All posts by Debbie Sears

Tax Preparation as it Pertains to Your Health Insurance

As you prepare your documents for your CPA to complete your 2014 income tax, you will find a new document/disclosure regarding health insurance.

This form is for people who purchased coverage through www.healthcare.gov. If you did not purchase through a state or federal marketplace, then this form will not pertain to you. The form is being used to help determine subsidy eligibility and/or “penalties” for not participating in a plan.

We highly encourage people to take a look at all options available to them through their employer, spouses employment and individual purchases of their own, so you have control over your network of providers available to you at times of need. There are products and price tags to fit almost all budgets. Please call me. I would be happy to assist you. Please refer to this IRS form and discuss with your CPA to get all the details. We do not offer any tax advise, but we encourage you to obtain all of the knowledge you can. Taxes are changing, so be in the know!

Spring Break is Here!!!

Spring Break is a part of our lives this month, whether we’re just taking a break from our own business and going somewhere warm or whether we are trying to sync up with our kid’s spring break schedules – high school, college. etc. We feel that the majority of the insurance claims we see are unplanned and unscheduled events ranging from the flu to serious illnesses and accidents.

When that time comes, and you are in an ER or urgent care facility, you’ll be trying to find your ID cards, trying to determine what doctors are in your network, etc. I’m trying to make life simple by sharing a link with you that Wellmark has called “Wellmark Mobile App”. With this app, you can check your ID Card, view it and email it. You can locate doctors and facilities; you can talk to a nurse 24/7 or your doctor’s office with just a touch of the screen. You can also check your claims status, coverage details, flex spending amounts and wellness information. There’s just a ton of good stuff on this site. Take a five minute break in your day and download this app. You’ll feel better about it later.

More than 90% of all hospitals and physicians throughout the United States contract with Blue Cross Blue Shield plans. You are also covered worldwide with bluecard worldwide. Your claim will be handled just like it would be if you were at home. You will also notice that there’s a link to international hospital doctor finders. If you’re a student exploring the world, please know how to get help when you need it.

 

Iowa Insurance Commissioner’s Recent Statement Regarding Security Breach

In light of the recent news concerning the security breach and Anthem, please read this statement just released by the Iowa Insurance Commissioner. If you have any problems we encourage all to follow the Commissioners advice immediately.
He urged folks that feel they have been compromised as follows:
Affected Iowans should visit https://anthem.allclearid.com or call 1-877-263-7995 to sign up for the additional protections provided by Anthem.  For more information visit https://www.anthemfacts.com.

 

Business Owners and Health Insurance

The IRS is really taking a look at the distinction between employees and independent contractors.

This year especially, because of the ACA’s requirement that employers with more than 50 workers offer health coverage. I have been advised by the National Association of Health Underwriters (NAHU) as well as the Iowa Association of Health Underwriters (IAHU) and many CPAs that it is ultimately important that when we work on your group benefits packages, that we get an accurate census of all employees and distinguish the difference between part time, full time, full-time eligible and independent contractors.

There is a calculation that is used to determine who is eligible and who is not. And that will define your responsibilities as a business owner. There will be consequences if this calculation is taken for granted. We work with your professionals as a team to keep you with a benefits package that suits the needs of your members, that is budget-friendly and compliant. This article will give you some insight.

Our consultations are free, please call us. I will educate you, I will distinguish your choices and keep you compliant and on budget. Please understand that this article is lengthy and probably more detailed than you need or want; however, it is from the IRS and that is the big brother that we have to answer to in the end. So, to provide you with the most current and the most accurate information, I rely on sources that are going to be what we have to live with to begin with. Scroll through this, and read what interests you. Please let know that this is an issue. I would be happy to partner with your CPA so that we provide optimum performance for your choices. If you do not currently have a CPA and you want references, we have a preferred directory for your reference.

February is National Heart Health Month!

February is National Heart Awareness Month, as deemed by the CDC. Here’s an article from the American Heart Association that is a quite in depth explanation of the warning signs of heart attack, stroke and cardiac address. The symptoms are different for women than there are for men, and sometimes these are silent, so I think my Valentine tip to all of the people I care about would be – know as much as you can about your ticker.

If you have the seasonal crud that seems to be circulating, it’s important to know the difference between a viral and a bacterial infection. Again, here’s an easy reference that explains the differences. There are certain things to do and there are certain things you should not do deepending on your situation. There’s an easy cheat sheet here as well as well as a mobile app.

If you’re looking for something to do over the Valentine’s weekend, click this link. Sometimes the best gift is a surprise. Sky’s the limit. Have fun, be safe, call me with your insurance needs.

Please be sure to have your insurance in place by the deadline of February 15 to avoid penalties. Call me. I would be glad to help you.

Commissioner Issues Press Release Regarding Liquidation

Sears Insurance always prides itself on quality and perfection.

When I make statements regarding how adamant I am about the quality and perfection, who I have in mind is YOU, your family and your health. The things money does not buy.

We represent “the A-Team”. We’re independent agents in the health insurance business and have been a recognized and reliable source for over 40 years. We can meet your budget, but we will do it in such a manner that when you or your loved one gets a “bad diagnosis”, you can go anywhere you want to seek professional medical help.

