Hi,

My wife and I live and work full time in a 40' Bluebird Wanderlodge
(Bus RV).  We have been full time RVers for 18 months.  We have no
other residence, we live only in the motorhome.

We are both in our mid 30's, no dependents.  We have our own S
Corporation that we work for, one part-time employee (no benefits).
The business is a "work at home" over the internet business (I author
software, my wife does support).  The motorhome has nothing to do
with the business, we just have it as the freedom of modern cell
phones allows us to work many places.  So we try to travel when we
have time, most of the time we park and live in it like one would a
small house.

Our corporation and "official address" is in Washington (Seattle
Area).  However, we are considering moving our official residence and
business to Arizona (project to fully research later in the year).

We have had full coverage for 18 months paying COBRA rates.  That
expires today, so we are looking for options.

We only want "major medical" and so far a MSA looks like something to
consider.  We have no pre-existing conditions, and we are very light
users of medical coverage (I suspect we used only $800 last year as
an example).

We don't know where to start and are anxious to get a policy
started.  If we get in a MSA, is moving states going to cause us
problems?  Can someone recommend a plan that offers good nationwide
coverage, as we do live full time "on the road".

Thanks for any and all info, suggestions on where to purchase /
enroll, etc.

Thank you.

Hi.  I've read a lot about MSAs over the last few days and I am
thoroughly confused.  My scenario seems like it would be pretty
simple, so if anyone could provide advice (even if you're an agent
wishing to solicit a customer), I'd appreciate it!

Me:

- Single, male, 26 years old, healthy, non-smoker, Houston (77081)

Current coverage is:

- PPO Select Advantage (Plan I) with BCBS of Texas
- $180/month premium
- $500 deductible
- $20 co-pay for doctor visits and prescriptions
- 80% in-network

Coverage needs for the rest of 2003:

- Don't go to doctors very often
- Occasionally fill prescriptions
- Need $1000 - $2500 of dental work in the next month
- Considering having Lasik done

I'm looking for a plan that will cost me the least amount in the
best case without having a scary worst case.  Since I'm having the
dental work done very soon, I also need something that I can enroll
in very quickly.

Thanks for any help that anyone can provide,
Mike

You should contact Ed Sealy as he will have the most
knowledge of health plans in your area.  Dental
coverage may not be an option.  These are pretty
similar anywhere for individual plans.   A standard
exclusion for dental plans is major procedures
(crowns, root canals) are not covered during the first
12 months of continuous coverage.  You may also expect
that even after 12 month of coverage major procedures
are going to be limited to about 50% and $1000 maximum
benefit or less.

The great thing about an MSA plan is that the money
you set aside for you MSA account can be used to pay
for dental procedures with pre-tax dollars.

Mario


--- Michael Hoeffner <mhoeffner@...> wrote:
> Hi.  I've read a lot about MSAs over the last few
> days and I am
> thoroughly confused.  My scenario seems like it
> would be pretty
> simple, so if anyone could provide advice (even if
> you're an agent
> wishing to solicit a customer), I'd appreciate it!
>
> Me:
>
> - Single, male, 26 years old, healthy, non-smoker,
> Houston (77081)
>
> Current coverage is:
>
> - PPO Select Advantage (Plan I) with BCBS of Texas
> - $180/month premium
> - $500 deductible
> - $20 co-pay for doctor visits and prescriptions
> - 80% in-network
>
> Coverage needs for the rest of 2003:
>
> - Don't go to doctors very often
> - Occasionally fill prescriptions
> - Need $1000 - $2500 of dental work in the next
> month
> - Considering having Lasik done
>
> I'm looking for a plan that will cost me the least
> amount in the
> best case without having a scary worst case.  Since
> I'm having the
> dental work done very soon, I also need something
> that I can enroll
> in very quickly.
>
> Thanks for any help that anyone can provide,
> Mike
>
>
>


__________________________________________________
Do you Yahoo!?
Yahoo! Tax Center - File online, calculators, forms, and more
http://platinum.yahoo.com

I've been playing with the numbers and I just can't get the MSA to
look that favorable based on my claims last year.

