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Welcome to the Life, Health, & Retirement Department. Here at Mel Himes & Associates we have many options that will help to fit the needs of your family, and employees. If you are looking for individual health insurance for you and your family, or group health insurance for you and your staff we have companies with many different options to help fit your needs. We also have the option for you to create a benefit package ranging from Group Dental, Group Life, Group Vision, and Group Disability for your employees.
Not only are we dedicated in meeting your insurance needs, but we are also here to inform and educate our clients. Insurance terminology can be confusing, and many of our clients are grateful in the time we spend with them explaining their options, and helping them understand how the health insurance industry works. Here at Mel Himes & Associates we don’t claim to know everything; however, if we don’t have an answer to one of your questions we will try with intense energy to find the answer for you. Mel Himes & Associates has been dedicated to serving our community, individuals, places of business, and churches outside of our community since 1984. Please look over our website for the information you might be looking for, and give us a call if you have any questions. We are here to serve you.
Principal requires there to be at least five employees. If the business adds a second line of coverage there only needs to be three employees.
Principal’s Vision Coverage needs ten employees.
Group Health Companies
United Health Care:
At least two full time employees
Aetna
At least two full time employees
Florida Health Care
Florida Health Care only operates in Volusia and Flagler counties. They offer many different HMO plans.
Humana
At least two full time employees
Blue Cross Blue Shield
Need five or more employees
Pacific Life
At least two full times employees
The group companies that we are affiliated with offer many different types of plans. These companies depending on your location have PPO’s available. These PPO’s have many different *deductible options, and *co-insurance options.
Most of our companies excluding Blue Cross Blue Shield only require the business to only have two full time employees to qualify for a group plan. You will need to show with tax forms and a payroll form that you have two full time employees.
An HSA is a savings account for setting aside tax-free funds to be used for non-covered medical expenses. With an HSA you may choose individual coverage or family coverage.
How do I establish an HSA?
Any insurance company or bank can be an HSA trustee or custodian. Also, any other person approved to be a trustee or custodian of IRAs or Archer MSAs is automatically approved to be the trustee or custodian of an HSA.
Who qualifies to contribute to an HSA?
An individual is eligible to establish an HSA as long as the following 3 conditions are met:
the individual is covered under a high-deductible health plan and
the individual is not covered by any other health plan that is not a high-deductible health plan and
the individual is not eligible to receive Medicare (usually has not reached age 65).
The employee or the employer may make the contributions to an HSA.
What qualifies as a high-deductible health plan?
For individual coverage a high-deductible health plan would be a plan with an annual deductible of at least $1,000, but not more than $5,000. For family coverage a high deductible health plan would be a plan with an annual deductible of at least $2,000 and not more than $10,000.
What are the contribution limits?
For individual coverage the maximum contribution would be the lesser of $2,250 or the amount of the annual deductible. For family cover the maximum would be the lesser of $4,500 or the amount of the annual deductible. In addition, for those ages 55 to 65 there is a catch-up contribution. See chart below.
Year
Add’l Catch-up Contribution
2004
$ 500
2005
$ 600
2006
$ 700
2007
$ 800
2008
$ 900
2009
$1,000
What about tax treatment?
For dual-status ministers any individual contributions would be taxable for Self-employment purposes but not taxable for federal income tax. Employer contributions would eliminate the Self-employment tax but are subject to discrimination rules. Employer contributions would need to be alike for all comparable employees
Who is eligible for a Health Savings Account?
To be eligible for a Health Savings Account, an individual must be covered by a HSA-qualified High Deductible Health Plan (HDHP) and must not be covered by other health insurance that is not an HDHP. Certain types of insurance are not considered “health insurance” (see below) and will not jeopardize your eligibility for an HSA.
Can I get an HSA even if I have other insurance that pays medical bills?
