Dog's Eye View

One reason why so many companies offer group health insurance to their employees is because they can offer these benefits in Tennessee, Indiana and in other states pre-tax.

While health insurance premiums (yes, even Health Savings Account-based plans to an extent) continue to increase every year, The Affordable Care Act has created a tax credit for qualifying small businesses and tax-exempt organziations, so that they can continue to offer benefits.  

Trouble is... how much is this credit worth, and how can your company qualify?  Qualifying depends on: 

1. Total number of Full Time Employees
2. Total annual hours worked by part-time staff
3. Total annual wages
4. Total employer premium contribution (health, dental, vision)

If you can come up with the above information then plug it into this insurance company's calculater and get an estimate of what your company stands to save.

So here's a pretty good article on the basics behind why a Health Savings Account-based plan is a better fit for either a group or individual health insurance.

The basics:

1. Your premiums (what you pay to the insurance company -- or expect to pay in claims if you're self insured) fall -- sometimes anywhere between 20% - 40%
2. Take a portion of that savings in premiums, and contribute it to your health savings account
3. Any money contributed to your health savings account is triple tax advantaged:  1) goes in pretax, 2) earns interest pretax and 3) can be spent on qualified medical expenses at any age, without incurring any tax implications
4. Take the other portion you saved on premiums, and keep it :)
5. Future increases on your premiums are projected to be less than what you are accustomed to seeing -- Bernard Health clients see increases sometimes <50% less than their status quo
6. Annual contribution to health savings account (previously a cost subject to the increase you used to see on your health insurance premiums) is now flat.  In fact, most Bernard Health clients continue to contribute the same amount to their employee's health savings accounts year after year because they feel it helps instill confidence that the plan is better for their employees, and that it decreases employee turnover.

All that said (and as we've mentioned before), successful implementation is going to be based on whether or not your employees buy into how the insurance works.  We know it isn't the easiest thing, but we have helped companies in Tennessee, Kentucky, Indiana, Florida, Texas, Illinois and Georgia...  so if you're wondering how it might work for you, give us a call!

Krazy to think you can lose your health insurance just because you lost your job.  (Wait, did I spell crazy with a "k" back there???  Whoa, krazy...)

So, back to this insurance thing.  What should I do... how does it all work?  Well, in short, here are your options:

1. COBRA:  This is simply a continuation of your health insurance benefits previously offered through your employer.  Companies with >20 full time employees are required to offer it.  You can enroll yourself and your family in it for up to 18 months.  So, while you may be most familiar with how it works... you'll likely be sticker shocked by the price because your former employer no longer pays anything on your behalf!
2. State Continuation:  The same as COBRA, except for two things -- (1) companies with <20 full time employees offer it and (2) extends health insurance benefits previously offered through your employer for just 3 months (instead of 18).
3. Individual Policy:  This is a health insurance policy offered through any insurance company (Blue Cross, United, Humana, Aetna, Cigna, Bluegrass etc.) to you or your family, individually.  While usually cheaper than electing COBRA or State Continuation, the insurance company will require that you (and your family) go through underwriting -- meaning you can be "rated up" because on your health history or, even worse, flat out denied coverage(!)
4. Guaranteed Issue Policy:  This policy is guaranteed through the government.  It covers all pre-existing conditions (assuming you have not had a lapse in your healthinsurance coverage for longer than 63 days.)  If you can't get covered by an Individual Policy, this is your option.  While expensive, it will cover all pre-existing conditions and will never lapse.  The catch: in order to be eligible for a Guaranteed Issue policy, you must have exhausted the benefits offered to you through either COBRA or State Continuation.  So, don't even worry about trying to apply for this until your time on one of those coverages is about to lapse.
5. Short-term Policy:  While this will cover all future expenses, it will not cover any future expenses that are (or may be) caused by a pre-existing condition.  Example:  If you have diabetes, it will not cover any expenses you incur because of your diabetic condition.  

