Life and Health

Opioid addiction is a national crisis that affects people in every state. In fact, 100 people across the United States suffer from drug overdoses every day. The health care reform bill addresses the opioid crisis in several ways.

The Opioid Crisis in America

Before learning how the health care reform bill addresses the opioid crisis, you must understand more about opioids. Opiods can include prescription pain-relieving medication such as OxyContin and illegal street drugs like heroin.

A total of 52,000 people across the U.S. died from drug overdoses in 2015. More than six in 10 of those deaths were caused by opioids. These overdoses and any drug abuse harm the victim, affect families and strain community resources.

Treatment options for an opioid addiction often start with a medically supervised detox followed by inpatient or outpatient care at a drug addiction recovery center. Recovery usually focuses on the physical, mental and emotional aspects of addiction and provides counseling, therapy and other assistance to addicts and their families.

Drug abusers typically use their insurance to pay for drug treatment. Without treatment, however, sufferers may end up in jail, in the hospital or homeless.

Health Care Reform Funds Drug Treatment Options

The U.S. Senate’s current health care reform bill designates $2 billion to the opioid fight. These funds include grants that equip states to offer treatment and recovery services to people who suffer from substance or mental abuse disorders.

Health Care Reform Supplements the 21st Century Cures Act

Passed in December 2016, the 21st Century Cures Act boosted funds for mental illness issues.

• Approved $1 billion for opioid prevention and treatment programs with the majority of those funds supporting medication-assisted treatment therapies that curb a person’s urge to abuse drugs.
• Included $4.8 billion in financial resources for the National Institutes of Health to perform additional drug addiction research.

Health Care Reform Revamps Medicaid

Under the new health care reform bill, Medicaid will move to a block-grant system. A block-grant system gives every state the same percentage of funds regardless of the state’s need. The fund amount is reevaluated every three years.

Currently, states receive Medicaid based on the number of poor people who live in their state. These people may be unable to afford traditional insurance and rely on the extra financial assistance Medicaid provides. Some states that opted to receive Medicaid funding under the Affordable Care Act spend as much as 61 percent of their Medicaid funding on substance abuse treatment.

The healthcare reform bill is poised to address the nation’s opioid crisis. However, the bill is still undergoing changes. Monitor the details as you track the available options and assistance provided to opioid abusers across the country and in your community.

Chances are, you are like the majority of individuals who have reached middle age. The primary concerns in your life are paying your monthly bills, making sure your children receive a good education, as well as the all-important goal of saving some money every month for retirement. At this point, it seems a long way off, but do not be deceived; it will be here sooner than you think. You might have heard about Long-Term Care insurance, but you probably dismissed it with questions such as “What is it?” or “Who needs it?”

The answer is that you do, and so does everyone else. You might reply that you already have Health insurance. If you do, congratulations; it is hard to get in today’s political climate. The problem with most health insurance is that it does not cover what are known as custodial expenses. These expenses arise from custodial care, which is defined as the care needed as a result of the inability to carry out tasks relating to the following daily activities: bathing, dressing, eating, continence, toileting and transferring.

As people age, many of them find these basic tasks harder and harder to do without some form of help. The need for this type of care necessitates having Long-Term Care insurance, which can provide the monies necessary in order to hire and maintain the proper care needed. This is made even more necessary by the fact that people are living much longer, sometimes 20 or 30 years beyond retirement. Oddly, the fondest wish of these people is to remain independent. Fortunately, they can do so if they obtain Long-Term Care insurance.

The best time to do this is when someone is in their mid-forties, because that time of life is when insurance companies offer the lowest rates and premiums for their policies. Children can also purchase it for their aging parents. If they do not, there are two options left if something goes wrong, both of which are very unattractive. They either have to pay for the cost of their own income, or their parents have to pay for it out of their assets.

When you take into consideration the fact that this care routinely costs $75,000 and up annually, this is a tremendous burden to take on for either the children or the parents. Statistical research reveals that the average retired couple exhausts their savings in a matter of months when paying for care themselves. Even wealthy retirees find their money severely shrunk, which lives little for their children or grandchildren.

Long-Term Care insurance from a reputable and trustworthy insurance company can help retirees receive the care they need at a price they can afford both now and 20 or 30 years from now. Buyers must exercise the virtue of prudence when choosing a policy; each one comes with a set of circumstances and options to consider. After taking care of these, they are then free to enjoy the peace of mind that results from an effective Long-Term Care policy. Our professionals can help – call our office today!

