HMO, PPO, or High Deductible?

A Health Maintenance Organization (HMO) is a network usually restricted to certain areas. Your primary care provider—if inside the network—is covered however you will need referrals to specialists or outside parties and may be expected to pay the full cost of care outside the network with the exception of emergencies.

Preferred Provider Organizations (PPO) also have provider networks, but he may choose any network specialist without a referral, and may also receive outside network care although your cost will be a higher proportion of the bill.

Point of Service (POS) are hybrid of an HMO and PPO. It allows members to use doctors and hospitals outside the plan’s network, for an additional cost. You may choose a primary care doctor and need a referral fee if specialist but as with the PPO, there is coverage for out-of-network providers.

High deductible plans usually have lower premiums and consumers can choose plans with high deductibles designed to pair with a health savings account (HSA) or health reimbursement arrangement (HRA). The money put in an HSA or HRA by your employer you were both may be withdrawn tax-free paper cervical fund medical expenses such as deductibles, co-pays, and items of interest might not cover, such as hearing aids or eyeglasses.

What’s Your Priority?

Lower premiums usually have high deductibles because you pay a larger portion of your cost before the insurance kicks in. But if you have high health care costs your savings from a lower premium may not offset a higher deductible. And if you cannot afford to pay money into an HSA’s, as many people do, you may face higher out-of-pocket costs if you ever become seriously ill.

Disease management and wellness programs are available if you have a chronic condition or looking for weight, diet management, or fitness programs. This may be a feature you are seeking, however any health plan may have eligibility requirements vary, so be sure to get  details.

Early Retiree Reinsurance Program

The Affordable Care Act creates a new program called the Early Retiree Reinsurance Program to help address this challenge that employers and older employees are facing.  The Early Retiree Reinsurance Program provides $5 billion in financial assistance to employers and unions to help them maintain coverage for early retirees age 55 and older who are not yet eligible for Medicare.

Reimbursement

Businesses accepted into the program, along with other employers, and unions receive reimbursement for medical claims for early retirees and their spouses, surviving spouses, and dependents. Savings can be used to reduce employer health care costs, provide premium relief to workers and families, or both. Applicants who are approved into the program receive reinsurance for the claims of high-cost retirees and their families (80 percent of the costs from $15,000 to $90,000). The program ends on January 1, 2014 when state health insurance exchanges are up and running.

Get Organized

One of the best ways to reduce your stress at tax time is to have your documents organized in one place. Your best option is to create a file for your tax documents and receipts. Keep a file folder for these tax records, or a digital copy on your computer. As you prepare for tax time, here are some of the documents and records you will want to keep ready:

• Receipts for charitable contributions of money and goods.
• Mileage logs
• Receipts for deductible expenses (including receipts for qualified health care expenses paid for from a HSA or FSA).
• Receipts for credits, including receipts for items bought if you want to claim an energy tax credit.
• Information about investment transactions, including buying and selling information, and cost basis information, including IRA records (usually provided to you).
• Records related to your rental property.
• Records related to a home improvement project or home purchase.
• Receipts for dependent care expenses paid.

Business Tax Planning

If you own a business, you will have other tax issues to deal with. You will need to make sure that your business records are separate from your individual records. Do your best to make sure that there is a defining line between personal and business tax records so that you can more easily separate them during tax time. Some of the records that you will need at tax time include:

• Gross receipts. These can include deposit slips, register tapes, invoices, 1099 forms, and receipt books.
• Records of business related purchases, including receipts, canceled checks, and paid invoices.
• You should also keep track of expense documents related to business. This can include business travel receipts, expense requests, and other items.
• Mileage logs for vehicles involved.
  Documents that help verify the assets that your business holds, including closing documents for real estate, and bills of sale. This is especially important if you have purchased equipment for your business.
  Payroll and benefits information. Keep track of what you are paying employees, and the benefits they are getting.

Staying Prepared for Tax Season

If you automatically keep these tax records in some sort of a file throughout the year, you will have them easily accessible during tax season, and a great deal of stress will be avoided. If you have a scanner, it may be a good idea to scan all these documents in order to keep electronic versions just in case you misplace any hard-copy documents throughout the year.

Self-funded plans may differ significantly from each other. For example, some self-funded plans may offer a managed care approach within the self-funded plan framework; others may offer a more traditional approach. Some self-funded plans may be administered directly by the plan sponsor — the corporation, union, association, or state or municipal government agency — while others may be administered by a plan administrator such as an insurance company.

Self-funded plans also differ significantly from both traditional health insurance plans and managed care plans in a number of ways. First, traditional health insurance plans or managed care plans are generally designed by an insurer, and the insurer makes benefit-related decisions in terms of the plan rules. However, a self-funded plan is usually designed by the plan sponsor, a corporation, a union, an association, or a state or municipal government agency. If an insurance company serves as the plan administrator for a self-funded plan, the company generally acts only as the administrator, not as the insurer. In that capacity, the insurance company carries out the plan rules established by the sponsor.