I know I know, wildly confusing right.  Plus, impossible to get an unbiased opinion on what the right thing to do for you and/or your family.  Well, that's where Bernard Health comes in.  Come on out to our retail store location in the 100 Oaks area to talk with one of our non-commissioned advisers about your situation.  We'll help you make sense of it :)

I'm just going to copy and paste an email I was forwarded by a happy client now using the BerniePortal for their group health insurance open enrollment:



I know how hard it is to get compliments from employees... especially when it comes to the group health insurance plan (even if you are offering a Health Savings Account-based plan) so use the BerniePortal to help streamline your process, and get happier employees along the way!!  :)

Want to read something that doesn't pass the laugh out loud test?  (Yes, you say...? Thanks, Mom.)

Let's say your Nashville, Indianapolis or Louisville-based company has hired a new employee and you, the HR Person or Office Manager is responsible for getting them enrolled in the benefits.  We've identified the 10 jobs that need to be completed just to get them enrolled.  In chronological order, here they are:

1. Your employee needs to find out what the health benefit options are on the groupinsurance (medical-maybe HSA-eligible, dental, life, disability, vision, other voluntary options etc.)
2. Your employee needs to find out how much these group insurance benefits will cost (how much will be deducted from their paycheck)
3. You (the HR person or Office Manager) needs to communicate the above information to your new employee.  If you are like most companies you will likely hand out, mail out, fax out or email out paper forms that include this information.
4. Your employee then needs to take these forms home, review all the options (perhaps with a spouse) and fill them out.  I know, not funny yet
5. Your employee then needs to return these forms (sometimes one for each benefit) back to you by either handing in, mailing in, faxing in or scanning and emailing in the forms they've completed.
6. You now need to review each of these forms to make sure they have completed all the necessary information (names, date of birth, social security number, address, dependent information and signature).  Since employees don't do this all the time, we know that mistakes can be made which means...
7. You need to go back to the new hire to get the correct information (stop by their office, mail out, fax out, email...  whatever your preference) so that they can enroll in the medical plans.  Laughing yet?
8. Your employee corrects the form and gets it back to you.
9. You now need to communicate this information to payroll in order to make the appropriate payroll deductions from your new employee's paycheck so they are enrolled in the group health plan.  If you also handle payroll, this isn't so bad... you just sift through the paper forms you received from the employee.  However, if someone else handles payroll, then you would either scan and email (or fax) the forms to payroll, or enter the information into a spreadsheet and then email it to payroll.  How about now!?!
10. You also need to communicate the information to the insurance carriers... yes, all of them.  If you are familiar with their online systems, then you can take the forms you received and add them to your plan online.  If you are not familiar with their system, then you'll either scan and email them directly to your carrier (or to your broker).

At last, we're done!!!!!  Your new employee is enrolled in the group health insurance benefits so go ahead, pat yourself on the back!!

But then it happens:  two months later and recently married, your very happy new hire is back in your office saying, "now that I'm married, I'd like to review the benefits again and maybe add my spouse."  Ahhhhhhhhhhhhh!!!  Never before have you been so upset at another person's joy.  But, you're a professional.  You calm yourself, smile, and begin the above process again.  Anxiety sets in... you're not laughing anymore

And let's not forget that process needs to be repeated by every employee, every year, during open enrollment.  I get it, you're not laughing anymore, you're just rolling your eyes at the absurdity. 

Aside from the frustration and waste of time, The Hunter group (via CFO.com) estimates that the above process costs $192 per employee, per year.  You do everything else online, so move away from this archaic paper process, and use the BerniePortal to move your group health plan communication to a customizable online benefits enrollment process!

I'll admit it... health insurance, is tricky.  All aspects of it.  Even for people who eat, drink and breath it.  Because of that, mistakes are made all the time.

Take a look at the HSA eligible health insurance premiums illustrated for one of Bernard's clients below.  Notice anything different between the two screen-shots? (like the spot the difference game):

   

Here's a hint: the cost of the one on the left is ~15.5% lower than the one on the right!  Same plan design. Same client. Same, well, everything... except for the price of course.  So, how can the price be so different?  (Hmmmmmm, you must not have been listening.  Go back up and read the first paragraph, I'll wait...)

