It's That Time! Employee Benefits and More

By  Kate Welker, CFP®

This month we want to continue to remind our readers that it will soon be open enrollment through your employer and Medicare, the time of year you are able to review and change your health insurance and other benefits. 

There are several posts on our blog that cover this topic more in depth:

• Last week Rachel discussed how to review your health insurance options and prepare for making that decision in her post “Knock, Knock - Open Enrollment Who?”

• Last year I wrote a guide to the terms and options you may be deciding on in a post titled “Build Your Wealth by Taking Advantage of Benefits Open Enrollment.”

While you are taking the time to review your employee benefits it is also a good time to tackle several other employment related tasks.

• Beneficiary Review- We recommend that you review your beneficiary designations once a year on all of your accounts. Those tied to your employment would be your retirement accounts (Pension, 401(k), 403(b), etc) and any life insurance benefits.

• Benefit Package - If you have a position that comes with flexibility in negotiating additional benefits such as bonus payouts or additional time off, this would be a time to review your performance and approach your supervisor. 

• Salary Benchmarking - It is a good practice to occasionally review your salary for your position and duties. Compare what your compensation is against others in your industry and in your geographical area. If your research shows you are underpaid this would again be another time to approach your supervisor for a discussion. To research this you could use sites such as salary.com or glassdoor.com.

Knock Knock - Open Enrollment, Who?

By: Rachel Poe

Open Enrollment is a time in which individuals are required to opt in or out of health, dental, and vision insurance for the upcoming calendar year. Those who receive benefits through an employer program will usually receive notification and be a part of a company census to gather quotes. While important in itself, it is also noted that, once open enrollment closes, so does your chance to change coverage for the upcoming years (unless you qualify for a life event change). Life event changes consist of some of the following: marriage, divorce, additional children, loss of job, movement from region, etc. 

Open Enrollment for 2021 generally runs from mid-October to mid-December for coverage that begins January 1, 2021.  According to Value Penguin, within individual households, it is important to review these insurance plans compared to 2020’s Affordable Care Act; plans may vary based on coverage and provider. In addition, depending on your state, individuals who opt out of health care coverage provided by ObamaCare will not be required to pay a tax penalty, however, it is important to check your state-level mandates. 

Duke Health offers the following tips to prepare during the open enrollment process.

1. Know your needs - chronic conditions, emergency options, upcoming procedures, risk analysis

2. Family Changes - college, study abroad, new family members

3. Know What’s Covered

4. Identify Your Provider Network

5. Calculate costs

6. Evaluate Health Savings (HSA) and Flexible Savings Accounts (FSA)

7. Consider Other Insurances

8. Don’t Ignore - even if satisfied with the current plan - always review!

WARNING, open enrollment is not the same as Medicaid and Medicare. As a reminder, Medicaid is put in place to aid in low-income households and disabilities. This has no enrollment period and can be applied for at any time. Medicare creates access for individuals 65+ to health care (disabled individuals can apply at a younger age). Coverage begins January 1, 2021 with open enrollment ranging from October 15, 2020 till December 7, 2020. 

While reviewing dental, vision, and health insurance needs, it is equally important to consider reviewing other needs such as long-term care, disability, and life insurances. See this attached pdf to review some questions that may help identify some of the needs, revisions, or gaps within upcoming insurance policies. 

Not sure where to start? Contact us today for a Discovery Call to schedule a Free Consultation to discuss if an employee benefits review and an insurance policy review and recommendation session is right for you!

Medicare Part D - Parts and Pieces

In this weeks blog, Financial Planner Kerrie Beene, CFP® digs into the parts and pieces of Medicare Part D - Prescription Coverage:

What is Medicare Part D?

Medicare Part D is an optional U.S. federal-government program to help Medicare beneficiaries pay for self-administered prescription drugs through prescription drug insurance premiums (most professionally administered prescriptions are covered under Part B)

Do you have to have Medicare Part D?

Medicare Part D is optional.  However, if you do not enroll, you may pay very high prescription drug coverage costs.  Additionally, if you do not enroll when you first become eligible at age 65, you may pay a lifelong penalty if you decide to sign up later. 

For those that choose to sign up, understanding the differences in the plans is very important. In general, the higher the tier, the higher the member’s out of pocket cost for the covered drug.   

Tier 1 - Preferred Generic

This is the lowest tier.  This is the least expensive drugs your plan covers, includes preferred generic drugs. 

Tier 2 - Generic 

This tier includes preferred generic drugs that have proven to be the most effective in their class. 

Tier 3 - Preferred Brand

This tier includes preferred brand drugs and non-preferred generic drugs.  

