Keeping You in the Know

Health Tips and Information


A Potential Coronavirus Tax Credit for Employers

As you continue to grapple with the effects of coronavirus upon our businesses and livelihoods, we hope to bring you encouraging news in the form of various aid packages from the government. One piece of good news is an employee retention provision within the CARES Act, that offers a tax credit to employers who continue paying the health insurance premiums of furloughed employees.

In the unfortunate event that you do need to lay off or furlough employees, you might not be able to continue paying their salaries. But if you do continue to make payments toward their healthcare plan premiums, in absence of any other wages, the IRS will allow you to treat that expense as qualified wages.

In order to qualify for this special treatment, the premiums must have been paid between March 12, 2020 and December 31, 2020 (if the pandemic lasts for longer than expected and the IRS extends this time period, we will be sure to notify you).

Some limitations do apply. The qualified health expenses paid for each employee cannot include amounts that the employee paid with after-tax contributions. If an employee participates in more than one healthcare plan offered by the same employer, the expenses for each plan are aggregated for that employee. The expenses are limited to $10,000 per employee for all calendar quarters of this year.

This is at least a piece of good news during an otherwise difficult time. If you are forced to take the unfortunate step of laying off employees, know that the government is putting provisions into place that should help you continue their small group healthcare plan. Now is no time for anyone to be without health insurance if we can all prevent it. And of course, employees with a valuable health insurance plan are loyal employees.

For more information on this tax credit, give us a call. We can explain more about the CARES Act and how it relates to your healthcare plan.


A Special Enrollment Period for Some California Workers

As of January 1, California law requires all of us to enroll in a healthcare plan or pay a penalty at tax time. So what happens to those workers who had the opportunity to enroll in a small group healthcare plan, but declined for some reason?

Luckily, the law does provide for a Special Enrollment Period for those workers, if they change their minds (for any reason) and want to enroll after all.

Why would someone change their mind? There are a myriad of reasons, but some small business workers decline their group healthcare plan because they are covered under a spouse’s plan.  This decision might be considered if the spouse loses their job, or a divorce occurs.

In other situations, a worker might enroll in Medi-Cal instead, but later lose that coverage. In that case, a 60-day enrollment period will apply.

These are just some of many reasons that an individual might decline healthcare coverage through a small business group plan, but later change their mind.

You don’t need to experience a qualifying life event. This Special Enrollment Period applies to anyone who previously denied coverage under a small group plan, for any reason.

Coverage and premiums will be equivalent to other members of the plan. Benefits must be equal to those offered to earlier enrollees. Late enrollees cannot be charged higher premiums, either.

Pre-existing conditions cannot disqualify anyone from coverage. Under the Affordable Care Act, healthcare coverage cannot be denied to anyone due to a pre-existing condition, assuming they are otherwise eligible for the plan. A general health questionnaire is sometimes used during the enrollment process, but enrollees cannot be required to undergo a physical or submit a full health history. Premiums cannot be based upon health conditions, either.

If you’ve formerly denied healthcare coverage under a small group plan, but have since changed your mind, get in touch with us for more information. Different plans impose different timelines for this Special Enrollment Period, so do act quickly so that coverage can begin soon.




Open Enrollment Deadline Has Been Extended

We’ve all experienced enormous changes in a short period of time, due to the coronavirus situation. With many Californians facing economic changes and possible loss of health insurance, Covered California has extended the Open Enrollment period for health insurance. Now, you have until June 30 to enroll in a healthcare plan or make changes to your existing plan.

Who is eligible? Anyone who is eligible to enroll through Covered California can take advantage of this extended enrollment period. Those who do not qualify for a employer-provided health insurance plan can create an account through Covered California and begin to shop for plans.

What about premium subsidies? It might relieve you to hear that yes, healthcare plans offered through Covered California qualify for a subsidy to help with the cost of your premiums.

Individuals who earn less than $17,237 annually can qualify for Medi-Cal.You can submit an application to Medi-Cal at any time.

Those earning between $17,237 and $49,960 qualify for subsidies through Covered California to cover part or most of their premiums, but you must submit your application by June 30.

Those income limits change for households of more than one person. You will need to create an account and input your personal information in order to receive an estimate of your subsidy amount.

Has the coronavirus outbreak prompted any changes to healthcare plans? Yes! For one thing, those enrolled in Medi-Cal or a Covered California plan should be able to obtain testing for coronavirus free of any charges such as a copayment.