Let's say that I have the following with similar monthly premiums:

Normal
    $2,500 deductible
    $3,000 max out-of-pocket
    $25 for office visit and RX

MSA
    $2,500 deductible

(I omitted the premiums below since they'd be very close and I also
used 30% for taxes which means about $500 in non-premium-based tax
savings (2,500 * .65 * .3))

If I have no medical needs at all, the MSA wins by $500:

    Normal = $0
    MSA = $500 in tax savings for future medical needs = -$500

If I am in an unlikely disaster, the MSA wins by $1,000:

    Normal = max out-of-pocket = $3,000
    MSA = deductible - $500 tax savings = $2,000

In a typical situation where I go to the doctor occasionally and
fill some prescriptions, the MSA barely loses.  Let's say that an
office visit is $90 and a prescription is $60.  If I do 6 of each:

    Normal = 12 co-pays = $300
    MSA = $900 - $500 tax savings = $400

So far so good for the MSA.  I went back and looked at my claims for
this year however and I found that I would have lost $2,200 with an
MSA.  I had some office visits, some X-rays, bloodwork, etc. but
they still managed to cost $4,000 in fees.  I still only had to pay
$300 in co-pays though since they were almost all preventative.

    Normal = $300 in co-pays = $300
    MSA = deductible = $2,500

I was really hoping to get some tax breaks for some upcoming dental
work, but without an MSA offering co-pays for preventative
treatment, I don't think that they would benefit me.

Am I missing something?

Thanks,
Mike

P.S.  I currently have a $500 deductible, but based on researching
my claims for last year, I'm going to switch it to $2,500.  Only one
claim out of 15-20 (including prescriptions) that I had counted
toward the deductible...

You appear to be comparing your $500 ded plan as well
as the $2500 deductible non MSA plan.  It makes sense
that the the $2500 ded plan is going to be a close in
terms of expenses as the MSA plan because the are both
high deductible plans.  You have referred to $4000 of
expenses last year, but the question is are these
typical expenses?  Prior to that year what kind of
claims did you have?  Do you expect similar claims
this year.  There are quite a few factors to consider
here and you are at an age where the premiums
differences are not as significant.  However, in my
experience those cost differences will increase
dramatically with each rate renewal.  Also you will
find that the greatest savings are going to be in the
years that you do not have significant claims. As a 26
year old male, even $1000 in claims per year is not
typical.

This in mind, it is impossible to determine what your
claims are going to be in the next year.  This can
only be guesstimated by your overall health, risk
factors, and propensity for medical treatment.  Your
comparison overall is fairly sound, but you should not
omit the premium as that is certainly an expense
factor however small.


--- Michael Hoeffner <mhoeffner@...> wrote:
> I've been playing with the numbers and I just can't
> get the MSA to
> look that favorable based on my claims last year.
>
> Let's say that I have the following with similar
> monthly premiums:
>
> Normal
>    $2,500 deductible
>    $3,000 max out-of-pocket
>    $25 for office visit and RX
>
> MSA
>    $2,500 deductible
>
> (I omitted the premiums below since they'd be very
> close and I also
> used 30% for taxes which means about $500 in
> non-premium-based tax
> savings (2,500 * .65 * .3))
>
> If I have no medical needs at all, the MSA wins by
> $500:
>
>    Normal = $0
>    MSA = $500 in tax savings for future medical
> needs = -$500
>
> If I am in an unlikely disaster, the MSA wins by
> $1,000:
>
>    Normal = max out-of-pocket = $3,000
>    MSA = deductible - $500 tax savings = $2,000
>
> In a typical situation where I go to the doctor
> occasionally and
> fill some prescriptions, the MSA barely loses.
> Let's say that an
> office visit is $90 and a prescription is $60.  If I
> do 6 of each:
>
>    Normal = 12 co-pays = $300
>    MSA = $900 - $500 tax savings = $400
>
> So far so good for the MSA.  I went back and looked
> at my claims for
> this year however and I found that I would have lost
> $2,200 with an
> MSA.  I had some office visits, some X-rays,
> bloodwork, etc. but
> they still managed to cost $4,000 in fees.  I still
> only had to pay
> $300 in co-pays though since they were almost all
> preventative.
>
>    Normal = $300 in co-pays = $300
>    MSA = deductible = $2,500
>
> I was really hoping to get some tax breaks for some
> upcoming dental
> work, but without an MSA offering co-pays for
> preventative
> treatment, I don't think that they would benefit me.
>
> Am I missing something?
>
> Thanks,
> Mike
>
> P.S.  I currently have a $500 deductible, but based
> on researching
> my claims for last year, I'm going to switch it to
> $2,500.  Only one
> claim out of 15-20 (including prescriptions) that I
> had counted
> toward the deductible...
>
>
>


