Category Archives: Uncategorized

Changes to Oxford Group Plans for 2018

For 2018, Oxford, while eliminating some plans, has increased the number of options to 46.  Increases for this year look to be around 5.2%.  Liberty advantage is new, with 2 referral-required plans.  Most of the plans have changed to a $20 Lab copay (from 100%), and the ER copay increasing to $700.  Rx deductibles on some plans are increasing from $100 to $200.

The pharmacy network on the Metro plan is the Value network (no CVS or Target).  The Metro network still does not include Northwell, Stonybrook, NYU or Maimonides.

From an underwriting standpoint, parental waivers will now be accepted as valid – critical on younger groups.

Will your 2% Social Security increase “disappear”?

The Social Security Administration recently announced a 2017 cost-of-living adjustment, or COLA, of 2%, meaning that Social Security recipients will receive this increase to their monthly benefit checks staring in December 2017. This is the highest COLA in six years and is welcome news for many American retirees.

However, it may not mean a heck of a lot in the end.  Why?

First, the COLA (low by historical standards) doesn’t actually track the cost of living for those over 65.  The government uses the CPI-W index, instead of 2017’s COLA may not be much of an increase after all.  Second., I appears likely that when the 2018 part B premium increases are released, it may eat up most, if not all, of your increase.

Fix your claim problem – before it happens

There are 5 steps to fixing your claim problem – but most people don’t follow them.  By the time claim problems get to our office, they are usually months old, and huge issues.  So here is the best way to handle it, in this order:

  1.  Don’t ignore your mail.  Read those bills from doctors, explanation of benefits and especially collection notices.  Ignore these at your peril as they will only get bigger.  Ignore them long enough and they will hurt your credit.
  2. Do Something – If the claims look wrong, if the bill isn’t paid right – do something.  If you get a collection notice – do something now!  Who to call?  Collection notice- Call the collection company.  Bill – call the hospital or doctor and find out if they submitted it to the insurance carrier.
  3. Call the insurance company.  The numbers right on your card, easy-peezy.  Except for the 45 minutes of listening to the tape of “your call is important to us…”  Truth is, almost all claim problems are the result of minor coding errors and can be resolved with one phone call to the insurance company.
  4. Take Great Notes- Not good notes – great notes.  Time you called, number you called, who you spoke to, their extension, what they said to you exactly.  Especially if they tell you something is approved, or covered – we made need these later.
  5. Call your broker-  This is a last step, because it involves a lot – you have to sign a HIPAA release form for us to look at it, then send us all your documentation and notes, and then we can discuss.  If you are our client, we will usually appeal the claim for you – if it appears that things have not been processed correctly.

The appeals process has several steps, prescribed in your contract, that must be followed.   It tends to be a lengthy process, often taking months.  The best way to avoid this is step 1 – please read and react to your mail right away!

HSA and FSA Limits for 2018 announced

FLEXIBLE SPENDING ARRANGEMENTS (FSAs)
Salary Reduction Annual Limit
Employee contributions to employer-sponsored health flexible spending arrangements (FSAs) will increase to $2,650 (up $50 from 2017).

2015 2016 2017 2018
Salary Reduction Annual Limit $2,550 $2,550 $2,600 $2,650

 
HEALTH SAVINGS ACCOUNTS (HSAs)
Annual Contribution Limitation
Self-only coverage under a high deductible health plan is $3,450 (up $50 from 2017). Family coverage under a high-deductible health plan is $6,900 (up $150 from 2017).

Deductibles 
For calendar year 2018, a “high-deductible health plan” is defined as a health plan with an annual deductible that is not less than $1,350 for self-only coverage or $2,700 for family coverage, and annual out-of-pocket expenses (deductibles, co-payments, and other amounts, but not premiums) that do not exceed $6,650 for self-only coverage (up $100 from 2017) or $13,300 (up $200 from 2017) for family coverage.

2015 2016 2017 2018
Minimum deductible amounts for the qualifying high-deductible health plan (HDHP)
Individual coverage $1,300 $1,300 $1,300 $1,350
Family coverage $2,600 $2,600 $2,600 $2,700
Maximum contribution levels
Individual coverage $3,350 $3,350 $3,400 $3,450
Family coverage $6,650 $6,750 $6,750 $6,900
Catch up allowed for those 55 and over $1,000 $1,000 $1,000 $1,000
Maximums for HDHP out-of-pocket expenses
Individual coverage $6,450 $6,550 $6,550 $6,650
Family coverage $12,900 $13,100 $13,100 $13,300


QUALIFIED SMALL EMPLOYER HEALTH REIMBURSEMENT ARRANGEMENTS (QSEHRAs) 
For tax year 2018, to qualify as a QSEHRA, the total amount of payments and reimbursements cannot exceed $5,050 per employee (up from $4,950 for 2017) or $10,250 per family (up from $10,000 for 2017).
 

2016 2017 2018
Individual coverage $4,950 $4,950 $5,050
Family coverage $10,000 $10,050 $10,250

IRS Announces 2018 Contribution Limits

Participant limits- 401(k), 403(b) plans-                                      $18,500 (from $18,000)

Catch up for these plans, over age 50                                              $ 6,000 (no change)

SIMPLE Participant Limit                                                                 $12,500 (no change)

Annual Benefit Limit                                                                           $220,000

Defined Contribution Limit                                                                $55,000 (from $54,000)

TopHeavy Key Employee                                                                    $175,000

Highly Compensated Employee                                                          $120,000

IRA Limit                                                                                                 $5,500 (unchanged)

IRA Catchup                                                                                             $1,000

 

 

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Reeve Conover is a Registered Representative. Securities offered through Cambridge Investment Research, Inc., a Broker/dealer member FINRA/SPIC. Cambridge and Conover Consulting are not affiliated. Licensed in SC, NC, NY, CT, NJ, and CA.
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