This press release issued by the Iowa Insurance Division explains the resolve to a company called CoOpportunity Health. While this is a very unfortunate thing, life happens, things change, but if you will call us, we will make the transition painless.

Health and Wellness Checkups

Now that all of our holidays have come to pass and we’re all back to some sort of normal routine, let’s not forget that our annual wellness/preventative checkups should be maintained. Here are a few recommended guidelines for adult and pediatric patients as well as pre-natal.

When you go in for your checkup, I recommend that you take the time to create a list so that on your way home, you have maximized that visit and have all of your questions answered. Stay well, stay warm, be safe. Call me with any questions…

Happy New Year from Sears Insurance!

As we embark on the new year, there have been several items that have come to attention on the health care front.  I always rely on, well respected industry resources anytime I make reference. As we progress forward through the years and the ongoing implementation the provisions of the 2010 Affordable Care Act, I try to keep you informed. I take a very neutral political position, as there are always pros and cons to any law. Some will agree, some will win, others will not. It is not my job to judge, but to take the time to help each and every client sort through options and find a plan that meets their needs and their budget.
Below I have some interesting tax increases effective January 2015 that you should be aware of:
  • Top Medicare tax went from 1.45% to 2.35%
  • Top Income tax bracket went from 35% to 39.6%
  • Top Income payroll tax went from 37.4% to 52.2%
  • Capital Gains tax went from 15% to 39.6%
  • Estate tax went from 0% to 55%
  • These taxes were all passed under the Affordable Care Act aka Obamacare
This article from Forbes regarding sales tax increases as well as the implementation time line provided by The Kaiser Foundation.
Another source that I refer to often is The Galen Institute. I am also providing their website explaining 46 Changes to Obamacare thus far.
Healthcare is a complex system and it is an expensive system.  The ACA has a schedule of provisions occurring each year and at the same time the cost for the Affordable Care Act is also increasing.
My suggestion is to explore your options.  The marketplace is like a store front.  Anyone can shop there…some have a “coupon” (entitlement) and some do not.  When it comes to your health and the providers that we want access to when we have a serious illness or injury…it eventually becomes a situation where it has to be “all about the money”.  Our finest doctors have high cost and a long number of years of education.  They have years of experience.  In some states there is “no cap” on their malpractice liability driving their malpractice liability insurance premiums. (i.e. you could have a OB/GYN that does not choose to make part of their practice delivery of newborns, rather see patients with other needs and refer to others in the practice for their expecting patients).  When a patient comes to them they are wearing more than one hat – yes they are a doctors first, however, they are also assessing their liability with the acceptance of that new patient.  They must also assess how they are going to be reimbursed for the liability that they are taking.  If your insurance carrier reimburses them at a very low reimbursement, they may refer you to someone that could be accepting patients with your choice of  insurance.  Think of it as a niche in their market – the doctor taking the lower reimbursement will have volume to offset the low reimbursement.  That doctor may see three patients to the first doctor’s one patient.  In essence, like most things, you get what you pay for.
I have heard from well educated people that have spent many hours trying to navigate the system – then make benefit determinations – and then the cost.  But in the end do they know what provider network they have access to? Do they know how they will be covered if they are out of their “home” location on a trip?  Do they know how their college children are covered several states away?  Do they know if any one of their family would leave the country, such as study abroad, vacation, business, etc. would be treated?  Usually that is no.  For the maintenance issues some lesser quality plans will work, but for highly specialized care or care provided out of a given area, they may not have been your best choice.
To find a plan that meets your needs and your budget we recommend an independent agent.  We will help you with your healthcare options, decisions and budget.  We will also make suggestions for some tax-deferred options.  At Sears Insurance our business comes from repeat clients and the direct referrals they send us…because we know our business and we take care of our clients.  Please give us a call for a free consultation.  Know where you’re at.

 

Insurance Commissioner Places Health Insurer CoOportunity Health in Rehabilitation

With the recent announcement regarding CoOpportunity, I encourage you to take a look at your options.  Whether you are an individual or a small business, please heed the recommendation of the Iowa Insurance Commissioner in the bulletin that is posted on the Department site.
I would like to draw your attention to Item 3 (bottom sentence) and Item 8 as it pertains to individual questions. On the Group platform, please be sure to note the recommendation in Item 1 – first sentence.
Please know that I have been in business for over 36 years as an independent agent and I only contract with quality carriers as defined by many criteria. We are not be the “bargain” agency representing “bargain insurance” but our quality can certainly be proven. When we have an emergency we probably do not want “bargain medical providers”.
We purchase insurance primarily for two reasons; preventative/wellness benefits, which is always encouraged and unpredicted, unscheduled catastrophic illnesses and injuries. When you purchase insurance, but realize that your access is very limited, you have put yourself and all that love you at a tremendous disadvantage. This disadvantage that I refer to is your health – one of the things that cannot be purchased – and then your financial health also becomes as risk.
I will work with your budget – I will show you all options – but I will not lead you down a path that will end on a questionable or bad note.
Please call me – our consultations and quotes are FREE – I can make this easy for you to understand.
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