California HSA health insurance
plans and Funding Reality
Well into the mid-2000's (is there
some snazzy way to describe that
decade), HSA plans on the California
health insurance market were pretty
tough to beat. The market place
broke down into 3 main categories:
HMO's, traditional PPO's, and HSA
plans. HMO's were on their fast
ascent into inaffordability. PPO's
were generally richer even for high
deductible plans with office visits
and medication broken out separately
which also priced them quite a bit
above California HSA compatible
plans. In this scenario, the HSA
plans became very competitive when
comparing the annual premium
difference versus either HMO or PPO
plans on the market. Even with
office visits and RX coverage being
subject to the main deductible, you
couldn't justify going anywhere else
for anyone in their 30's or older
and this was especially true for
older Californians or for families.
This comparison worked whether a
person funded the HSA account for
the tax benefit or not. That's no
longer the case. Let's take a look
at the current HSA versus PPO (since
HMO's have completely priced
themselves out of the market) and
see if it make sense and when.
First, a quick introduction to the
core components of the California
HSA insurance plan. Essentially,
there are two pieces. The first is
just a straight high deductible
insurance plan. Keep in mind that
just having a high deductible does
not make a plan HSA qualified.
There are certain parameters for the
deductibles and max amounts and also
requirements for benefits (basically
preventative) that are not subject
to the main deductible. That's the
insurance part of the HSA and most "HSA"
plans are PPO plans by design. In
the quote engine, they may say HSA
as a type for California health
plans but the underlying plan uses
the PPO network. The HSA type deals
with our second piece. If a plan is
listed as HSA, it means that the
insurance plans allows you to take
advantage of the tax benefits
associated with the HSA law. In a
nutshell (we've covered HSA plans in
detail with other articles), you're
able to fund into a separate
tax-favored account up to a certain
amount each year (depending on
family makeup and when the the HSA
plan starts) into this account on a
pre-tax basis. You can then use
these funds for qualified medical
and dental expenses (but not health
insurance premium) with pre-tax
money. If you don't use the money,
it rolls over year to year and
investment/interest can be
tax-deferred. The theory is that
you take the premium savings
associated with a high deductible
plan and fund the HSA account for
the smaller bills. Sounds great and
it worked well for about a decade.
That's the ideal but let's look at
the what we hear daily.
The HSA health plan is now priced
the same or slightly more expensive
than similar deductibles for
California PPO health insurance
plans. Some PPO plans now have
lower premiums with comparable core
benefit plus some level of office
copays and RX coverage up front.
Here's the rub. The HSA only makes
sense in those situations if you
fully fund the HSA account. Easier
said than done. For an individual,
this is about $3K and double that
for more than 1 family member. This
is in addition to the health
insurance premium. That money is
also somewhat locked away since
there's a penalty for in-eligible
withdrawals. Why does this matter?
Let's say you have a 30% tax
bracket. $3K at 30% is about $1000
in real savings per year. You
divide that by 12 months and it's
about $80 in real monthly savings.
If you subtract the $80 from your
HSA insurance plan premium, it
starts to look really attractive.
Even more so for a family
situation. We all have good
intentions and we all plan to fully
fund the HSA accounts but plans
change...especially in this economic
environment. If you feel that
funding the HSA account will be a
struggle in spite of your best
intentions then traditional PPO
plans might be the better option.
We're happy to look at your
particular situation (age, zip code,
etc) and see which approach to
California health insurance will
work best in your favor.
Other
important
concepts
to help
you
understand
your
California health
insurance
quote
are:
Question
on the
individual
health
insurance
application
Individual
health
insurance
underwriting
Enrolling
for
Individual
health
coverage
in
California
Download
the
health
application
or apply
online
What can
delay
your
individual
health
application
Options
for
people
who do
not
qualify
To
run your
instant
health
insurance:
California
Individual
Family
health
insurance
quote
California
group
health
insurance
quote