Several recent reports have discovered that the number of female breadwinners is growing. Women are largely unprepared to manage a large payout from a life insurance policy or inheritance, however. The results of these reports can motivate and empower you and the women you love to take steps toward financial confidence.

Female Breadwinners are on the Rise

According to the Center for American Progress, up to 42 percent of moms are the sole or primary breadwinner in their home, meaning they earn at least half of the family’s income. An additional 22 percent of moms are co-breadwinners earning between 25 and 49 percent of the family’s total income.

Female Breadwinners Feel Financially Unprepared

Despite their increased earnings, many women don’t feel prepared to handle an inheritance or other large financial gift reports RBC Wealth Management. With this money, a family could repay debt, save for retirement or contribute to a child’s college tuition, but they may squander it if they don’t have a sound financial plan.

How to Find an Inheritance

Based on the findings of these reports, women are encouraged to take steps to boost their financial confidence. They can handle a life insurance payment or other inheritance wisely with help.

Find a financial advisor.

If you don’t already work with a trusted financial advisor, make time to find one. He or she will be:

• Trustworthy
• Qualified
• Certified
• Sensitive

Interview several candidates before you choose one. This way, you can compare the commissions, ensure you’re on the same page and know that the person you hire will put your needs first.

Wait one year.

It’s smart to take your time and make thoughtful financial decisions. The money you receive can provide you and your family with substantial benefits for years to come if you plan wisely.

Prioritize your current and future needs.

You may consider buying a luxury car or dream vacation with your inheritance, but prioritize your spending. Balance current needs with future needs so you’re not part of the 70 percent of people who receive a windfall and are broke within a few years.

Take action.

With the help of your financial advisor, take action to spend your inheritance wisely. Ask for small, actionable steps that assist you in achieving your goals. When you have a specific and detailed plan that’s broken into small pieces, you feel less overwhelmed and more confident about managing your money.

Female breadwinners may be unprepared to handle a life insurance payment or other inheritance, but they can learn how to manage money successfully. Ask for help and take charge of your finances today.

There’s no time better than the beginning of the year to set some fiscal goals and create a plan for improving your financial situation. You are probably ready for a brand new beginning and the thought of sticking to a budget after the holiday spending spree might sound a little more appealing than it would at any other time of year. Here is a step-by-step guide to create some annual goals as well as a financial plan that will help usher in a whole new financial foundation for you and your family.

Step one: List your goals for this year. It is important to remember that this step involves setting goals that are specifically to be achieved this year. That could involve paying off credit cards or small loans, saving money for a large purchase at the end of the year, or reducing your monthly bills so you can reduce your hours at work. This step should be completed with your family so that you can all discuss the goals and prioritize them. That helps to keep you all involved in committing yourself toward the goal and makes financial sacrifices easier for everyone to make.

Step two: Create a household financial plan. Your financial plan should be comprehensive and should consider all the insurance you have, the deductibles you have, and the emergency savings you have. The plan should also outline your average monthly budget, your debt and your plans for debt repayment or reduction. The purpose of the plan is to help you to recognize any shortcomings you have in insurance and savings needs and to give you some idea of how practical and achievable your goals are.

Step three: Make a new budget. In this budget, you should compare your income to your fixed monthly expenses and then determine what portion of your extra income should go toward achieving your listed goals for this year, which to apply to your long-term goals, and how much to set aside for shoring up all the shortcomings you found in step two.

Step four: Make sure your investments are well diversified. Because a loss in your savings account, retirement account or college savings plan could adversely affect the budget and financial plan you have created, it is a good idea to make sure these accounts are all well diversified. By diversifying the assets you have, you create a layer of protection against losses.

For instance, if you are heavily invested in company stock and the industry you work in has a bad year, you could see your retirement account balance decrease significantly. While this may not equal a definitive long-term loss (since the stock could increase over the next few years) it will certainly shake your confidence and create perceived financial stress as you become unsure of whether or not your retirement savings will be enough.

Make sure to have a balance in all your accounts of fixed products, high risk investments and low risk investments as well as investments in difference industries.

President Trump’s proposed budget cuts could save taxpayers $72 billion over the next 10 years. Revealed in May, the budget contains several policy changes that could affect your access to social security disability insurance benefits.