Self-Funded Health Plans could be for you if you have 10 to 50 employees and are:

…Tired of paying high premiums for benefits you seldom use.

…Looking for a way to get something back for what you pay into your health plan.

…Ready to take control over health care costs now and for years to come.

Self-funding is an approach many large corporations use to control health care costs. With self-funded healthcare plans, self-funding comes within reach for your small business, making it easy to establish and fund your own health benefit plan.

At renewal time, the insurer reviews claims paid, estimates inflationary trend and reserve requirements, projects expenses, and determines margins and profits in calculating the next year’s premium levels. In most situations if an insurer incurs a loss, that carrier passes that loss on to the employer through a premium increase upon renewal. Therefore, the argument can be made that even with conventional insurance you are self-insured to the extent that you eventually pay for your group’s own losses.

Self-funding is a method by which an employer can pay for health insurance claims for employees and design the benefit levels, while maintaining control of a reserve account. He eliminates the high cost of a fixed premium normally paid to an insurance carrier and hires a Third Party Administrator (TPA) to administer the medical claims as they occur. The employer can provide these services at a cost far less than an insurance company because expenses are far less. The third Party Administrator can also procure “Excess Risk” or “Stop-Loss” insurance to eliminate the large unforeseeable individual “catastrophic” claim as well as protection for a large total volume of claims of the entire group.

Why Self–Funding?

Self-funding enables the employer to become involved in the payment and administration of the program through the TPA. Further, self-funding allows better management of medical program costs by providing cash flow improvements, therefore using a greater part of every health care dollar to pay claims. Involvement by the employer creates an attitude, which has a favorable impact on utilization, flow, and administrative aspects of the plan.

Fixed costs of a self-funded plan are far less than a fully insured arrangement. Typically, fixed costs are reduced by two thirds. This savings can then be utilized to pay claims. If claims experience is favorable, the employer receives the benefit of retaining all monies not used. Should claim experience be unfavorable, the employer is protected through the purchase of excess risk insurance.

The Importance of Goals

You can’t begin contributing to retirement accounts unless you set proper plans for what you want life to be like when you arrive to the post-working era. One of the first goals you will likely want to set is determining when you would like to retire by using a retiring plan calculator. By knowing the age at which you would like to stop working, you can then begin the pre planning process for how much you will need to start saving to turn that dream into reality.

Another important pre plan step to consider is determining how much you will need to live comfortably during the golden years. If you plan to lead the same lifestyle as you are living now, then you may only need the range that is close to the current income that you are earning. However, if you plan to travel often or want to move to a retirement resort, you may require more of an income to match this more expensive life style. These and other pre retirement planning goals can be essential for determining how much money you should start saving.

Benefits of Early Planning

The benefits you can receive from taking the necessary pre retirement planning actions can be immense. Again, those who follow the proper pre plan steps are much more likely to achieve the goals that they have set. Whether this means you will be able to retire at an early age or save more for the retirement years, achieving your goals can be immensely important. Next, by completing the pre retirement planning process now, you will be ensuring that the nest egg accounts you open will have as many years as possible to grow. This can ensure that you will be saving more for the golden years and that you will be able to retire when you would like.

Accounts to Consider

After you set the pre retirement planning goals such as determining when you would like to retire, the next step is to determine how you can begin achieving those goals. First, you’ll need to select the retirement accounts that you would like to begin investing in. The pre planning process needs to include a prompt account selection since you won’t be able to begin building your nest egg until you’ve selected a place into which you can invest. Everything from 401k workplace plans to Roth IRA accounts are available for most people to being investing into.

Being Proactive

If you truly want to maximize the pre retirement planning benefits, your best option is likely to begin investing into more than one account. By pre planning properly and investing in such options as both a 401k and a Roth IRA, you can maximize your contributions and ensure you have saved enough by the time that retirement arrives. By being proactive and beginning the pre steps needed to plan for the golden years, you can retire sooner with more money than you will likely need to live comfortably during the post working years.

As a self-employed individual, you have a number of income tax planning opportunities, some of which are not available to employees. This discussion provides a brief overview of some of the tax planning opportunities you may wish to consider.

Tax Planning for the Business Owners

When starting a business, you must consider a number of tax-related issues. Although business tax planning is a complicated area, it is essential to understand three major topics: tax consequences when the business is formed, tax consequences when the business generates income or loss, and tax consequences of business distributions. Additionally, you may wish to consider whether your chosen form of business will offer you opportunities to split your income tax liability among family members, thereby potentially lowering your overall family tax bill.