Tier 4 - Non-Preferred Drug

This tier includes non-preferred brand drugs and non-preferred generic drugs. 

Tier 5 - Specialty Tier

This is the highest tier. It contains very high cost brand and generic drug, which may require special handling and/or close monitoring. 

When trying to decide which plan to choose, it is important to think about the following factors:

• How often you take prescription drugs

• Do you take generic, brand name, or a combination of both

• Deductible preferences, such as, a $0 deductible plan with a higher cost-sharing or a higher monthly premium

• Your copay and coinsurance options

• Know what happens if you go into the Donut Hole

What is the donut hole? 

Most Medicare Part D plans have a coverage gap. This coverage gap is called the Donut Hole. This is the time period after you and the drug plan have spent a certain amount of money for covered drugs, then you have to pay all costs up to the yearly limit. Once you have hit this limit, your plan will help pay for covered drugs again.  For 2020, the gap starts when you’ve spent $4,020 on covered drugs.

In 2020, the donut hole will close for generic drugs.

Picking a plan can be frustrating and confusion.  Just be sure to take the time to understand which tier/plan is best for you and do not hesitate to reach out for guidance. 

Uncork Your Wealth - Discover the Difference Between HSA and FSA

In this week’s blog, Financial Planner Kerrie Beene, CFP® defines two benefit terms that often cause confusion:

The products available to us in the financial and healthcare industry can be confusing.  So, with the use of Health Savings Accounts (HSA’s) and Flexible Spending Accounts (FSA’s), we are combining the two worlds and this can be overwhelming when trying to pick a health care plan.  Healthcare plans vary from job to job and state to state, but most of the time the options include health care plans with HSA’s and FSA”s as one of the available plans, along with other plans. So what is the difference and should I choose one of these options?

Similarities 

• Both HSA’s and FSA’s are used in conjunction with your health care plan.  

• Both also reduce your income tax liability and help pay for medical expenses with pre-tax dollars

• You and your employer can deposit money into the account

• Debit/Credit Card offered to pay for expenses

• Must maintain receipts and records for expenses

Health Savings Account

• Used in conjunction with a High-Deductible Plan

  • For 2019, the IRS defines a high deductible as $1,750 for individuals and $2,700 for a family 

  • For 2020, the IRS defines a high deductible as $1,800 for individuals and $2,800 for a family

• Available to self-employed individuals

• Money deposited into the HSA is tax-deductible

  • Interest and earnings are tax-free 

• Withdrawals used to pay for medical expenses are tax-free

  • Withdrawals can be used for medical expenses, such as doctor visits, hospital stays, eyeglasses, contacts, dental procedures, prescription drugs, etc.

• HSA’s are portable

  • The account belongs to you 

  • You keep it even if you switch jobs

  • Money remains in the account from year to year, even if not used

  • Money can be invested within the account

• HSA funds can be used to pay insurance premiums if you are collecting federal or state unemployment benefits or you have COBRA insurance through a former employer

• The IRS also imposes contribution limits on the amount that can be deposited into an HSA account

  • For 2019, the maximum contribution is $3,500 for individuals and $7,000 for families, with a $1,000 catch-up amount for those 55 and older (including employer contributions)

  • For 2020, the maximum contribution is $3,550 for individuals and $7,100 for families, with a $1,000 catch-up amount for those 55 and older (including employer contributions)

Flexible Spending Account

• Used in conjunction with a Health Care Plan

• Not available to self-employed individuals

• Money deposited into the FSA is tax-deductible

• Withdrawals used to pay for medical expenses are tax-free

  • Withdrawals can be used for medical expenses, such as doctor visits, hospital stays, eyeglasses, contacts, dental procedures, prescription drugs, etc.

• FSA’s are not portable

  • The account belongs to your employer 

  • Money must be used by the end of the year or you lose it

    • There are a few exceptions some employers offer, such as being able to carry-over $500 or a 2.5 month grace period to use the funds. (Employers can offer either option, but not both)

• The IRS also imposes contribution limits on the amount that can be deposited into an FSA account

  • For 2019, the maximum contribution is $2,700 

  • For 2020, the maximum contribution is $2,750

• Employers often offer other types of FSA accounts 

  • Dependent Care Account - used to pay for eligible child and adult care expenses like daycare, before and after school care, nursery school, preschool, and summer day camp

  • Other FSA Accounts

    • Adoption Assistance

    • Transit and Parking

The most important things to do when trying to pick a health care plan:

• Understand your available options

• Know your annual healthcare expenses

• Understand the requirements for required documentation for tax purposes

• Don’t be scared to ask questions