Whether you live in Nashville, Louisville or Indianapolis, group health insurance is tricky.  In this case, a mistake was made by the underwriters when they issued the quote on the right.  Fortunately, I happen to fall in the category of eating, drinking and breathing this stuff, so I caught it pretty quickly.  I asked for the underwriters to review their quote, and they re-issued the prices on the left.

As a result, our client will end up using that 15% savings somewhere else in their business.  Really makes you start to realize why it's so important to have a trusted advisor for your health insurance needs.

If you live in Nashville, Tennessee, the cicada epidemic may have you down.  If you live in Indianapolis, Indiana, or Louisville, Kentucky, the recent spring storms may have you down.  And, if you live anywhere in the United States, health insurance or group health insurance benefits may also have you down!

Well, the IRS recently announced a reason to look on the bright side (ironic I know)...  they've increased the annual contribution limit to your health savings account (HSA).  That's right, each year the IRS reviews the guidelines around Health Savings Accounts, so it's important to stay on top of what's hip and cool. 

Onto the good news...  after making no adjustment for the 2011 maximum from the 2010 limit (3,050 for individuals and $6,150 for families), the IRS has increased HSA annual contribution limits for 2012 to $3,100 for individuals and $6,250 for families.  And if you're over age 55, you can put an additional $1,000 in your account each year as well.

Thanks be to the IRS... errrr, something like that.

It's true, no two companies or organizations face the same challenges.  This is especially true when it comes to trying to offer affordable group insurance in Tennessee, Indiana, and Kentucky.  When we talk to managers and owners about the challenges they face, some of the common differences we hear about include:

1. Industry
2. White collar vs. blue collar workforce 
3. Hourly vs. Salaried employees
4. Single site vs. Multi-location
5. Employee age and average turnover

When evaluating whether a group health insurance plan that includes a Health Savings Account is the right fit, it might be best to hear the results of organizations similar to yours.

Well, if you are a government entity, this story on how Manitowoc County (Wisconsin) has saved an estimated $1.1 million since 2007 might be a good reference.  Here are some of the highlights:

1. Health insurance premiums had increased 131% from 1996 - 2006 (~13% a year)
2. Transitioning to a HSA-based plan saved the county $300,000 in 2007, and $1.1 million in total
3. Manitowoc's premiums are now 7% lower than other government entities in the area

The article concludes that there must be, "some reason why we're not seeing (other government agencies consider the HSA) -- if it's this good, why aren't other people on it?"

I'm not sure why there is so much hesitation either... but our team members in Tennessee, Indiana and Kentucky are doing their best to help organizations like Manitowoc achieve similar success!

If you have an individual or group health insurance plan that has a Health Savings Account in Tennessee, Indiana, or any other state, you need to pay special attention to the two changes that will affect your individual HSA on January 1, 2011:

1. Over-the-counter prescriptions: You will no longer be able to pay for these expenses (without a doctors prescription) with money out of your health savings account
2. Excise Tax: If you spend money out of your health savings account on a non qualified medical expense, you will incur income taxes and a 20% penalty on the amount spent.

So, if you are accustomed to spending money out of your Health Savings Account on over-the-counter drugs, be sure to "load up" before the ball drops in 2011!

Have you or someone you know recently left your employer and have questions about what to do for health insurance?  Well, you aren't alone.  

The first solution is to simply accept COBRA.  COBRA is nothing more than a continuation of the benefits offered by your prior employer.  However, there are two potential problems with doing this:

1. The price may be more than you can afford
2. The benefits may not be the right fit for you and your families needs

As a result, there might be an individual insurance policy (like a health savings account based plan) or a short term health insurance policy that might be a better fit for you.

If you have questions, we at Bernard Health would be happy to help.  Visit our retail store at 720 Thompson Lane here in Nashville for advice from one of our non-commissioned advisors!

Healthcare reform has been a popular topic for companies who offer group health insurance in Tennessee and Indiana.  Whether your company offers a Health Savings Account-based plan, or a more traditional plan, reform will change the way companies are required to file employee W-2's.

