Risk Managment and Insurance Planning Flashcards
Risk Avoidance
Used when risk cannot be reduced or transferred
ie. deciding not to go bungee jumping or choosing not to drive due to fear of being in an accident
Risk Reduction
Techniques used to reduce the likelihood of loss
ie. security systems, smoke detectors and seatbelts
Risk Transfer
Shifting financial consequences associated with a risk to a third party
ie. buying insurance
Risk Retention
Intentionally or unintentionally retaining the risk of loss, some or all, from exposure
ie. self insuring or insurance deductibles
HSA (who, when and tax advantages)
Individuals and employers can contribute (typically individuals)
If you are insured on the first day of the last month of the tax year you can make full HSA contributions for the Tax year
Pre-tax contributions, tax free growth, and tax free distributions (if used to pay for medical). Triple tax advantage
HSA Contribution Limits
Self- $3,850
Family - $7,750
Catch up (55 or older)- $1,000 additional
HSA Uses
Medical and superscription expenses
Includes OTC drugs, Dental, Vision, and qualified LTCi premiums
HDHP- Deductibles and out of pocket maximums
Minimum deductible- self- $1,500
Family - $3,000
Maximum out of pocket -
self - $7,500
Family- $15,000
Cobra
Group plans of 20 or more employees required to extend temporary extension of health coverage in certain circumstances
AKA continuation coverage
Cobra qualifying event
Termination (or reduction in hours)- 18 months (E,S,DC)
Disability through SS- 29 months (E,S,DC)
Employee enrolled in medicare, Divorce or death - 36 months (S,DC)
Loss of dependent status under the plan - 36 months (DC)
Cobra Costs
Costs can be passed on to the beneficiary at a max of 102% of the plan cost
Due monthly
Long-term Care locations (least intensive to most)
Home Maker Services
Home Health Aid
Adult Day Health Care
Assisted living facilities
Nursing home care
Medicare and Long term care
Medicare does not cover LTC
Will pay for a limited time after hospitalization
Days 1-20 - zero co pay
Days 21-100 - Patient pays $200 coinsurance per day
Days 101+ = Patient pays all costs
LTCi - Benefit period
Specific time frame (2 years) or pool of money
LTCi- Elimination Period
Waiting period before benefits kick in
LTCi- Daily Benefit
Maximum insurance will pay per care for care. Set at inception of policy
LTCi- Rider
add on features to the policy. An important one to consider is inflation protection
LTCi- Waiver of Premium
The policy holder does not pay premiums while receiving benefits
LTCi- Renew-ability
Most LTCi policies are guaranteed renewable
Qualified LTCi Requirements
Payable for LTC services only
Must be guaranteed renewable
Does not reimburse for medicare reimbursable expenses
No cash surrender value
Dividends must reduce premiums or increase benefits
Limitations and exclusions are prohibited, except preexisting conditions within 6 months of application
Qualified LTCi Benefits
Benefits are tax free
Premiums are qualified medical expenses for tax purposes
Premiums can be paid from HSA
If premiums are paid by the employer the payments and the benefit are tax free
LTC Benefits triggers
Option 1- Unable to preform 2 of the 6 activities of daily living for 90+ days
Option 2- substantial cognitive impairment
Either must be certified by a doctor
Activities of Daily Living (ADLs)
Bathing
Continence
Dressing
Eating
Transferring on and off toilet
Blindness and unable to walk are not ADLs
Partnership Long-term Care insurance
Partnership between states and insurance companies
Provides asset protection if LTCi benefits are exhausted and insured files for medicaid
Total amount paid under LTCi is added to Medicaid spend down limits and protections