Insurance – Subject Matter Minute Blog

Subject Matter Minute, Episode #67 – Submitting a Health Claim on Cigna’s Website

The below post is taken from the Video Blog, the Subject Matter Minute. You can view the episode on YouTube if you would like. Find it here: Episode #67 – Submitting a Health Claim on Cigna’s Website

If YouTube is blocked for you or your agency, you can scroll to the bottom of this post to view it from Google Drive. (I would prefer you view it on YouTube, so I know how many people have watched)

You can also listen to an audio version.

Hello Everybody and welcome to another Subject Matter Minute!

So the last episode was on the Cigna Wyoming on Wellness website that makes it easy to find wellness resources. I hope everyone went out and gave it a look. I decided to give one of the services a go and did a few weeks of therapy through TalkSpace. That’s a service that allows you to get therapy in several ways… Video chat, Live chat and regular chat, where you are just messaging when you have the time. To be honest, the first therapist I was paired with wasn’t responding quickly enough for my taste, so I fired her and was paired with another therapist that is great. It was easy to set up and with our EAP, we get 3 “sessions” for free. This can be 3 video chats, or in my case when you are messaging, you get 3 weeks of chatting back and forth.

So… don’t be scared to get out there and use these services.

I also did an episode recently on the “Ideas Festival.” Well, we seem to have a lot of ideas! At the time of this recording, there have been 225 submissions. And I’ve been told that there are a ton of really good ideas. So… hopefully, these good ideas get implemented and those that submitted them get rewarded! Nice work!

Finally, there has been a big change at the Nagy household, but since I’ve already been rambling on, I’ll save it for next time.

So, typically, when we have health related costs, the provider and our insurance chat and everything gets magically taken care of, right? Well, there are a few reasons why this might not happen, and, thus, we might be required to do the magic ourselves. Today, I’m going to show you how to submit a claim on Cigna’s website. (music)

Before I get started, I want to thank Alice Burron of Cigna for being this month’s episode’s Subject Matter Minute. Thanks Alice.

Like I mentioned, there are a few reasons that we may have to submit our own claims on the Cigna website.

While in-network providers are required to submit our claims, out-of-network providers are not. Some will, but some might not. Another reason we will have to submit ourselves is if we get a blood test beyond the free blood chem test at Wyoming Health Fairs. Also, if you get a Covid vaccine and they don’t submit for you. And finally, if you have emergency care outside the US, you can submit the claim yourself. Also, just so you know… you have 15 months after the expense to submit a claim.

Let’s get to it. So, if you haven’t been there before, you want to start at My.Cigna.com. Either register if it’s your first time or go ahead and login. If it’s your first time in a while, you may need to do the two-step authorization code to your phone thing. Then, you may get an annoying page that asks if you want to invite family members to register. I have just been scrolling down and clicking “skip for now.”

Next, go to “claims” and click on “submit a claim online.” Then you choose the appropriate claim. Mine is a behavioral health claim.

As a side note, you can also submit claims for Covid-19 tests here. You can actually claim up to 8 tests a month. But…. today I’m showing you how to submit a medical or behavioral health claim. So, again, click here.

They give you some instructions here. In my case, it’s a claim from an out-of-network provider, so I’m submitting a superbill. You can see the definition of that here. Otherwise, make sure your digital document has these items on it. Then click the “start a claim” button.

Then you choose the family member that this is for, and click next. There’s a few more steps here. Is this Due to an Auto Accident or Work Related Illness/Injury? I’m going to select “no,” and click next. Is the Patient Covered by Medicare? Again, “no” and next. Does the Patient Have Other Insurance/Coverage for this Claim? One more “no” and next.

If you have different answers for some of those steps, like “if it was an accident” or “covered by medicare,” you will need to have further information. However, you will still end up at the same place where you will upload your claim.

So, click on “choose a file.” Select the file from your computer, and click open. You will see the filename right here. Then click “upload file.” You can add multiple files here as long as all of the steps were answered the same. When you are done uploading the files, click next.

Select who you want the payment to go to. Click the checkbox. Enter a name for the claim. I just leave the person’s name and date as they make it. Then click done. Success! You can read the little “what happens next” text, and you can see that a confirmation message has been sent to you.

So that is the process of uploading claims to Cigna. I’ve done dozens of them and have not had any problems.

If at any point you need help, you can click on this contact us link right here, scroll down, and choose from phone, chat or email. I have made several calls to ask questions about other things, and they have always been very helpful and polite. So don’t hesitate to call.

Alright, that’s it for today! I hope everyone is dealing with the spring weather ups and downs well. And if you need some emotional help to get through it, as soon as you are finished submitting your claim, scroll to the top of the page and click on “mental health support” under the wellness menu item, and set up some time with a therapist. You won’t regret it.

Subject Matter Minute, Episode #66 – Wyoming On Wellness Resources

The below post is taken from the Video Blog, the Subject Matter Minute. You can view the episode on YouTube if you would like. Find it here: Episode #66 – Wyoming on Wellness

If YouTube is blocked for you or your agency, you can scroll to the bottom of this post to view it from Google Drive. (I would prefer you view it on YouTube, so I know how many people have watched)

You can also listen to an audio version.

Hello and welcome to another episode of the Subject Matter Minute! I hope everyone is enjoying winter! Now that it’s getting back to winter!

So, I have a couple updates related to two of the more recent SMM’s. After I did the episode on Pet Insurance, I had a couple state employee friends call me out on not figuring out if the benefit is a good deal. One said that he felt let down, and the other said that I’m just a shill for the man.

But anyways. I did some research into pet insurance, which is an optional voluntary benefit offered by EGI. And I would say that it is “fair to middlin’” price wise. I used a comparison site, used a 5 year old black lab for the pet, and ours came in maybe middle low. There were less expensive plans and considerably more expensive plans. And there are tons of them out there. But, just like with any insurance, different things can be covered, so it’s hard to directly compare. I guess my advice is while it’s a solid choice, everyone may need to do some comparison shopping. (Sorry I can’t be more specific, Bobby!)

The other update is on the employee referral bonus. People have been putting this to use! In the first 6 months of the fiscal year, so July through December, the state (HRD?) paid out $30,500. So, about 122 positions filled with folks that were recommended by you. Last year, they paid a total of $18,500 for the full year. So, I guess a lot of you out there have received a chunk of change for getting someone you know a new job. Nice work! I’m hoping that it was the SMM I did back in August that got you all thinking about it.

Alright… let’s move on. Today I want to talk about our Cigna benefits that are showcased on the website Wyoming on Wellness. (music)

For those of you who were around back in 2019, you may remember that I did an episode that covered some of the wellness benefits that we have through Cigna. Well, that was episode #25, and it still holds up. So give it a watch, if you can. Both for that episode and today’s episode, I was helped along by Alice Burron of Cigna. She is the person that does all the Walkingspree events and the wellness initiatives that regularly spread a bit of money around to many of those that participate. Alice is today’s subject matter expert. Thanks Alice.

So, Wyoming on Wellness is a website that tries to make navigating Cigna’s health and wellness resources easier. There is quite a bit of information on the Cigna website, but wellness is just one of the many items. So, if you are looking for help with your financial wellness, your mental health, maybe you need some coaching, want to catch up on the latest walkingspree initiative, etc… Wyoming on Wellness is where you wanna go.

I’m going to take you to the website and give you a little tour.

