leevena

The $3,000 max oop quoted you is ok for both the individual and the family because it is below the $5,500 for individual and $11,000 for family. Since it has a lower oop, it will be more expensive. As for your 2nd question, pay the premium on a tax free basis, I am not an accountant, nor did I sleep in a Holiday Inn Express last night, but I would venture a guess as no. You should consult your tax advisor. My guess is that you are asking this as an individual, so the answer is 99% no, short of 7.5 of agi. But there are some exceptions, such as if you are collecting unemployment (you can use your HSA funds to pay the premium) of if you are self-employed. Good luck

Plans that qualify for HSA's usually have some type of marketing material that identifies them as such. For 2007 the deductibles must be at least $1,100 per individual and $2,200 for families. Max out of pockets must be $5,500 individual, $11,000 family. Keep in mind that some plans have corridor deductibles and some do not, which may or may not be an issue for you. Corridor is for HSA plans with 2 or more members. If you do not have a corridor deductible plan, you may have more oop than you expect. For example, using the 2007 numbers above, and a non-corridor deductible, let's say you are the only person (out of 4) who incurs a claim. The claim is for $15,000. Your oop would be $11,000. The contracts were drawn up on the old tax laws that required it to be this way. Over the past 2 or so years, Corridor deductibles (other names are used) allowed for the this situation to be changed. Good luck.

Could you help me understand what you meant by "I am a union musician and recently took a job conducting a musical in China, but not under the jurisdiction of my union." If you took the job outside of the union, why would you expect the union to offer coverage through their plan?

Sorry for the delay. I don't see any reason why this 90-day plan would not be subject to COBRA. I know it sounds strange, but let's look at it from a different perspective. If the same employee was in a regular health plan and left on the 89th day, they would be eligible for COBRA, assuming all other requirements were met. Only reason I asked about the union issue was due to the "appears" comment in your question.

The 90-day training period sounds like a union type of program. Is this part of a barganing plan? Also, you mention "It appears" in your description. Why do you say "appears", what does the plan documents say about this issue?

Nini, you can also have a maximum amount of dollars contributed. You could state that the total amount available to the employee is equal to the deductible.

I have been through two sales. What type of information are you asking for? I assume that legal issues are covered, since you mentioned "competent legal counsel." There is much that can be considered, so can you be a little more specific? For example, are you talking about evaluation, administrative issues, how to structure the financial deal, etc. Thanks. Lee

John...could you add some additional information? If I remember correctly, you are in SoCal with me. So is this group in CA? Is it small or large group? What information is the carrier asking for? Thanks. Lee

I have had two teeth that required root canal and caps. The original work was done some 35 years ago. Since then I needed to have the caps replaced (20 years ago) because of damage. That scenario was considered medically necessary. This scenario sounds more like cosmetic, unless there is proof to the contrary.

HI. It would help if you could tell us where this client is located.

I am not a WC person, so to answer your first question, "Can NY employer terminate someone on WC", I do not know the answer. As for the COBRA part of the question, this is simple. A loss of the group health plan at work, which termination of employement should cause, would allow someone to take COBRA.

Hi John. I had some time to think this through and believe I have an answer. Your last posting took me some time to understand. First, the original posting asked if an employer with an on-site medical provider could offer an HSA. The answer to that is yes, they can. Just because the employer offers on-site medical provider does not make them ineligible to offer an HSA. The requirements around the first dollar coverage is on the employee, not the employer. Secondly, I agree with MJB, but could not explain it as clear as he/she did. This is how I understood the regs, and since I could not find anything official from the govt regarding the use of on-site providers, I would be open to any help you can provide. Thanks. Lee

I don't disagree with your observation about consumerism, but as I see the law, if the on-site care, or any provider care is not submitted to the insurance company, it would not disqualify someone from taking a HSA. PS, by insurance, I am including a self-funded plan also.

Jacmo, could you please be a little more specific with your answer, I could not find the reference you made. It seems to me that the key is the insurance function, not the provision of healthcare. The HSA regulations all refer to the use of the insurance, not the receipt of health care. If the on-site medical provider provides health care services, and the expenses are not submitted to the insurance plan, why wouldn't the employee qualify for HSA? Wouldn't the on-site medical provider be considered in the same light as any other provider?

I agree, but without any reply from Marcy, we will never know.

All I ever said was there might be a viable legal argument. I've been in private practice and believe me, if there is an argument that can be made it will be made (wether its winner or not) If you actually read my posts, you'd see I think the argument is weak. Are you confusing me with someone else? Oops! A million apologies Steelerfan. I thought you were the one posting the question and have now just realized my mistake.

If I could add my 2 cents and hopefully end this. Steelerfan...you are out of luck. No matter what angle you take, there is no way to compel the employer to get you group health insurance. The best you may be able to do is to have them give you some amount of money that would have been given to you for the insurance, but I doubt if you could even do that. Sorry to be so blunt, but based on what you have told us, and the replies I have seen, your out of luck.

Amazing. Don, do you sell benefits in Texas?

Interesting. Let me ask you another question. A small employer offers hospital indemnity plans to the employees (AFLAC, Colonial, etc) and as long as the plans are run through a 125 plan, they (hospital indemnity plans) are considered group? If this is so, does the state laws for small group now apply to these hospital indemnity plans? Thanks. Lee

Don, thanks for the input. Not being from TX, and not knowing what type of AFLAC plans were in place, I cannot say with certainity what the answer to the post was. But I do have a question for you. Let's assume the AFLAC plans are the hospital reimbursement plans I believe they are (certain dollar amount paid per day in the hospital). How would these become a group plan? Thanks. Lee

I am sorry if my earlier posting was not clear. AFLAC policies, to my knowledge, are individual policies, not group. Only group plans are subject to COBRA. So if the AFLAC plans are individual there is no COBRA responsibility. When an employee terminates employement at an employer who offers AFLAC policies (which are individual) AFLAC will send the employee a notice allowing them to self-pay from home.

I would like to suggest that you find another provider that does offer LFSA's. I applaud you for trying to make it right, and it sounds like you care. But you can get into problems quickly if you try to do this yourself without any knowledge or expertise. Also, if you have a broker/consultant who placed this business, I would call them in and find out why they put you into such a situation. The issue of a HSA and LFSA has been known for quite time and should have been known.

COBRA applies to group medical plans. I am not knowledgeable of all of AFLAC plans, but I do believe they are individual limited plans, which would not be subject to COBRA. Since your question mentioned a "wrap plan" being offered, it should be noted that it does not matter. Just because an employer packages together a variety of plans, it does not make it a "group" type of benefit.

Once the participant is eligible for Medicare, don't they have to stop making/receiving HSA contributions ? If someone is enrolled in Medicare they cannot open a HSA account. If you are elgible, but not enrolled, you can open a HSA and you can make contributions. Thanks. So the old practice of enrolling in Part A even if you have employer provided coverage does not work if your employer coverage is an HDHP/HSA plan. Thats true, once enrolled in Part A, the enrollee must stop contributions to the HSA.

Once the participant is eligible for Medicare, don't they have to stop making/receiving HSA contributions ? If someone is enrolled in Medicare they cannot open a HSA account. If you are elgible, but not enrolled, you can open a HSA and you can make contributions.