You are only allowed to have auto, dental, vision, disability and long-term care insurance at the same time as an HDHP. You may also have coverage for a specific disease or illness as long as it pays a specific dollar amount when the policy is triggered. Wellness programs offered by your employer are also permitted if they do not pay significant medical benefits.
Does the HDHP policy have to be in my name to open an HSA?
No, the policy does not have to be in your name. As long as you have coverage under the HDHP policy, you can be eligible for an HSA (assuming you meet the other eligibility requirements for contributing to an HSA). You can still be eligible for an HSA even if the policy is in your spouse’s name.
I don’t have health insurance, can I get an HSA?
You cannot establish and contribute to an HSA unless you have coverage under a HDHP.
I’m on Medicare, can I have an HSA?
You are not eligible for an HSA after you have enrolled in Medicare. If you had an HSA before you enrolled in Medicare, you can keep it. However, you cannot continue to make contributions to an HSA after you enroll in Medicare.
I am a Veteran, can I have an HSA?
If you have received any health benefits from the Veterans Administration or one of their facilities, including prescription drugs, in the last three months, you are not eligible for an HSA.
I’m active-duty military and have Tricare coverage, can I have an HSA?
At this time, Tricare does not offer an HDHP options so you are not eligible for an HSA.
My employer offers an FSA, can I have both an FSA and an HSA?
You can have both types of accounts, but only under certain circumstances. General Flexible Spending Arrangements (FSAs) will probably make you ineligible for an HSA. If your employer offers a “limited purpose” (limited to dental, vision or preventive care) or “post-deductible” (pay for medical expenses after the plan deductible is met) FSA, then you can still be eligible for an HSA.
My employer offers an HRA, can I have both an HRA and an HSA?
You can have both types of accounts, but only under certain circumstances. General Health Reimbursement Arrangements (HRAs) will probably make you ineligible for an HSA. If your employer offers a “limited purpose” (limited to dental, vision or preventive care) or “post-deductible” (pay for medical expenses after the plan deductible is met) HRA, then you can still be eligible for an HSA. If your employer contributes to an HRA that can only be used when you retire, you can still be eligible for an HSA.
My spouse has an FSA or HRA through their employer, can I have HSA?
You cannot have an HSA if your spouse’s FSA or HRA can pay for any of your medical expenses before your HDHP deductible is met.
I don’t have a job, can I have an HSA?
Yes, if you have coverage under an HDHP. You do not have to have earned income from employment – in other words, the money can be from your own personal savings, income from dividends, unemployment or welfare benefits, etc.
Does my income affect whether I can have an HSA?
There are no income limits that affect HSA eligibility. However, if you do not file a federal income tax return, you may not receive all the tax benefits HSAs offer.
Can I start an HSA for my child?
No, you cannot establish separate accounts for your dependent children, including children who can legally be claimed as a dependent on your tax return.
I’m a single parent with HDHP coverage but have child/relative that can be claimed as a dependent for tax purposes, and this dependent also has non-HDHP coverage. Am I still eligible for an HSA?
Yes, you are still eligible for an HSA. Your dependent’s non-HDHP coverage does not affect your eligibility, even if they are covered by your HDHP.
What is the difference between PPO and HMO coverage?
PPO: Preferred Provider Organization is a network of physicians and hospitals that have discounted their rates to members through a contract. The networks are usually very large, and the members are able to seek care from any physician or provider within the network, including specialist without a referral. PPO plans usually have deductibles, co-pays, prescription benefits, and co-insurance.
HMO: Health Maintenance Organization provides: preventive care coverage and low-out-of-pocket costs. There is usually no coverage for care from doctors or hospitals outside your HMO plan, unless you have an emergency, or a Point of Service option. HMO plans usually offer comprehensive benefits, affordable premiums with no deductibles, and minimal cost sharing. You will select a Primary Care Physician that will oversee all of your care. If you want to see a specialist you will have to get a referral from your Primary Care Physician.
The degree of benefits and the amount of freedom to choose among physicians and hospitals are usually the two main differences.
Life & Health Department
