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Florida-based Simple Health Plans shut down for selling “sham insurance”

According to the FTC, Simple Health Plans and its subsidiaries collected more than $100 million through deceptive marketing and sales practices that left many people stuck with thousands in unpaid medical costs.
By KEVIN TRUONG / MedCity News

Hollywood, Florida-based Simple Health Plans has been shut down by a federal judge due to allegations from the Federal Trade Commission that the company was selling junk insurance under the guise of providing comprehensive coverage to patients.

According to an announcement from the FTC, Simple Health Plans and its subsidiaries collected more than $100 million through deceptive marketing and sales practices that left many people stuck with thousands in unpaid medical costs.

While the company portrayed its coverage as comprehensive, customers reported paying as much as $500 a month for extremely limited benefit programs that “effectively left consumers uninsured,” according to the FTC.

The federal court order is only temporary, but the FTC is seeking to permanently shut down the company’s operations and return money to customers.

Medicare Costs for 2019 Released

Description 2018 2019
Part A Inpatient hospital deductible $1,340 $1,364
Daily coinsurance for 61st-90th Day $ 335 $ 341
Daily coinsurance for lifetime reserve days $ 670 $ 682
Skilled Nursing Facility coinsurance $167.50 $170.50
Medicare Part B annual deductible $183 $185
Medicare Part B standard monthly premium $134 $135.50
High-Deductible Plan F $2,240 $2,300
Plan K out-of-pocket limit $5,240 $5,560
Plan L out-of-pocket limit $2,620 $2,780

Expanding HRA’s to help individual employees

A recent article in Employee Benefit Adviser on 10/25:

If this change is allowed it would help small business owners and employees alike, providing an alternative to traditional group insurance, along with level- funded plans.- Reeve

“A new proposed law loosening restrictions on health reimbursement accounts could significantly expand the use of such accounts and make them a much bigger part of employers’ healthcare offerings.

The Trump administration this week proposed to allow employers to fund tax-exempted HRAs to help pay for employees’ individual health insurance premiums, undoing Obama-era guidance that restricted HRAs for that purpose. HRAs currently have to be connected to a group health plan, with some exceptions for retirees, and are typically used to pay out-of-pocket expenses and for other medical and dental services defined by the IRS.

The proposed rule also would allow employers that offer traditional group health coverage to fund an HRA of up to $1,800 each year to reimburse employees for “qualified medical expenses” such as stand-alone dental visits.”

2019 Retirement Plan Numbers released

The IRS on Thursday increased the pre-tax contribution limits for employees who participate in a 401(k), 403(b) and most 457 plans to $19,000 from $18,500. That limit also applies to the federal government’s Thrift Savings Plan.

For participants ages 50 and over, the additional catch-up contribution limit, which is set by law, will stay at $6,000.

Meanwhile, IRA contribution limits were raised to $6,000 from $5,500 — the first time the IRS has increased the limits since 2013. The catch-up contribution limit for people 50 and over will still be $1,000.

IRA contribution limits were raised to $6,000 from $5,500 — the first time the IRS has increased the limits since 2013. The catch-up contribution limit for people 50 and over will still be $1,000.

  • 401(k) will be $19,000 (catch-up stays at $6,000)
  • Maximum compensation is $280,000 (up $5,000)
  • Defined Contribution limit is $56,000 (up $1,000)
  • Highly Compensated Employee income designation is $125,000 (up for $5,000 for the first time in many years)
  • Key Employee is $180,000 (up $5,000)
  • IRA finally went up to $6,000 (first time in many years it raised and catch-up remains at $1,000)
  • SEP remains at $600 for eligibility purposes (be careful, anybody that earns at least $600 in a year has that year count for eligibility)
  • SIMPLE has raised to $13,000 (up $500 for the first time in many years and catch-up remains at $3,000)

Labcorp added to Aetna Medicare

Aetna and LabCorp have signed an expanded agreement to make LabCorp a preferred national laboratory for all Aetna Medicare health plans, products and members beginning January 1, 2019.

This means our 2019 members will have in-network laboratory access to both Quest Diagnostics’ and LabCorp’s full range of services, as well as their broad patient access points, including a growing retail presence. Or, they can choose from one of the many other participating labs in our network.

May 2019
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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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