__________________________________________________
Do you Yahoo!?
Yahoo! Tax Center - File online, calculators, forms, and more
http://tax.yahoo.com

Good call, Ed.  The out of pocket max is the a
critical factor.  I assumed the information that $3000
out-of-pocket max was correct for his BCBS plan.  Your
knowledge of the local plans is helpful.

Mario

--- Edward Sealy <edsealy@...> wrote:
> Mike:
>
> First thing you need to compare the insurance
> coverage in terms of what your
> total exposure is between the two plans:
>
> Your Plan: BCBS Select Blue Advantage for male Std
> NS age 26 in Hou/TX
> Deductible: $2,500
> Coinsurance: $5,000 max @ 85% after the deductible.
> Total Major medical exposure = $2,500 + $5,000
> Limit on Rx drugs: $1,500 per year! NO GOOD!
> Premium: $100 (Std)
>
> John Alden MSA
> Deductible: $2,500
> Coinsurance: 100%
> Total Exposure = $2,500
> Premium: $100 (Std)
>
> For tax year 2003 you can now deduct 100% of your
> premiums and MSA
> contributions.
> ..........

__________________________________________________
Do you Yahoo!?
Yahoo! Tax Center - File online, calculators, forms, and more
http://tax.yahoo.com

Interesting how much it can vary from state to state.

California has legislated mental health benefits into
the health plans.  However, this has has had two
unwanted side effects. The first is that rates were
inflated to "offset" the cost of these benefits.  The
second is that carriers became much more strict about
the underwriting criteria.   What I have found is that
carriers will now decline applicants for what used to
be minor issues.

The exception has been the MSA plans (for rates).
Interestingly enough an MSA plan for an individual age
26 in CA is only about $50 per month.  ($2400 ded and
$3200 OOP Max) Sadly, underwriting has been strict
even for some of these plans.

