16 Brilliant Ave Aspinwall, PA 15215 p:412-939-3780 info@locklingroup.com

16 Brilliant Ave Aspinwall, PA 15215 p:412-939-3780 info@locklingroup.com

Insurance FAQs

Insurance FAQs

The insurance coverage and employee benefits you need for your new business will depend on many factors. Does your business operate as a franchise or independent business? Do you run your business from your home or a building that you own or lease? Do you have employees? Do you sell a product or provide a service for your customers?

Here are the answers to the most commonly asked questions of new business owners.

Q: What is the differences between FSA’s, HSA’s and HRA’s?
A: Flexible Savings Account (FSA) – With an FSA, money is taken from your paycheck before taxes (you set the amount) and put into an account. You can then use that money to pay for medical expenses throughout the year. It’s important to understand that FSAs have a “use it or lose it” provision, meaning that you must use the dollars in the year in which they are saved or you will lose them at the end of the year. Check with your plan to make sure expenses are “covered,” meaning they are approved by the Internal Revenue Service as a qualified medical expense that can be paid for with your tax-free dollars.

Health Savings Account (HSA) – An HSA is a tax-sheltered account similar to an IRA, but can be used for care expenses before you reach your plans deductible. Your HSA not only lets you use account funds for plan-covered expenses, it lets you use funds for a wide range of “qualified medical expenses.” So you can use your HSA to pay for a broad range of care services and products that include everything from acupuncture to chiropractic care, dental care to eyeglasses. You can use accounts funds to improve your health by joining a weight loss or stop smoking program.

Investing with your HSA: each healthcare provider will have different custodian, many of which are banks. They are who you will invest your money through, once you have a balance of $500 in your HSA you will become eligible to invest. You have a wide selection of mutual funds – from conservative options such as a U.S. Treasury fund to more aggressive stock funds.

Health Reimbursement Account (HRA) – For example employees would pay for half of eligible expenses that are applied toward the deductible, and the HRA pays for the other 50 percent. Employees pay for the difference between the medical deductible and HRA contribution. Does not have to be 50 percent, could 80 percent it all depends on the employer. Then, the HRA pays for additional eligible expenses that are applied toward the deductible. The standard HRA features an innovative weekly on-demand funding process so you don’t have to pre-fund employee expenses with a deposit. That means you keep your money longer, so it can work harder for your business.

Q: How is Health Care Reform going to affect me?
A: (See Health Care Reform Tab) ← add link to (health care reform tab)

Q: Are there pre-existing conditions on individual health plans?
A: Yes, some plans will exclude anything you have been treated for in the past for 12 months. However, Health Care Reform will do away with pre-existing conditions.

Q: Will my doctor be in the network?
A: DO NOT take the time to figure this out on your own, that is our job. Let us find out if your doctor is in the network for you. Send us their information and we will get back to you quickly, usually within 24 hours.

Q: Can I get an individual Dental and/or Vision plan for me and my family?
A: Yes! There are several great Dental and Vision plans that can be tailored for you and your family’s needs.

Q: When am I eligible for a medicare supplement?
A: You’re eligible for Medicare when:

  • You’re 65 or older;
  •  You or your spouse worked for at least 10 years in Medicare-covered employment;
  •  You’ve been a U.S. citizen or legal resident for at least five consecutive years; and/or
  •  You are younger than 65, but qualify for Medicare due to a disability or End-Stage Renal disease (ESRD).
  • If you’re nearing Medicare eligibility because of your age—also called “aging into” Medicare—it’s important to remember:
  •  Even if you’re already collecting Social Security, you must wait until you’re 65 to join Medicare.
  •  If you’re not collecting Social Security, you may still join Medicare after you turn 65.
  • You must be 65 to join Medicare. Your spouse’s age doesn’t count. So if you were receiving insurance benefits through your spouse and they are aging into Medicare, you will need to find coverage for yourself until you turn 65.