This weeks post is meant to be sort of a deep breath; or reset on where we’re at with respect to the Affordable Care Act (ACA). Clearly much is being said and written about the law, and in particular, its implementation. Those of us who are charged with explaining and implementing the various requirements of the law don’t have the luxury of questioning its content, complaining about its impact, or bemoaning its “unintended consequences”. Its full speed ahead with implementation and compliance, unless or until Congress, HHS, DOL, CMS, IRS, or someone in a position of authority tells us to STOP; and that is highly unlikely.
As medical costs and insurance premiums continue to escalate, and health care reform poses new and additional cost pressures, employers are seeking innovative ways to reduce the costs associated with group insurance programs. The solution for many employers has been the implementation of some form of self-funding.
SELF-FUNDING ALLOWS THE EMPLOYER TO ASSUME ONLY AS MUCH RISK OR EXPOSURE AS THE COMPANY CAN WITHSTAND, WITHOUT CAUSING FINANCIAL DISTRESS.
Health insurance is comprised of two (2) separate and distinct components of exposure: predictable claims and unpredictable claims.
Last weeks post provided an overview of Health Savings Accounts or HSAs. This weeks post is meant to provide an in depth understanding of the HSAs 1st cousin – the Health Reimbursement Arrangement or HRA.
In June of 2002 the IRS issued an important revenue ruling which created the HRA. The ruling created tremendous flexibility for the use of employer funded dollars set aside to pay for specific health care items. As this week's blog title suggests, HRAs are similar to HSAs, but are actually much more similar to Flexible Spending Accounts (FSAs). However, HRAs have distinct advantages for both employer and employee, over FSAs and HSAs.
Last weeks blog post recognized (and celebrated!) the upcoming 10th birthday of Health Savings Accounts (HSAs) in 2014. Recognizing that some readers don't necessarily understand all the “ins and out;s” of HSAs, this weeks post offers an in depth overview, and addresses many of the key requirements, limitations, benefits, etc. Once again, HAPPY BIRTHDAY HSAs!
A Health Savings Account (HSA) is a tax-favored savings account used to pay qualified medical expenses (See IRS Publication 502; click – http://www.irs.gov/pub/irs-pdf/p502.pdf ), in conjunction with a QUALIFIED HIGH DEDUCTIBLE HEALTH PLAN. Some have described them as a “medical IRA”.
The attractiveness and establishment of HSAs continues to grow, as HSAs approach their 10th birthday. For many, it has long since been forgotten how they came to be, save for those “consumer driven health care geeks like yours truly. While many realize that HSAs or Health Savings Accounts, replaced MSAs (Medical Savings Accounts) starting in January of 2004, how they came to be is rather interesting, if not disjointed. Actually, HSAs were created by the very law that gave us the largest expansion of Medicare since its origin in 1965 – the Medicare Prescription Drug Improvement and Modernization Act of 2003 (later referred to as the MMA), signed by then President George W. Bush on December 8, 2003.