2020 Health Insurance Open Enrollment: The Facts

Hello Freelancer Friend, the enrollment period for health insurance is here, now through mid-December (in most states). Because health insurance is a vital topic, I decided to defer to an expert and pass along info compiled by Les Masterson for Insure.com. For more detailed information, please visit the site. https://www.insure.com/health-insurance/open-enrollment-for-individual-health-insurance.html

We have 6 weeks to make a decision on individual/ family health insurance or the Affordable Care Act (ACA) exchanges plan (in most states). We can sign up for health insurance on our state’s health insurance exchange or individual marketplace only during the annual open enrollment period, unless one has a “qualifying life event.” Those events include getting married or having a baby.

If buying health insurance on your own, there are several options for purchasing a policy:

  • Your state’s health insurance marketplace — see healthcare.gov https://www.healthcare.gov
  • Directly from a health insurance company
  • Sites like Insure.com that offers insurance quotes from multiple carriers
  • A health insurance agent
Open enrollment for 2020 individual and family health insurance plans
Begins Ends
November 1, 2019 December 15, 2019

The open enrollment period differs in these states: 

  • CA – Oct. 15, 2019 to Jan. 15, 2020
  • CO – Nov. 1, 2019 to Jan. 15, 2020
  • DC – Nov. 1 , 2019 to Jan. 31, 2020
  • MA – Nov. 1, 2019 to Jan. 23, 2020
  • MN – Nov. 1, 2019 to Dec. 23, 2019
  • NY – Nov. 1, 2019 to Jan. 31, 2020
  • RI – Nov. 1, 2019 to Dec. 23, 2019

If you buy after December 15 in the states that are extending the enrollment period, confirm when the coverage will start. Most states require you to obtain your plan by December 15 for a January 1 start date. If you buy late, your plan might not start until February 1 or March 1.

Those who qualify for Medicaid or the Children’s Health Insurance Program (CHIP) can enroll at any time, because they are state/ federal programs created for people with limited incomes or disabilities.

Marketplace Open Enrollment is for health insurance only

The Open Enrollment period does not apply to life insurance, long-term care insurance, or Medicare. The fall open enrollment period for Medicare is October 15 to December 7, 2019. If you qualify for employer-sponsored health insurance, you will want to buy health insurance through your employer. Individual insurance usually costs more than employer-sponsored plans.

That said, if you qualify for subsidies based on your income, you may find an inexpensive plan on the Affordable Care Act (ACA) Exchange. Many states offer financial help for people with income below 400% of the federal poverty limit. You can find out more about these subsidies at insure.com. 

Remember to enroll!

It is not possible to sign up for coverage if you miss open enrollment, unless one qualifies for one of the special enrollment periods. The following events may grant entrance into a special enrollment period:

  • Divorce
  • Marriage
  • Birth or adoption of a child
  • Death of a spouse or partner that leaves you without coverage
  • Your spouse or partner, who has you covered, loses his/her job and health insurance
  • You lose your job and with it your health insurance
  • Your hours are cut making you ineligible for your employer’s health insurance plan
  • You are in an HMO and move outside its coverage area

Update your plan during Open Enrollment only

What you can do during open enrollment:

  • Renew your current individual or family health insurance plan
  • Choose a new health insurance plan through the marketplace in your state or through private insurance

If currently enrolled in a marketplace health insurance plan, it will automatically renew. However, the plan may make changes to its provider network, co-pays, co-insurance and drug coverage. Your plan must send you a notice of any changes it will make for 2020.

Read the health insurance update notice to learn what it means for youConfirm that your doctors and preferred hospital are still in your network. Be aware that you may be able to use out-of-network doctors and hospitals if you’re willing to pay more. That’s an option in Preferred Provider Organization (PPO) plans. In some cases, such as Health Maintenance Organization (HMO) plans, you’re covered if you go out of network. That means you’ll have to pick up the costs. 

