Archive for the ‘2010 updates’ Category

New taxes and fees on the 2010 health care overhaul

Wednesday, April 14th, 2010

Good Neighbor Insurance, Inc (www.gninsurance.com) is keeping up with the changes in our US health care system and will be, over the course of the next months and years, expanding this section with up-to-date information.   Health care overhaul will bring change but it is going to happen slowly.  There will be a lot of minor as well as major changes over the course of the next few years with a bulk of these changes happening in 2014 and the last parts being implemented by 2018.   Keep in mind that there will probably be additional regulations coming in the next few years to expand on what has become law signed on March 22nd,  2010. 

In this article you will find some key taxes and fees that may be applicable to you.  Please realize this is not all the taxes and fees that have become law and we will be providing more updates shortly.

TAXES AND FEES ON INDIVIDUALS AND FAMILIES

1.   Starting in 2014, tax on individuals without acceptable health care coverage.   These dollar amounts are not adjusted for inflation.  (A) A 2.5% income tax on individuals who do not have health care coverage, but the fine cannot be more than what the government states is the average annual premium for an individual insurance plan in a stated year.   (B)  High income tax payers making a joint (family) return over $250,000 and a standard (single)return of over $200,000 are required to pay an additional 0.5% of wages whether you are self-employed, on a 1099, or a W-2 employee. (C)  A 1% tax increase for individuals making $350,000-$499,999 and couples making $500,000 – $999,999.  (D)  A 1.5% tax increase for individuals making $500,000 – $999,999 and couples/families making $1 million or more.

2. Starting in 2012, Medicare, www.gninsurance.com/medicare.asp, payroll tax on investment income will be expanded to include unearned income (unearned income could be such vehicles like 401k, IRA’s, ROTH IRAs, and other stocks and bonds). 

3.   Starting in 2012, there will be a 3.8% tax on investment income for individuals making more than $200,000 per year and for families making more than $250,000 per year.

4.   Starting in 2011, there will be an increase in taxes on distribution from health savings accounts and Archer medical saving accounts not used for medical purposes. This means that the monies you have in these two types of accounts are to be used for qualified medical expenses.  If not used for qualified medical expenses, the tax on non-medical products and services you used will be increasing from 10% to 20%.

5.   Starting in 2018, a policyholder will be paying an excise tax on high cost, employer-sponsored health coverage of up to 40% on plans that are greater than predetermined levels (also called “Cadillac” high-end insurance plans).  For example, if your company’s yearly premium (what you pay and what your employer pays together) is higher than $10,200 for self/individual plan than you will be taxed 40% anything over $10,200.  The same goes for a family with premiums higher than $27,500 annually.

TAXES AND FEES ON SMALL BUSINESS

1.   Starting in 2014, a small business (when talking about the new health insurance law the US government states that small businesses employ 2 to 49 employees) that already offers group insurance can pay a $3,000 per-year tax on each employee if that employee qualifies and accepts government health care premium subsidies or government-run health care. Thus, if the employee takes the government-run plan over the employer’s plan even for one month of the calendar year the employer will have to pay a $3,000 annual tax. This can happen even though the employer’s plan may have stronger benefits than the government-run plan. Government-run plans can be Medicare, Medicaid, CHIPS, Veteran, and other possible State government plans including exchanges.  This also is applicable if your employee’s spouse takes any government-run plan you as an employer will be liable for this $3,000 tax.  Thus, the employer of your employee’s spouse and you will be paying a total of $6,000 annual tax if one takes any government-run insurance plan.

2.   Businesses electing not to have group coverage for their employees will be charged an 8% tax on payroll.  This tax will be applied for each employee not meeting the government’s minimal coverage requirement.

3.  A small business could incur two types of taxes for the same employee if the employer does not provide group insurance and if an employee receives premium subsidies from the government to help pay for health insurance.

Doug Gulleson loves to scuba dive overseas. He makes sure he always takes his credit card AND international travel insurance. Visit Good Neighbor Insurance  at www.gnazhealth.com  for a FREE Arizona quote or if you are needing trip cancellation coverage please go to www.gninsurance.com/tripcancellation/ .

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Changes to the US Health Care System (2014 – 2018)

Friday, March 26th, 2010

Good Neighbor Insurance, Inc (www.gnazhealth.com)  is keeping up with the changes in our US health care system and will be, over the course of the next months and years, expanding this section with up-to-date information.   Health care overhaul will bring change but it is going to happen slowly.  There will be a lot of minor as well as major changes over the course of the next few years with a bulk of these changes happening in 2014 and the last parts being implemented by 2018.   However, keep in mind that there will probably be additional regulation(s) coming in the next few years to expand on what has become law this month, March 2010. 