Mario




--- Edward Sealy <edsealy@...> wrote:
> Mario -
>
> Actually, I was incorrect about that $3,000 figure.
> As you may know, BCBS
> offers 3 different plans, and in checking the
> "Advantage plans" I found the
> one with $500 deductible has only $2,000 in
> coinsurance OOP, not $3,000, so
> I was off by $1,000 on that issue. However, in my
> response to his second
> message, comparing the $2,500 deductible plan V, it
> does show to have $5,000
> AFTER the deductible.
>
> It is obvious why any insurance company would not
> wish to advertise is
> weaknesses, but I feel it is misleading at best, to
> not provide important
> pertinent information like the coinsurance maximum
> and max limit on Rx drugs
> to the general public on their upfront marketing
> pages. The info is in
> there, but it sure is not what I would call easy to
> find, and most people
> would not even think about looking for that in the
> first place. As you can
> tell, it galls me when a respected "non-profit"
> (largest in Texas) insurance
> company goes out of its way to hide key exclusions
> from unsuspecting people.
>
> I did not mention it before, but as I was reviewing
> the BCBS description of
> benefits, it states there is NO benefit for "mental
> and nervous disorders
> except for Organic Brain Disease as defined in the
> Contract" Further, NO
> benefit for "Services or supplies for treatment of
> Chemical Dependency;
> services or supplies provided by a Licensed Chemical
> Dependency Counselor;
> or Licensed Psychological Associate."
>
> As you are aware, most individual policies do not
> provide generous benefits
> in these areas, but to their credit, John
> Alden/Fortis and Unicare do
> provide for at least some minimal coverage of $2,500
> to $3,000 per year for
> this. And neither has taken the draconian step to
> limit Rx drugs as has the
> trusted BCBS.
>
> Ed Sealy
>
>
>
>
>
> -----Original Message-----
> From: Mario Murillo [mailto:groboz@...]
> Sent: Thursday, April 03, 2003 10:59 AM
> To: MSA_insurance@yahoogroups.com
> Subject: RE: [MSA_insurance] An MSA would have cost
> me an extra $2,200...
>
>
> Good call, Ed.  The out of pocket max is the a
> critical factor.  I assumed the information that
> $3000
> out-of-pocket max was correct for his BCBS plan.
> Your
> knowledge of the local plans is helpful.
>
> Mario
>
> --- Edward Sealy <edsealy@...> wrote:
> > Mike:
> >
> > First thing you need to compare the insurance
> > coverage in terms of what your
> > total exposure is between the two plans:
> >
> > Your Plan: BCBS Select Blue Advantage for male Std
> > NS age 26 in Hou/TX
> > Deductible: $2,500
> > Coinsurance: $5,000 max @ 85% after the
> deductible.
> > Total Major medical exposure = $2,500 + $5,000
> > Limit on Rx drugs: $1,500 per year! NO GOOD!
> > Premium: $100 (Std)
> >
> > John Alden MSA
> > Deductible: $2,500
> > Coinsurance: 100%
> > Total Exposure = $2,500
> > Premium: $100 (Std)
> >
> > For tax year 2003 you can now deduct 100% of your
> > premiums and MSA
> > contributions.
> > ..........
>
> __________________________________________________
> Do you Yahoo!?
> Yahoo! Tax Center - File online, calculators, forms,
> and more
> http://tax.yahoo.com
>
>       Yahoo! Groups Sponsor
>             ADVERTISEMENT
>
>
>
>
> To unsubscribe from this group, send an email to:
> MSA_insurance-unsubscribe@yahoogroups.com
>
>
>
> Your use of Yahoo! Groups is subject to the Yahoo!
> Terms of Service.
>


__________________________________________________
Do you Yahoo!?
Yahoo! Tax Center - File online, calculators, forms, and more
http://tax.yahoo.com

Which company is only $50 for an MSA in CA at age $26 because I would
like to use them as a carrier if the major medical benefits are good?