Prescription drug coverage also could change. The plan may no longer cover the drugs you take to manage your chronic conditions. Confirm your plan’s drug benefits for 2020 before you allow it to renew. You may need to find a different plan for your needs and now’s the time to do it. Health plans must provide an online link to the list of drugs they will cover, known as formularies.

ACA Premiums set to decrease for some plans

The premium you pay depends on several factors, including income, your state and the plan type. The Centers for Medicare and Medicaid Services said the average ACA federal exchange plans premium costs dropped for the first time this year. However, because not all plans will be cheaper, it’s still important to shop around to find the right plan for you. 

Choose a level of health plan coverage

Plans in the health insurance marketplace are divided into 4 categories:

  • Bronze – highest out-of-pocket expenses for services (lower premiums)
  • Silver
  • Gold
  • Platinum – least out-of-pocket expenses for services (higher premiums)

Each level indicates how much cost-sharing each requires. Cost-sharing includes deductibles, co-pays and co-insurance that we must pay until the annual out-of-pocket maximum limit is reached.

Bronze plans have the highest deductibles and other cost-sharing expenses. That means more out-of-pocket costs when one uses healthcare services. Silver plans have lower cost-sharing than Bronze and Gold plans even lower than Silver. Platinum plans have the lowest deductibles and co-pays. Once one signs up for a level of coverage, changes are not allowed during that year. If you choose a Bronze plan and discover you need surgery, you cannot change to a plan with a lower deductible.

Generally, the more you pay in premiums the lower your cost-sharing.

In a 2019 report, eHealth estimated that 2-person families paid more than $1,000 in premiums monthly for the first time in the individual market in 2019. Premiums for individual coverage for a single person was $448 in 2019. 

The average premiums for individual coverage according to eHealth:

  • Bronze — $440
  • Silver — $481
  • Gold — $596
  • Platinum — $706

The average premiums for family coverage according to ehealth:

  • Bronze — $1,080
  • Silver — $1,179
  • Gold — $1.426
  • Platinum — $1,460

The health plans, no matter the level, must provide some coverage for at least 10 essential benefits. They are:

  • Outpatient care including chronic disease management
  • Emergency care
  • Hospitalization
  • Pregnancy and newborn care
  • Mental health and substance abuse services
  • Prescription drugs
  • Rehabilitation services and devices
  • Lab tests
  • Preventive and wellness services
  • Dental and vision care for children

The level of coverage for these services can vary. All the plans in the marketplace must provide consumers with a brief, understandable description of what they cover and how their plan works. The Summary of Benefits and Coverage (SBC) must be posted on the plan’s website. Check out the SBCs for the different plans you are considering. This is a good way to compare plans and benefits.

Not all states require health insurance

The ACA once required nearly all Americans to have health insurance. However, Congress decided in 2017 to eliminate the individual mandate penalty. Although the individual mandate is technically still on the books, the tax penalty is not. Still, a growing number of states have implemented their own individual mandate. Here are states that have an individual mandate in 2020:

  • California
  • District of Columbia
  • Massachusetts
  • New Jersey 
  • Rhode Island
  • Vermont

I hope you found this information helpful.

Thanks for reading,

Kim

Image: Thomas Eakins (Philadelphia 1844-1916) The Agnew Clinic, 1899 courtesy of The Philadelphia Museum of Art. The painting was commissioned to honor the anatomist and surgeon David Hayes Agnew, on his retirement from teaching at the University of Pennsylvania.

Dates to Keep You Straight

Every year, Freelancers have an important list of dates to remember and act on, primarily those related to tax filings, retirement account management and health insurance plan enrollment. To help you stay organized, I’ve compiled this date planner that brings together all deadlines into one document that you can bookmark, copy into your calendar or even print out and post on your refrigerator.

TAXES

January 31, 2019: 1099-MISC due to contractors
Those who hired Freelancers (independent contractors) to whom they paid $600 or more in the previous year must send 1099-MISC forms by January 31, 2019.  If a client paid you less than $600, then you probably will not be mailed a 1099-MISC, although the IRS nevertheless requires you to report all income.