Here is the Wyoming on Wellness .org website. I’m going to take you through the navigation menu here in a minute, but first let’s take a look at the home page. The slider at the top usually has announcements and can be a good place to get started. Just click through them with the arrows. I would suggest you watch any of the videos on the website. They give you good introductory information on all of the aspects of WOW. This one goes through how to make the most of your benefits. And then they map out the 4 steps to get things moving with the Cigna wellness program. The rest of the home page includes links to the events calendar, links to the FAQ, and contact links. We will hit all of that from the top navigation.

I’m going to go through the main menu items here and then finish out with the “wow care navigator.”

So the first menu item is the Cigna steps which you get to by clicking on the main menu item. These are 4 steps to make sure you are making the most of your health plan benefits. And doing this gets you entered to win gift cards if you register for Walkingspree. They give hundreds of $50 gift cards throughout the year. So get your free blood draw at the Wyoming Health Fairs (you get two free screenings a year), register at mycigna.com to fill out your health assessment, then schedule your annual checkup with your doctor and go through those blood work results. Your results will show up automatically in your health assessment.

Ok, if you go down the menu and click on mycigna, you will get information about the registering step. If you go to the health assessment dropdown, you will get information about taking the health assessment.

Ok, let’s move onto events. Here you will see the events calendar, and be able to subscribe to it as well, if you would like. This is where you can find out about walkingspree challenges, webinars, and other special events.

Ok… let’s move on to the programs dropdown. If you click on the main menu item “programs” you will see this page that has the programs shown visually and has some additional info. So you can navigate from this page or the dropdown menu.

So, as you can see the wellness programs include coaching, financial wellness, Mental Health, Omada and Walkingspree. Let’s check out coaching first.

First of all watch the video. It highlights the areas where coaching could help and how we can get it. Then dig through the page to get the details. There are all sorts of areas where coaching could come in handy, like when you’re feeling stressed or would like to work with a coach to improve your health… for example.

Let’s move on to financial wellness. The first thing you should do is take the financial assessment. It’s free and it’s pretty interesting… I took it. Then sign up for the financial webinars that we put on monthly. And, again, we can get help for stress or anxiety related to finances. And who hasn’t had that!?

Next we will head to the mental health page. There are a lot of resources here. They’ve grouped the resources by topic. Building Resilience, Kids Teens and Families, Opioid Use, and Virtual Therapy. Alot of great stuff here. A few that I find interesting right out of the gate include Talkspace where you can get therapy via text messaging or live video. I think I would like text messaging. Also, there are a couple for children and teens that also include help for the parents… Bend Health and Brightline are similar and both provide healthcare and support for the whole family that includes children age 1 to 17. They both offer accessible coaching, therapy and medication management if needed. We can access these services through an app and through virtual sessions. For folks in parts of Wyoming that don’t have pediatric and adolescent mental health providers, or there’s a long waiting list, these services will give you access to Wyoming licensed and in-network providers. You may hear more about Brightline in the future, so keep your eyes open for that.

The next program is Omada. This is a free program for folks that are at risk for type 2 diabetes or heart disease. There’s a video that explains what it is about. It sounds very effective. I guess you get a wireless smart scale for free that monitors and syncs your weight to an online account. You do have to be eligible to enroll. (just click on the button on the Omada page to see if you qualify).

The last of the Program pages talks about the Walkingspree program. Here you can find out how to set up your account, how to earn points, and what you can win. I find the walkingspree challenges to be motivational. Makes me want to get out there and at least walk. And the more points you earn, the higher your chances of winning one of those gift cards!

Ok and finally… they have an FAQ page that has a ton of info on it, a podcast page where there will be monthly podcasts added… including one this month where I talk about benefits with Alice Burron of Cigna… so at least check that one out. 🙂 And then a contact page.

To finish things out let’s take a quick look at the WOW care navigator. This is pretty cool. If you come to the site with a problem but don’t really know where to start, just click here. With a few questions, you can be guided to the information and/or resources you need.

So, that’s a lot of information, I know… and to top it off, we also have another EAP that offers similar services. Look back at episode #41 for information on that.

The bottom line is that we have access to anything we might need in the wellness area. And it’s for our entire family. Do your research and find what you need to improve your situation, or your life.

Subject Matter Minute, Episode #60 – Vision Benefits 2023

The below post is taken from the Video Blog, the Subject Matter Minute. If it’s a little hard to read, it’s because it’s taken from the spoken word. You can view the episode on YouTube if you would like. Find it here: Episode #60 – Vision Benefits 2023

If YouTube is blocked for you or your agency, you can scroll to the bottom of this post to view it from Google Drive. (I would prefer you view it on YouTube, so I know how many people have watched)

You can also listen to an audio version.

Hello All, I hope you all had a fabulous holiday and that you got to use some of that hard-earned vacation time! I took on a challenge during the holiday season. A buddy of mine and I installed a new steering rack in my 2004 Toyota Camry. This is no small task. That’s why the shops wanted to charge around $2000 to get it done. Well, I bought the part, and with a little help from our friend, YouTube… we got it done. Quite a feeling of accomplishment! My buddy is a bit more confident in the auto repair arts, so he convinced me that we could make it happen, and by golly, we did. You gotta love YouTube, right?

So, I started making this show 5 years ago. Time flies… And because of that, I decided that I really needed to go through all the episodes to make sure that the information was still correct, and correct anything that wasn’t. So, for some things, that means completely removing, or hiding, the video. For instance… we no longer use Saba Talentspace for our performance evaluations. I had several videos showing the online processes for that software. So, I’ve now hidden those. Some just have small tweaks that I can add a new voiceover with some text or something to highlight the small changes. Others are just going to have too many changes to deal with without completely redoing them.

Well, episode #1, longevity pay is still the same, nothing has changed. We still get $40 per month added to our pay for every 5 years of service. Check out the episode that started it all.

Episode #2 was/is Vision Benefits. As I went through it, I tried hard to come up with ways to patch it up, but besides the changes, the episode just wasn’t all that great at covering the benefit. So… today, I’m going to redo the episode on Vision Benefits. (music)

While I mostly got my information from the VSP brochure, (which is linked below) I did, of course, have Employees’ Group Insurance look things over and make sure I didn’t misspeak or leave anything out. So thanks to this month’s Subject Matter Experts, the whole crew down at EGI.

So, the first thing to know about our vision benefits is that these are voluntary benefits. This means that the state does not pay for them, we do. We don’t have to have them. They are voluntary. So, I hope that I can help you decide if this benefit is for you or not. I will say that just an eye exam at our doctor costs $242.00 without insurance. Right now, at current rates, the most an individual employee, paying for coverage only for him or herself, (not paying for a family) the most they will pay is just a smidge over $100 a year. So, the math works out.

One other thing to know upfront… There is both a waiting and a commitment period. If you don’t select vision when you are first hired, or if you drop it, you have a 1 year waiting period before you can sign up. Also, once you have selected it, you must pay for the coverage for a year.

The covered components with our vision benefits are eye exams, glasses, and contacts. A new addition since I last covered this is something they are calling Essential Medical Eye Care. I’ll go into that as well.

As far as your exams, glasses, and contacts go, there are two different plans to choose from. Cleverly named Plan B and Plan C. It’s anyone’s guess where Plan A went. First I’ll cover what both plans give us and then I’ll cover the differences. Both plans give you a $10 exam every 12 months. Ok? So, it’s a $10 copay. That’s for the basic exam. Both plans also now have what’s called “essential medical eye care.” This covers additional exams and services beyond routine care to treat immediate issues from pink eye to sudden changes in vision or to monitor ongoing conditions such as dry eye, diabetic eye disease, glaucoma, and more. Each exam will require a $20 copay.

