The acronym HSA is
being tossed around quite a bit nowadays especially since the tax
advantages of owning an HSA and a corresponding qualified HDHP
(High Deductible Health Plan) have been significantly increased
under the Bush administration. Effective December 20, 2006 President
George W. Bush signed the Health Opportunity Patient Empowerment Act
of 2006, enhancing Americans' access to tax-advantaged health care
savings. The law, part of the Tax Relief and Health Care Act of
2006, provides new opportunities for health savings account (HSA)
participants' to build their funds. To read about the new
adjustments in HSA law for the year 2007 & forward please
Click here:
http://www.treas.gov/press/releases/hp209.htm
For the 2009 IRS H.S.A. COLA (Cost of Living Adjustments) please
click here:
http://www.treasury.gov/press/releases/hp975.htm
HSA stands for
Health Savings Account. Health Savings Accounts are a unique way to
attractively manage your health insurance costs. They were
originally named MSA's or Medical Savings Accounts designed by
Senator Bill Archer (R) of Texas. Bill's project was to find a way
to reduce the cost of health insurance for the self employed without
sacrificing quality coverage for a major medical illness. Bill's
brilliant idea was to eliminate the parts of a traditional health
insurance plan that cost the consumer the most money. These
expensive benefits include outpatient doctor "co pays" and
outpatient prescription "co pays". Bill approached Congress with a
proposal that stated in essence that if you remove those two
features and keep the major medical coverage in place you could
conceivably cut the cost of your health insurance
premium considerably. He was absolutely right!
To illustrate how
Bill's idea works in the real world. We will use a real world
example. Tony & his wife
are currently paying $1,134 a month for
Cobra continuation coverage from a previous group plan. In
comparison, the monthly premium for an HSA qualified HDHP
(High Deductible Health Plan) which covers each insured family
member up to $5 million dollars is less than half of the
premium that they are paying now ($481.64 monthly to be exact). This
is a yearly savings of $7,828.32 or a monthly savings of $652.36.
This is a significant difference.
However the insured has to give up all of their outpatient co pays.
Is this worth it? This was the question posed to Senator Bill Archer
(R) when he approached Congress back in the late 1990's. His answer
to Congress was quite simply "make it worth it".
In other words, he
asked Congress to make it worth it to the insured. Their response
was two fold. And it is these two primary reasons that make HSA's
a "no-brainer" for every self employed prospective insured and for
their corresponding employees. The first thing Congress did was to
state that if a policy holder buys a major medical health insurance
policy (HDHP) with a yearly family deductible between
$2,200 per family (not per person) or as high as $5,800 per family
we will call that an HSA qualified health insurance plan (HDHP)
They further said that
in order to make giving up outpatient co pays more attractive to the
insured we will allow anyone who has an HSA qualified health
insurance plan (HDHP) the option to open a tax favored HSA
(Health Savings Account) with their local bank or financial
brokerage house. Since the insured is saving a considerable amount
of money each month by giving up their out patient co pays, we will
allow them to take that extra premium that they would have normally
given the insurance company for the "privilege" of a co pay and put
it into a 100% tax deductible account that will grow tax deferred at
an interest rate adjusted by the Fed.
In addition to
depositing the amount you save in insurance premiums, you may
also deposit in your HSA an amount equal what the IRS allows
for that given year. For the year 2009 the maximum contribution a
family can make to their HSA account is $5,950 In addition, any
family member who is 55 years of age or older can deposit an
additional $1,000 annually (more on the age 55 allowance below). This
means that the total amount that Tony and his wife (in our example
above) can deposit per calendar year is $6,950 and they can take a
100% tax deduction for that contribution similar to an IRA.
Furthermore, if they do
incur medical expenses that arise throughout the course of the year
that are subject to the deductible (i.e. prescriptions, doctor's
office visit charges, etc.) the IRS will allow them to pull
out that money that they put into their optional tax deductible, tax
deferred HSA savings account to pay for those expenses. When they
use their HSA money to pay for those expenses the IRS will
allow them to write those expenses off at a 100% tax deduction. The
list that the IRS allows them to spend their HSA money on is
very liberal and includes things like dental, orthodontics,
eyeglasses, radiokeratonomy (Lasik
corrective eye surgery), alternative medicines etc. Click the
hyperlink to see the list of allowable expenses and
disallowed expenses on the HSA section of the IRS web site
here:
http://www.irs.gov/publications/p502/index.html
Arguably the most
attractive tax advantage to owning an HSA is the fact that the
money left over in the HSA account
that was not used on medical expenses at the end of the
year is "rolled over" into the next year and awarded a higher rate
of tax deferred interest. The insured also has the option to roll
those unused funds into no load mutual funds, thereby building an
extra tax deferred retirement account with money they would have
normally given to the insurance company each and every year
whether or not they had any claims that
year!
