This year’s entertainment will be local favorite, Robbie Limon.

So which one do you choose?

If you are like most seniors, you will choose to do nothing and stay put in the same plan as the past year.  But that could be costly!  Most plans make changes from year to year including premium increases, deductible increases, co-pay changes and the specific medications that are covered this year may not be covered next year.  Plans are required to send out an Annual Notice of Change (ANOC) letter describing the plan changes from this year to the next, but few beneficiaries actually read this information.  The bulk of the information seniors receive in the mail can be quite overwhelming.

That’s where Creekside Insurance Advisors, Inc. comes in.  Creekside has over 3500 Medicare clients who need this assistance and they are more than willing to help – even without compensation.  Over 600 drug lists were voluntarily sent to Creekside by their clients for evaluation during the Fall 2012 AEP season and 420 clients decided the savings were worthy of making a change.  In all, Creekside’s clients saved a documented total of $205,909 in out-of-pocket prescription expenses for the 2013 Medicare Part D year.  This savings is easy to compute as the Medicare website tool calculates the estimated total out-of-pocket for all plans, including the client’s current plan.  Creekside’s new database allows for the tracking of this data.

In addition to Creekside, Medicare beneficiaries can also do their own research by using the www.medicare.gov website tool or getting help from their local pharmacy.  Creekside is licensed in Virginia and West Virginia and also specializes in other Medicare products, individual and family health insurance, group health insurance and fixed annuities.  Creekside Insurance Advisors, Inc. may be contacted at info@creeksideadvisors.net or visit website http://www.creeksideadvisors.net

The credit is only available to employers (both for-profit and non-profit) with 25 or fewer full-time equivalent employees (FTEs) and average annual salary below $50,000.  The full credit with for-profit employers equals 35% in 2010-2013 and increases to 50% in 2014 and beyond.  Non-profits are reduced to a maximum credit of 25% in 2010-2013 and increases to 35% in 2014 and beyond.  The credit phases out proportionately between 11 and 25 FTEs and $25,000 and $50,000 average annual salary.  Eligible premiums for this credit are also capped at the average state premiums.

Employers may also use premium contributions as a deductible expense, but must be adjusted for the tax credit received.  Non-profits that have no tax liability  may receive a refundable credit to the extent that it offsets payroll taxes such as Medicare withholding.  Please seek the advise of your tax preparer for specific details.

Small businesses throughout Virginia and West Virginia may contact Creekside Insurance Advisors, LLC for savings on group health insurance rates and updated information on state-specific options and Health Care Reform at http://www.creeksideadvisors.net/group-health-products/

Business Owners:  1-25 full time equivalent employees (FTEs) with average salaries below $50,000 can get up to a 35% tax credit now (up to 50% in 2014) on what you pay towards employee health insurance.  Credit is reduced for employers who have 10-25 FTEs and/or whose average salary is greater than $25,000.  Employers above 25 FTEs and/or $50,000 average salary are not eligible for this credit.  Beginning 2014, employers of 50+ FTEs must offer health insurance to their employees or pay between $2000-$3000 tax per employee.  There is however an exemption for the first 30 full-time employees on this penalty.  Tax deductibility of premiums is still allowed, but deductible amount is reduced by tax credit received.  The tax credit is ONLY available for 2 years!  Note: FTE is calculated by total number of hours worked per year by entire workforce divided by 2080 (40 hrs. per week x 52 weeks per year).  Group health quotes prior to 2014 can visit http://www.creeksideadvisors.net/group-health-products/

Individuals under age 65:  If health insurance is not offered through an employer, you will be required to purchase coverage for you and your family members or pay a tax beginning January 1, 2014.  Individual households up to 400% of poverty level will be eligible for a partial or full tax credit to help pay for this coverage if purchased through an exchange.  Current 2012 Poverty levels (annual income) are as follows:  Household size 1: $11,170, Household Size 2: $15,130, Household Size 4: $18,671.  It is our belief that individual policies purchased prior to January 1, 2014 will hold rates lower than policies issued after that date.  This is because the insurance company can assign your rate based on medical history now, but will have to adjust rates higher in 2014 to compensate for a higher risk pool.  Note:  Purchase individual coverage prior to 2014 if pre-existing conditions permit.  You can always switch later if necessary, but you will not be able to go back to a grandfathered plan. For current rates, go to http://www.creeksideadvisors.net/individual-insurance/under-65-healthcare/

Individuals age 65+ or Medicare Eligible due to disability:  Medicare coverage will remain mostly unchanged with the exception of increasing Part B premiums and lower funding for Medicare Advantage plans.  Those who prefer Medicare Advantage plans to Original Medicare, as a result, will likely see a combination of higher premiums and higher copays moving forward.  Also, doctors and other medical providers will see reduced reimbursements from Medicare which may adversely affect the number of providers willing to participate with Medicare in the future.  Time will be the test of these outcomes.  Medicare Supplement insurance will still require pre-existing medical underwriting except for the first six months of Medicare Part B eligibility.