Employer Retirement Plans for Business Owners

Perhaps you are self-employed or own a small business. Or, you may be directly involved in running a corporation or a tax-exempt organization. In any of these cases, you generally have the option of establishing a retirement plan in which you and/or your employees may participate. One of the main advantages of a retirement plan is that it promotes regular savings for the future. Having a good plan can also help you to attract and retain quality employees, and to maximize employee productivity.

5 Ways Employers Benefit from an Employee Wellness Program

Decrease Health Insurance Costs

Health care costs for companies using Employee Wellness Programs are significantly reduced. Health insurance premiums are rising exponentially every year. The cost is rapidly rising to the point where employers have to find new ways to reduce their health expenses. Employee Wellness Programs have shown incredible returns and remarkable results that cannot be ignored.

Increase Productivity

Increased productivity in the work place is a by-product of a successful Employee Wellness Program. The main aim of an Employee Wellness Program is to encourage employees to lead healthier lifestyles. This is affected through education, incentives and health care directed by the company and the Wellness Program. It is proven that when an employee is healthy they are more productive. Being healthy increases concentration, energy levels and output. It also ensures you are able to consistently perform at the desired level.

Reduced Absenteeism

Wellness Programs reduce employee absenteeism, resulting in a reduction of company costs and an increase in productivity. There are many factors that influence a person’s health and well-being. These could be minor infliction such as a cold or flu or major such as heart problems or obesity. Any of these could result in the employee taking time off work. The benefit of an Employee Wellness Program is that employee absenteeism will be significantly reduced, if not avoided all together. There are many small changes in lifestyle that can influence overall health and well-being. A Wellness Program identifies these lifestyle changes, educates, and implements them.

Improve Work Performance

Statistically, employees who participate in Wellness Programs offered by their employer(s) make substantial improvements in work performance. Employee Wellness Programs cater for all manner of health and lifestyle problems. The aim is to promote healthy lifestyle choices to reduce the amount of medical attention required. Lower medical costs are just the tip of the ice burg.

Reduce Overall Costs

Employee Wellness Programs have proven to be one of the most significant factors to reduce overall costs for employers. It is hard to qualify what you gain through increased moral, but the productivity, employee work performance, and reduced absenteeism and lower health costs contribute to a sizable reduction in overall costs.

Regardless of a company’s size, there is always a good reason to look into Employee Wellness Programs. A company’s cost for a good Wellness Program pales in comparison to the long-term benefits, as it will create a stress-free and more productive environment that will benefit both employers and employees alike.

Request information regarding an Employee Wellness Program for your company by contacting Business Planning Group of Oklahoma.

You are now allowed to drug-test anytime an employee is injured on the job or is involved in an incident where the employer’s property is damaged. You are no longer required to have “reasonable suspicion” to perform testing after an incident / accident. [40O.S. Section 554]

You Choose the Testing Physician

The employer can now select the physician at any time, even if the claimant has already selected a physician. Quick reporting and direction to the appropriate medical care provider helps employees get well faster and reduces cost. [85 O.S. Section 14(B)]

Light Duty Tax Credit

Bring your injured worker back to work on light duty and revive a tax credit. The credit is for wages paid to a worker on light duty for up to 90 days, not to exceed $25,000 total per year. This is an innovative reform not found in other states. [68 O.S. Section 2357.46]

Safety Pays Tax Exemption

Utilize the Safety Pays OSHA Consultation service provided by Oklahoma Department of Labor and get a $1,000 tax exemption. [68 O.S. Section 2358 (A) (9)]

‘First Report of Injury’ Forms are Now Confidential

Form 2′s (first report of injury), are now confidential, thereby preventing your employee(s) from being easily solicited by trial lawyers. Now there is no downside to early reporting, whether it is a Form 2 or otherwise. Early reporting of injuries is always helpful in keeping case under control; it allows for a more thorough investigation when evidence and witnesses are still around.

As a business owner dealing with these issues can seem overwhelming. Start by reviewing your employees’ benefits package, and continue to evaluate and create solutions to enhance the healthcare options of your company.

By updating your healthcare benefits through voluntary coverage, like dental, and vision, wellness programs, or a tailored program, your company can gain an edge on the competition.

Wellness programs can offer cash or credit type incentives to participating employees, for example; reaching and maintaining healthy cholesterol levels, or, weight loss goals set by a healthcare professional. Wellness incentives create healthier, more productive employees that in turn cost your company less in the long term.

Insurance coverage is decreasing as the cost of individual coverage increases, almost 45% in five years. Health care can easily become one of your major expenses, and it may also increase as your age goes up.

To prepare for these increases you should get an idea or projection of how much you will need to save. Then review your retirement and healthcare options today, while planning for tomorrow. Take the necessary steps to help you prepare and protect your dreams and contact BPG Oklahoma today!