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Health insurance for maternity care

Question received online this morning: “I want to know if someone without social security number can enrol for insurance and does it cover maternal care?”

OnlineAdviser response: “Yes. Anyone in the U.S.

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, citizen or not, short-term or permanent resident, can enroll in health insurance without a social security number. A social security number is not required for any of the insurance plans listed or linked from Freedom Benefits. Some health insurance covers maternity expenses, others do not. Generally the plans offered through state insurance exchanges in the fall offer maternity coverage and cover this as a pre-existing medical condition (your question did not mention if this is the case). Meanwhile some other coverage else may be needed that does not offer maternity coverage for pre-existing conditions.”

I fear that sometimes people don’t phrase their questions in a useful way. For example

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, what if he had meant “Help! My girlfriend is pregnant and doesn’t have health insurance”. Then the response is completely different.

Also, despite popular misconception, a social security number is never required to obtain health insurance. The federal government has made this abundantly clear and I’ve covered this in several past blog posts. Still, the belief persists. Again, this might be a phrasing issue. perhaps they meant that a social security number is required for government-paid health benefits or to use the government’s online health insurance exchange.

 

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Tax-free employee benefits

One of the primary goals of small business employee benefit plans is to provide tax-free compensation to employees.

Employer-provided employee benefits are generally taxable in the same way as regular wages. There are exceptions, however, that allow tax-free treatment. Freedom Benefits focuses on allowing employers to maximize those nontaxable benefits that are selected by individual employees. The savings can add up to thousands of dollars in tax savings to both the employer and each individual employee.

Nontaxable benefits include:

Accident and health benefits.
Achievement awards.
Adoption assistance.
Athletic facilities.
De minimis (minimal) benefits.
Dependent care assistance.
Educational assistance.
Employee discounts.
Employee stock options.
Employer-provided cell phones.
Group-term life insurance coverage.
Health savings accounts (HSAs).
Lodging on your business premises.
Meals.
No-additional-cost services.
Retirement planning services.
Transportation (commuting) benefits.
Tuition reduction.
Working condition benefits

Employers  must meet other additional administrative requirements to keep each of these listed benefits free of federal income taxes1 to employees. That’s where Freedom Benefits come in. These benefits are tax-deductible by the employer and not taxable to the employee when provided under a Freedom Benefits small business employee benefit plan.

Employee contributions

Employees typically elect to receive compensation in the form of tax-free benefits instead of cash compensation

,

Employer contributions

We generally recommend that employers allocate a minimum of 2% of total payroll of eligible employees to this type of employee benefit plan. When this funding requirement is met, the employer meets the requirements for non-discriminatory benefits. when this amount is allocated to benefits provided by us then no additional fees are charged by Freedom Benefits 2.

Ask for a proposal on the tax savings that can be offered to your firm’s employees.

 

1 In some cases the taxation under state laws varies from the federal tax treatment. Freedom Benefits does not provide tax advice except when included as part of a separate payroll services agreement or other tax services agreement.
2 Freedom Benefits charges a $300 initial consultation and proposal fee that is applied to the amount of available employer-paid benefits if the plan is started with the proposed amount of employer funding.

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Fixing the Affordable Care Act?

Yesterday Democrats in the US House of representatives introduced a bill to undue the changes that the current President made to the Affordable Care Act and attempt to fix many of the broken parts of the law. The bill is called “Undo Sabotage and Expand Affordability of Health Insurance Act of 2018“.

Since the Democrats are expected to take majority control of the House of Representatives this year it seems possible that this or similar bills could be approved. Even so

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, the bill is largely symbolic at this point, it is highly unlikely to become law under the current president,

In short, this bill is the exact opposite of what the Republican Party wants.  It would expand availability of qualified health insurance and undo the expansion of limited benefit insurance.

The focus of my attention and the purpose of this blog is to help clients prepare for and cope with whatever the health plans and laws are

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, and not to take a side or offer an opinion as to the merits of any plan.

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EZ Short Term Medical Insurance ends

The health insurance market continues to evolve at a rapid pace. Insurance plans that have been popular in the past are being replaced with new insurance and non-insurance products. A range of the latest products are listed for each state at Freedom Benefits.

