring Relief to Those That Require Expensive Specialty Drugs

Many people that suffer from chronic conditions such as asthma, hepatitis C, Cancer, MS, rheumatoid arthritis and others are feeling discriminated against due to the high cost of the drugs that they need.  These drugs are referred to as Specialty Drugs.  The emergence of these very high cost specialty drugs has led health plans and insurers to impose high copays and coinsurance on these drugs.  Such drugs are often placed on the highest cost tier of a drug formulary (commonly known as the “fourth tier” or the “specialty tier”) with coinsurance of up to 20%, 30% or even 40% as opposed to a fixed co-payment.  As a result, Californians that suffer from chronic conditions can face high out-of-pocket costs and may even exhaust their annual out-of-pocket limit of $6,500 with a single prescription in the first month! Fortunately, Consumer Protection Bill AB339 is currently moving through the California Legislature.  The point of AB339 is to get the patient out of the middle of the fight between the health plans and the drug companies by providing basic consumer protections, including a cap of no more than $250 per monthly prescription for most coverage, or $500 for products in the bronze tier. The bill must be approved by the Legislature by Sept. 11 in order to go to Gov. Jerry Brown (D), who has until Oct. 11 to sign or veto...

How To Avoid The Painful Surprise of an Unexpected Medical Bill

It has happened to most of us, we visit the doctor, provide our health insurance ID card for services and then receive an unexpected bill a few weeks later.  Over the past two years, nearly one-third of privately insured Americans have received an unexpected medical bill where their health plan paid less than expected.  With Annual Out-of-Pocket Maximums now over $6000 for an individual, these balance bills are often extremely difficult to handle.  To make matters worse, whether you’re disputing the charge or simply can’t pay, medical debts are quick to reach collection status.  According to the Consumer Financial Protection Bureau, one in five consumers have an unpaid medical debt on their credit report. Here are a few small, but important steps that you can take to avoid unexpected medical bills.   Call your insurer ahead of a medical procedure as some procedures require pre-authorization.  Carriers like to make sure that certain expensive procedures are medically necessary and if you have the procedure without making sure that it is authorized, you could get stuck with the bill. Familiarize yourself with your health plan. Dig into plan specifics related to deductibles, coinsurance and maximum out-of-pocket costs.  Deductibles and coinsurance can be confusing if you do not know how they work on your specific health plan.  Also, many people can be caught off guard by the individual vs family deductible. A quick email to your broker can help refresh your memory on material covered in your benefit orientation. Don’t assume that because your doctor or hospital is in-network, that you’re all clear. Some insurers have tiered-service networks, reimbursing some in-network providers...