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Health Insurance Shopping Resources
Old 07-13-2005, 08:26 AM   #1
 
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Health Insurance Shopping Resources

I'm considering checking out different health insurance providers here in California, looking for high-deductable coverage. Any good resources on the web for this?

Also, as I go from self-employed to retired, does that make any difference for health insurance coverage?
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Re: Health Insurance Shopping Resources
Old 07-13-2005, 08:41 AM   #2
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Re: Health Insurance Shopping Resources

Quote:
Originally Posted by TromboneAl
I'm considering checking out different health insurance providers here in California, looking for high-deductable coverage. Any good resources on the web for this?

Also, as I go from self-employed to retired, does that make any difference for health insurance coverage?
Kaiser has some cheap plans - I'm not sure if you live close to them - but give it a try ( www.kp.org )

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Re: Health Insurance Shopping Resources
Old 07-13-2005, 08:56 AM   #3
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Re: Health Insurance Shopping Resources

Quote:
Originally Posted by TromboneAl
I'm considering checking out different health insurance providers here in California, looking for high-deductable coverage.* Any good resources on the web for this?

Also, as I go from self-employed to retired, does that make any difference for health insurance coverage?
Check out Blue Shield's high deductible Preferred Provider Organization (PPO) Plans that work with Health Savings Accounts (HSAs. Wells Fargo handles the HSA). Much more freedom of choice than a Health Maintenance Organization (HMO) such as Kaiser. I don't like Blue Cross of California, but I'm sure they have PPO/HSA plans too (In CA, Blue Shield and Blue Cross are two completely separate companies).

You can try Blue Shield's website at mylifepath.com. Or try the producers # (800-559-5905) and ask them to give you the consumer's phone number.

Your employment/retirement status is irrelevant. All that matters is your health and age- once you hit 65- your plan will terminate and you'll get picked up by Medicare and (my advice) a Plan F Blue Shield Medicare Supplement.

All Medicare Supplement Plans are Standardized Plans A-J.
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Re: Health Insurance Shopping Resources
Old 07-13-2005, 08:57 AM   #4
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Re: Health Insurance Shopping Resources

Al, for general information on the California health insurance market and what insurers can and cannot do, look at the Georgetown University website on health insurance: http://www.healthinsuranceinfo.net/ca00.html

For insurance quotes, you might try www.eheathinsurance.com.
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Re: Health Insurance Shopping Resources
Old 07-13-2005, 09:20 AM   #5
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Re: Health Insurance Shopping Resources

One last point about PPOs: the SIZE of the network (the number of "preferred" doctors and hospitals is a HUGE factor, because if you see a NON-preferred provider (except in an emergency) your out-of-pocket costs increase greatly.

So I recommend Blue Shield because the size of their network (and Blue Cross') is almost certainly the largest in the state. Saving a couple of bucks in premium at the cost of a smaller network may not be smart.

I also am very impressed with Blue Shield for another reason. They just approved a VERY expensive (at least $80,000 for eight infusions) experimental application of a Genentech drug for me (rituxan) solely on the basis of a single study in Italy and a one patient "Letter to the Editor" out of England. I believe most companies would not have paid on the grounds that the application was considered "experimental".

I've represented them since 1981, but the pre-cert commitee (which initially rejected the request) and the appeals MD who approved it, had no way of knowing that, nor would they care, in my opinion.
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Re: Health Insurance Shopping Resources
Old 07-13-2005, 09:44 AM   #6
 
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Re: Health Insurance Shopping Resources

Wow, great info thanks. That eHealthInsurance site is perfect, thanks Martha.

Questions about HSA's

As a self-employed person, all of our medical expenses are deductible. So, until I retire, an HSA makes no sense for us, right? But wait, we could deduct the money put into the account and use it after I retire.

And after I retire, I could take money from my IRA and put it in the MSA, yes?

What if I had money in my HSA, then switched to a plan that wasn't an HSA plan?
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Re: Health Insurance Shopping Resources
Old 07-13-2005, 10:00 AM   #7
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Re: Health Insurance Shopping Resources

I'd call Wells Fargo about the HSA questions at 866-890-8313.
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Re: Health Insurance Shopping Resources
Old 07-13-2005, 10:06 AM   #8
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Re: Health Insurance Shopping Resources

Al, if you have a HSA and later switch to a different type of plan that isn't eligible for an HSA, I believe that you can still keep the HSA, you just can't contribute to it anymore. Save it or use it for medical expenses.


The applicable fed stuff on FSAs that answers your questions:
http://www.treas.gov/offices/public-...tice2004-2.pdf
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Re: Health Insurance Shopping Resources
Old 07-13-2005, 11:22 AM   #9
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Re: Health Insurance Shopping Resources

Art....what does 'I've represented them since 1981' mean in relation to Blue Shield of CA? Do you work for them?
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Re: Health Insurance Shopping Resources
Old 07-13-2005, 11:44 AM   #10
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Re: Health Insurance Shopping Resources

Yes, along with several dozen other insurance companies.
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Re: Health Insurance Shopping Resources
Old 07-13-2005, 12:57 PM   #11
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Re: Health Insurance Shopping Resources

Quote:
Originally Posted by TromboneAl

As a self-employed person, all of our medical expenses are deductible. So, until I retire, an HSA makes no sense for us, right?
I believe self-employed medical expenses are only deductible after you pass a certain threshold.

Self-employed insurance premiums are now fully deductible, though.