Both plans will get you a set of prescription glasses for a $25 copay. Actually, there are 3 different scenarios. If you just want frames, you pay a $25 copay. If you just want lenses, you pay a $25 copay. And again, if you want full glasses (frames and lenses) you pay a $25 copay. It’s always just going to be one copay.

But here is where the two plans split. With Plan B you have a $170 allowance for the cost of the frames. This means that after the $25 copay, VSP will cover up to $170 of the cost. With Plan C, you have a $190 allowance. Then… because frames can be quite expensive, you will get a 20% discount on the amount above the allowance for both plans.

Ok, and here is another difference between the two plans. With Plan B, you can only get new frames every 2 years… so 24 months. With Plan C, you can get them every 12 months. So, if you have a small child that’s good at snapping your frames, you may want Plan C. Or if your style preferences change more than they should, again, get plan C.

Now, this difference is just with the frames. You can get new lenses every 12 months with both plans.

So to sum that up a bit… you pay a little bit less with Plan B, monthly, and you get a little bit less.

Keep in mind that the lenses that are fully covered are fairly simple lenses. There are a whole bunch of “lens enhancements” that are going to cost you more. VSP claims that you get an average of a 30% discount on these, but they can really add up quickly. The best way to deal with this, if you are trying to keep your costs low, is to log in to the vsp website at vsp.com and see how much they cover for things you might want. Might even make sense to bring that list so you know how much each of those add-ons that they are selling you cost. Cause they will ask.

Ok, next is contact lenses. There is no copay for contacts, and the same allowances apply. So for plan B, you get a $170 allowance and for plan C you get a $190 allowance. You can get the allowance every 12 months for both plans.

If you want to, you can also get non-prescription sunglasses instead of glasses … with the same allowances and time periods. So, every 2 years for Plan B and every 1 year for Plan C. So, if you take care of your glasses, and/or your eyes don’t change too much, you can get some nice sunglasses instead.

There are a few other benefits, like discounts for laser corrective surgery and higher allowances for special (ie. expensive) frames that they are partnering with, discounts on additional pairs of glasses, etc…

Like most things insurance, you will need to use an in-network provider. You can find your providers on the VSP website. I’m going to give you a quick tour of that in a minute.

Please keep in mind that this video is being created at the beginning of 2023. Prices and numbers will change. The easiest way to find the current cost of the vision coverage is on the a&i website. You can find that info below.

Once you have vsp coverage, the best way to see what you benefits are, and to see if you are eligible for new glasses, or whatever, is to login to the vsp site. I’m going to show you that now: (quick site tour)

This is the VSP website – vsp.com. First time here you’re probably going to need to create an account otherwise you log in. That brings you to your dashboard. One thing you need to know here is that you can switch members here. Right here it says switch member if you have family coverage you might want to look at somebody else’s coverage. I’m not going to switch but I’m going to show you how… shows you the drop-down of my family. I’m not going to do it I’m going to bag out and I’m going to look at just for me.

There are a lot of things you can see here… your benefits, your most recent doctor, your claim history, you can manage your account, and all that. I’m not going to show you everything but I’m going to show you where you can look at your benefits so you have an idea of what kind of coverage you have, where you are at in the timeline, and all that. I’m going to click “view your benefits” …you can also switch your member in here again, but you’re going to have to “review your benefits” now to get to this area.

This area basically shows you everything I have said in this video. You can go down through here and see where you’re at and what your coverage is. My exam… I’m eligible on February 1st so I’m not quite eligible, my co-pay is only ten dollars all right, frequency every 12 months. This is actually a contact lens exam which I did not mention in the video but that might cost up to sixty dollars to get that done… if you’re already getting contact lenses you won’t have to do that. The retinal screening is also something I didn’t mention but it’s that thing we’ve all dealt with where you can either get a free one by dilating your eyes or you can get the fancy one and that can cost up to $39. Now we’re down here to what I was talking about… the prescription lenses. I’m eligible for my lenses every 12 months, $25 copay.

Here are all the enhancements that I mentioned. It says here you should expect to pay no more than the following costs. This is what I said you might want to print out or write down and take with you because they’re going to ask you “do you want this, do you want that” and you’re going to go “uh uh I don’t know” so bring that along and at least you’ll know how much it’ll cost you if you do. Frames $25 copay for just the frame… I’m in Plan B so it’s every 24 months… I have a 170 dollar allowance for that. You can also click here if you want to get some much more expensive frames… you’ll get a higher allowance for that. If you keep going down you can get contacts instead of glasses, you can see what your coverage is… this is the Essential Medical Eye Care that I mentioned. It says that I’m eligible, the co-pay is twenty dollars per office visit, and then it continues on. Shows you that you can get an average of 15% off of Laser Vision Care and so on. This is a great place to come see if you’re due for an eye exam, if you’re due to get glasses, and to see all the benefits that you have with VSP.

Ok! Hopefully I’ve helped those trying to decide if they want vision or not and also helped some of you out there that need a refresher on our vision coverage. I’m going to keep going through the early Subject Matter Minutes to see what other ones need to be redone, so keep an eye out for the next email. Also… don’t forget that you can learn anything on youtube! Alright, thanks for joining me on the subject matter minute, I’ll see ya next time.

Subject Matter Minute, Episode #59 – Open Enrollment Changes 2023

If YouTube is blocked for you or your agency, you can scroll to the bottom of this post to view it from Google Drive. (I would prefer you view it on YouTube, so I know how many people have watched)

You can also listen to an audio version.

Hello and welcome to the Subject Matter Minute, I’m Matt Nagy, thanks for joining me! I started putting this episode together last week when the weather was still perfect. Has everyone else been enjoying the most perfect fall ever? It may be coming to an end now, but, I can’t believe I had to work last week. There should be a “perfect weather” holiday. Right? (maybe that’s a good retention strategy the state could consider?) anyways… I digress…

Speaking of nature… I want to show you guys a little video of my wife’s office in Steamboat. The quality is really poor, but you’ll get the idea. (Bear Video) The whole family! I guess they were trying to make an appointment! It would be cute except I just read the article about those two wrestlers who were attacked near Cody. If you haven’t read it, search for it… it’s quite a story.

Ok, now that I told you to go outside to enjoy the weather and then basically told you to stay indoors, cause, well, bears…. Let’s get to the content!

As you SHOULD know… we are nearly halfway through Open Enrollment for 2023. And while a month ago might have been better, now still seems like a good time to talk about a few open enrollment changes. (music)

So… open enrollment starts on October 1st and goes through the end of November. This is the time that you can add, drop, and/or make changes to the benefits that we all get through Employees’ Group Insurance. The changes that we make take effect the following year. So the changes we make now are put in place for the 2023 calendar year. While you can go view your benefits on the portal, nothing needs to be done if you aren’t making any changes. However, don’t forget that flex medical and daycare has to be enrolled in each year if you wish to participate.

It seems like for me, the only thing that I sometimes change is the flexible spending account amount. Although I did drop short-term disability last year as I figured I had accrued enough sick leave to cover the short term.

Otherwise, you can go in and change your health insurance deductible,
elect or drop preventive dental and/or the optional dental (if the 3-year waiting rule is met),
you can elect or drop basic and voluntary life insurance (in limited amounts and possible underwriting),
elect, drop or change your vision plan (if waiting period/commitment period met),
elect or drop ambulance coverage (if waiting period is met),
elect or drop short term disability or long-term disability,
elect flexible spending accounts for 2023 .
and finally, add, drop, or change dependents where appropriate. (documents may be needed!)

There are some small changes that will go into effect in 2023. If you recall, vision insurance had a waiting and commitment period of two years. This meant that if you didn’t elect it when you first were hired, or you dropped it, you had to wait 2 years to get it. It also meant that once you elect it, you had to keep it for 2 years. That period has been reduced to 1 year.