CHANGES IN 2014

GENERAL

*   States must have established Exchanges

*   States must organize “exchanges” where individuals and small businesses can purchase insurance if their employer does not provide it. Requirements for a minimum set of benefits are outlined in the legislation, including provisions for preventive care and mental health services. Subsidies are provided to help low- and moderate-income individuals, as well as small businesses, buy insurance.

*   All non-grandfathered and Exchange health plans required to meet federally mandated levels of coverage

*   States must cover parents /childless adults up to 138% of poverty on Medicaid, receive increased FMAP

*   Employers with more than 200 employees can auto‐enroll employees in health coverage, with opt-out

*   Tax credits available for Exchange‐based coverage, amount varies by income up to 400% of poverty

*   Modified community rating: individual or family coverage by insurance companies and any government run plans, exchanges, and other State programs; geography; 3:1 ratio for age; 1.5 :1 for smoking

UNDER 65

*   Insurance companies will be barred from turning adults down with medical problems.   Insurers will be required to take all applicants and all applicants will be charged the same depending on their age.

*   The government will provide tax credits to help millions of working families buy coverage they cannot afford now.

*   All Americans will be required to carry health insurance, either through an employer, a government program, or by buying their own.  Those who refuse will face fines from the IRS starting at $695 or 2.5% of income, which ever is greater, annual fee which will go up each year.

*   Tax credits to help pay for premiums will start flowing to middle-class working families.

*   Limits out-of‐pocket cost sharing (tied to limits in HSAs, currently $5,950/$11,900 indexed to COLA). 

*   Insurance plans must include government defined “essential benefits” and coverage levels

*    OPM must offer at least two multi‐state plans in every state

*    Impose tax on nearly all private health insurance plans

MEDICARE (65 and over)

*   Medicare Part D of the Rx coverage the “doughnut hole” will slowly close and be eliminated.   The prescription coverage gap will be totally closed in 2020. At that point seniors will be responsible for 25% of the cost of their medications until Medicare’s catastrophic coverage kicks in, dropping their copayments to 5%.

*   To pay for these cost Medicare Advantage (option under Part C) plans the US government will cut funding on these private insurance plans which generally offer lower out-of-pocket costs.  That has been possible since the government pays the plans about 13% more than it costs to cover seniors in traditional Medicare A and B.  The reason for these extra costs is because Medicare Advantage covers more than what the government covers on Part A and B.

*   More Medicare cuts to home health begin

*   Government board (IPAB) begins submitting proposals to cut Medicare

*   Medicare payment cuts for hospital‐acquired infections begin (starts fiscal year 2015)

 MEDICAID (under 65 for low income individuals and families)

*   Requires States to expand Medicaid to include childless adults.

*   Federal government pays 100% of cost for covering newly eligible individuals through 2016

BUSINESS (small and large)

*   Small businesses, self-employed, and the uninsured can pick a health insurance plan offered through the new State-based purchasing pools called exchanges or insurance supermarkets. 

*   Individuals and families between 133% and 400% of the poverty level will receive subsidies if they want to participate in the exchange.  But they must not be eligible for Medicare, Medicaid, and cannot be covered by an employer.   Eligible buyers receive premium credits and there is a cap for how much they have to contribute to their premiums on a sliding scale.

*    There will be also be exchanges created just for small businesses to purchase coverage for their employees and dependents.

*   Federal government will have funding available to States to establish exchanges with one year of enactment until 1-1-2015.

*   Exchanges will offer the same kind of purchasing power that employees of big companies and government workers benefit from.  Employees working in medium and large firms would not see any major changes and if they leave their place of employment they may be eligible for insurance through the exchange

*   Employers with more than 50 employees must provide health insurance or pay a fine of $2000 per worker each year if any of the workers receive federal subsidies to purchase health insurance. 

*   Employers can offer some employees free choice vouchers for health insurance in the Exchange

 CHANGES IN 2015

MEDICARE (65 and over)

*   More Medicare cuts to home health begin

CHANGES IN 2016

GENERAL

*   States can form interstate insurance compacts if the coverage with HHS approval

CHANGES IN 2017

GENERAL

*   Physician pay-for-quality program begins for all physicians

*   States may allow large employers and multi‐employer health plans to purchase coverage in the Exchange.

*   States may apply to the Secretary for a limited waiver from certain federal requirements

CHANGES IN 2018

GENERAL

*   Impose “Cadillac tax on “high cost” plans, 40% tax on the benefit value above a certain threshold: ($10,200 individual coverage, $27,500 family or self‐only union multiemployer coverage)

For Arizona health insurance quotes go to our two Arizona web sites at www.gnazhealth.com and www.gnhealthplan.com or feel free and call Doug Gulleson and his agents at 480-633-9500 or stop by our office in Gilbert.

 Doug Gulleson loves to scuba dive overseas and he makes sure he always takes his Amex card AND international travel insurance.  Visit Good Neighbor Insurance at www.gninsurance.com  for your next overseas trip and get a FREE quote.