Also, Medi-Cal and many Covered California plans are beginning to offer telehealth appointments, so that you can schedule a virtual appointment with a physician in the event that you don’t want to leave the house. This option provides a terrific way to access quality healthcare without unnecessarily exposing yourself to viruses that can lurk in waiting rooms.

Hopefully, the extended deadline will help more Californians to obtain healthcare when we all need it most. Give us a call if you have any questions about health insurance plans, and we will be happy to assist you in making this important decision.

Coronavirus Job Loss: How to Get Health Insurance When Unemployed

We hope you’re all doing well and staying healthy at this difficult time. Having said that, we know that unemployment – or the risk of imminent unemployment – concerns a lot of you. While both the state and federal governments are taking steps to provide stimulus payments and unemployment benefits at this time, you might be wondering what to do about health insurance coverage.

Federal law does require employers to allow you to remain enrolled in your group healthcare plan when you’re laid off. The COBRA law allows you to continue in the same plan, if you wish, but you have to pay the entire cost of the premiums (including your former employer’s share). That might work for a few people, particularly those whose spouses are still employed and can cover the cost of the premiums, but for many unemployed people the cost of the entire premium simply is not feasible.

So, what else can you do about healthcare coverage if you’ve recently become unemployed?

First, know this: If you’ve lost your health insurance due to job loss, you qualify for a Special Enrollment Period. This means that you can enroll in a new healthcare plan outside of the usual Open Enrollment period (which normally happens in the fall).

If you elect to pursue coverage through Covered California, you might be eligible for a subsidy to help cover the cost of your premiums. Keep in mind that if you’ve applied in the past and didn’t receive a subsidy, that is likely to change now since your income has changed.

Also, those with lower incomes might be able to obtain free health insurance through Medi-Cal.

The next round of coronavirus relief legislation is set to proceed through Congress in coming weeks. Several lawmakers have called for 100 percent COBRA coverage, or otherwise addressing the shortage of healthcare coverage in light of widespread unemployment. It is possible one of those provisions might work out for you. However, if you would prefer to proceed with obtaining coverage now – and that is likely the wise thing to do – then give us a call and we’ll be happy to help you compare health insurance plans.

What To Do if You Are Sick

If you’re reading this, chances are good that you’re snug inside your home while we all ride out the pandemic situation. But even if you’ve practiced regular hand washing and social distancing techniques, it is still possible to get sick. Some people will still experience regular colds, allergy symptoms, the flu, or other illnesses during this time. And yes, Covid-19 is a possibility for anyone. Here’s what to do if you get sick.

Don’t proceed to the emergency room, unless you are truly experiencing a life threatening emergency. For one thing, you don’t want to expose yourself to all of the illnesses in the waiting room. Second, if you do have Covid-19, you wouldn’t want to expose everyone else to the illness. And most importantly, hospital staff are severely overworked right now. They need to focus on the most critically ill patients, and for most of us, minor illness is not an emergency.

If you think you might have Covid-19 and your symptoms are severe, proceeding to the emergency room is certainly what you want to do. But do call ahead first, so that they can review their procedure with you. You might be asked to use a separate entrance or take other precautions to avoid exposing others to the potential illness.

Call your doctor. We can’t stress this enough. Before going anywhere for medical attention (except in emergency) calling ahead is proper procedure now. Your doctor can assess your symptoms over the phone, decide if you need to be tested for Covid-19, and direct you on how to complete that lab work.

Otherwise, it might be possible to receive a prescription over the phone, or to schedule an appointment when necessary.

Don’t panic. Remember that for most people, Covid-19 is not a deadly illness. If you are over the age of 60, are immune compromised, or have health conditions that predispose you to complications (such as asthma, heart disease, high blood pressure or diabetes) then you certainly want to be extra careful. These are the people who need to seek more urgent care. Everyone else should still call their doctor and discuss their options, but there is no need to panic.

If you test positive for Covid-19, or if you experience mild symptoms but do not qualify for testing, follow self-quarantine procedures precisely in order to protect others from infection. This guide from the CDC shares more of this information in detail.



No Out-of-Pocket Fees for Coronavirus Testing

If you’re concerned about the novel coronavirus outbreak currently sweeping the globe, perhaps we can offer at least one bit of good news: Health insurance companies in California, New York, Vermont, and Maryland have waived all out-of-pocket fees associated with coronavirus testing.

This means that if you show symptoms of the virus, and head to your physician or hospital for the test, you won’t be required to pay your normal per-visit fee.

It is possible other states will soon follow suit. President Trump just signed a spending package worth $8.3 billion, aimed at reducing the spread of the outbreak and addressing patient needs. This funding will go toward testing as well, although at current time the requirements for receiving a test remain unclear.

