2023 Health Insurance Open Enrollments

There are numerous types of health insurance open enrollments, depending on what type of health insurance you have. 

• Direct and Marketplace Open Enrollment Nov 1 - Jan 15.  If you have individual health insurance direct with a health plan or through a marketplace, then you will want to take action to make sure you have the plans and programs form the upcoming year that work for you. Make your 2023 household gross income projection, make a list of your questions, and call us to schedule your annual health insurance review and enrollment.

• Medicare Annual Election Period Oct 15 - Dec 7. If you are eligible for Medicare, then you may enroll or make changes to your Medicare Advantage Plan. Most Medicare Beneficiaries will keep the plans they already have, but there are options to make changes annually during the Annual Election Period. If you need an annual review, or if you want to change plans, then call our office to schedule a phone or office appointment during the Medicare Annual Election Period. 

• Employer Health Insurance Plans; Many employers renew their group health plans in January, and have an open enrollment sometime in December. Other employers have open enrollment at other times during the year, usually the month before the contract renewal.  Employers should work with their agents about three months prior to the contract renewal to review new rates, check for the Small Business Health Care Tax Credit, check for changes, decide on plan and options, and plan the open enrollment activities. Open enrollment will usually include an Open Enrollment Announcement and deadline for enrolling or making changes, and some forms and materials. Sometimes your employers broker will be available to help you review your options, check on premium contributions, and help you enroll or make changes. If you are an employee and your employer provides you with health insurance or other benefits, then you will want to participate in the open enrollment period to make sure you have the plans you want for the new year.

Basic Employer Benefit Programs

Group health plans are employer sponsored plans that help to provide healthcare insurance to employees and their families. Below are some benefits to having a small group health plan.

• Small Business Health Care Tax Credit
• IRS favorable tax treatment with 125b payroll tax savings
• Easier access and enrollment for employees
• Employee and Employer premium Contributions
• Option to have a low cost plan, and possible buy up options
• Employee hire and retention tool
• Stable market, products, and pricing
• Broad Provider Networks not usually available on individual plans
• Tax deductible business expense for employers
• Helps employees and owners avoid complex marketplace
• Easy online enrollment and administration
• Broker support

Let us know if you need a group health plan, or if you need a plan and cost review for an existing group plan, or if you want to learn more about the favorable tax treatment, and small business health care tax credit.

Small Business Health Care Tax Credit

The Small Business Health Care Tax Credit can provide a tax credit up to 35% for not For Profit Organizations and up to 50% for Profit Companies for up to 24 months. We can show you qualified plans and help you to get a letter of plan certification that you can give to your tax advisor to see is you are eligible for the tax credit. The tax credit is based on certain factors of your business and payroll. There is a Small Business Tax Credit Estimator HERE. Let us know if you have questions or need support with the tax credit, or identifying the tax credit qualified plans.

Employer Compliance

Health Insurance, dental, retirement plans, voluntary worksite benefits, and other health & welfare plans require compliance with certain government regulatory agencies. Compliance typically includes the distribution of certain documents to employees about their rights within the benefit plans. Employers may also need to perform certain non-discrimination testing, and also retain certain documents, and follow certain procedures.  Most private sector health plans are covered by the Employee Retirement Income Security Act (ERISA). Among other things, ERISA provides protections for participants and beneficiaries in employee benefit plans (participant rights), including providing access to plan information. Also, those individuals who manage plans (and other fiduciaries) must meet certain standards of conduct under the fiduciary responsibilities specified in the law. The U.S. Department of Labor's Employee Benefits Security Administration is responsible for administering and enforcing these provisions of ERISA. There are risks for non-compliance including penalties and business disruption.  We offer easy and affordable ERISA and 125-b programs and can help with compliance advisements.

Life Insurance

Life Insurance provides cash to your beneficiaries when you die. This money helps to replace the income that you would have provided to the family during your working years, and also can pay for final expenses, family living expenses, debts, mortgage payments, education, childcare, and more. The benefit protects your family financially, and even a smaller life insurance policy can make a big difference. We offer numerous life insurance options for individuals and employers and can usually have proposals ready for you in 24-48 hours.

Individuals can usually purchase from $50,000 to $1 Million of life insurance coverage, and may be able to purchase a life insurance benefit that is from 1x to 10x annual gross income. Rates vary based on age, gender, health history, family history, tobacco use, and other factors. Term life insurance is usually the lowest cost.  A formal application, and paramedical exam are usually required and decisions from the life insurance underwriters usually take about a week or two.

Employers may also purchase group life insurance. The group life insurance is typically flat $25,000 or $50,000 with matching Accidental Death & dismemberment coverage. Some employers may purchase life insurance benefits equal to 1-3 times employee salary, or more.