Do keep scrupulous records of who owes you a 1099-MISC so that you can accurately report your income on your tax return.  Your clients will also send 1099-MISC data re: you to the IRS and any differences between your numbers and the clients’ could trigger an audit.  If you haven’t received a 1099-MISC from a client by January 31, contact your client ASAP and request a re-send.

If you used any subcontractors to whom you paid at least $600 last year, you must likewise send them a 1099-MISC by January 31.

April 15, 2019: Individual income tax filing deadline
You have until April 15, 2019 to file your Form 1040 individual income tax return for 2018. Be aware that April 15 isn’t the deadline to pay your taxes — tax payments for Freelancers are due on a quarterly schedule (see 2019 quarterly estimated tax deadlines, below). If you wait until the tax filing deadline to pay your taxes, the IRS may charge you penalties and interest on top of the tax you owe.

If you’re still waiting for information, or you’re too busy to file a return by April 15, you may apply for a six-month extension that gives you until October 15, 2019 to file. The extension application needs to be filed by April 15, 2019. Remember again that the extension is for filing, not paying your taxes.  Payments are still due on the quarterly schedule no matter when you file and penalties and interest can accumulate if you wait to pay.

QUARTERLY TAX FILING DATES

The IRS requires business owners to pay income taxes on a quarterly schedule. This may seem like a hassle, but it’s easier to pay in four installments than to try and come up with a whole year’s worth of income taxes all at once.

Here are the 2019 deadlines for quarterly estimated tax payments. Note that the four quarters are not of equal lengths: the 2nd Quarter covers only April and May, while the 4th Quarter covers the last four months of the year.

DEADLINE                                                         PERIOD COVERED

April 15, 2019                                                     January 1 – March 31, 2019

June 17, 2019                                                      April 1 – May 31, 2019

September 16, 2019                                           June 1 – August 31, 2019

January 15, 2020                                                September 1 – December 31, 2019

 

RETIREMENT ACCOUNTS

April 15, 2019: Deadline to set up and contribute to an IRA for 2018
Even if you made no contributions to your retirement savings account in 2018, you can still make a 2018 contribution to an IRA up until April 15, 2019. This includes traditional, Roth and SEP IRAs. You can also make 2019 contributions to these plans from now up until next year’s tax filing deadline of April 15, 2020.

December 31, 2019: Deadline to set up an individual 401(K) 
An individual 401(K) is another type of plan that Freelancers can use to save for retirement. One important detail is that an individual 401(K) must be established by December 31st of the first plan year (as opposed to an IRA, which can be opened up until April 15 of the following year). That means it’s too late to set up an individual 401(K) for 2018, but you may set one up for 2019.

Contribution limits 2019 update:

Solo 401(K)                                                                                                                            Employer: 20% of net self-employment income                                                            Employee: 100 % of earned income up to $19,000 (for age 50 years +, up to $25,000)   Total combined contribution: $56,000

Traditional or Roth 401(K)                                                                                                     $6000 annually $7000 if age 50 years +

SEP IRA                                                                                                                                               The lesser of 20% of net self-employment income, or $56,000 annually

 

HEALTH INSURANCE

The open enrollment dates to purchase health insurance for 2020 on the Affordable Care Act exchange will be November 1 – December 15, 2019.  Open enrollment for 2020 through the national health insurance exchange will also be run from November 1 – December 15, 2019.

 

Thanks for reading,

Kim

 

 

Open Enrollment: Freelancer’s Health Insurance

Open enrollment for 2015 Affordable Care Act health insurance began on November 15.  Individuals who earn maximum $46, 680 and families of four (couples with two dependent children) that generate a maximum total income of $95, 400 are potentially eligible for a tax credit that will help defray the cost of insurance premiums. In tax year 2015,  the penalty for not carrying insurance will rise from $95 to $325,  or 2% of household income,  whichever is greater.