Thanks,
Bret Lewis


--- In MSA_insurance@yahoogroups.com, Mario Murillo <groboz@y...>
wrote:
> Interesting how much it can vary from state to state.
>
> California has legislated mental health benefits into
> the health plans.  However, this has has had two
> unwanted side effects. The first is that rates were
> inflated to "offset" the cost of these benefits.  The
> second is that carriers became much more strict about
> the underwriting criteria.   What I have found is that
> carriers will now decline applicants for what used to
> be minor issues.
>
> The exception has been the MSA plans (for rates).
> Interestingly enough an MSA plan for an individual age
> 26 in CA is only about $50 per month.  ($2400 ded and
> $3200 OOP Max) Sadly, underwriting has been strict
> even for some of these plans.
>
> Mario
>
>
>
>
> --- Edward Sealy <edsealy@s...> wrote:
> > Mario -
> >
> > Actually, I was incorrect about that $3,000 figure.
> > As you may know, BCBS
> > offers 3 different plans, and in checking the
> > "Advantage plans" I found the
> > one with $500 deductible has only $2,000 in
> > coinsurance OOP, not $3,000, so
> > I was off by $1,000 on that issue. However, in my
> > response to his second
> > message, comparing the $2,500 deductible plan V, it
> > does show to have $5,000
> > AFTER the deductible.
> >
> > It is obvious why any insurance company would not
> > wish to advertise is
> > weaknesses, but I feel it is misleading at best, to
> > not provide important
> > pertinent information like the coinsurance maximum
> > and max limit on Rx drugs
> > to the general public on their upfront marketing
> > pages. The info is in
> > there, but it sure is not what I would call easy to
> > find, and most people
> > would not even think about looking for that in the
> > first place. As you can
> > tell, it galls me when a respected "non-profit"
> > (largest in Texas) insurance
> > company goes out of its way to hide key exclusions
> > from unsuspecting people.
> >
> > I did not mention it before, but as I was reviewing
> > the BCBS description of
> > benefits, it states there is NO benefit for "mental
> > and nervous disorders
> > except for Organic Brain Disease as defined in the
> > Contract" Further, NO
> > benefit for "Services or supplies for treatment of
> > Chemical Dependency;
> > services or supplies provided by a Licensed Chemical
> > Dependency Counselor;
> > or Licensed Psychological Associate."
> >
> > As you are aware, most individual policies do not
> > provide generous benefits
> > in these areas, but to their credit, John
> > Alden/Fortis and Unicare do
> > provide for at least some minimal coverage of $2,500
> > to $3,000 per year for
> > this. And neither has taken the draconian step to
> > limit Rx drugs as has the
> > trusted BCBS.
> >
> > Ed Sealy
> >
> >
> >
> >
> >
> > -----Original Message-----
> > From: Mario Murillo [mailto:groboz@y...]
> > Sent: Thursday, April 03, 2003 10:59 AM
> > To: MSA_insurance@yahoogroups.com
> > Subject: RE: [MSA_insurance] An MSA would have cost
> > me an extra $2,200...
> >
> >
> > Good call, Ed.  The out of pocket max is the a
> > critical factor.  I assumed the information that
> > $3000
> > out-of-pocket max was correct for his BCBS plan.
> > Your
> > knowledge of the local plans is helpful.
> >
> > Mario
> >
> > --- Edward Sealy <edsealy@s...> wrote:
> > > Mike:
> > >
> > > First thing you need to compare the insurance
> > > coverage in terms of what your
> > > total exposure is between the two plans:
> > >
> > > Your Plan: BCBS Select Blue Advantage for male Std
> > > NS age 26 in Hou/TX
> > > Deductible: $2,500
> > > Coinsurance: $5,000 max @ 85% after the
> > deductible.
> > > Total Major medical exposure = $2,500 + $5,000
> > > Limit on Rx drugs: $1,500 per year! NO GOOD!
> > > Premium: $100 (Std)
> > >
> > > John Alden MSA
> > > Deductible: $2,500
> > > Coinsurance: 100%
> > > Total Exposure = $2,500
> > > Premium: $100 (Std)
> > >
> > > For tax year 2003 you can now deduct 100% of your
> > > premiums and MSA
> > > contributions.
> > > ..........
> >
> > __________________________________________________
> > Do you Yahoo!?
> > Yahoo! Tax Center - File online, calculators, forms,
> > and more
> > http://tax.yahoo.com
> >
> >       Yahoo! Groups Sponsor
> >             ADVERTISEMENT
> >
> >
> >
> >
> > To unsubscribe from this group, send an email to:
> > MSA_insurance-unsubscribe@yahoogroups.com
> >
> >
> >
> > Your use of Yahoo! Groups is subject to the Yahoo!
> > Terms of Service.
> >
>
>
> __________________________________________________
> Do you Yahoo!?
> Yahoo! Tax Center - File online, calculators, forms, and more
> http://tax.yahoo.com

Blue Sheild of CA
Rates very with each county but most are at about that
rate.  Broker services is at 800-559-5905