The benefit for optional dental has been increased from $1500 to $2000 per calendar year. So if you have optional dental, delta dental will pay up to $2000 for things such as crowns. This is a good thing for me, as my teeth are all sorts of cracked up!

Also, the maximum you can use for the medical reimbursement went up from $2700 to $2850. So, if you are always maxing that account out, you can bump up your monthly amount a bit.

Please keep in mind that I, by no means, have gone through all the details. Sometimes documents are needed, and sometimes you need one thing to get another. There are other waiting periods. But those are details that I’ve gone through in other Subject Matter Minutes, I’ve put links to the appropriate ones below. I have also included a link to a video taking you through the entire portal open enrollment process below. Of course, if you have real questions, important questions, please contact EGI. (contact info on screen)

Finally, please don’t wait until the last minute to get this done. EGI business hours are Monday – Friday 8 am-5 pm, so while we can submit an online enrollment until midnight on 11/30, if you experience any errors or technical problems, there is no way to get assistance after hours. Alright? We are given 2 months to get this done, so get in there and make it happen.

Alright, that’s it for today! But before I go, I want to give a shout-out to Travis McGinnis of Big Piney. It was great chatting with you at the UW football game the other night! It’s great meeting cool state employees like you. Now, everyone… go outside before winter hits…get on your bike, go on a hike, sit on your porch… wait, unless there have been bear sightings nearby.

Subject Matter Minute, Episode #34 – Air Ambulance Coverage

If YouTube is blocked for you or your agency, you can scroll to the bottom of this post to view it from Google Drive. (I would prefer you view on YouTube, so I know how many people have watched)

You can also listen to an audio version.

Hello All! So, last month’s SMM was on COBRA. I think the general consensus from the feedback I got, was that all of us will have to work until we are Medicare eligible. Sad, but true.

Thanks for watching that episode and thanks for joining me today! If you didn’t watch that episode, or you’ve missed some others, I went ahead and posted a link to the SMM playlist in the show notes below the video. If you haven’t checked out the show notes before, I want to mention that you almost always have to click the “show more” button to actually see what’s in there. For some reason, YouTube gives very little space for it.

Alright. Today we are going to talk about the cost and/or our coverage of Air Ambulance service.

So, I started thinking about this, unfortunately, because a friend of ours was involved in a car accident that sent someone in a helicopter to Denver. We spoke with them and naturally began talking about car insurance and health insurance. Totally unrelated to this episode, but your car insurance is unlikely to cover much in a multiple injury and/or death type scenario. You might check out what your car insurance covers.

Anyway, we also spoke about the helicopter ride. Now interestingly, this is a bit timely, because both the legislature and the governor have also been talking about it. They are trying to create a new system to avoid the occasional huge charge that some have received after a medical flight.

Oh, by the way, when we talk about Air Ambulance, we are talking about both helicopters and airplanes. You can get a helicopter ride from the scene of an accident and either a plane or helicopter from the hospital to another hospital.

The price for this sort of service is all over the place. However, after speaking with Franz Fuchs of the Wyoming Department of Health, I have some numbers that are more pertinent for the State of Wyoming employee.

First of all, the claims for this sort of thing that EGI has dealt with average around 100 trips a year. They tend to be half plane and half helicopter with only about 10% of the flights being on the side of the road 9-1-1 calls. 90% are interfacility which can be by plane or helicopter. While either situation means you have been badly hurt, the flight from the scene type probably means you are worse off. Luckily, with only 10% being that type, there are only approximately 10 roadside flights a year. And this includes all the people that EGI covers.

The average that EGI paid for this sort of transfer (and this includes all the transfers… the 100 on average per year) was $33K in 2015 and went up to $36K by 2018. So EGI is getting a big bill.

Now, the average amount that a covered person paid… I keep saying “covered person” because EGI covers more than just State employees, there are some school districts and such…. Anyway, the average amount was just $250-$300. Franz pointed out that this number doesn’t really mean anything, however, as 70%-90% of folks paid close to $0. These were likely folks that had reached their maximum or covered their deductibles, ya know, different situations.
The actual maximum a person paid (that is covered by our insurance) in 2015 – 2017 was $3K, but there was one person in 2018 that was charged $10K. Honestly, we don’t actually know how much they ended up paying because the claims data doesn’t tell us. You can often negotiate that kind of stuff down.

So… after hearing this, it seems that state employees aren’t really the ones that the governor and the Legislature are talking about when they say that people are getting hit with huge bills. The bottom line is our insurance covers this sort of thing at least to 75%.

I’ve been asked to mention that Insurance companies have some coverage requirements for them to pay an air ambulance service, perhaps the most important of these is the one that says, “the service is medically reasonable and necessary.” So, in a situation, does the patient’s medical condition demand rapid and immediate air ambulance services? A broken leg probably does not warrant an air ambulance while bleeding inside the skull that warrants the medical intervention of a neurosurgeon might. Unfortunately, the patient rarely, if ever, has a choice or enough knowledge to make the call in this matter, so hopefully, the medical professionals are making the right decisions at the time. In this situation, it’s Cigna that makes this call after the fact… not EGI.

Now if you are in an accident that requires this sort of thing, you are obviously going to be dealing with a whole lot more than just a helicopter flight, but it is good to know that at least this piece is covered and won’t break the bank.

Also, if you do end up with a balance bill, I’ve been told that you should definitely do some haggling with the air ambulance company. They are often willing to accept a lot less than the bill if they can get it quickly or easily. I know that this seems weird, but it’s true.

I want to thank this month’s subject matter expert, Franz, of the Wyoming Department of Health for getting me the stats that have helped put our minds at ease. Thanks, Franz.

That’s it for today, check-in next month for another exciting episode of the Subject Matter Minute! See ya then!

Subject Matter Minute, Episode #33 – COBRA

You can also listen to an audio version.

Hello ya’ll! Thanks for joining me for another fabulous episode of the subject matter minute. I really do appreciate how many of you guys actually watch the show. It amazes me every month. So, thanks a ton! I also appreciate getting feedback and answers to my questions! I asked for input on my future Alaska cruise and I got a bunch. Really useful stuff. From small things that you wouldn’t think of… like putting some sort of decoration on your cabin door (so you can find it), to bigger decisions… like not booking excursions through the cruise line… possibly fetching you a much better deal onshore and a less crowded adventure. Thanks for all the advice, and now I’m really looking forward to the trip!

Alright, so today let’s talk about something we’ve all heard about, (we’ve seen the word) but most of us really don’t know what it means. Today let’s talk about COBRA. (music)

COBRA stands for the Consolidated Omnibus Budget Reconciliation Act of 1985. A mouthful, eh?

Before I get started, I would like to thank this month’s subject matter expert, Kathy Simpson of EGI. This topic is considerably more confusing than I thought it would be, and Kathy patiently took my barrage of questions and guided me to COBRA enlightenment. Thanks Kathy.

Ok, so the basic idea behind COBRA is to allow workers and their dependents to maintain their health coverage after an event such as job loss, divorce, or death.

Before I get into the details of eligibility and such, let’s talk about the elephant in the room with COBRA. First of all, Health insurance is crazy. And by crazy, I mean crazy expensive. We have it so good at the state. The bottom line with COBRA is that the state no longer kicks in anything. You have to cover the total cost. Not sure if you guys have ever paid attention to that number, but it’s big. So, let’s look at how much COBRA costs. Here’s a fancy little graph. I currently have family coverage with a $500 deductible. That means that the total cost is $2422… but the state kicks in $2121, which means I pay basically $300/month. If I were to go on COBRA, I would be paying the whole thing at $2470/month. That total is what I would have paid without a match, plus a 2% administration fee. Now that would be a shock to the system. Same with a $900 deductible. Not much difference there. So… my point here is that it’s expensive.