Business entities of 50 or fewer employees and located in Delaware,  Illinois,  Missouri,  New Jersey or Ohio can set up a Small Business Health Options Program (SHOP) account by completing an application that determines eligibility and if accepted,  investigate plans and prices and contract with an insurance company.  A 2014 University of Chicago study found that 2013 insurance prices offered through SHOP exchanges in 26 states were on average 7 % lower (about $220) than comparable insurance bought outside of the SHOP exchanges marketplace.

Freelancers and small business owners who did not buy health insurance in 2014 will need information to guide decision-making about the upcoming year.  The Freelancers Union  http://freelancersunion.org,  a New York City-based nonprofit organization that advocates for the interests of self-employed workers,   plans to help its 233,000 members purchase medical and/or dental insurance in all 50 states.

Freelance Union members also have access to retirement plans and disability,  liability and life insurance.  Additionally,  the Union operates two health and wellness centers in New York City,  where members can obtain primary care services at no charge and also participate in classes such as tai chi and yoga.  Membership in the Freelancers Union is free.

I went to the Union website and found that medical insurance is not offered in my state,  but dental coverage is available for $60.77 /month  ($112.32 /married couple and $164.89 /family).  The twice-yearly cleanings are 100% covered as are annual x-rays.  Services such as crowns,  fillings and anesthesia are covered at 80% after a $50 deductible and root canals,  endodontic and periodontal services are covered only after a 12 month waiting period and then at 50 % after the $50 deductible.  The yearly maximum benefit is $1250.

An individual pays about $730 for the year.  I might spend that amount in a year paying out-of-pocket for two cleanings with bi-annual x-rays averaged in.  My gums are not great and I must very soon see a periodontist.  Heaven knows what he will charge but the visits will not be covered,  since only two are allowed in 12 months.  Periodontal work would only be half covered and the maximum annual benefit is only $1250 for a premium that costs $730/year.  In sum,  health insurance is all too often not an advantage,  unfortunately.  Maybe the medical plans are better?  An individual Bronze level plan in New York City will cost $393/month in 2015.

Still,  it appears that Freelancers can benefit in other ways from Union membership (I am not a member).  There are plans over the next five years to open 15 primary care clinics across the country,  including Los Angeles and Austin, TX.  The clinics will not charge co-pays for office visits and will be open to all who purchase health insurance through the Freelancers Union.  There are numerous professional benefits as well.  Maybe I will join before too long.

More good information on health insurance prices is available at the Consumer Reports Health Law Helper,  which walks you through questions to help you understand your options for buying health plans,  with links to marketplace sites   http://healthlawhelper.org.  The American Association of Retired People AARP sponsors the Health Law Answers site,  which provides information for health insurance seekers of any age  http://healthlawanswers.aarp.org/en.  The Kaiser Family Foundation provides the Insurance Marketplace Calculator,  which helps you estimate the cost of health insurance based on your location,  age and income,  along with pricing for various level plans  http://kff.org/interactive/subsidy-calculator/.

Thanks for reading,

Kim

Year End Tax Planning 2013

Lo and behold it is the first week of November and time for you to begin your year-end tax planning.  If you have an accountant or bookkeeper,  pick up the phone and make an appointment.   If you perform these functions yourself,  then take action now,  before Thanksgiving and Christmas ambush you.  Your mission is to minimize the tax bill payable in April 2014.

Let’s start with your place of business.  Do you work from home?  Then consider taking the home office deduction.

Next,  take a look at revenue generated in 2013.  If this was a lucrative year,  you are advised to push income into 2014,  especially if you expect next year to be less flush.   Study the matter before you invoice late 4th quarter projects.  Call clients to confirm that it will be OK to invoice in January.  Many are not on a January – December fiscal year,  so deferring payment until January may not be a problem.