The Social Security Disability Insurance (SSDI) program gives financial support to one in five or roughly 11 million Americans. The average social security disability insurance payment is currently $1,171 per month or $14,000 per year. Unfortunately, the program is fraught with overpayments and fraud. Trump’s proposed reform would address these issues.

Reforms Address Overpayments

The majority of overpayments resulted from benefit recipients who received both social security disability insurance and unemployment. In the new budget, beneficiaries would not be able to double dip. While receiving both benefits is not illegal, it did allow 117,000 American to receive over $856 million in 2010 alone with total overpayments amounting to $12.2 billion between 2005 and 2015.

Reforms Address Fraud

Trump’s proposed budget changes would also address fraud. Federal investigators uncovered repeated schemes where doctors issued phony diagnoses of physical or mental impairment that allowed beneficiaries to receive millions of dollars for which they were not qualified.

Additional Social Security Insurance Disability Reforms

In addition to addressing overpayments and fraud, the budget proposal includes several additional reforms.

1. 1. Limit retroactive benefits to six months rather than one year before the applicant’s official eligibility. There is currently a five-month waiting period built into the application process.

1. 1. Require applicants to prove that they tried to find a job before they filed for social security disability insurance.

1. 1. Mandate rehabilitation before recipients with back pain or arthritis can receive full disability benefits.

1. 1. Increase work incentives that encourage social security disability insurance beneficiaries to find a job, saving the program $50 billion in five years.

1. 1. Give administrative law judges a one-year probation period before promoting them to a lifetime appointment.

1. 1. Implement tougher measures that require facilitators of fraud to repay any overpayments.

Opponents criticize the proposed budget. They fear that the cuts will adversely affect eligibility and benefits for t he disabled Americans who need SSDI. They also cite the failure of previous return-to-work efforts implemented since 1980 and believe the changes benefit the wealthy and punish the middle class.

One spending watchdog group the Committee for a Responsible Federal Budget approves of the proposals. It believes a reform of the social security disability insurance system is necessary to secure the organization’s solvency for Americans in the future.

The Congress is currently debating President Trump’s proposed budget. Time will tell if the reforms will build a healthier social security disability insurance system. In the meantime, consumers can continue to draw on their benefits and report fraud as they improve the program for everyone

Once annual enrollment has come and gone, it’s a good time to brush up on some basic benefit plan requirements, to avoid some of the common mistakes made in employee benefit plan administration. The following list of potential errors is by no means exhaustive, but represents a sampling of issues to steer clear of:

Keep your plan documents up to date and reference them in related plan communications.

ERISA requires that all employee benefit plans be maintained pursuant to a written plan document. As the governing document for the plan, it should be reviewed regularly, and amended if necessary, to keep up with new laws and regulations (such as health care reform). Since this will be the most detailed document regarding any given plan, it should be referenced in disclaimer materials included in less formal plan communications (such as annual enrollment materials) as the document that will control in the event of discrepancies, or errors or omissions in these other ancillary communications.

Keep summary plan descriptions (SPDs) up to date and distribute them to employees.

ERISA requires that employees receive an SPD covering each benefit plan, and specifies the information that must be included in the SPD. Plan vendors might supply booklets or other communications materials to distribute to employees that describe the plan, but these are unlikely to meet the requirements for an SPD. When plan changes result in an SPD needing modification, an employer might distribute a summary of material modifications in the interim before preparing an updated SPD.

Include only eligible employees (and dependents) in your plans, as to do otherwise will run contrary to plan documents and represent unnecessary coverage costs for your company.

Improperly covering ineligible individuals — contractors, leased employees, former employees, etc. — can be a costly proposition. Similarly, maintaining formerly eligible dependents who, for example, have aged out of the plan, unnecessarily adds to plan costs. Eligibility audits can help to mitigate this problem.

Follow plan terms in administrative practices.

The plan document governs, and both internal staff and outside administrators must follow the terms of the plan when making eligibility and claims decisions, issuing plan notices, handling appeals, etc.

Make sure plan contributions are calculated properly.

This includes taking into account the definition of compensation that is in the plan (which might include bonuses, commissions, etc.) and calculating matching and profit sharing contributions correctly.

If you allow employees to pay for any benefits on a pretax basis, a cafeteria plan is required.

Although the term “cafeteria plan” might conjure images of employees selecting from a menu of benefit choices, a cafeteria plan is, at its most basic level, a premium only plan, and is required to be adopted before employees can pay their health (or dental, vision, etc.) plan premiums with before-tax dollars, or to make before-tax contributions to a health care or dependent care flexible spending account.