COBRA fees

However, since I’ve been warm and cozy in my little state employment cocoon, I don’t have any idea what private health insurance costs these days. It may cost the same for all I know. But you obviously would have to compare.

There is an exception here, and that is if you get Riffed. You can see that the state still kicks in a large portion in that scenario.

Ok, let’s get back to the details of COBRA.

First of all, as a COBRA Participant, you can only select a plan with the same or lower cost than the plan you had as an active employee or under active coverage. You may not select coverage (e.g. vision) that you did not have as an active participant. You only need to enroll in the benefits you need. For instance, if you only need dental, and you had it before, you can elect only dental. However, you do not have to elect dental if enrolling in a health plan with COBRA.

COBRA applies to most employers with 20 or more employees, with a few notable exceptions such as health plans sponsored by the federal government, and church-based employers. But COBRA does apply to the state.

In order to be eligible for COBRA, you must meet 3 requirements:

The plan must be covered by COBRA.
A qualifying event must take place — this includes a job loss (other than for gross misconduct), reduction of working hours, divorce or legal separation, death of the worker, or a worker’s child losing their dependent status under the plan.
The individual must be a qualifying beneficiary, which basically means that they were covered by the employer’s plan the day before the qualifying event took place.

So, you can’t have COBRA forever. It’s time limited. The maximum coverage period depends on the type of qualifying event and certain special circumstances. If the qualifying event is the termination of the employee (other than for gross misconduct) or a reduction in hours, the maximum coverage period is 18 months. There are a few exceptions to this, dealing with medicare, disability and such… However, after going back and forth with Kathy, I’ve come to the realization that it can be a bit confusing… so I’ve decided to take the easy way out. Please take your confusing scenario to EGI and let them explain the details. I mean, you need to talk to them anyways…

Ok, so the bottom line, as I said before, is that for termination or reduction of hours… aside from the few exceptions, you are allowed 18 months of COBRA. For all other qualifying events, the maximum coverage period is up to 36 months. These qualifying events include:

Employee enrollment in Medicare (spouse and dependents get 36 months COBRA)
Divorce or legal separation (spouse and dependents get 36 months COBRA)
Death of the employee (spouse and dependents get 36 months COBRA)
And Loss of “dependent child” status under the plan. (when a kid turns 26 they can get 36 months of COBRA

There are some reasons that a plan administrator could terminate COBRA coverage before the time period is up. The main reasons are:

Failure to pay premiums due
The employer ceases to offer a group health plan
The COBRA beneficiary becomes entitled to Medicare

Ok… some timelines here… Within 14 days of EGI becoming aware of your qualifying event, you’ll be sent an election notice. Since the State must notify EGI within 30 days of most qualifying events, within a month and a half of losing your job or some other qualifying event taking place, you should receive a detailed COBRA Packet to help you decide if you are going to continue your health coverage through COBRA. This packet has the enrollment form and all information related to COBRA.

Under federal law, you have 60 days after the date of the notice or the last day of coverage, whichever is later, to decide whether you want to elect COBRA. You do not have to send any payment with the Election Form; however coverage will not be activated until full payment is received. Payment in full is due within 45 days of your election. There cannot be a lapse in coverage.

And, it’s important to mention that every person covered under your group health benefits can make their own election to sign up.

Finally, cancellation of COBRA must be received in writing to EGI, and once COBRA is canceled there is no opportunity for reinstatement.

Continuing your health coverage through COBRA can be rather expensive, so it may be worth looking into these other options first:

Buying coverage through the marketplace at www.healthcare.gov
Checking your eligibility for Medicaid
Obtaining coverage through your spouse’s employer (a qualifying event for COBRA also entitles you to a special enrollment period for other group health plans)

Ok!! I hope I didn’t just make this more confusing for everyone! I mean, you are going to have to talk to EGI anyways, because this is an important decision, right? The bottom line is that COBRA is a short term coverage option for employees and dependents when the employee has one of the previously mentioned “qualifying events” occur to them.

That’s it for today, thanks for joining me on the Subject Matter Minute. I’ll see ya next time.

Subject Matter Minute, Episode #27 – Assigning Beneficiaries

If YouTube is blocked for you or your agency, you can scroll to the bottom of this post to view it from Google Drive. (I would prefer you view in YouTube, so I know how many people have watched)

You can also listen to an audio version.

Hello, and welcome to yet again, another episode of your favorite video blog…… the subject matter minute. If you got here by accident, I’m sorry. 🙂

So, this video is coming out a little late. I just got back from Japan. Yeah, really! My sister is a Navy Nurse and has been stationed there for the usual 2 years. We decided we’d better take our one chance to see Japan while we still have a place to stay and an awesome tour guide. We had a great time! We ate a lot of fabulous food, did some touristy crafty things, stayed at a military “resort” for a couple days, and put in some good beach/ocean time. I even got to experience something new on the way home. We actually flew out of LA because it cost so much to go out of Denver, and on the way back stayed in Las Vegas. Well, we got to experience our first earthquake! It was weird, exciting and kinda fun. Luckily is was small there. Although it did make the lights sway and then afterwards gave us some vertigo.

Before I get started on this months subject, I want to thank last episode’s subject matter experts… Jared Hanson and Brenda Kelly of HRD. The subject was using the PMI software between phases, if you missed it. So go back and catch that episode. And, thanks Brenda and Jared!

The Subject matter experts for this episode are Polly Scott of the Wyoming Retirement System and Pam Unruh of Employees Group Insurance. I also want to thank Mitzi, one of our fabulous HR coordinators out in the state for the topic suggestion!

Today I want to talk about the importance of assigning a beneficiary.

There are potentially 4 things that state of wyoming employees must choose a beneficiary for… They are Life Insurance through Employees Group Insurance… and your pension, the 457 plan, and Prudential life insurance through the Wyoming Retirement System. These each need different beneficiary designations. They don’t have to be different people…. They just each need to be assigned separately.

You are automatically enrolled in your pension, and the 457 plan. The state pays for the life insurance that you can get through EGI, but you have to elect it. (so definitely do that… it’s free) And finally, the Prudential Life insurance through the WRS is also a voluntary program. So, you pay for it and don’t have to sign up for it.

So…. what happens if you don’t select a beneficiary for these things??

When electing life insurance or changing your beneficiary through EGI, you can use paper or the online portal. When using the portal, if you elect life insurance, the system will require that you add a beneficiary. If you use paper, it doesn’t…

So…If an employee that has elected life insurance through EGI does not elect a beneficiary or the designated beneficiary is also deceased, benefits will be paid first, to your spouse, then your children, then your parents, then your brothers and sisters, and finally your estate. If it’s going to more than one person… like you have 3 siblings, then the money will be distributed equally among them.

One thing you need to be aware of… if you name a minor as your beneficiary, benefits can’t be paid to them. A guardian would have to be court ordered and the benefit would be payable to the guardian.

Ok, so that seems pretty standard, right? Well, when you name your beneficiary, you put in their name…. Not relationship. So, if you put down your wife or husband and then you get divorced, the money will still go to them. I’m guessing that not a lot of divorced people want their $50,000 life insurance policy going to their ex. Just a guess. Might make a few people roll over in their graves! So keep that in mind!

The issue of people not selecting beneficiaries has grown since we went to online systems and also automatic enrollment. People’s pension accounts and 457 accounts are set up automatically, but they still need to log into their online account for each and add the beneficiary information.