If you expect no substantive change in revenue generated from 2013 to 2014,  consider investing in your business and creating additional tax write-offs this year,  rather than next.  Remember also  to make a contribution to your Solo 401K,  IRA or Roth retirement account.  Freelancers who have already celebrated their 50th birthday are eligible to make a maximum $22,000 tax-deferred catch-up contribution to their Solo 401K each year,  on money generated from self-employment only.

Further,  those who’ve had a good year and hold a Solo 401K may deposit up to 25% of their income into the account.  The tax-deductible and tax-deferred income limit is $49,000 for those under 50 years and $54,500 for those aged 50 years and older.  See my post https://freelancetheconsultantsdiary.wordpress.com/2010/11/09/the-self-employed-401k-plan/  for more information.

The Affordable Healthcare Act must now be factored into your year-end tax strategy.  Freelance soloprenuers who qualify for a health insurance subsidy (approximate income maximums of $45,000 for a single person household and $94,000 for a family of four)  need not worry about the subsidy being treated as taxable income.  However,  if your insurer refunds to you a portion of premiums paid,  that refund will be taxable and a 1099 will be sent.

Healthcare Act subsidies function to limit out-of-pocket  monthly insurance premium costs for those who generate revenues below a certain threshold.  The subsidy may be requested as follows:

1. Premium assistance credits, to reduce the monthly cost of health insurance

2. Up-front lump-sum payment

3. Tax credit on Form 1040, to reduce any taxes owed and perhaps create a refund

A statement that documents any subsidy will be issued and there will be an annual reconciliation.  If you underestimated your 2014 income,  you will be required to pay back a portion of your subsidy.  If 2014 income was overestimated,  then a refund will be somehow issued.  Visit the website of either your state or federal health insurance exchange to obtain information about how to estimate your 2014 income.

YOU will be responsible for monitoring your annual income and ensuring that you receive the correct subsidy.  Ben Tallman of Tallman Tax Service in Atlanta recommends that Freelancers monitor revenues and expenses at least quarterly and contact their health exchange and get themselves re-certified in the event of a large increase in income generated,  to reduce the chance of facing a subsidy claw-back at tax time.

Thanks for reading,

Kim

Health Insurance Options for Freelancers in 2014

There are five months left in the year and it is time to start planning for a successful 2014.  One important element of the business strategy plan for self-employed professionals must be our health insurance.  In 2014,  our options and requirements will change and we must be apprised of those changes and prepare to either make the most of them or minimize impact,  depending on our circumstances.

The individual mandate of the 2010 Affordable Care Act will require Freelance consultants and other self-employed individuals to purchase health insurance as of January 1, 2014,  or pay a penalty of $95.00 or 1%  of income,  whichever is greater.  That penalty will increase to $695.00 or 2.5%  of income,  whichever is greater,   in 2016.  If the revenue your consultancy generates is between 138%  and 400%  of the poverty level,  you may be eligible for a subsidy that will  ( in theory)  make the health insurance premium more affordable for you.

The subsidy for health insurance premiums will be available on the Health Insurance Exchange  (HIX).  Eligibility for a HIX premium subsidy is expected to be on a sliding scale,  but exact income thresholds have not yet been revealed.  It is possible that a single individual who generates about $45,000 annually will be eligible to receive a HIX premium subsidy,  according to information published by the National Association for the Self-Employed  http://www.nase.org .  It is expected that the income upper limit for a four person household to qualify for the HIX subsidy will be about $94,000.00 in annual revenue.

HIX enrollment is scheduled to begin on October 1, 2013,  for coverage that will commence on January 1, 2014.   Federal,  state and private health insurance plan options will be available for purchase through an online marketplace ,  where one can compare product features and prices.  One’s income tax data will be part of the enrollment application,  so that any subsidies applicable to enrollees will automatically be deducted as a tax credit.  Eligibility for Medicaid,  Medicare,  veteran’s benefits or HIX subsidy will be automatically calculated.  Be mindful that income of the self-employed tends to fluctuate and eligibility will fluctuate along with annual revenue.  It will be possible to renew with your present insurer,  but why not shop around and find out what else is available at your price point?