--- tempelife <sales@...> wrote:
> Which company is only $50 for an MSA in CA at age
> $26 because I would
> like to use them as a carrier if the major medical
> benefits are good?
>
> Thanks,
> Bret Lewis
>
>
> --- In MSA_insurance@yahoogroups.com, Mario Murillo
> <groboz@y...>
> wrote:
> > Interesting how much it can vary from state to
> state.
> >
> > California has legislated mental health benefits
> into
> > the health plans.  However, this has has had two
> > unwanted side effects. The first is that rates
> were
> > inflated to "offset" the cost of these benefits.
> The
> > second is that carriers became much more strict
> about
> > the underwriting criteria.   What I have found is
> that
> > carriers will now decline applicants for what used
> to
> > be minor issues.
> >
> > The exception has been the MSA plans (for rates).
> > Interestingly enough an MSA plan for an individual
> age
> > 26 in CA is only about $50 per month.  ($2400 ded
> and
> > $3200 OOP Max) Sadly, underwriting has been strict
> > even for some of these plans.
> >
> > Mario
> >
> >
> >
> >
> > --- Edward Sealy <edsealy@s...> wrote:
> > > Mario -
> > >
> > > Actually, I was incorrect about that $3,000
> figure.
> > > As you may know, BCBS
> > > offers 3 different plans, and in checking the
> > > "Advantage plans" I found the
> > > one with $500 deductible has only $2,000 in
> > > coinsurance OOP, not $3,000, so
> > > I was off by $1,000 on that issue. However, in
> my
> > > response to his second
> > > message, comparing the $2,500 deductible plan V,
> it
> > > does show to have $5,000
> > > AFTER the deductible.
> > >
> > > It is obvious why any insurance company would
> not
> > > wish to advertise is
> > > weaknesses, but I feel it is misleading at best,
> to
> > > not provide important
> > > pertinent information like the coinsurance
> maximum
> > > and max limit on Rx drugs
> > > to the general public on their upfront marketing
> > > pages. The info is in
> > > there, but it sure is not what I would call easy
> to
> > > find, and most people
> > > would not even think about looking for that in
> the
> > > first place. As you can
> > > tell, it galls me when a respected "non-profit"
> > > (largest in Texas) insurance
> > > company goes out of its way to hide key
> exclusions
> > > from unsuspecting people.
> > >
> > > I did not mention it before, but as I was
> reviewing
> > > the BCBS description of
> > > benefits, it states there is NO benefit for
> "mental
> > > and nervous disorders
> > > except for Organic Brain Disease as defined in
> the
> > > Contract" Further, NO
> > > benefit for "Services or supplies for treatment
> of
> > > Chemical Dependency;
> > > services or supplies provided by a Licensed
> Chemical
> > > Dependency Counselor;
> > > or Licensed Psychological Associate."
> > >
> > > As you are aware, most individual policies do
> not
> > > provide generous benefits
> > > in these areas, but to their credit, John
> > > Alden/Fortis and Unicare do
> > > provide for at least some minimal coverage of
> $2,500
> > > to $3,000 per year for
> > > this. And neither has taken the draconian step
> to
> > > limit Rx drugs as has the
> > > trusted BCBS.
> > >
> > > Ed Sealy
> > >
> > >
> > >
> > >
> > >
> > > -----Original Message-----
> > > From: Mario Murillo [mailto:groboz@y...]
> > > Sent: Thursday, April 03, 2003 10:59 AM
> > > To: MSA_insurance@yahoogroups.com
> > > Subject: RE: [MSA_insurance] An MSA would have
> cost
> > > me an extra $2,200...
> > >
> > >
> > > Good call, Ed.  The out of pocket max is the a
> > > critical factor.  I assumed the information that
> > > $3000
> > > out-of-pocket max was correct for his BCBS plan.
>
> > > Your
> > > knowledge of the local plans is helpful.
> > >
> > > Mario
> > >
> > > --- Edward Sealy <edsealy@s...> wrote:
> > > > Mike:
> > > >
> > > > First thing you need to compare the insurance
> > > > coverage in terms of what your
> > > > total exposure is between the two plans:
> > > >
> > > > Your Plan: BCBS Select Blue Advantage for male
> Std
> > > > NS age 26 in Hou/TX
> > > > Deductible: $2,500
> > > > Coinsurance: $5,000 max @ 85% after the
> > > deductible.
> > > > Total Major medical exposure = $2,500 + $5,000
> > > > Limit on Rx drugs: $1,500 per year! NO GOOD!
> > > > Premium: $100 (Std)
> > > >
> > > > John Alden MSA
> > > > Deductible: $2,500
> > > > Coinsurance: 100%
> > > > Total Exposure = $2,500
> > > > Premium: $100 (Std)
> > > >
> > > > For tax year 2003 you can now deduct 100% of
> your
> > > > premiums and MSA
> > > > contributions.
> > > > ..........
> > >
> > >
> __________________________________________________
> > > Do you Yahoo!?
> > > Yahoo! Tax Center - File online, calculators,
> forms,
> > > and more
> > > http://tax.yahoo.com
> > >
> > >       Yahoo! Groups Sponsor
> > >             ADVERTISEMENT
> > >
> > >
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I am a bit confused about the term "Out-Of-Pocket Maximum"