Something to note on the pension, if you elect more than one primary beneficiary on your pension then the beneficiaries won’t have the choice of a lifetime monthly benefit and will have to take a lump sum refund. Consider this carefully, and you can always add contingent beneficiaries who take the place if the primary beneficiary is deceased. If you should die in-service without a beneficiary, benefits would be paid to the estate. There isn’t an order precedence for pension benefits. That is why it is so important to establish beneficiary(ies), because going to the estate could complicate matters, or make things work out differently than you had planned.

The 457 Plan does have an order of precedence, but it is still important to designate a beneficiary because there would be an additional waiting period if the order of precedence is used. So if you don’t have a beneficiary selected, the money would first go to your estate, then your spouse, then a child or children and finally to a parent.

Finally, the Prudential life insurance through WRS has an order of precedence that goes

surviving spouse
all surviving children
all surviving parents
all surviving siblings
estate

Ok, I’m going to quickly show you where and how to change your beneficiaries. 3 of them can be done online. It’s simple. Prudential Life Insurance can be changed by calling 800-525-8056 and requesting a form.

First, I’m going to show you how to add or change your beneficiary in the life insurance that we get through EGI. First of all, go to A&I’s website and come up here to divisions. Click on Human Resources or the arrow next to it, then click on group insurance.

Now you’ll be on EGI’s site. Here’s the benefit portal go ahead and click on that. If you’d like there’s a couple videos you can watch: “how to register” and “using the portal for open enrollment changes,” but here is the portal access down at the bottom.

That’ll open up a new window and you’ll have to log in. It gives you more choices typically, but because I logged in with with Google that’s what it’s giving me and that’s kind of a familiar login. It will give you an opportunity to pick your gmail account and then you’d be in. So, as you can see, I’m in. This is the page that shows up. Here is your life insurance beneficiary.

Very simple. You can see I have my wife as the primary and then I have my two kids as contingent; they would be 50% and 50% should it go to them. All you do is click on update beneficiaries, you can see everyone that’s listed.

Here you can edit or you can add. If you edit someone you go in you change the name, blah blah blah, save. I’m gonna cancel out. If you want to add go ahead and add one. You would put primary or contingent, relationship percentage, save it. I’m gonna cancel out of that. After you change something you need to click here, and then save. But I’m not gonna do any of that because I’m already good here.

That’s the employees group insurance life insurance beneficiary add or change.

Now I’m gonna show you how to add or change beneficiaries for your pension through the Wyoming Retirement System. First, go to members, and then online pension account, come down to change your beneficiary.

This opens up a new window. You’ll need to login, and it takes you right there. You can see right now I have a primary beneficiary as my wife. I have not added my kids… I think it’s mainly because I could not remember their social security numbers, but all you would do is update the information.

If I wanted to add them as contingent beneficiaries I would create new, add one daughter, and then I would create new and do another one.

But since I’m not adding them today, since I still don’t remember their social security numbers, I will just cancel out of that. Then you click continue when you’re done.

This time we’re going to change our beneficiaries in the 457 deferred comp account. In order to do this, come on over here to login click on that. Click on the 457 plan login. Login to it.

Click on account, and then right over here under account overview is beneficiaries, or down here beneficiaries.

You can go to add/edit down here, and as you can see my wife is my primary beneficiary and one of my daughter’s is a contingent beneficiary. If you wanted to add, you would just add. If you wanted to edit, you could edit.

I’m gonna cancel. If you add, you would choose the type, contingent or primary, and save it. I’m gonna cancel out of that.

That’s all there is to changing or adding your 457 beneficiary.

There might be a few of you out there that just really don’t give a rip where your money goes after you die. After all, your dead. But I’m guessing that most do care. Please get in the systems and add your beneficiaries if you haven’t, and then check them somewhat regularly to make sure they are still good. Especially if you have changes in your family.

Well, it’s not a lot of fun to talk about things that involve our deaths, but we are all gonna go. So get your ducks in a row. 🙂

That’s it for this month’s subject matter minute. Please join me next month for what “might” be a more uplifting topic. Actually, I’m not sure what it’s going to be yet… but we’ll see you then.

Subject Matter Minute, Episode #25 – Cigna Wellness Initiatives

You can also listen to an audio version.

Hello, and welcome to another episode of the Subject Matter Minute. I’m Matt Nagy, thanks for joining me! Before we get started with today’s topic that includes how you can possibly make some cashola, I want to thank last month’s subject matter expert, Casey Baxter of Surplus Property. Thanks for your help, Casey.

It’s a coincidence, but this episode happens to be on preventative care the day after I had a bit of preventative care done on myself. I had a mole removed yesterday. Good times…Ya know… everyone blames the sun for this sort of thing…. Personally, I blame the moles. It’s not the sun’s fault that I’m covered in moles. So anyways, it seemed like a good preventative measure to get this removed, and we will find out next week, if everything is cool. I’m not worried and the doctor didn’t seem too worried. So…. speaking of health care, and preventative health care….

We all hear it every day… our healthcare system is in shambles… it’s broken… right? Well, while the government fails to figure this out, some people, organizations, and even insurance companies, are trying to figure out ways to, at least, slow the rise in costs.

There is one proven way to lower costs, and it just happens to have the side effect of helping people as well. And in this case, you might even win some money. Today I’m going to talk about Cigna and their Wellness Initiatives.

So… if you’ve been watching the show for a while, you know that I did one on the free blood chem screening through Wyoming Health Fairs. If you need to check it out, that was episode #15, and I’ve linked to it in the show notes. The chem screening is a great deal and something everyone should be doing. Well there’s more that you can do for your health that is free.

Did you know that you can go to the doctor once a year for a free well visit? You can also get free coaching from Cigna professionals on all sorts of health related topics, such as losing weight, quitting tobacco, managing stress and even dealing with chronic diseases. I’m going to go deeper into that in another episode. Today I want to talk about their current wellness initiative. Having said that, keep in mind that they do have ongoing wellness initiatives. I’m going to talk about the current one, but if you are watching this video far in the future, keep your eyes open for the emails that go out about every other month.

I chatted with my friend Alice Burron of Cigna, and she gave me the lowdown on the current wellness initiative. There are 3 steps (and possibly several rewards!)

Get your free blood chem screening through Wyoming Health Fairs
Take the Cigna Health Assessment online
Go to your in-network Dr. and get a free well visit.

You should probably do these things just because, but Alice has been given the power to incentivize it.

If you go to an in-network Dr. to get your free 100% covered annual wellness visit by Nov. 30, you will get entered into a drawing for one of 100 $200 gift cards. And if you take the health assessment before July 31, you are eligible to win one of 100 $50 gift cards. And, they just wrapped up a Walkingspree challenge and 50 of those who participated and earned badges won $50. There will be one more of those challenges this year. There is no doubt that this is real. I won $50 last year. 🙂 Now that I think about it… telling you guys about this has probably reduced my chances of winning. Dang… oh well… it’s good for everyone, right? I mean exercise is good and so is cash. 🙂

A couple items I need to mention about the wellness Doctor visit. When you make the appointment you need to specify that it is for the 100% well visit / annual checkup. Also, if you had your well visit anytime in 2019 before Nov. 30, you are eligible for the drawing. That means starting 1/1 of this year, any well visit from that point on is counted. Some of you already had your visit without knowing about this incentive, but don’t worry, you will be automatically included. And speaking of that, there is no paperwork related to the incentive. It’s all captured electronically, so you don’t have to turn in a claim form for the Dr. visit, or anything for the health assessment, either.

