The Push towards Telemedicine

Telemedicine

How many times have you been bothered by a cough, rash, fever, or other minor medical problem, but can’t easily get to your regular doctor?  Imagine being able to be seen by a doctor without leaving your home or office. Or having access to medical care when you’re traveling.

Telemedicine may be the answer.

Most major health insurance carriers are making a big push towards including telemedicine — online doctor visits — as a covered benefit on their health plans.

Anthem BC/BS launched a telemedicine service, LiveHealth Online, back in 2013 to a limited market.  Last summer, it was made available as a covered benefit to all Anthem BC/BS policyholders.  Non-Anthem policyholders can also use the service for a fee of $49.

Anthem will begin heavily publicizing LiveHealth Online to its members — both individual and group policyholders — in the upcoming weeks, and will be offering incentives for those who register by a certain date.

So if you are an Anthem customer, be on the lookout for more information via phone, email, or direct mail. Rumor has it they’ll be offering prizes like a chance to win a $500 gift card.

Benefits of Telemedicine

Telemedicine is a trend that is not likely to go away, given today’s busy lives and increasing reliance on technology.

The benefits of an online doctor visit are not hard to imagine:

  • Doctor available 24/7, 365 days a year from wherever you happen to be (as long as you have access to internet service and a computer or mobile device!)
  • Faster than a visit to urgent care when your regular doctor is not available
  • No appointment necessary
  • No driving
  • No long wait times
  • Access to prescriptions in many states (including Virginia, Maryland, DC)

When to Use Telemedicine

Of course, there are times when an online visit will not be not a good substitute for an actual visit with your regular doctor. For serious health issues, it’s best to be seen in person.  For medical emergencies, you should seek immediate care or call 911.

We strongly recommend you develop and maintain an in-person relationship with your primary care provider so you have someone you trust to manage your health.

But for times when convenience is important, an online visit to address more minor things like allergies, colds, sore throats, pink eye, flu, sinus infection, stomach bug, rashes, etc., may be appropriate.

Learn more about the benefits of telemedicine here.

Company Benefits BrochureAre you a small business owner (employing less than 50 FTE)?

Do you offer health insurance to your employees?

Have you heard of SHOP —  the Small Business Health Options Program — and is it right for your business?

 

Group Health Insurance

Although small business owners are not required by law to provide health insurance, doing so is a great way to attract and retain the best and brightest talent for your company.  Providing coverage also promotes a healthy lifestyle that keeps your workers at work, doing the jobs that are critical to your organization’s success.

But choosing the right plan for your business can be overwhelming.

Small business owners have always had a lot to consider when it comes to offering health insurance to their employees:

  • Cost to you (the employer)
  • Cost to your employees
  • Details of the coverage including provider networks and prescription benefits
  • Ease of working with the carrier you choose
  • Whether or not to offer and contribute to a Flexible Spending Account (FSA) for your employees
  • Whether or not and how much to contribute toward premiums for employees’ dependent coverage
  • Etc.

SHOP – Small Business Health Options Program

Now that the Affordable Care Act is in place, small business owners have another thing to consider:

Should you purchase a group plan through SHOP — the Small Business Health Options Program — or outside of SHOP?

SHOP is the federal online health insurance marketplace for small businesses. Like the federal health insurance marketplace for individuals (healthcare.gov), SHOP was conceived as a one-stop shop where small business owners (less than 50 FTE) could shop online to compare and purchase exchange plans.

However, in reality, at this point SHOP does not offer a wide variety of plans to choose from. Instead, only a select few carriers offer plans on SHOP, meaning your options are limited.

(SHOP is for small employers in states which have not set up their own exchanges (including Virginia). Business owners in Maryland and DC can buy group plans through the state exchange.)

What Kinds of Businesses Should Use SHOP?

Given that SHOP offers only limited options for group plans, it may not be an ideal solution for many business owners.

However, there is a subset of small business owners for whom SHOP does make sense.  If you own a small business with:

  • Less than 25 employees, AND
  • The average income of those employees is less than $50,000

you may be eligible for a small business health care tax credit.

The tax credit is offered on a sliding scale, based on the size of your business. The smaller the business (either in FTEs or wages), the bigger the credit — and the more reason it may make sense to buy a plan on SHOP.

Conversely, the larger your business (the closer to 50 FTE you employ or the higher the average wages of your employees), the less benefit you stand to reap by shopping on SHOP.

Virginia Medical Plans Can Help

The bottom line is that if you own a small business, it’s best to fully understand all of your options before choosing a group plan.

At Virginia Medical Plans we have been helping small business owners in Virginia, Maryland, and the District of Columbia choose and administer their employee health insurance plan for over 20 years.  We are available to help you at each step along the way — whether you enroll through SHOP or through the private marketplace.

Give us a call at 703-707-8270 to discuss your options for group plans.

Resources for Small Business Owners

The federal government recently released helpful user guides for SHOP — one for employers and one for employees:

  • SHOP Employer User Guide – gives step-by-step instructions for using SHOP to browse, choose, and purchase a group plan.
  • SHOP Employee User Guide – gives step-by-step instructions for using SHOP to enroll in employer-sponsored group coverage.

Most Americans must have health insurance. It’s the law.

Surprised by tax penaltyBut as the 2014 tax filing season gets underway, you may be caught off guard by an extra tax of $95 or more due with your 2014 tax return. 

That’s because if you went for three consecutive months or more during 2014 without health insurance, you will be hit with a penalty tax (unless you are exempt).