If you are an employer
and are considering HSA qualified plans for your employees
consider this. An individual's employer can make contributions that
are not taxed to either the employer or the employee. The combined
income and payroll tax deductibility leads to discounts for health
insurance of over 40 percent in some cases relative to other forms
of insurance. For more details about the advantages to the employer
please click
http://www.treas.gov/offices/public-affairs/hsa/faq_employer-participation.shtml
Beginning in the year
2007 one company - American Community Mutual (www.american-community.com)
introduced a truly unique HSA qualified HDHP. It is called the
"Next Generation" HSA (see the first brochure pictured below).
This HSA qualified HDHP has three unique features that make
it superior in design over all other individual HSA qualified HDHP's on the market today.
The first of the three
benefits is called the "embedded deductible feature".
As aforementioned, the typical HSA qualified HDHP does not
start paying anything until the entire family deductible has been
satisfied. This means that whether one person gets sick or multiple
family members get sick the insurance company will not pay anything
until the entire family deductible has been satisfied. If your plan
has a $5,450 family deductible this can feel quite unfair if only
one member of your family gets sick.
In stark contrast, the
American Community Mutual "Next Generation" HSA qualified HDHP
eliminates this problem by offering the "embedded deductible
feature." This benefit (for a few dollars more per month)
requires the insurance company to start paying after only one family
member has satisfied their individual deductible (half
of the family deductible). This significantly reduces the out of
pocket expense to the family if only one person gets sick.
This is a valuable benefit since statistically speaking only one
family member (if any) will incur medical claims in any given year.
The second and more valuable benefit is the
$10,000 "stop loss" number that is included when
the 80% coinsurance option is chosen. According to IRS Doc
5305-B (http://www.hsacenter.com/2008-HSA-Contribution-Limits.php)
the new (2009) adjusted maximum annual out of pocket expense
that a family will pay that owns an HSA qualified HDHP
with the 80% coinsurance option is $11,600
regardless of the deductible chosen.
Although this is the maximum
allowable
out of pocket expense that a family will
experience if they choose the 80% option with any other
HSA qualified HDHP American Community Mutual
decided to reduce the maximum out of
pocket a family can experience per year on their "Next
Generation" plan to only $2,000 in addition to the
chosen deductible. See page two line 6 of the Next
Generation HSA qualified HDHP brochure below.
This quite simply means
that after a family has satisfied their chosen calendar year family
deductible the insurance company will pay 80% ($8,000) and
the family will pay 20% ($2,000) of the first $10,000 in medical
bills that are incurred. Afterwards the insurance company will pay
100%.
This first $10,000 is known as the "stop
loss number".
The Next Generation plan is the only HSA
qualified plan on the market today that offers this type of
co-insurance arrangement and it is much
better than the typical HSA qualified plan that offers an 80%
option because it results in significant out of pocket risk
reductions to a family.
To
illustrate this further, we will use the $5,450 family deductible
for example. With the typical HSA qualified plan, if an 80%
option is chosen then this would subject the family to an out of
pocket expense of $11,600. In stark contrast, the Next Generation
plan would subject the family to only $7,450 before American
Community Mutual would pay 100% of the family's medical bills for
the rest of the calendar year. This is $4,150 less out of pocket
than any other HSA qualified HDHP on the market today and the
Next Generation plan is priced the same or less than most plans!
The third unique
benefit is the unlimited "Accident Medical Expense"
benefit.
This benefit will waive the entire
deductible if an accidental injury occurs and pay for all the
charges related to the accident at either 100% or 80% depending on
the coinsurance you chose. This benefit will kick in each and every
time an injury occurs to any family member.
Please
“Contact Us”
with questions about HSA qualified HDHP's. If you have a
C.P.A. or tax advisor please feel free to ask he or she about the
advantages of owning an HSA as well. Five of the best priced HSA Qualified HDHP's available on the market today are
highlighted below.