If employees make salary deferrals to a 401(k) plan, these deferrals must be deposited into the plan trust on a timely basis, as by DOL regulation they become plan assets as soon as they can be reasonably segregated from the employer’s general assets.

Review your COBRA administrative practices to make sure all individuals qualified to elect COBRA coverage receive the proper notices, for all plans subject to COBRA (the health plan, but also the dental and vision plan, and the health care flexible spending account).

Administrative errors can result in fines and penalties, lawsuits, and employee discontent. An annual plan self-review can avoid these potential costly consequences of common mistakes.

Some large companies offer great perks like paid gym memberships, flexible scheduling or company stock. You may not receive these perks as a small business employee, but you could be eligible for valuable health insurance. As many as 54 percent of small business owners choose not to offer health insurance because of the cost, though. Share information with your employer about five health care options for small businesses that help you get the insurance coverage you need.

1. 1. Private Small Group Plan

      Some insurance companies offer private small group insurance plans. The insurance company assesses the small business’s employees to determine risk, and then they create a plan that outlines the benefits they’ll offer and the premium cost per employee. This option gives small businesses greater opportunities to shop around as they find the best coverage and rates for their employees.

1. 1. SHOP Marketplace

      Small businesses with fewer than 50 employees may purchase insurance through the SHOP Marketplace. It’s operated by public federal or state exchanges although some states offer limited SHOP Marketplace options. Registered SHOP Marketplace brokers assist business owners in selecting and setting up the right plan for them. Small businesses receive tax credit for enrolling, but they are required to meet requirements, including premium contributions or enrollment percentages.

1. 1. Private Exchange

      A small business can contribute a set amount to each employee who purchases insurance through a private exchange. Employees may choose from several plan options. A broker works with employees to help them find and select the right coverage for their needs.

1. 1. Co-operative

      Co-operatives are a traditional way for small businesses to offer health insurance to their employees. Several businesses can work together to negotiate rates and benefits while lowering administrative and management costs. Employee participation is optional. Because each co-op is structured differently, some may offer better rates than other health care options for small businesses.

1. 1. Individual Health Insurance
      
      Small businesses may choose not to offer health insurance. In this case, choose the insurance you want when you buy individual health insurance. Talk to a broker or purchase a policy through the Marketplace, and select the insurance company, coverage and deductible you want. Some employers will give employees a defined contribution allowance that reimburses a portion of the premium cost. They choose how much to contribute as long as it’s within federal limits.

As a small business employee, your employer may not offer the health insurance you need. Share these health care options for small businesses and ask your employer to choose an option that fits your needs.  If you do already receive health insurance, compare other options to ensure you’re getting best rate and the right coverage.

In March, Republicans in the United States House announced updates designed to strengthen the American Health Care Act (AHCA). The AHCA replaces the Affordable Care Act or Obamacare and will give all Americans access to the healthcare they want and deserve. While the AHCA is not law yet, several updates are important for you to understand since it can potentially affect the health care you receive.

1. 1. Makes Insurance More Affordable

      Premiums are expected to decrease under the AHCA. Limits will also be placed on deductibles and out-of-pocket maximums while annual and lifetime limits on essential health benefits are removed. These actions make insurance more affordable to individuals.

1. 1. Increases Insurance Accessibility

      Several potential health care updates could improve insurance accessibility for all Americans. These updates include:

      • Guaranteed issue regardless of pre-existing conditions.
      • Advanceable tax credit for low and middle class individuals and families.
      • Increase in tax credits for Americans between 50 and 64 years of age.
      • Financial support for certain Americans with high health care costs.
      • Reduction in the allowable tax deduction for medical expenses from 10 percent of income to 5.8 percent.

1. 1. Removes Individual Insurance Mandate

      Under Obamacare, every American must purchase insurance. The Updates on the Health Care Act remove this mandate. It also would repeal the Obamacare tax starting in 2017, allowing anyone who paid the tax to receive a refund.

1. 1. Removes Employee Mandate

      Many employers must provide insurance coverage for full-time employees. This mandate is removed with the Health Care Act updates. Employers could still cap health FSA contributions as they increase HSA contributions.

1. 1. Promotes Flexibility for State Medicaid Programs

      Each state boasts a unique population, and governors want flexibility in meeting their citizens’ needs. The Medicaid updates on the health care act establish a Patient and State Stability Fund that allows states to customize programs for their unique populations. It gives states power to:

      • Opt out of the per capita allotment baseline and choose a block grant from the federal government.
      • Create optional work requirements for healthy adults.
      • Reevaluate their need and preference every 10 years.