This is easy stuff that you can do for free, that can possibly win you some money; that is the right thing to do for your health, and could even slow down the rise in health insurance costs.

So, get involved in the cigna wellness initiative. And when you do, be on the lookout for an email saying you are a winner from Cigna, Walkingspree, or Tango gift cards!

If you have any questions, you can call the Cigna Customer Service number at 800.685.1060. Or email Alice at Alice.Burron@cigna.com. You can also find that number and email address down below in the show notes. There is also some brochures and information in the show notes, so be sure to take a look.

Alright, that’s it for this month. I’ll see you next time on the Subject Matter Minute.

Subject Matter Minute, Episode #22 – Health Savings Accounts

You can also listen to an audio version.

Hello and welcome to another episode of the Subject Matter Minute, I’m Matt Nagy, thank you for joining me. Before I get started on today’s episode, I want to first thank the subject matter expert from last episode, which was Wyoming retirement system… specifically Polly Scott. She always makes sure that I’m not making stuff up and that I’m getting things right. Thanks!

Also, a couple episodes ago I briefly mentioned something about my daughter that I wanted to talk about get off my chest. I don’t know if you guys remember but back in the day, I mentioned that my parents had given us a Subaru Outback for our daughters to use. An older model, but a fabulous car that they had bought new. So my older daughter got to drive it. Well, within three weeks she totaled it. Don’t worry she, was fine… it was a low-speed thing. Then after that I had a 93 Camry that I bought from my parents a while back. I put enough money into it to make it tip-top. So I let her drive that and about five months ago she totaled that car. Again, she’s fine. This one was in Ridley’s parking lot, right into a pole… dead center in the front. I mean crushed it. I’m glad she was fine, but heartbreaking two wonderful cars down the tubes. She had to buy her next car herself, obviously, and now my younger daughter turns 16 so she is driving as well. We set her up with a really cheap 97 Sentra, and and we also tried to change her behavior with some promises of helping her with a car after high school if she doesn’t total this one. I don’t know if it’ll help, but so far so good with that one. Thanks for letting me tell my story and get that off my chest. I know that speaking to people when I tell this story that others deal with this, so a lot of you out there feel my pain.

Today I’m gonna talk about something related to our healthcare plan. It’s a change you can make if you can afford it, and if it works for you. Today I’m going to talk about health savings accounts.

Health savings accounts, also known as HSAs.. Before I go into that I want to thank this month’s subject matter expert on this topic which is Ralph Hayes of employees group insurance. Of course it’s employees group insurance, right? Ralph helped me out, and he actually has been doing this personally for a while and he’s a believer in it, so he was the perfect person to help me out with this information. Thanks Ralph.

An HSA is like a personal savings account but it is used for health expenses, medical expenses. Set up in 2003 by the government to allow those folks who had high deductible health plans a way to pay for current expenses and future expenses, in a pretty tax favored way.

So in order to take advantage of an HSA you have to, again, have a high deductible health plan, and like the name says, a high deductible health plan has a high deductible. Currently the state has one plan or two plans, that you can use. For an individual, it’s the $1500 high deductible health plan, and for an employee with a dependent or basically families, it’s a $3000 deductible. Now keep in mind that while we the deductible is high with these, it means that your monthly premium is lower. Take me, for instance. Right now, I have a family plan at the $500 deductible point. This means that my premium is about $260 a month. If I go to the $3000 HDHP plan, my monthly premium goes down to about $63, so about a two hundred dollar difference there.

So if you go with this qualified plan that the state offers, you can open an HSA.

Something to know is that the state does not contribute to this plan and the reason I say this, the reason I tell you this, is because after all my reading I found that actually a lot of employers do contribute to HSA. Kind of as a benefit. But not at the state, you have to fund this yourself.

In 2019 you can contribute up to $3500 as an individual into your HSA, or $7000 as a family. At age 55, they give you a little extra room, if you can afford it, you can put another $1000 per year into your account.

First I want to talk about the advantages to an HSA. The big one that caught my eye and got me excited is you get a triple tax advantage. 1. Contributions are tax deductible, which means that you can either pull the money pre-tax out of your check, or any money that goes into the account after tax is deducted from your gross income on your tax return. 2. Earnings are tax-free. A lot of these counts you can earn money, like an IRA basically, and these earnings are tax-free. 3. Withdrawals are tax-free if they are used for
qualified medical expenses. So you’re talking a bunch of tax-free money right there.

Another advantage is funds rollover forever. Once you put them in, they’re yours. This is not like a flexible spending account, where you use it or lose it… this is your money to keep.

As I mentioned briefly the money in this account is invested in the good programs and can grow. There’s a lot of HSA providers out there, but you want to get one that, if you have excess in there, it can be invested like an IRA, and it can grow.

Another advantage is that it’s portable. The money is yours, again, even if you change plans, change jobs, or you retire.

Another advantage is the HSA can be used for retirement after age 65. You can still use it for health expenses, but you can also use it for anything else without penalty. I’m going to go into this penalty thing in just a minute, because now I want to talk about the disadvantages of an HSA.

The number one disadvantage, obviously, is the high deductible. It can be really difficult to come up with that kind of money for the deductible, especially in the first year or two of doing an HSA. That’s understandable.

Number two… unexpected health care costs. Kind of the same deal… if you aren’t putting enough money into your HSA, or it’s early on in your process, the first couple years, you might find it hard to pay for unexpected health care costs.

Now taxes and penalties… I mentioned this earlier. While you’re allowed to withdraw the funds from these accounts for anything that you would like to, if you pay for non qualified items you will have to pay income tax and a 20 percent penalty. I mentioned after 65 you don’t have to pay the penalty. You’ll still have to pay income tax on it, like an IRA, but no 20% penalty.

One last disadvantage is the pressure to leave the money alone. You may be reluctant to seek out medical care because you don’t want to spend that money that’s over there making money, and of course we want everyone to get medical care when they need to.

So really both healthy young people on a budget who want to reduce their monthly payment and families who can afford the high deductible and possibly max out the account, these are the kind of folks who might find these accounts especially beneficial.

Let’s let’s consider my situation for a second. This is me considering this whole thing. If I were to put the two hundred dollars a month that I saved by going to the $3000 deductible plan, I’ll be putting aside $2,400 a year. Not quite the deductible, but honestly we haven’t spent that much as a family for several years several years. Mostly because we’re done with braces and that sort of thing, but we’ve also been pretty healthy. So even at that contribution level of $2,400 a year I could probably expect some money to roll over, and then the account would grow.

Something to keep in mind if you’re thinking about expenses at this point… preventive care is still covered with a high deductible health plan at the same rate as it is now with your lower deductible.

If we were to put a little bit more into the HSA we could get it up to the $3000 deductible pretty easily… with $50 more a month… so a total of $250. That would get us to the deductible. Now, if we wanted to take it even further, I’m sure a lot of you, like me, use the flexible spending account, and typically we put in over a hundred dollars a month. If instead, we put that to the HSA, let’s just say a hundred, that would put us at $4,200 a year in our HSA. So even if you hit your deductible and paid your $3000, you’d have a little bit to roll over. Now, there is coinsurance and all that to take into account too, but $4,200 a year, if you don’t spend it all, you might be able to roll some over.

If you’re spending all the money in your HSA every year, then you are losing out on the growth benefit. However, at least you aren’t worried about the use-it-or-lose-it aspect of the flexible spending account, right? You’re getting the same tax benefit, but you don’t have the stress of trying to spend the money or having to do it by a certain date or buying things you don’t need (like these classes I got, and I got another pair of sunglasses this year because we didn’t have medical expenses… so I bought some computer glasses and then some sunglasses for in the car). You get that tax benefits but you don’t have to worry about that if you go with an HSA.