Unfortunately,  health insurance costs are expected to rise 10% – 13% in 2014,  in response to additional coverage that all plans must provide,  in accordance with Affordable Care Act regulations.  You may recall that in my April 2, 2013 post ,  I noted that when the Freelancers Union surveyed its members,  it was revealed that 58%  earn less than $50,000.00 / year and 29% earn less than $25,000.00 /year.  The majority of the groups’ members are in the New York City area,  a location that pays higher wages than many areas of the country.

That means many Freelancers will not qualify for the subsidy,  but will be required by law to pay large monthly health insurance premiums that will strain the already scarce cash flow.  As a result,  some will be forced to forgo health insurance,  because it is much less expense to pay the penalty,  even when it increases in 2016.

The penalty for avoiding health insurance in 2016 will be $1250.00 for those who earn $50,000.00 / year and annual health insurance premiums even for a healthy single person will far exceed that amount.  It’s a risky gamble that no one wants to take,  but for many it will be the only alternative.  When funds are both limited and unpredictable,  uncomfortable decisions must be made.

The rising cost of living and diminishing opportunities to generate adequate cash flow make it imperative that Freelance consultants must be savvy and diligent about marketing,  networking,  obtaining referrals and creating a good business model.  Responsible financial management is also necessary,  but first one needs to have money available  to manage.  Slacking off will not be an option,  at least not for those who are single or the primary breadwinner of their household.

Thanks for reading,

Kim

The Freelancers Union

Front page top half of the Sunday March 24 New York Times business section features a lengthy article on the Freelancers Union,  a Brooklyn,  New York based 501 (c) (3) organization that benefits Freelancers.  The organization was founded in 2001 by Sara Horowitz,  a New York City labor law attorney who 20 years ago was hired into a Manhattan law firm as a contract worker and found aspects of the experience unsettling.  There was a precursor group Horowitz founded in 1995,  Working Today.

The Freelancers Union is not a certified union,  but an association of independent workers,  from screenwriters to management consultants to nannies,  that promotes the interests of Freelancers.  It has no collective bargaining power,  does not negotiate contracts and does not represent members in grievances.  If a client stiffs you on an invoice,  the Freelancers Union will not go to bat and help you collect.  Members pay no dues or membership fee.

Freelancers Union keeps issues of concern to Freelancers alive in the media,  as a strategy to impact government policies that benefit us.  The group advocates for legal reform on worker’s compensation,  unemployment benefits and tax relief  (our taxes are higher, as you know),  areas in which we are vulnerable.   In 2009,  the group successfully persuaded New York City to eliminate the unincorporated business tax levied on Freelancers who earn less than $100,000,  a saving of up to $3,400/year.

An internal Freelancers Union survey found that 58%  of its members earn less than $50, 000/year and 29%  earn less than $25,000/ year.  Bear in mind that most members reside in Metro New York City and pay rates are usually higher there than in other areas of the country.  Also,  some prefer to work part-time and that limits earning potential.

In the March 24 article,  there were questions about the practical value of Freelancers Union beyond the delivery of health insurance.  Gordon Lafer,  professor of labor relations at University of Oregon said,  “The question is,  can they get any leverage to get a fair shake from employers,  to get companies to give a fair share of their profits to Freelancers? They may need to be more creative to do that.”

Still,  Freelancers Union is a fast-growing group that has 207,000+ members and more than 50%  live and work in New York state.  The website states that there are 42 million independent and part-time workers in this country,  workers who are not eligible for benefits of any kind.  In response,  the Freelancers Union’s primary deliverable is providing affordable insurance through its for-profit insurance company: medical,  dental,  disability,  retirement and life insurance policies.  Unfortunately,  not every form of insurance is available in every state.  I cannot at this time obtain medical insurance in my state,  but all other forms offered are available.

