Issue #55: Employee Benefits: Health Insurance

Ladies and gentlemen, brace yourselves because it's that time of year again – Benefits Season is knocking on our doors! From October to January, employers are deep in the trenches, navigating the wild world of employee benefits.

It's the season of choices, where employers decide what stays, goes, or gets a makeover in their benefits offerings. Meanwhile, employees are in the hot seat, trying to figure out what's best for them.

So, let's cut to the chase and dive into this month's focus – the nitty-gritty of employer benefit choices and some real talk about how employees can make smart decisions..

Health Insurance: The Boss of Benefits

Let's kick it off with the granddaddy of them all – #healthinsurance. Health coverage is like the OG benefit, but it's not just a one-size-fits-all deal. It's got some versatility, and that's where the magic happens. You've got three flavors to choose from: Copay, Coinsurance, and High-Deductible (HSA eligible) plans.

1. Copay: This one's like kindergarten-level simple. Copays are the fixed, upfront costs for services like prescriptions, office visits, ER jaunts, and more. It's the stuff you know you'll be shelling out during or right after your visit.
2. Coinsurance: Once you've hurdled over your deductible, it's time to tackle coinsurance. This is where things get real. You're paying a percentage of your healthcare costs now. Let me break it down with an example:Imagine you're rocking an individual plan (no dependents) with a hefty $3,000 deductible, $50 specialist copays, 80/20 coinsurance, and a maximum out-of-pocket cap of $6,000. You roll into your annual checkup (free because it's preventive), but you toss in a pesky shoulder issue.Your doc sends you to a specialist (that's a $50 copay). The specialist recommends an MRI for $1,500 – you're footing the whole bill because that deductible ain't met yet. But here's the kicker: you need surgery for a whopping $7,000. You've already forked over $1,500 for the MRI, so you've got to cough up another $1,500 to hit that deductible and unlock the coinsurance. After that, it's a 20% split, which in this case is $1,100. All in all, your busted rotator cuff is hitting your wallet for $4,100.Big shoutout to our pals at Investopedia for laying out this scenario. For an even deeper dive into Copays and Coinsurance, click here .
3. High-Deductible Health Plans (HSA Plans): Now, this is where things get juicy. HSA Plans often include copays and coinsurance, but they bring a game-changing element to the table – a 0% coinsurance rate. Yep, you heard it right. Once you've scaled that higher deductible peak (usually higher than most plans), you're free from shelling out any more cash as an employee! It's that simple. Sure, there are some twists if you venture out of the network, but let's keep it straightforward for this newsletter.

But wait, there's more! HSA Plans come with a treasure chest of goodies. Think tax deductions (when you stash money in your HSA), opportunities to watch your investments grow tax-deferred and potentially tax-free (with the cash in your account), and the sheer ease of use (you even get a debit card for medical expenses – aspirin at the store, toothpaste, you name it). Exciting, right? And here's the kicker – you can steer those investments into real estate, businesses, and more to potentially supercharge your wealth. It's like the moves the mega-rich are pulling off, and guess what? You can too, with a bit of know-how and a supportive team.

Now, you're probably itching to know what's best for you. Well, for business owners, it's a no-brainer. Offer these plan types. You get to call the shots on how much you, as the #employer, will contribute to your employees' plans. You can even tier these contributions based on job titles, dishing out different percentages for different roles – Staff (30%), Management (50%), Senior Management (60%) – it's your playground. You can even drop some dough into their HSA accounts, following the same tiered approach. If you want to toss in $500 a year for them, go for it. It's all part of the game to attract and retain top-tier talent!

Now, for employees, finding the "best for me" plan isn't a one-size-fits-all answer. It's a bit like a puzzle, and you need to ask yourself some real questions:

• Do I or my family have chronic health issues?
• Are there ongoing prescription drugs in the picture?
• How much is my employer putting in? What's the scoop with HSA investments? What's the percentage of health costs covered?
• What's my cash flow and budget? What can I comfortably handle without squeezing my wallet?
• Am I cool with the idea of paying out of pocket? (This one's more about your feelings than your bank balance)

These questions won't drop the perfect answer in your lap, but they'll steer you in the right direction. And hey, if you're really stumped, you can always invest in a one-hour session with a pro who can help you make the smartest move for your unique situation. Our team is right here, ready to support you. It's just an hour – that's all it takes!

Next Week’s Issue

Now, I know this newsletter's run a bit long, but hang tight because next week, we're getting into some spicy topics – #maternityleave, #studentloan benefits, and #lifeinsurance. So, keep your eyes peeled for more golden nuggets of wisdom!

#NoBSWealth?Clip of The Week

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