After after having said all that, trust me, I don’t know the best route for anybody, including myself. I’m just trying to wrap my head around this concept and see if maybe it would work for us. I do know that health expenses in retirement are one of the top expenses, and it’s serious expense. In fact, the last number on the average that we’ll spend on health care in retirement is $280,000! I’m not saying that the HSA will get us there, but it could certainly help and pay a chunk of that, and certainly in a incredibly tax advantaged way.

Again I want to thank Ralph for getting me this information. I find it very interesting. I hope you do too. I’m not telling anyone what to do financially. If it works for your family great, if not stay with that sweet low deductible plan that you have and be happy about it.

Thanks for joining me on the Subject Matter Minute, and I’ll see you next time!

Subject Matter Minute, Episode #18 – Long Term Care Insurance

You can also listen to an audio version.

Hello fellow state of Wyoming employees, thanks for joining me on another episode of the SMM, I’m Matt Nagy. A couple of you may have noticed… it’s unlikely… but I skipped the last episode of the subject matter minute because I was burning vacation in July. It was great, and it was really hard to get back to work, but basically, I got a river trip in, I had a staycation, which was actually supposed to be a supported mountain bike trip, but due to fires in Colorado, it got cancelled… but I stayed home anyways, that was a blast. Then we went to Walla Walla for a long vacation… Walla Walla Washington to do some wine drinking, or tasting. It’s kind of more my wife’s gig, but we had a lot of fun… we had good friends with us. So so in the end I didn’t feel like I had enough time to get her done, so I took a month off. If you were waiting with bated breath, I hope you took a breath, and I’m very sorry.

I want to thank the subject matter expert for that last one, which was EGI who gave me the information for telehealth. I think that a lot of you found that information useful. I got several comments about people not knowing about it, and basically, it’s a pretty inexpensive way to get a doctor’s opinion. So thank you EGI.

On that note, this month’s subject matter expert is once again EGI. We’re burning through all their benefits. This one’s loosely a benefit because it’s a voluntary benefit, which means it puts it in the same area as vision and long and short term disability in that the state doesn’t actually kick anything in. So it’s a benefit still because we’re getting group rates because of our numbers.

This episode we’re going to be talking about long-term care insurance.

Long-term care insurance… what is it? Basically, it is insurance to provide money for custodial care if you’re in an accident or get some sort of long-term disease like cancer… it’ll help pay for custodial things such as bathing, cooking, feeding, dressing… you know? If you get to that point, you forget about those, and those aren’t covered by medical insurance because they’re not actually medical items.

So that’s the what… why would you want to do it? First of all, it can help protect your retirement income. I say “help” because these sorts of scenarios can get very expensive. It can also help protect your family and friends from the burdens of continual care. It can help you choose where you want to get your care … it can be at home or in a facility or a combination. And that leads to the next one which is it allows you to bring someone into your home for care.

We need to keep in mind… when you think about long-term care – if you’ve thought about long-term care – we think about that being for the elderly or for when you’re really old. That’s not necessarily the case. If you have an accident or you get a disease like cancer, this coverage can kick in way before your old age.

Like I said, many people think that health insurance will help pay for this sort of stuff… it does not. Health insurance covers medical items only. This helps with custodial things… day-to-day activities. Another thing people think is that the government will kick in for this sort of thing. Well apparently that’s true, but you have to basically use all of your retirement savings, and sell off all your assets before the government will truly kick in. Some people think that they’re gonna have enough retirement to do this. Some people might, but it can get very expensive. I’m gonna go to their website and show you some stuff… the numbers are huge… you’ll be surprised.

For instance, my grandma… over ten years ago was put into – it was either assisted living or a nursing home or a combination place – that cost six thousand dollars a month, and this was a long time ago. It drove my grandpa crazy because it was destroying his retirement savings.

I kind of see this as a an insurance for the middle… all of us in the middle. If you’re broke when this happens to you you’ll probably get some help. If you’re really wealthy, you’ll probably be able to cover it. But if you’re in the middle, like most of us, this could help.

Their website is very useful… it has all these questions that I answered already, but you can read read through them again, and it also has a way to find out what your monthly cost will be. And because there’s lots of variables, you can change how much you get per day, you can change the overall amount, you can make it go up by a percentage every year to kind of keep up with inflation… so I’ll stop there and I’ll just go straight to the website and show you what you can do.

Because this is a voluntary benefit, a different company puts it on… this company is Genworth. so you go to Genworth.com/groupltc. The user is statewy password is groupltc, then you select your state, and then you select the applicant type, so I’m doing an employee as opposed to spouse. Then you click get started.

This has a bunch of information that you should read before deciding.

Why consider long-term insurance?
What does it cover?
Some misconceptions?
Why consider this program?

And then it goes over the Genworth the company. Whether or not it’s a good company, how long it’s been doing business…

Then you can look at questions regarding the plans:

How do I choose my coverage?
What features are included?
What additional options?
What happens when I need it?
What is not covered?

Definitely read through it all.

They also have a section about how to apply. Now I’m gonna go in to get a quote… I’m gonna go through this real quick. I’m gonna say it’s just me… you would say yes if it’s a spouse. Then you put in your birth date, where you are gonna retire… I’m gonna say rest of state, cuz probably not Casper or Cheyenne, and then click “next step.”

This is where you can adjust things to change your monthly fee. Right now it’s $56.09, and that means I’m gonna get out a maximum of a $150 a day for care, and a maximum (complete maximum) of $164,250. You can adjust… you can say, “how about if I just want hundred dollars a day?” That changes it to $37 a month. Or maybe let’s just go clear up to the two hundred dollars a day… now it not only adjusts the the daily but it adjusts the total coverage, so that’s $219,000 total. Alright, you really want to see it jump up let’s go to the max. $85 a month… not terrible, but if I want this amount to increase by a certain amount every year to keep up with inflation – let’s just do the three percent – jumps up to $189 a month. But, your total will increase yearly for life. At five percent, the highest you can do, it is $315.22 for my birth date.

Now there’s some things here that you need to look at. Let’s calculate the cost of waiting… that means if I were to do this plan in five years it would cost me $360 for a month, in ten years it will cost me 438. That’s a nice comparison as far as should I wait or should I start this now.

The other thing is here calculating self-insuring options. So this is how long it would take me to save that amount of money at 6%. I’ll be 78 years old by the time I have $292,000. now if you do it that way you should realize you won’t have it till your that age, and you hope that your problems start after that. With the coverage, you can get payouts earlier if things were to happen earlier.

Also you can compare plans and you can print out a plan summary.

One thing I want to show you that I had to back up to the Learning Center… I want to show you the cost of care in your area. So, this is a way to see how much it costs right now to get this sort of care. If you go to your state, and let’s do annually, and let’s say cheyenne, because a lot of you are in cheyenne. So this is how much it costs annually in Cheyenne right now for these sorts of things. Right now for a Home Health Aide, it cost $51,000 a year. You’ve got to keep in mind, too, that these sorts things are going up by this much every year. So assisted living facility… $55,000, but it’s going up seven percent a year! Let’s say you need it in 20 years… it’s gonna be way more than this. And consider this private room in a nursing home… $101,000 now, going up at three percent.

As you can see, the website is very handy, has a ton of information, and allows you to look at some numbers.

I hope that helps with your decision-making process as far as long-term care goes. As with most things in this insurance world in this area the younger you get in the cheaper it is per month, so consider it.

That’s it for this episode! Thanks for joining me on the subject matter minute I’ll see you next time.