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Re: Health Insurance Shopping Resources
Old 07-13-2005, 01:18 PM   #12
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Re: Health Insurance Shopping Resources

Quote:
Originally Posted by Peter
I believe self-employed medical expenses are only deductible after you pass a certain threshold.
Yes, I think medical expenses are only deductible to the extent they exceed 7.2% of your gross income.
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Re: Health Insurance Shopping Resources
Old 07-13-2005, 01:52 PM   #13
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Re: Health Insurance Shopping Resources

Excellent thread- thanks for the info.

Ha
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Re: Health Insurance Shopping Resources
Old 07-13-2005, 02:45 PM   #14
 
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Re: Health Insurance Shopping Resources

Quote:
I believe self-employed medical expenses are only deductible after you pass a certain threshold.

Self-employed insurance premiums are now fully deductible, though.
Here's how it works. My company pays 100% pf all medical and dental expenses, including insurance premiums. Isn't that nice of it?

That is, it has a medical reimbursement plan. So, it's a company expense, and fully deductible. Since the company consists of me, DW and DD, I'm not paying for any strangers.

My accountant set this up for me. There are companies that will administer a plan like this, but it's not necessary.

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Old 07-13-2005, 03:04 PM   #15
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Re: Health Insurance Shopping Resources

Quote:
Originally Posted by TromboneAl
. . . My accountant set this up for me.* . . .
What had to be set up? Is this simply a matter of including those costs on your schedule C? or is something else involved?
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Re: Health Insurance Shopping Resources
Old 07-13-2005, 04:56 PM   #16
 
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Re: Health Insurance Shopping Resources

No, there are rules. Well, one rule that was relevant to me: you have to have a written Medical Reimbursement Plan. Mine is a 4-page word document -- not sure where I got it, and I can make it available to anyone (see excerpt below).

The first year or two I paid a company call Agriplan to set it up and administer it for me ($250 per year??). But then I found out it was easy to do it myself. All I needed to do was have the document, and keep track of medical expenses.

Here are excerpts:

Medical Reimbursement Plan, Responsive Software

Section 1 Purpose of Plan
1.01 The purpose of this Medical Reimbursement Plan (hereinafter the "Plan") is to provide for the payment for, or provision of, uninsured medical and dental expenses for participating Employees, spouses of participating Employees, and Dependents of participating Employees.
1.02 It is intended that this Plan qualify as an accident and health insurance plan as defined by Code Sec. 105 of the Internal Revenue Code of 1986, as amended ("Code"), and that benefits paid to Employees hereunder be excludable from their gross incomes by reason of Code Sec. 105(b).
Section 2 Definitions
Unless a different meaning is clearly indicated by the context, whenever used in this document, these words shall have the following meaning:
2.01 Benefits. Any amounts paid to a Participant in the Plan as reimbursement for Eligible Medical and Dental Expenses (as defined in Section 2.06) incurred by the Participant during the Plan Year or by the Participant's spouse or the Participant's Dependents (as defined in Code Sec. 152).
2.02 Code. The Internal Revenue Code of 1986, as amended.
2.03 Coverage Period. The Plan Year during which Benefits under this Plan are available.
2.04 Dependent. Any individual who is a Dependent (as defined in Code Sec. 152) of a Participant.
2.05 Effective Date. The First day of January, 2001.
2.06 Eligible Medical and Dental Expenses. Expenses incurred by the Employee, the Employee's Spouse, or the Employee's Dependents, after the Effective Date of the Employee's participation in this Plan and during the Plan Year otherwise allowable as deductions under Code Sec. 213 (without regard to the limitations in Code Sec. 213(a)). For purposes of this Plan, an expense is incurred when the Employee, Spouse or Dependent receives the medical care or services giving rise to the claimed expense.

--------------------

Section 3 Conditions for Eligibility
3.01 Any full-time Employee is eligible to participate in the Plan as of the Effective Date provided that the Employee is not a member of a collective bargaining unit of Employees covered by a collective bargaining agreement with Employer as part of which accident and health benefits have been the subject of good-faith negotiations.
3.02 For this purpose, a full-time Employee is an individual who normally works at least one hour per week.
Section 4 Amount of Benefits
4.01 The maximum amount per Plan Year that a Participant may receive as reimbursement under this Plan is $10,000.
4.02 For purposes of this Section 4, reimbursements of expenses for a Participant's Spouse or Dependent are treated as having been received by the Participant.
4.03 Employer shall pay all costs of providing the Benefits due under this Plan. Employer reserves the right to enter into any arrangement, contractual or otherwise, that Employer deems helpful to the proper and efficient operation of the Plan including, but not by way of limitation, the right to enter contracts with insurance companies and third-party administrators.
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Old 07-13-2005, 08:10 PM   #17
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Re: Health Insurance Shopping Resources

Al, thanks for the information, very interesting. How is your company set up? S corp?

Peter
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Old 07-14-2005, 10:08 AM   #18
 
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Re: Health Insurance Shopping Resources

I'm a sole proprietorship. Looked into incorporating several times, but it was never worth it.
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Old 07-14-2005, 07:15 PM   #19
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Re: Health Insurance Shopping Resources

Same here, sole proprietorship. Now, I always thought that meant you had no employees. I guess I was wrong?

Peter
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Old 07-15-2005, 07:50 AM   #20
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Re: Health Insurance Shopping Resources

It just means you are the only owner and you haven't formed an entity. You can have as many employees as you want.
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