The Trump administration proposes expanding these limited benefit insurance plans so we expect that a range of new products will be available soon.

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Where we stand on tax cuts and bigger paychecks

It is one thing for Congress to pass a tax bill but it is quite another to see increases in the paychecks of employees – especially the paychecks of America’s small businesses. The mechanical process of increasing paychecks is dependent of the system of controls used by employers and their payroll contractors. The IRS recently issued statements saying that might happen by the end of February 2018 thanks to the independent efforts of payroll companies acting more quickly than the IRS. But for small businesses the process of boosting employee paychecks may take longer.

As of today. February 21, 2018 this is where small businesses stand on he issues:

Payroll accountants and their software platforms are generally proficient in these matters so the only problems I expect are among those relatively few ‘do-it-yourself’ manual payroll operations.

While this article focuses on employer actions and responsibilities, I  strongly recommend that individual taxpayers prepare an estimate of 2018 taxes based on the new law to accurately plan for payroll tax withholding.

I am pleased to discuss this issue as it relates to your small business.

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Exploring the phenomenon of increased early insurance terminations

An increasing number of consumers are terminating health coverage within days, weeks or months of buying health insurance online.

I’ve noticed a trend in online health insurance enrollment that seems to be accelerating. I don’t understand it yet; this post is primary a basis to seek additional information.

The observation: The incidence of early termination of benefits is accelerating. In a growing number of cases, the benefits are canceled within days of online enrollment.

Background: I’ve been involved in online health insurance enrollment since the early 1990s an ran a national enrollment service for about a decade. In those early days online insurance enrollees typically relied on professional advice and assistance via telephone that, in my observation, contributed to increased suitability and satisfaction. Today’s health insurance exchange enrollees typically do not use available human advisory services so there is less data available on the motivations

, psychology or emotional influences of enrollees on the insurance enrollment process.

Possible explanations:

Lack of consumer information – I’ve long been suspicious that online health insurance enrollees do not have sufficient information to make appropriate decisions. I’ve noticed, for example, confusion between primary coverage and supplemental health insurance.

Confusion with the Affordable Care Act – The Trump administration’s push to promote lower cost insurance with lower level of benefits may be misunderstood by consumers. Consumers may not understand for example, that they may enroll in expensive coverage that covers pre-existing medical conditions without limits OR low cost coverage that limits those benefits, but that they can not enroll in low cost insurance that covers pre-existing medical conditions in the entirety.

General distrust – Formerly an online consumer typically felt they could trust advice from a telephone support. I’m not sure that is true anymore. The wave of ‘fake news’ and propaganda about heat care this year is unprecedented.

Short term use – It is possible that consumers are enrolling for coverage immediately before a schedule doctor visit, for example, and cancelling coverage immediately afterward. I have only  few anecdotal comments to indicate this might be true. No reliable base of information is available. Some commenters speculate this will be accelerated by the cancellation of the health insurance requirement known as the ‘individual mandate’ under the Tax Cuts and Jobs Act.

Solutions: One possibility is to include health insurance advisory services as part of an employer-provided employee benefit plan. Not coincidentally

, this is the approach that Freedom Benefits has adopted for 2018.

Another possibility is restoration and expansion of the health insurance navigator program that was established in 2010. This does not seem politically likely under the current political leadership.

A third possibility is to use improvements in technology to screen applicants and communicate on suitability and policyholder satisfaction issues. Our partners are working on these issues that require a greater investment in Artificial Intelligence and technology.