1.  Who sets it - ins. co. or IRS?

2.  I understand it is a truer number with MSA plans, but what does it mean?
After reading Ed Sealy's last message, I get the impression the O-O-P Max is
IN ADDITION to the deductible instead of inclusive of it.

3.  Are different plans different in this regard?

Thanks in advance for your help.

Gordon Crawford
Systems Manager
Vanmark Corp.
(vmhr33)

This number is set by the insurance company.  Ideally
this number is in a prominent place on the benefit
summary.  Some carriers have hidden this in another
part of the brochure.  Some carriers have also defined
the OOP max as separate and additional to the
deductible and some make this inclusive of the
deductible. You have to watch for this.

Mario Murillo

--- Gordon Crawford <vmadmin@...> wrote:
> I am a bit confused about the term "Out-Of-Pocket
> Maximum"
>
> 1.  Who sets it - ins. co. or IRS?
>
> 2.  I understand it is a truer number with MSA
> plans, but what does it mean?
> After reading Ed Sealy's last message, I get the
> impression the O-O-P Max is
> IN ADDITION to the deductible instead of inclusive
> of it.
>
> 3.  Are different plans different in this regard?
>
> Thanks in advance for your help.
>
> Gordon Crawford
> Systems Manager
> Vanmark Corp.
> (vmhr33)
>


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http://tax.yahoo.com

Hello, all.  I have a couple of questions regarding MSAs that perhaps
someone can answer.

First... I took a retirement planning seminar a few months back, and
one of the covered topics was health insurance.  The presenter said
that under new regulations (I assume he meant HIPAA) that insurers
cannot refuse you health insurance.  He said that they could charge
you up to 150% of their normal premium, but couldn't turn you down
flat.  True?  Are there restrictions or qualifications that are
relevant here?

Secondly, my wife has some health issues that make her worried that
she'll be turned down for coverage in a HDHP.  (I've heard that a
denial from any health insurer is a black mark against you that
forever after makes it much harder to get insurance.)  Can she and I
have separate HDHP policies?  She is self-employed, I work for a very
small company.  If we can get separate policies, do we also have to
maintain separate MSA accounts?

Thanks.

  - Earl

A couple of years ago I did a lot of research on getting an MSA for
my corporation (Techbridge, Inc.)  I am the only employee of the
corporation. This is in California, where at that time there were
only two MSA providers (Blue Cross and Blue Shield).  I was given two
reasons why  my corporation could not get one:
1. I was a 'group' of one. (this appears to be a provider restriction)
2. The corporation was a 'C' corp not an 'S' corp. (this may be a
legal or regulatory restriction)

I recently was told that this was changed, but I can confirm it. Does
anyone know the the regulations/law have changed in last 2 years on
these points?

If some one could point me to where this information is found I would
also appreciate that.

Thanks,
Dave

In most states the insurance companies do not have to take you. But
HIPPA laws do prevent employer groups from being denied coverage for
medical reasons. In Texas the surcharge can be as high as 70% over
std rates. Some states DO have "guaranteed insurability" and there
you will find the rates to be about double or higher than elsewhere.

I don't think you have too much to worry about with being black
listed if denied. Every company has its own underwriting criteria, so
one company's "decline" is anothers "accept."

Re: MSA accounts - think you must maintain separate MSA accounts if
the insurance is separate.