Currently, more than 500 cases of the novel coronavirus have been diagnosed in the United States, with our own death toll standing at 22. Worldwide, the virus has infected more than 114,000 and killed more than 4,000.

Between two and fourteen days after exposure, patients with coronavirus notice the following symptoms:

  • Fever
  • Cough
  • Shortness of breath
  • Difficulty breathing/wheezing

The illness is typically more severe in those with known health complications, including asthma, other breathing disorders, or suppressed immune systems. The elderly tend to experience more trouble with the illness as well. Yet, regardless of your state of health, testing is important in order to detect and quarantine patients so that we can reduce spread of the virus to the most vulnerable populations.

If you suspect you might have contracted the novel coronavirus – and remember, odds for that are still extremely low unless you have a known exposure risk – remember to call your physician or the emergency room before heading their way. Health officials have ordered certain preparations be made ahead of potential patient exams, so that the spread of the virus can be contained. Follow their instructions when arriving for your exam and test.

7 Medicare Facts You Need to Understand

As you prepare for your retirement years, planning for medical care and expenses will become a considerable part of your strategy. Here are the basic facts you need to know about Medicare, so you can begin to make some of those important decisions.

There are two parts of Medicare. Medicare Part A covers hospitalization, and it’s free to everyone who has worked and paid Medicare taxes for ten years (or is married to someone who did). Part B covers doctor visits and certain other services, and is available for a premium.

You have to sign up at 65, unless you have credible employer or union coverage. You’re required to enroll in Medicare at age 65 (from three months before your birthday until three months afterward). If you miss that enrollment window you will be charged a permanent penalty on your monthly Part B premiums, in the amount of 10 percent for each 12-month period that you delay enrollment.

Note: This requirement does not apply to those with credible employer or union coverage.

You can enroll in Medicare before claiming your Social Security benefits. If you’ve claimed Social Security prior to turning 65, you will be automatically enrolled in Medicare. On the other hand, you might prefer to wait until your full retirement age (66 to 67, currently) before filing for Social Security. In that case you will need to remember to enroll in Medicare at 65.

You must choose between Original Medicare or Medicare Advantage. You can choose to enroll in Medicare Parts A and B (and optional Part D prescription coverage) or a Medicare Advantage plan, but not both. Medicare Advantage plans are administered by private health insurance companies, and must offer at least the same amount of coverage as Original Medicare. However, many plans offer additional benefits such as dental or eye exams.

Part B premiums are based on income. Most people pay the standard Part B premium, which is currently $144.60 per month. But some higher earners will pay a bit more. Currently, single tax filers who earn above $87,000 or married couples who earn above $174,000 are subject to this premium adjustment.

You can enroll in Medicare and also maintain private insurance coverage… If you’re still working at age 65 and covered by an employer’s plan, or you’re covered by a working spouse’s plan, you can enroll in Medicare. If the employer has 20 or more workers, Medicare will serve as secondary insurance. In many cases this can mean you owe very little to nothing for out-of-pocket medicare expenses.

But you can’t contribute to a health savings account anymore. Those covered by an employer’s health insurance plan plus Medicare cannot contribute to a health savings account (HSA) so that’s something to consider before enrolling.

There’s a lot to know about Medicare coverage, and these facts are just the basics. For more in-depth information related to your specific situation, give us a call and we’ll be happy to help you.


Coronavirus: Separating Fact from Fiction

If you’ve been hearing the news about the coronavirus outbreak in China that has now spread around the globe, you might be feeling concerned. It doesn’t help that sensational headlines and even conspiracy theories are fanning the flames.

If you’re overly worried about coronavirus, don’t be. As we separate fact from fiction, you will hopefully feel better about the situation.

Is coronavirus a brand new pathogen we’ve never seen before? No, not really. Many different strains of coronavirus exist, and we’ve known about them for years. In fact, coronaviruses are some of the most frequent causes of the common cold.

The particular strain of coronavirus causing the outbreak is a new one, but new strains of virus are discovered all the time. So, the situation is not that unusual.

Is this new coronavirus an instant death sentence? Definitely not! The news has focused heavily on the number of deaths, but glosses over the number of people infected by this new strain of coronavirus. The fatality rate is actually about 2 percent, which admittedly is concerning, but we’re not exactly living out a science fiction movie.