1. 1. Freezes Medicaid Expansion

      New states will not be allowed to opt into Obamacare’s Medicaid expansion, but beneficiaries who are enrolled before December, 31, 2019 may be grandfathered into the expansion. Enrollees will be removed from the program as their income and other circumstances change.

1. 1. Increases Reimbursement to Certain Medicaid Enrollees

      Elderly and disabled Medicaid enrollees will receive an annual raise based on inflation. This update ensures the most vulnerable Medicaid recipients receive the health care they need.

If you have an opinion on the AHCA or updates on the health care act, contact your U.S. representative or senator today. Your voice matters as you get the health care you want and deserve.

Many employers have grappled with defining “involuntary termination” under COBRA. According to a recent IRS bulletin, here are the standards. Note: These questions apply solely for purposes of determining whether there is an involuntary termination under section 3001 of ARRA (including new Code sections added by section 3001 of ARRA — but not for any other purposes under the Code or any other law).

What circumstances constitute an involuntary termination for purposes of the definition of an assistance-eligible individual?

An involuntary termination means a severance from employment due to the independent exercise of the unilateral authority of the employer to terminate the employment, other than due to the employee’s implicit or explicit request, where the employee was willing and able to continue performing services. An involuntary termination may include the employer’s failure to renew a contract at the time the contract expires, if the employee was willing and able to execute a new contract providing terms and conditions similar to those in the expiring contract and to continue providing the services.

In addition, an employee-initiated termination from employment constitutes an involuntary termination from employment for purposes of the premium reduction if the termination from employment constitutes a termination for good reason due to employer action that causes a material negative change in the employment relationship for the employee.

Involuntary termination is the involuntary termination of employment, not the involuntary termination of health coverage. Thus, qualifying events other than an involuntary termination, such as divorce or a dependent child ceasing to be a dependent child under the generally applicable requirements of the plan (for example, loss of dependent status due to aging out of eligibility), are not involuntary terminations qualifying an individual for the premium reduction. In addition, involuntary termination does not include the death of an employee or absence from work due to illness or disability.

The determination of whether a termination is involuntary is based on all the facts and circumstances. For example, if a termination is designated as voluntary or as a resignation, but the facts and circumstances indicate that, absent such voluntary termination, the employer would have terminated the employee’s services, and that the employee had knowledge that the employee would be terminated, the termination is involuntary.

Does an involuntary termination include a lay-off period with a right of recall or a temporary furlough period?

Yes. An involuntary reduction to zero hours, such as a layoff, furlough, or other suspension of employment, resulting in a loss of health coverage is an involuntary termination for purposes of the premium reduction.

Does an involuntary termination include a reduction in hours?

Generally no. If the reduction in hours is not a reduction to zero, the mere reduction in hours is not an involuntary termination. However, an employee’s voluntary termination in response to an employer-imposed reduction in hours may be an involuntary termination if the reduction in hours is a material negative change in the employment relationship for the employee.

Does involuntary termination include an employer’s action to end an individual’s employment while the individual is absent from work due to illness or disability?

Yes. Involuntary termination occurs when the employer takes action to end the individual’s employment status (but mere absence from work due to illness or disability before the employer has taken action to end the individual’s employment status is not an involuntary termination).

Does an involuntary termination include retirement?

If the facts and circumstances indicate that, absent retirement, the employer would have terminated the employee’s services, and the employee had knowledge that the employee would be terminated, the retirement is involuntary.

Does involuntary termination include involuntary termination for cause?

Yes. However, for purposes of Federal COBRA, if the termination of employment is due to gross misconduct of the employee, the termination is not a qualifying event and the employee and other family members losing health coverage by reason of the employee’ termination of employment are not eligible for COBRA continuation coverage.

Does an involuntary termination include a resignation as the result of a material change in the geographic location of employment for the employee?

Yes.

Does an involuntary termination include a work stoppage as the result of a strike initiated by employees or their representatives?

No. However, a lockout initiated by the employer is an involuntary termination.

Does an involuntary termination include a termination elected by the employee in return for a severance package (a buy-out) where the employer indicates that after the offer period for the severance package, a certain number of remaining employees in the employees group will be terminated?

Yes.

Click here to learn more.