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16 popular employee benefits for small businesses

A Freedom Benefits small business Consumer Driven Employee Benefit Plan can include these 16 benefits:

1) Group Health Insurance

2) Health Savings Account (HSA)

3) PPO Discount Pricing Service (PPO)

4) Health Reimbursement Arrangement (HRA)

5) Special Purpose Health Reimbursement Arrangement (SPHRA)

6) Qualified Small Employer Health Reimbursement Arrangement (QSEHRA)

7) Flexible Spending Account (FSA) including Dependent Care Plan

8) 401(k) Plan

9) Pension Plan

10) IRA or SEP Retirement Savings Plan

11) Deferred Compensation Plan

12) Thrift Savings Plan

13) Employee Home Office Expense Reimbursement Plan

14) Employee Travel Expenses Reimbursement Plan

15) Employee Work-Related Expense Reimbursement Plan

16) Other benefits specified by the employer

For a free copy of Freedom Benefits small business employee bnenfits Summary Plan Description

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, call or write us.
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Small Business Employee Benefits Made Easy!

Small business employee benefits are managed much more effectively when the business owner has a basic working knowledge of the components that make the plan successful. This bog post lists those basic components.

  1. Understand the purpose of the employee benefit plan – Usually the goal, at least the starting point goal, is to provide benefits that are tax-deductible as a business expense and tax-free to the employee. If not for this tax advantage, there would be little incentive for employers to be involved. Each employer has a unique and specific goal and so the employee benefit plan is designed to match that goal.
  2. Understand what is not the purpose of an employee benefit plan – No longer do employers provide a ‘one size fits all’ and ‘take it or leave it’ benefit plan design. Today’s employee benefits are designed to extract and maximize the benefits and efficiencies of consumer-driven choices.
  3. Communication – Good communication is the key to a successful employee benefit plan. All of the stakeholders – the employer

    , employees, spouses and dependents of employees, plan administrator, claim administrator, insurer, and payroll company must feel comfortable that they have a reliable source of information. A reputable benefit plan adviser makes all the difference.

  4. Documentation – Employer resolutions, Enrollment forms, Plan Documents and summary plan Descriptions are typically required. A non-attorney typically provides these sample documents but cannot provide legal advice. The employer is encouraged to seek independent legal advice on all business documents.
  5. Claim accounting – Nowadays this is typically handled via secure portal, email or text message, at the option of the employee. The result is an approved claim report that is sent to payroll processing.
  6. Payroll processing – Most employee benefit transactions between the employer and the employe are handled through a payroll processing service. Once the benefits accounts are set up properly within the payroll system, this process usually flows smoothly. Typically the payroll processor sends reports back to the employer for general accounting purposes.
  7. Tax filings – some employee benefit plans require year-end filings either singularly or as a data inclusion on another form like a W2. Again

    , this process flows effortlessly within a properly set up payroll and benefits administration system.

Freedom Benefits is prepared to make all the details flow effortlessly. Just give a call to discuss your own small business employee benefit plan. 

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Short term medical insurance covers unexpected medical costs

This users question and the response highlights the use of short term medical insurance and the potential for consumer misunderstanding.

Q:  I am looking for a basic insurance. I am a healthy 64 yrs. and usually go to the Doctor for an annual check up. Pap

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, Mam., and blood-work. I take five prescriptions, which are not expensive as generics and the use of prescription cards. I will be getting Medicare in about two months. I don’t want to spend over $170.00 a month. Can you advise me on which plan would work best for me?

A: It seems like you are looking for short term medical insurance that covers expected medical costs. Commercial short term medical insurance works exactly the opposite way. It covers unexpected medical costs but excludes expected medical costs. So we would be unable to recommend an insurance that does what you suggest. Coverage for short term expected medical costs is best approached through uninsured benefit programs.

If it would be useful to discuss the longer term expenses that will be covered and not covered under Medicare then this might be a more productive use of your time and budget.

More information about short term medical insurance is available at the Smart Insurance Marketplace.

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Insurance for small businesses

Q: Do you offer plans for small business? We are a small business of 3 people. Or can they purchase health insurance through you individually?

A: All of these plans shown in links related to Freedom Benefits are available to small businesses on a list bill basis. The easiest thing is to allow individuals to enroll without entering payment data and then ask us to set up the list bill.

If the business plans to pay for Obamacare-type individual insurance then an additional step is required to set up a Qualified Small Employer Health Reimbursement Arrangement.

Small group major medical coverage may also be available however these are traditionally not purchased through online enrollment services. A local representative may be the best bet.