Here is the amount of the penalty, which will increase for 2015 and 2016:

2014 2015 2016
$95 per adult
$47.50 per child
Family Maximum of $285 OR 1% household income, whichever is GREATER
$325 per adult
$162.50 per child
Family Maximum of $975 OR 2% household income, whichever is GREATER
$695 per adult
$347.50 per child
Family Maximum of $2,085 OR 2.5% of household income, whichever is GREATER

If you were penalized for not having coverage in 2014, and still have not purchased coverage for 2015, the government is giving you a second chance to buy 2015 coverage and avoid another — even higher — penalty.

Virginia residents can visit www.enrollvirginianow.com to enroll in less than 15 minutes!

Second Chance to Enroll — Special Enrollment Period March 15 – April 30, 2015

Although open enrollment for 2015 ended on February 15, 2015, you can enroll in coverage between March 15 and April 30, 2015 if all of the following are true:

  • You live in a state (including Virginia) that uses the federal marketplace (healthcare.gov); and
  • You are NOT enrolled in health insurance for 2015; and
  • You attest that when you filed your 2014 tax return you paid the fee for not being covered in 2014; and
  • You attest that you first learned about or understood the implications of the penalty tax after open enrollment ended on February 15, 2015, as a result of preparing your 2014 tax return.

In other words, you must state that you did not understand the law enough to realize you’d be penalized for not being covered in 2014, AND that you only found out by virtue of completing your 2014 tax return, by which time it was too late to buy coverage for 2015 during regular open enrollment, which ended on February 15, 2015.

By taking advantage of the special enrollment period, you can get 2015 coverage, effective on the following dates:

  • Enroll between March 15 – April 14 — Coverage effective May 1
  • Enroll between April 15 – April 30 — Coverage effective June 1

Virginia Medical Plans Can Help

If this situation applies to you, visit www.enrollvirginianow.com to see available plans.

If you need help understanding your options and selecting the best plan for you, give us a call at 703-707-8270.

Being covered in 2015 will save you from some of the penalty.  AND our services are completely free!  You pay no more for your coverage when you purchase it through us, but you get the benefit of our guidance and help.

We are happy to help. Call our office at 703-707-8270.

Piggy Bank - Tax SavingsAre you self-employed or thinking of becoming self-employed?

The Affordable Care Act has made health insurance available to anyone — regardless of current medical status. This means you can purchase coverage for yourself and/or your family on the individual health insurance market — even if you have a pre-existing medical condition.

But did you know today’s tax code can save you money if you’re self-employed and you buy health insurance?

Here are 5 things every self-employed person should know about health insurance and taxes:

1 – Premium Tax Credit (Subsidies)

Depending on your income, you may be eligible for financial assistance to help you pay for health insurance. The government subsidy comes in the form of a premium tax credit and can be paid directly to your insurance carrier to reduce your financial burden. (Subsidies are available to anyone who qualifies, not just the self-employed.)

2 – Self-Employed Health Insurance Premium Deduction

If you are self-employed and show a profit for the year, you can deduct 100% of your health insurance premium on your personal income tax return — Form 1040, Line 29. This reduces your adjusted gross income (AGI) for the year.

Tip: This means if you are self-employed and collected a subsidy to help pay for coverage, your AGI depends on the amount of health insurance premium you paid, and the amount of health insurance premium you paid depends on your AGI — a circular cycle with seemingly no end! The IRS released regulation 26 CFR 601.105 with instructions and examples of how to figure this out. It’s pretty tedious, so if in doubt, consult a tax professional. Also, some do-it-yourself tax programs can help.

Important: You can not take the Line 29 deduction if you were eligible for group coverage from your or your spouse’s employer.

3 – More-than-2% S-corp Shareholders

Since 2008, more-than-2% shareholders of an S-corp could buy individual health insurance in their own name, and then get reimbursed by the S-corp. The premiums would be included on the shareholder’s W-2, and then deducted on the first page of the 1040, resulting in a lower AGI.

However, a provision in the Affordable Care Act prohibits employers from reimbursing employees for individual health insurance premiums — and the IRS will assess a penalty for doing so.

Now what?

In February of 2015, the IRS released Notice 2015-17, and it’s good news for more-than-2% S-corp shareholders, as well other small business owners. Here’s what you need to know if you’re self-employed:

  • Assessment of the penalties for reimbursing individual health insurance premiums has been delayed until June 30, 2015 for businesses with fewer than 50 FTE. (Penalties were supposed to start 1/1/14).
  • More-than-2% shareholders are exempt from the Affordable Care Act’s market reforms at least through 2015.
  • If a shareholder and his/her spouse are both employed by the corporation, AND they are covered together on one individual health insurance policy, they can continue to have the corporation reimburse their health insurance premiums and deduct them on their 1040. (As provided in IRS Notice 2008-1)

4 – Health Savings Accounts

If you are self-employed, it may be worthwhile to consider purchasing a high deductible health plan (HDHP), with a health savings account (HSA). If you are covered under an HSA-qualified HDHP, you can make pre-tax contributions to an HSA to pay for medical expenses.

Your HSA contributions are deducted on your personal 1040 – whether or not you itemize deductions.

5 – Deduction of Medical Expenses

If you itemize your tax deductions AND you paid a lot in medical expenses for the year, you may be able to deduct some of those medical expenses — and premiums you paid for health insurance and qualified long-term care — on Schedule A of your tax return.

But, you can’t both deduct your health insurance premiums as explained above AND include those premiums in your deductible medical expenses.

So it’s a good idea to keep track of your medical expenses for the year, just in case you hit that threshold and can deduct them on your income taxes.

Tip: Only medical expenses in excess of a certain percentage of your AGI can be deducted (7.5% through 2016 for filers age 65 and up, 10% for all other filers; 10% for all filers starting in 2017).

For More Information

If you are self-insured or are considering starting your own business and want to explore your options for health insurance on the individual market, please give our office a call at 703-707-8270.

For specific tax advice, it’s always best to consult a tax professional.