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Changes to the US Health Care System (2010 – 2013)

Friday, March 26th, 2010

Good Neighbor Insurance, Inc (www.gnazhealth.com)  is keeping up with the changes in our US health care system and will be, over the course of the next months and years, expanding this section with up-to-date information.   Health care overhaul will bring change but it is going to happen slowly.  There will be a lot of minor as well as major changes over the course of the next few years with a bulk of these changes happening in 2014 and the last parts being implemented by 2018.   However, keep in mind that there will probably be additional regulation(s) coming in the next few years to expand on what has become law this month, March 2010. 

CHANGES IN 2010:

UNDER 65

*   Young adults moving from college to work will be able to stay on their parents’ plans until they turn 26 (starts 9-23-2010).

*   Coverage for children with medical conditions will not be declined and will cover all medical conditions (starts October).

*   There will be no lifetime dollar limits on insurance policies (starts 9-23-2010).

*   State and Federal officials start reviewing premium increases

*  Requires plans to cover, at no charge, most preventive care (starts 9-23-2010)

MEDICARE (65 and over)

*   Medicare payments increase to physicians in primarily rural areas for 2 years

*   Medicare cuts to inpatient psych hospital (starting 7-1-2010)

MEDICAID (under 65 for low income individuals and families)

*   Increase brand name Rx rebate (from 15.1% to 23.1%)

BUSINESS AND OTHERS

*   Provide income exclusion for specified Indian tribe health benefits provided after 3-23-2010.

*   Provide temporary high-risk pool and high-cost union retiree reinsurance for 3 years of $5 billion per year (starting 6-23-2010)

 *   Tax credits provided to certain small employers for health care-related expenses (starting 2010)

CHANGES IN 2011

GENERAL

*   Americans begin paying premiums for federal long‐term care insurance (CLASS Act)

*   Health plans required to spend a minimum of 80% of premiums on medical claims

*   Steps towards health insurance administrative simplification (reduced paperwork, etc) begins (5 yr process)

*   New tax on all private health insurance policies to pay for comp. eff. research (starts for fiscal 2012)

 UNDER 65

*   No longer allowed to use FSA, HSA, HRA, Archer MSA distributions for over the counter medicines

MEDICARE (65 and over)

*    Brand name drug companies begin providing 50% discount in the Part D “donut hole”

*   $500 billion in Medicare cuts over the next decade

*   Medicare cuts to home health begin

*   Wealthier seniors ($85k/$170k) begin paying higher Part D premiums (not indexed for inflation in Parts B/D)

*   Medicare reimbursement cuts when seniors use diagnostic imaging like MRIs, CT scans, etc.

*   Medicare cuts begin to ambulance services, ASCs, diagnostic labs, and durable medical equipment

*   Prohibition on Medicare payments to new physician‐owned hospitals

*   Seniors prohibited from purchasing power wheelchairs unless they first rent for 13 months

*   Seniors who hit Part D “donut hole “in 2010 receive $250 check (starts 3/15/11)

*   New Medicare cuts to long‐term care hospitals begin (starts 7/1/11)

*   Additional Medicare cuts to hospitals and cuts to nursing homes and inpatient rehab facilities begin (starts for fiscal year 2012)

MEDICAID (under 65 for low income individuals and families)

*   Medicaid will be expanded to 133% of federal poverty level which in 2010 is currently $29.327 for a family of four.

*  Medicaid eligibility will expand to a broader range of income levels reaching an additional 16 million individuals across the country. The Senate bill also requires states to establish state enrollment websites to promote seamless enrollment and to coordinate with state insurance exchanges.

CHANGES IN 2012

GENERAL

*   Hospital pay‐for‐quality program begins (starts fiscal year 2013)

MEDICARE (65 and over)

•   Medicare cuts to dialysis treatment begins

*   Medicare to reduce spending by using an HMO like coordinated care model (Accountable Care Organizations)

•   Medicare Advantage plans with a 4 or 5 star rating receive a quality bonus payment

•   New Medicare cuts to inpatient psych hospitals (starts 7-1-2012)

•   Medicare cuts to hospitals with high readmission rates begin (starts fiscal year 2013)

•   Medicare cuts to hospice begin (starts fiscal year 2013)

CHANGES IN 2013

GENERAL

*   Post- acute pay for quality reporting begins

MEDICARE (65 and over)

•   Medicare cuts to hospitals who treat low- income seniors begin

•   Part D “donut hole” reduction begins, reaching a 25% reduction by 2020

Doug Gulleson loves to scuba dive overseas and he makes sure he always takes his Amex card AND international travel insurance.  Visit Good Neighbor Insurance at www.gninsurance.com  for your next overseas trip and get a FREE quote.

For Arizona health insurance quotes go to our two Arizona web sites at www.gnazhealth.com and www.gnhealthplan.com or feel free and call Doug Gulleson and his agents at 480-633-9500 or stop by our office in Gilbert.

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