Although Term Life Insurance is most common, there is also Universal Life Insurance that requires more premium, but benefits may last longer, and there may be guaranteed values in this type of policy.

Request Individual Quotes HERE.

Request group Life Insurance Quotes HERE.

Disability Insurance

Many Americans can't afford to miss a paycheck, but most of us are not financially prepared in the event of an emergency. Disability insurance protects your paycheck by replacing a portion of your income if you are not able to work due to illness or injury. We offer numerous disability programs, and can help find a program to protect your income.

Individuals may purchase individual Disability Income policies that may replace about 66.75% of pre-disability income, and will be tax free income. There are numerous optional riders that you can select to enhance the coverage. Request your Individual Disability Income Replacement proposal HERE.

Employers can sponsor group Long-Term and Short-Term Disability insurance for employees. This program is usually paid 100% by the employer. This program typically pays about 60% of employee pre-disability gross income, and is taxable. Since the employer group disability benefit usually pays at about 60% and is taxable, the employees are encouraged to confirm if the net benefit will be adequate for their income replacement needs, or if they may want to consider purchasing a private partial disability policy, that can give additional tax free cash, to go with the employer benefit.

We are here to help you review your disability income protection needs, and provide you with solutions that can meet this often overlooked gap in most peoples insurance needs.

Request Individual Disability Quote HERE

Request Group Disability Quote HERE

Financial Assistance

There are numerous ways to get financial assistance starting with hospital bills.  Most hospitals will publish their financial assistance guidelines, application instructions, and applications on the hospital web sites.  We are familiar with financial assistance from hospitals and other sources, and would be happy to help you review the programs if you need assistance. 

Oregon Paid Family and Medical Leave

Paid Leave Oregon is a new program that ensures individuals, employers, and families have the time and support they need to care for themselves and their loved ones when life's important moments affect their health and safety.  The new Paid Family and Medical Leave Insurance allows eligible employees to take time away from work to bond with a child during the first year after birth, adoption, or foster care placement, care for a family member who has a serious health condition, take medical leave for an employee's own serious health condition, and take safe leave for an employee experiencing issues related to domestic violence, harassment, sexual assault, or stalking. The medical conditions covered are similar to what is covered by the Oregon Family Leave Act, but there are some differences. The program is funded through a payroll based contribution. Payroll contributions begin January 1, 2022, so we recommend that you contact your employer, payroll service, tax advisor, Human Resourced Representative or Health Insurance Broker for guidance and support. Read about the Paid Family and Medical Leave Insurance Insurance HERE.

1095-A and other Tax Forms

It will soon be time to gather tax forms related to health insurance, and include them in your tax filing.  If you are an individual marketplace consumer, then it is recommended that you keep tax returns current to avoid potential disruption of the Advanced Premium Tax Credit (APTC), or Cost Sharing Reduction benefits (CSR).

Form 1095-A is furnished by the Health Insurance Marketplaces to the IRS and to Individuals who enroll in a qualified health plan through the Health Insurance Marketplaces. The form allows individuals to reconcile the credit on their tax returns with the advanced payments of the premium tax credit, and file an accurate tax return.

Form 1095-B is used to report certain information to the IRS and to taxpayers about individuals who are covered by minimum essential coverage.

Form 1095-C is filed and furnished to any employee of an Applicable Large Employer (ALE) who is a fill-time employee for one or months of the calendar year. ALE members must report that information for all twelve months of the calendar year.

Form 8962: This is the Advanced Premium Tax Credit reconciliation form that is used to reconcile your premium tax credit, on your tax return. This form will determine if you have excess APTC, or if you will have repayment for some or all of the APTC you received for the prior calendar year. There are various APTC repayment calculators.

Advanced Premium Tax Credit Resources

• Increased Tax Credits on the Marketplace
• Tax Credit expanded to include those over 400% of the FPL
• IRS
• Healthcare.gov
• Suspension of Repayment of Excess APTC for 2020
• Repaying excess advance credit payments for tax years other than 2020
• Tax Credit Eligibility Calculator

Agency News

• WiredEnroll is our Small Employer quoting and enrollment system. If you are a small employer and want quick turn around for small group health plan rates, live web based spreadsheet comparisons, and online web based enrollment, then we can help you with easy online small group reviews and enrollment.

• HealthSherpa is our individual health and dental shopping and enrollment service. Check out our individual health and dental shopping site here. When you use our eligibility, shopping and enrollment website, be sure to watch for any emails from noreply@healthsherpa.com for information and information about your quotes, or enrollment activity.

• Positive Customer Feedback Continues. Read Customer Ratings & Reviews for Laughlin Insurance, Inc., and leave your own feedback HERE.