CalChoice Health Savings Account (HSA) Options – Q4 2016

As the majority of group renewals are fast approaching, I wanted to outline the different HSA options available to CaliforniaChoice clients.  For the fourth quarter of 2016, there are twelve different HSA eligible medical policies from five different carriers. (Listed Below – Please note that not all plans are available in all 19 regions) Note that there are not any PPO HSA options available to CaliforniaChoice clients at the moment.  You may assume that Anthem’s EPO policy would be a close fit, but beware the limited network without any out-of-network coverage, aside from emergencies.   While the private exchange offers employees the flexibility to choose various plans without the need for employers to meet specific participation requirements, the only way to offer a PPO HSA currently is outside of CaliforniaChoice.  For employers that wish to concurrently offer a PPO alongside Kaiser, you must have a minimum of 5 non-Kaiser employees that wish to enroll, which make up at least 25% of eligible enrollees. While the state’s public exchange, Covered CA, has setup a mirrored network of health plans that offer the same participation flexibility as CaliforniaChoice, they are only offering six HMO HSA policies from three carriers: Kaiser, Sharp, and Western Health. As premiums continue to increase, and plans become more limited and standardized, small group shoppers are losing their flexibility within private exchanges.  We can only hope that the insurance carriers and partners will loosen the reins in 2017. Deductible – A specified amount of money that you must pay before an insurance company will contribute towards a claim. Out of Pocket Max – The most you will have to...

(HSA) Health Savings Account – Eligible Medical Policies

As insurance premiums continue to rise, you may find yourself exploring coverage options you may not have considered in the past.  One of which is an HSA eligible policy that has risen in popularity over the years for multiple reasons.    Health Savings Accounts are associated with high deductible health plans – a plan with an annual deductible no less than $1,300, and an annual out-of-pocket maximum not to exceed $6,550; the overall cost of an HSA eligible policy can be less than other plans, while it still provides you with the same catastrophic coverage. Health Savings Accounts allows the account holder to pay for current health care expenses and save for those in the future.  Payments towards qualified medical expenses are withdrawn tax-free, and interest earned on deposits also accrue tax deferred.  Funds roll-over each year, and the account belongs to the individual and follows the individual throughout his/her career.  An HSA eligible policy can be purchased on both the individual and group marketplace, providing full flexibility. Contributions are tax-deductible or are deducted directly from payroll pre-tax. Employers may also offer to contribute towards an HSA, and contributions are excludable from an employee’s income and are not subject to federal income tax, Social Security or Medicare taxes.  In addition, employer contributions are deductible as a business expense to the company.  Employers may choose to contribute a set amount or make ‘matching’ contributions.  The IRS sets annual limits on the amounts that may be contributed to the HSA.  If funded from both the employer and employee, it is important to ensure that the total contributions remain within the annual IRS...

2016 Covered CA Open Enrollment

It’s almost that time of year again.  Open Enrollment begins November 1st, 2015 and continues through January 31st, 2016. Individuals that are currently enrolled and wish to continue coverage without any changes can simply continue to pay as billed. No further action is necessary. Beginning October 12th, individuals can make changes to their existing application and shop for new plans.  Any changes made will not be transmitted to the carriers until Novemeber 1st. Submissions from November 1st through December 15th will reflect a January 1st start date. Submissions from December 16th through January 15th will reflect a February 1st start date. Submissions from January 16th through January 31st will reflect a March 1st start...

Covered CA Open Enrollment

The first 10 days of open enrollment for 2015 have been off to a great start.  We have been working diligently with all of our current and prospective clients to get them enrolled in the shortest amount of time possible.  Although the online system is a bit smoother this time around, the wait times to reach Covered CA via telephone is still on par with the 2+ hour hold times from last year; which makes our service even more valuable to the public. As certified Covered CA Agents, we can serve you to the same capacity any Covered CA employee can, and in many cases you are better off speaking with an experienced health insurance broker rather than a seasonal data entry clerk.  We are contracted with all the major medical carriers to assist on their behalf and have one fiduciary duty – to help our clients to the best of our ability, at no cost. For coverage effective January 1st, 2015 – you must enroll by December 15, 2014. For coverage effective February 1st, 2015 – you must enroll by January 15th, 2015. For coverage effective March 1st, 2015 – you must enroll by February 15th,...

Group Special Enrollment 11/15-12/15

Groups that do not meet regular participation and/or contribution guideline requirements are guaranteed approval during the annual special enrollment period from November 15th through December 15th.  For all small businesses that did not have enough participating employee’s to qualify for a particular plan, or do not want to offer a minimum set contribution towards your employee’s healthcare: now is the time to enroll.   Contact us for more details pertaining to insuring your group under the Affordable Care Act guidelines.  Do not let this once a year opportunity pass you by without inquiring for further details, your business cannot be refused...

Grandmothering – What is it? And who does it affect?

Governor Brown has signed into law SB 1446, the ‘grandmothering’ bill.  The bill was unopposed and passed through both Houses in the CA legislature and is in effect immediately.  Below are a few key points that outline what is now allowed under the bill: The bill allows a small employer health care plan in effect on Dec. 31, 2013, and is still in effect as of the date the bill was signed (July 7th, 2014), and that does not qualify as a grandfathered health plan under the Affordable Care Act, to be renewed until Jan. 1st, 2015, and continue to be in force through Dec. 31st, 2015. These plans must be amended to be in compliance with the ACA guidelines as of Jan. 1st, 2016 Small employer group policies must still include many ACA and state based mandated benefits such as: Preventative healthcare without co-pays or deductibles No lifetime caps on benefits Maternity care Coverage for autism Elimination of gender discrimination on setting premiums This bill is not a mandate and employers are not required to keep their current plans in place The bill does not address rates, so premiums for these plans may...