In fact, some health organizations believe the actual fatality rate is even lower than 2 percent, because many cases of coronavirus are mild and are not being diagnosed at a hospital. Therefore, more people are infected than we even know. That sounds bad, until you realize we don’t know about them because they think they simply have a mild cold.

Are hundreds of thousands, or even millions, of people dying? Some pretty wild reports have circulated on social media, but there is no substantive evidence of a high death toll at this time.

Unfortunately, around 1,000 people have died in the outbreak so far. But according to reports, the deaths are due to complications from pneumonia, which mostly strikes older people and those with compromised immune systems. We know that pneumonia is a problem in this population already; the situation isn’t exactly new.

Those who are otherwise healthy and have robust immune systems typically do not suffer the more serious complications.

Will you catch coronavirus? Chances are, you’ve had a few strains of coronavirus before. As for this new strain, nearly all cases are confined to China at the moment. Public health officials are doing all they can to quarantine suspected cases and prevent spread of the virus.

Overall, the odds are low that you will catch coronavirus. Officials do recommend that you reschedule travel plans to China, just in case.

If you have any concerning symptoms, such as fever, coughing, or shortness of breath, seek medical care right away… But it’s probably just a routine illness.

Health Insurance Enrollment Deadline Rapidly Approaches

As the deadline to enroll in an individual or family health insurance plan rapidly approaches, we wanted to take a moment to remind you of what you need to do.

The deadline for health insurance Open Enrollment is January 31. You must sign up for a healthcare plan, or you might miss your chance for the rest of the year (more on that in a moment). And, since California now enforces its own statewide version of the Individual Mandate, you might be subject to a penalty if you don’t have healthcare coverage in 2020.

This deadline applies to individual and family healthcare plans only. It does not apply to Medicare plans, or to group health insurance plans (those offered by an employer).

What you should do during Open Enrollment. Contact your health insurance professional for help with comparing different healthcare plans available in your area.

You might qualify for a subsidy to help with the cost of your premiums. Make sure to provide the appropriate financial information so that your subsidy can be calculated.

Or, if you already qualify for a subsidy, you should update your financial information to ensure that your subsidy can be recalculated for 2020.

If you like your current plan and want to keep it, review the details to be sure it’s still a good fit for you. Sometimes changes in coverage occur from one year to the next, and you shouldn’t assume that your plan will continue to fit your needs perfectly.

In some cases, you can enroll in a healthcare plan outside of Open Enrollment. If you experience a qualifying life event, such as a move or change in family structure, you can enroll in a plan or change to a different plan outside of the usual Open Enrollment window. However, since you can’t count on one of these events occurring, it would be wise to go ahead and enroll now.

Remember, the deadline for health insurance coverage is January 31, so get started today. Give us a call and we can help you determine the next steps you should take.

What to Do if You’re Turning 65 This Year

About ten thousand Baby Boomers turn 65 each day, meaning around 3,65,0000 will reach that milestone during 2020. That’s over three-and-a-half million people who will now become eligible for Medicare, and yet many aren’t yet sure what they’re supposed to do. So, if your 65’th birthday is rapidly approaching, this brief Medicare enrollment primer might help.

If you claim your Social Security benefits… You will be automatically enrolled in Part A coverage, which is free for most people, and you will have the option to enroll in Part B coverage (for a monthly premium).

If you aren’t claiming your Social Security benefits yet, you will need to take the initiative to enroll in Medicare. You will not be automatically enrolled, so it is very important to remember the following time frame.

You’re eligible to enroll in Medicare during a seven-month period. You can start the enrollment process at any point during the three months before your 65’th birthday, during your birthday month, or for three months afterward. If you miss this initial enrollment window, you could face higher premiums when you do enroll. So mark this deadline on your calendar. Contact your local Social Security office, or apply online at

Decide if you want to enroll in Medicare Part D. Part D, or prescription drug coverage, is available to those who are concerned about the cost of current or future prescriptions. You will pay a monthly premium in exchange for managed prices on many common drugs.

Research Medicare Part C, or Medicare Advantage Plans. Instead of enrolling in Medicare Parts A and B, you can opt for a Part C plan (also called Medicare Advantage plans). These comprehensive plans roll Parts A and B into one healthcare plan, and many also include Part D coverage. These plans are available for a premium, but the type of coverage offered might be more convenient or affordable for you in the long run.

As with any other healthcare plan, what’s right for one person won’t be perfect for another. So you should carefully compare Advantage plans before determining whether this option better suits your needs.

We can help with this part. If you’re interested in Medicare Advantage plans, give us a call and we’ll discuss your needs. Then, we can match you with a plan and review the details with you.



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