Are You an HSA Fanatic Also?

[yorkriver1]

2 part comment, I also have a "how to" question about relatively high income clients deciding on HSA and then what deductible. See below.
But first, what are the different deductibles called:

October 3, 2014

Are there any QHPlans from Aetna or Humana that have a Single Shared Family deductible? If no one knows, I'll go dig through their SOB's. Have some families being termed on 12/31 that don't like the idea of giving up this shared deductible and paying more for the so-called "richer benefit" 2014/2015 plans. I think it's officially called a "composite" deductible?
-Allen

Allen, offhand I don't know, and thanks for reminder to check Aetna & Humana, but here's the official deductible definitions:
1. Embedded deductible: The one you describe as a "richer" benefit. One family member's bills meet the individual deductible and the after deductible benefits are triggered.
2. Non-embedded deductible: the whole family shares one larger deductible, usually 2X the individual deductible. No after deductible benefits until one or more family members expenses in total exceed the "family" deductible.
We talked about this a lot at local FMO meetings last fall. One local carrier notoriously has almost all plans with non-embedded deductible. Apples and oranges when comparing plans. For lower income folks this could be a big deal.

Higher income clients, other factors, especially if looking for the "triple tax" benefit of HSA's.

I have some clients right now with good strong incomes. No one ever feels "rich", though, I don't think. Some will still worry about high deductibles.

There may be some kind of simple calculator to help them decide. Yagents, do you do this?
I would think just look at the monthly savings by switching to an HDHP, then even it they exceed the allowable HSA contribution, which they do for one of my clients, save the money into the HSA and the balance into "emergency funds" in case of claims.
Unless an enormous claim happens, and is ongoing for multi-years, it would seem that many can come out ahead in the long run, even at older ages.

 

[Yagents]

I don't understand the h.s.a question

 

[taterpeeler]

I don't understand the h.s.a question

go play poker or something.... what kinda question is that

 

[Ann H]

If Yagents doesn't understand it, I have no chance. He's the king of HSAs.

 

[yorkriver1]

Well, that's embarrassing. I should have my writer kid edit my posts for clarity. Thanks for responding anyway.

Here's what kind of info I was looking for:
Is an HSA Right for Me? - HSA Bank
HSAcenter - Health Savings Accounts - Health Care and Savings for You and Your Family
The 2nd website is sponsored by Golden Rule Insurance.

I was also trying to ask if anyone has a simple way they frame HSA benefits. Example: There is a way one of the agents on the Senior Forum explains the choice between Plan F and Plan G to clients that moves them to see G is a no brainer, in one sentence. I just used it last week. Maybe HSA's aren't always a no brainer, but in some situations, worth the risk.

 

[FLM2]

I spent about 2 years being a full time HSA proponent and putting as many clients as possible into HSA eligible plans.

I realized after the first couple of years, however, when doing renewals, that most of my clients failed to fund their plans to any extent and were somewhat unhappy with their choice.

Since then I have asked clients if copays were important to them-if the answer is Yes I put them into a traditional plan, if not I discuss HSA's and make sure that they understand how to use the plan to the best advantage.

 

[somarco]

Assurant, Cigna and possibly GR/UHC have embedded deductibles. BX and Humana have aggregate deductibles.

I rarely sell HSA plans any more unless someone is looking for maximum catastrophic coverage. When commissions were cut I no longer had the time to offer more than a cursory explanation of the HSA qualified plan.

The new Obamacare plan designs where copay's and Rx deductible accumulates toward the MOOP make the HSA design almost moot unless someone is looking for the tax favored HSA contribution.

Embedded and Aggregate Deductibles Explained | ComedyCE.com

 

[Ann H]

HSAs take a long time to explain. Subsidies take a long time to explain, pre-qualify, and apply for (unless you're TaterPeeler).

Usually those 2 clients are in opposite economic conditions.

So, I don't try to explain an HSA to a family with a stressed budget, and kids that go to the doctor a lot. If the family has more money, is in a professional class (Doctor, Dentist, Accountant, Financial Planner, Engineering, etc.) I often take the time to explain it. If the family uses alternative medicine and naturopathic treatments, they often understand it and will use the tax-free benefits for medical expenses that qualify with the IRS, but are not covered under the insurance.

After "profiling" them to see if it's worth our time to explain an HSA, I start with a sentence like this:

Are you interested in "catastrophic only" coverage with a high deductible, where you drive the premium down, put aside some money in a bank account, and pay the smaller expenses yourself?

If they say, "Huh? Say what?", or "what is a deductible", then I move back to copay plans. If they enthusiastically agree, I move forward, and say, "How about if the money you contribute to that bank account is tax-deductible?"

Those are my only simplified processes. If you find a process that simplifies it from there, be sure to share it with me!

By the way, I refer people to hsabank and hsacenter for their research too! I didn't know one was owned by GR, though!

What is the one-sentence explanation for Plan F vs Plan G?

 

[somarco]

What is the one-sentence explanation for Plan F vs Plan G?

Plan F premium is $200; plan G is $150. Plan F pays your $147 Part B deductible; plan G doesn't. If you had plan G and wanted plan F, would you be willing to pay the carrier an extra $50/mo ......... $600 a year to pay your $147 deductible for you?


Ok, that is more than one sentence and the differential in F vs G is rarely $50 unless you are comparing a high priced F (such as BX) with a competitively priced G. I have had some situations where the differential is $70/mo.

 

[WCMason]

Plan F premium is $200; plan G is $150. Plan F pays your $147 Part B deductible; plan G doesn't. If you had plan G and wanted plan F, would you be willing to pay the carrier an extra $50/mo ......... $600 a year to pay your $147 deductible for you? Ok, that is more than one sentence and the differential in F vs G is rarely $50 unless you are comparing a high priced F (such as BX) with a competitively priced G. I have had some situations where the differential is $70/mo.

My description is similar to this one. You can pay your doctor the first $147 at the beginning of the year and have 100% coverage for the rest of the year, or you can pay your insurance company an extra $500-600 over the course of year, let them pay the $147 to your doctor for you and they keep the change.