Ed Sealy

Dave, John Alden/Fortis offers MSA plans in CA. I don't know of any
new laws that would allow you to have a "group" plan without 2
people, nor an individual MSA as an employee of your own C corp, but
suggest the CA John Alden/Fortis rep can help you with that one at
www.nstarmerketing.com

Ed Sealy

Have recently begun to learn about this new legislation (summer
of '02) that appears to alleviate the problems with group MSA plans
and MSA contributions. These sound like a great deal for any type of
group plan, but expecially those with no frills, high deductible
plans like the MSA prototype plans.

Does anyone out there have any experience with these and how you go
about setting them up?

Ed Sealy

A few things to consider.  HIPAA is a federal mandate
that required guaranteed acceptance to individual
plans under certain conditions.  Primarily, that you
must have exhausted COBRA eligiblity and have had 18
months of continous coveage AND are applying within 62
days of loss.  (an excepton was granted to states that
implemented their own portability rules)

Also HIPAA itself did not regulate the premium that
can be charged by an insurance carrier (although some
states have done so.) For instance in CA the rates for
HIPAA plans are typically 300% higher than comparable
preferred rate plans.

Mario Murillo

--- earl_s_jones <earl_jones@...> wrote:
> Hello, all.  I have a couple of questions regarding
> MSAs that perhaps
> someone can answer.
>
> First... I took a retirement planning seminar a few
> months back, and
> one of the covered topics was health insurance.  The
> presenter said
> that under new regulations (I assume he meant HIPAA)
> that insurers
> cannot refuse you health insurance.  He said that
> they could charge
> you up to 150% of their normal premium, but couldn't
> turn you down
> flat.  True?  Are there restrictions or
> qualifications that are
> relevant here?
>
> Secondly, my wife has some health issues that make
> her worried that
> she'll be turned down for coverage in a HDHP.  (I've
> heard that a
> denial from any health insurer is a black mark
> against you that
> forever after makes it much harder to get
> insurance.)  Can she and I
> have separate HDHP policies?  She is self-employed,
> I work for a very
> small company.  If we can get separate policies, do
> we also have to
> maintain separate MSA accounts?
>
> Thanks.
>
>  - Earl
>
>
>


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Background:  sole owner, small business, no employees, C-Corp (S-Corp
tax status), All of my taxable income is Schedule K-1 (S-Corp), no
payroll, no W-2, no 1099.

I started an MSA in 2002.  But now my accountant is telling me: ¡§MSA
contributions are only deductable from *earned income* (i.e. W-2,
1099), the K-1 income is not *earned income*¡¨

I then suggested I can (creatively) generate 1099 income from some of
my clients (don¡¦t ask how¡K¡K.*wink*¡K..) but my accountant tells me
that the 1099 income will then be subject to payroll taxes (ss.,
medicare, etc¡K..) or subject to ATM tax (15%) but will
Qualify for MSA deduction after above mentioned SS/ATM taxes.

Is this true?

If  I am going to take a 15% hit on my MSA contributions, I am
wondering if I should even bother with an MSA.

Any ideas, comments, suggestions are greatly appreciated.

My goal here is minimum tax exposure.

Thanks.  ļ

So you are saying:

1. Yes, K-1 schedule income is NOT earned income.

2. Any *earned income* will be subject too SS, Medicare, etc...
    and / or ATM tax BEFORE it is deductable.

Am I understanding it correctly?

The more I know, the more confused I get!   :)




--- In MSA_insurance@yahoogroups.com, "Edward Sealy" <edsealy@s...>
wrote:
> IRA's and MSA's have always required "earned income" to make them
work as
> Congress wanted people who "work/earn" for a living to be helped,
not "rich"
> people who are living off of inherited or other forms of "passive"
income.
> Obviously, this is not always the case, but try telling that to
Congress.
> Sounds like your CPA is giving you good advice. As to whether it is
worth
> conjuring up some earned income to make the MSA contributions
worthwhile is
> a question only your CPA could answer, but somehow I would doubt
it. As an
> alternative to billing some "clients" to provide the taxable
income, you
> could invest in an oil deal or others that the IRS recognizes
certain tax
> benefits for and if it hits will produce "active" earned income..I
happen to
> know about those type of deals as I invest in them myself and before
> becoming an insurance "expert" I was in the oil well drilling biz.
>
> Ed