Its health insurance company has enrolled 23,000 Freelancers in New York state.  Premiums are $225.00 – $600.00/month.  The Obama administration recently awarded Freelancers Union $340 million in low-interest loans to help the organization establish in New York,  New Jersey and Oregon cooperatives that will provide health insurance to Freelancers and others who need coverage.

For Sara Horowitz,  the goal is to persuade Freelancers to band together and set up social purpose institutions that serve our mutual needs.  “The social unionism of the 1920’s had it right”,  she stated in the March 24 New York Times article.  “They said: we serve workers 360 degrees.  It’s not just about their work.  It’s about their whole life.  We  (Freelancers Union)  view things the same way.”   See  http://freelancersunion.org for more info.

Thanks for reading,

Kim

The Doctor Will See You: Whatz Up With Health Insurance

At last,  health insurance will soon become more easily accessible to those who live in the US.  Belatedly,  we have joined the ranks of  industrialized nations by taking important steps toward providing access to health insurance for almost everyone.

The health care bill,  which was signed into law on my birthday,  is far from perfect but it is a start.  Unfortunately,  we will continue to pay too much for health plans that may not cover enough—like mammograms,  Pap smears,  prostate exams or periodontal care.  If  you should find a plan that will cover those necessities of health maintenance,  the deductible is likely to be exorbitant.

My guess is that in most instances,  we will be forced to pay more out of pocket than we would like and that we’ll pay more for our monthly premiums than we would like.  Same old story,  pay more to get less.

The insurance  companies have already begun to petition state regulators for rate increases.  Several states are bound to let them have their way because they own our political representatives—which is how we got stuck with a raw deal on health insurance in the first place (but you know that).

FYI,  here is what the health insurance roll-out will look like for Freelancers and small business owners:

2010

Freelancers with pre-existing medical conditions will be  eligible to buy health insurance at reduced rates.  By October,  insurance companies will no longer be allowed to place lifetime benefit limits on insurance coverage for those with pre-existing conditions.

Businesses with fewer than 26 employees and average annual wages of $50,000 or less will receive a 35%  tax credit  IF  the business pays more than half of its employees’  health benefits.

2011

Businesses with fewer than 100 employees will be eligible to set up employee wellness programs and offer either bonuses or a maximum 30%  health insurance rate discount to employees who join the wellness program.

Employers will be required to disclose the value of employee health care benefits on form W-2.  Beginning in 2018,  holders of health insurance plans deemed  “expensive”  will pay federal taxes on their value.

2013

Tax exempt contributions to health care accounts for medical expenses will be limited to $2500/ year.  Medicare taxes will rise to 2.35%  on earnings over $200,000 for unmarrieds and earnings over $250,000/ year for married couples  (from the current 1.4%).  Employer tax deductions for the cost of retiree Medicare drug benefits will be eliminated.

2014

All citizens and legal residents of the US will be required to purchase/possess health insurance.  Freelancers and small businesses with maximum 100 employees will be able to obtain health insurance through health care exchanges that states will be required to establish.

Small Business Health Options Programs,  called SHOP Exchanges,  will allow Freelancers and small businesses with maximum 100 employees to band together and purchase health insurance as a group to (presumably) save money.  States,  however,  will be allowed to throw a curve ball and temporarily redefine a small business as one having maximum 50 employees  (through 2016 only).

Insurers will be unable to deny health insurance to anyone with a  pre-existing medical condition.  Businesses with 50+  employees that fail to offer health benefits to employees may face penalties of up to $2000/ uninsured employee.

In the meantime,  venture capitalists are looking to fund start-ups that can streamline and improve upon health care delivery systems,  especially for chronic disease management, physician/medical practice profitability tools and patient (customer) relations management.  A woman in my CEO forum operates an employee wellness program business.  She has just hired two part time staff members and is developing a sales pitch for investors.

A votre sante (to your health),
Kim