This two page report from Aetna offers some more background.  Below are its highlights:

1. Employers must report the aggregate cost of "applicable employer-sponsored coverage".
2. For fully insured companies:  The "applicable employer-sponsored coverage" equals the total premium cost for that employee's coverage, regardless of who is paying for it (company or employee).
3. For self insured companies:  The "applicable employer-sponsored coverage" equals the COBRA rate for the coverage option the employee would be enrolled in if no longer employed by the company (minus the 2% administration fee).
4. All companies will be required to do this, regardless of how many employees they have.
5. The amount reported should be posted in Box 12, using code DD of the new Form W-2.

All that said... don't fret about it during the 2010 holiday season because these new requirements do not take effect until the 2011 tax year  :)

The Pre-existing Condition Insurance Plan is an HSA-eligible health plan available to individuals offered through the federal government.  This type of health insurance might be a great alternative for those people who have been denied individual coverage in the past or whose COBRA coverage is close to running out.  

However, because it was only made available on July 1, 2010, there isn't a great distribution channel for helping people sign up, or understand exactly how it works.  In fact, you're only able to sign up for the plan online.  Additionally, the pricing and process may be different depending on the state you live in.  Here is more specific information if you live in Tennessee and if you life in Indiana.

If you have more questions about how this works, or want help navigating the sign up process, we would be happy to help. In fact, our first store is opening in the middle of September 2010 to do just that (walk-ins welcome).

We'll also be helping people with Medicare questions, Cobra questions, Medical billing questions and individual health insurance options.

Much has been made (at least within the Woof Street Journal) of the significance of the Pre-Existing Condition Insurance Plan (PCIP) that was made available July 1, 2010. Well, here's why the team at Bernard Health is so excited:

1. Many Americans receive their health insurance through their employer for two reasons: (a) premiums can be paid for with pre-tax dollars and (b) companies that apply for group health insurance are guaranteed to be offered coverage.
2. Alternatively, individuals seeking coverage run into two distinct disadvantages: (a) premiums for an individual health insurance plan must be paid for with after tax money and (b) insurance companies can simply deny an individual applying for coverage because of a pre-existing condition.
3. Health care reform proposes to solve this second problem.  In other words, individuals who apply for medical insurance will not be denied coverage once all of healthcare reform takes affect.
4. Enter the PCIP:  Essentially, the government did not want to have to wait for health care reform to be fully implemented in order to allow individuals with pre-existing conditions to get coverage.
5. This plan was made available effective July 1, 2010.  Here's where you can apply.
6. Why Bernard Health is so excited: This single plan option is a Health Savings Account-eligible plan!

Bernard has been helping companies introduce HSA-based plans since 2006 and (as of the date of this posting) has helped more than 65 businesses through the transition with ~82% of their employees selecting the HSA-option over their more traditional plan.

As companies consider strategies on different affordable group insurance options, one of the concerns is that HSA-based plans will not be around for long.  Based on the introduction of the Pre-existing Condition Insurance Plan, I'm not sure you can get a stronger signal that HSA-based plans are the health insurance option of the future.

Moving to an Health Savings Account-based plan means there are now two different parts to your health plan: (1) the health insurance, and (2) the health savings account.

Jenny does a great job in this blog post explaining how the health insurance side of an HSA-based plan works.

The Health Savings Account allows for a person to pay for all of their medical expenses with pre-tax dollars.  More specifically, the account is actually triple tax-advantaged:

1. Contributions into the account are pre-tax - avoiding federal income, state income, city/county income, social security and medicare taxes (I know, they really start to add up when you list them out like that!)
2. Money rolls over at the end of the year, and earns interest tax-free - like your personal checking account, except you don't have to pay taxes on interest earned in this account
3. Spend the money out of your Health Savings Account on Qualified Medical Expenses without paying taxes - Matt posted here which over the counter drugs will require you to have a doctors prescription to be "qualified"

There are a number of additional things you should be familiar with on the "tax side" before rolling out an HSA-based plan.  Here are a few of them: 1, 2, 3!