Pre-existing conditions:  Beginning January 1, 2014, individuals under age 65 cannot be denied coverage for pre-existing medical conditions.  However, age and tobacco use can be used to adjust premium amounts.  It is our prediction that coverage purchased prior to January 1, 2014 will likely have more long term price stability than coverage purchased on or after January 1, 2014 as unadjusted medical risks are passed on to this group in the form of higher premiums. Currently, if you have been denied health insurance due to pre-existing conditions and have been without coverage for at least 6 months as a result, you can apply through the Federal Government for a Temporary Plan called PCIP.  PCIP will terminate on January 1, 2014 when other options become available.  You will need a letter from the denying insurance company or your insurance agent to confirm this.  Go to www.pcip.gov for more details.

Exchanges:  Beginning January 1, 2014, Virginia and many other states are expected to make Insurance Exchanges available for individuals under age 65 and small businesses (fewer than 100 employees) to purchase health insurance directly.  These Exchanges will either be administered by the state or non-profit entities.  In order for individuals and/or small businesses to receive any tax credit during the two year period as outlined above, they will be required to purchase through the exchanges rather than through a private health insurance company.  For those who are not eligible for the tax credit, there will be no advantage to use the exchanges except for the analysis of benefits and cost versus the private health insurance market.  It is unknown if the exchanges will provide personal face-to-face assistance to individuals and/or businesses dealing with plan details, analysis and selection, provider choice searches or claim assistance that is currently provided by our staff.  As we approach January 1, 2014, more details will hopefully surface.

Please note that these facts and opinions are based on information reviews in the public domain.  A great resource of information can be found at http://healthreform.kff.org/Timeline.aspx

CD-Type annuities offer nearly all advantages and safety of bank CDs. However, annuities also provide much higher interest rates, penalty-free withdrawal options, tax-deferral of interest and probate avoidance upon death. And just like a bank CD, when your term matures, there is no penalty to withdraw your funds.

If you are looking for safety AND higher interest rate growth – contact our experts today! Go to www.creeksideadvisors.net or call 800.467.5425. Virginia and West Virginia residents only.  *

Rates change without notice, so please visit our website or contact an agent for current rates.

2.  Max out-of-pocket.  Determine what amount in a given year would make you uncomfortable to pay if an unforeseen medical expense would occur.  This is your starting point.  In other word, if you can afford $5000 per year in out of pocket expenses, but nothing more, then try to shop for plans that have max out-of-pocket limits of $5000 and below.

3.  Deductible.  You don’t need to have a low deductible if the premium rate is too high.  I would rather have a $2500 deductible versus a $500 deductible if I can save at least $2000 in annualized premiums.  Consider the premium savings when you look at the deductible choices.  What’s more is that some companies give more favorable ratings on pre-existing condition risk factors with deductibles of $2500 and higher.  The right agency will know who these companies are.

4.  HSA Eligible Plans for higher income families or self-employed.  If you have higher income or are self-employed and would like a bigger tax deduction, consider a Qualified High Deductible plan with HSA account.  HSA account contributions are tax-deductible and distributions for medical expenses are tax-free.  Self-employed persons can also deduct the premiums.  It doesn’t necessarily make sense if your tax rate is low, but for higher taxable incomes, the tax savings can be substantial.

5.  Consider HMOs.   If your doctors and hospitals participate and you travel infrequently, HMOs could save you up to 25%.  HMOs don’t provide out-of-network benefits, so be very careful to check the provider network in your area before choosing an HMO product.  You will also need to be VERY flexible with provider choice to make this type of plan work.

6.  Ditch the $5 per day “junk” plans.  These plans should not even classify as insurance.  Be very careful of plans that accept all pre-existing conditions and only cost $x per day.  Most of these plans cap your hospital benefit and annual benefit to very low maximums.  Remember, it’s not just about the doctors visit co-pay, but rather the catastrophic event that will cause us financial ruin.

7.  Use a local, independent agent. Provider networks vary greatly from one locality to another.  Does your agent know which insurance companies participate with the local hospitals, doctors and even specialty hospitals that are out of the area?  This is why you want to stay away from agencies that do all lines of insurance.  These agencies typically pick one company or product and quote everyone that product regardless of the client circumstances because they don’t have the time or expertise to know the market.

8.  Give Creekside Insurance Advisors, LLC a call.  Did you think we would give you all of this great advice without telling you how good we are?  It truly makes us happy to save you money!  Our Individual Products Team specializes in health insurance for individuals, families and the self-employed.  Our job is to help you find the best possible plan that fits within your budget.  Whether a VA or WV resident, we have all of the available plans and the lowest rates in both states.  Call 540.722.2529 / 800.467.5425 or go to www.creeksideadvisors.net for more information.

So if you are looking for additional tax savings, HSA eligible health plans and HSA accounts may be a great option. Contact our Individual Products Team for more information at 540.722.2529 or 800.467.5425.

We hope to see you there.  Bring a friend or two!

While all brokers say they too can shop the market, few actually implement the same cost-cutting strategies used by our group specialists.

How much would 32% savings help your business?  Call today at 540.722.2529 for a free group analysis.