Because insurance is state regulated, we typically have not been helping companies in states where we do not already have offices.  So, if you aren't in Tennessee or Indiana, historically we would not have been able to help.  But things are starting to change...

One of our current clients referred us to a business owner in Texas who was in need of setting up a new group health plan for his company.  Our new client knew he wanted to offer an HSA-based plan, but could not find anyone local to help explain and support the plan benefits to his employees.  Long story short, we got the group enrolled with Blue Cross Blue Shield of Texas in about 45 days, and his employees enrolled in their benefits using our online enrollment system saving the company not only money, but time too!

Aside from having plans to open two other locations in the next 6-8 months, we will begin to be more open to working with companies based in states where we don't already have a presence.

Thanks in large part to team member Ryan McCostlin's hard work, we are excited to see that construction has begun!

   

Bernard Health is opening a retail store in Nashville TN. to help people with:

• Medicare Explanation of Benefits
• COBRA Questions
• Medicare EOB's
• Medicare Part B
• Medicare Part D
• Medicare Supplement
• Individual HSA-based plan options
• Health Benefit options
• Health Care bill audits

We are scheduled to open in later September, so check our blog out every few days to get updates on how we're coming along!

For employers looking for affordable group insurance, there are lots of videos out there, like the one below, that can help explain what a Health Savings Account-based health plan is and why it benefits companies and their employees:
These videos are a terrific way to efficiently explain the mechanics of Health Savings Accounts. However, what we have found in Nashville, Tennessee and Indianapolis, Indiana is that companies want someone who can deliver an interactive live presentation that explains how the insurance side works in a way that gets their employees on board -- and maybe even illustrate how a company HSA can be a better plan than copay-based plans that are sometimes more familiar.

While Bernard also offers a customizable video the helps explains how the Health Savings Accounts work for our clients in Tennessee, Indiana, Ohio, Georgia, Texas, New York, Alabama, Mississippi, etc. we can really deliver impact with live enrollment meetings for employees.  

It's true, there are websites just like this one out there that are designed to help people analyze health plan options  -- whether they are individual plans or offered through employers.  And for the most part, these sites are great.

However, we think they are missing a "human" element that some people want.  From our experience, people want to sit across from the person who is helping to analyze such options as:

1. Over 65 Insurance Options
2. Individual / family insurance options
3. Individual HSA Options
4. Help with Medical Billing questions

That's why Bernard Health has moved forward with plans to open a retail store in the Berry Hill area in Nashville, TN.

Assuming our construction plans stay on track, we hope to open our doors during the third week of September.  If you are faced with different options and want more than a website, please stop by (no appointments necessary)!

Bernard Health has been helping companies in Nashville, Tennessee and Indianapolis, Indiana introduce and implement Health Savings Account-based health plans since 2006.  We've developed partnerships with some of the industries leaders (HSA Bank and Healthcare Bluebook) and are one of the nations leaders in getting employees to embrace the plan over a more traditional or copay based plan.

Like any company trying to grow, one of our main challenges is finding people to grow with.  We are actively searching for someone to join our sales team here in the Nashville market.

Specifically, here is what we're looking for:

Job Description

Bernard Health is a fast-growing company solving problems in healthcare.  We are doing this by working to become the world's most trusted advisor when it comes to planning how to pay for both expected and unexpected healthcare expenses.  

We are in search of a highly motivated individual who wants to be passionate about what they do and to make a positive contribution to an industry that desperately needs it.  The primary responsibility will be to help companies design and implement a Health Savings Account-based health plan strategy that improves their employees' health insurance benefit while generating significant savings that drop straight to the company's bottom line.

Ideal Candidate

We are searching for a hard-working individual who:

1. Has a strong past record of being a self-starter
2. Wants to be in a sales / business development role
3. Has shown the persistence it takes to see a job to its completion
4. Has had leadership roles in the past and is therefore comfortable taking on responsibility and being held accountable for their work
5. Has proven to have excellent communication and presentation skills throughout prior experience
6. Is detail-oriented and capable of working with numbers
7. 2-5 years experience working in health insurance and/or finance (preferred but not required)

If you know of anyone who might be a good fit, let us know!