Horizon Worksite Advisors, LLC

Angela Jenkins-Newell & I are at Perrys Steakhouse & Grill. Wonderful dinner venue!

We offer Employee Benefits, Medicare, Other Supplemental Ancillary (Health, Life, Disability, etc)

(Employer & Individual Services)

Guidance When You Need It Most
Group • Individual • Life • Health

Today is International Women's Day!

My condolences on the loss of Nashville's Mayor Megan Berry's son, today. No words can express the heartache a parent feels when they lose a child.

The ever changing health insurance landscape in Nashville! See below news on Oscar Health partnering with Humana to offer small group coverage in the Nashville area this fall, pending regulatory approval.

Humana and Oscar Health Enter Strategic Partnership to Offer Consumer-Focused, Technology-Driven Commercial Small Business Health Insurance, Beginning in Nashville Area
July 12, 2017 06:00 AM Eastern Daylight Time

LOUISVILLE, Ky. & NEW YORK--(BUSINESS WIRE)--Humana Inc. (NYSE: HUM), one of the nation’s leading health and well-being companies, and Oscar Health, a consumer-focused, technology-driven insurance startup based in New York, are launching a strategic partnership to offer commercial health insurance to small businesses in a nine-county Nashville, Tenn. area. The announcement follows the recent launch of Oscar for Business, the country’s first technology-driven health insurance for employers in April 2017. The new plans will be available this fall, pending regulatory approval.

How disheartening to over 100,000 individuals who are impacted by BCBST decision to leave the individual market in middle TN markets of Nashville, Knoxville & Memphis area. There will now be limited choice of carriers and not to mention lack of hospital networks! So now 1) individuals are "mandated" by the Affordable Care Act (ACA) to have medical coverage, 2) TN is still not expanding Medicaid (TennCare) (which was the intent of the ACA), 2A) by not expanding Medicaid individuals who earn under $11,770 are not eligible for a premium tax credit/subsidy, 3) limited carrier and hospital choices, and 4) the IRS will "penalize" individuals who do not comply and purchase medical coverage. Is there something wrong with this picture?!?

The AP (9/26) reports BlueCross BlueShield of Tennessee is exiting Affordable Care Act marketplaces in Memphis, Nashville and Knoxville. This change is expected to impact about 100,000 Tennesseans. The insurer said it will continue to offer ACA plans in other parts of the state.
The Tennessean (9/26, Fletcher) reports that Roy Vaughn, chief communications officer of BCBST, said that the company “made ‘an extremely difficult but necessary decision’ to leave the Nashville, Memphis and Knoxville markets as it tries to manage its number of members to hit a break-even point amid three years of losses.” The article says BCBST informed HHS about this change for 2017 on Friday.

Just finished attending a two day Benefits Connect Summit in Nashville for brokers. Enjoyed meeting other brokers from around the country and their fellowship!

Sending prayers to all our service men who have served our country! For without their sacrifice and service, we remain free! My father was on the beaches of Normandy on D Day. Thank you Dad!

Disability Awareness Month

Three Steps to Beat Diabetes With the spread of obesity, poor eating habits, and inactivity around the world, how will we reverse this trend and begin to beat diabetes?

You can do anything you want to do. You can be anything you want to be. Life is full of opportunities. But you must be willing to have goals and work towards those goals!

Those 1095C forms are due to employees by March 31st! I have solutions to assist business owners file, if they've waited til now!

“Small employers with fewer than 50 full-time employees (including equivalents) will be required to file Forms 1095-C and 1094-C if they are members of a controlled or affiliated service group that collectively has at least 50 full-time employees (including equivalents). Companies could be in a controlled or affiliated service group if they have common owners, provide services for each other or work together to provide services to third parties.”

http://mcgladrey.com/content/mcgladrey/en_US/what-we-do/services/tax/new-information-reporting-requirements-under-the-affordable-care.html

New information reporting requirements under the Affordable Care Act Draft 2015 forms and instructions for reporting health plan information to the IRS under the Affordable Care Act are now available.

Busy time of year training! BCBST, Humana, UHC, Cigna HealthSpring, WellCare, AHIP Medicare, Federal Marketplace, etc! Preparing for 4th qtr enrollments! Fun!

Great week with MTAHU! Monday evening reception with TN S Speaker of the House Beth Harwell and other State representatives and Senators. Tuesday was a great "Day on the Hill" with Lt. Gov Ron Ramsey, Speaker of the House Beth Harwell and other great Senators & Representatives! Thank you MTAHU!

Horizon Worksite Advisors Logo

May is Disability Awareness Month

These charts are produced by CDA using publicly available data from the U.S. Social Security Administration

Health Care Reform – Who Must Buy Insurance and How They Are Helped
Fri Feb 15 2013 H&R Block
In March, 2010, sweeping health care reform was enacted through two new laws: the Patient Protection and Affordable Care Act of 2010 and the Health Care and Education Reconciliation Act of 2010. These two laws are commonly referred to together as the Affordable Care Act, or ACA.
The centerpiece of this legislation is the “individual mandate”—the requirement that most individuals have health insurance coverage starting in 2014. The ACA also calls for the creation of “exchanges”, basically marketplaces where individuals can purchase their insurance with help from the federal government beginning October 1, 2013. The easiest and most convenient way for affected individuals to have the information needed to complete the enrollment application used to purchase subsidized insurance through an exchange is to timely file their 2012 tax return.
Basics of the mandate:
• Most U.S. citizens and lawfully present aliens will be required to have health insurance for themselves and for their dependents starting in 2014. There are just a few exceptions to this requirement (certain religious exemptions, for example).
• The insurance must meet minimum essential coverage standards. That is, the primary purpose of the insurance must be to provide basic health care benefits. Plans that meet this requirement include:
o Government-sponsored plans, such as Medicare, Medicaid, Tri-care, and CHIP.
o Employer-sponsored plans.
o Private plans.
Insurance that does not have health care as its primary focus, such as an automobile policy with a medical rider, is not minimum essential coverage.
• Individuals who do not qualify for, or have access to health insurance through one of the ways listed above may purchase qualifying health insurance through an exchange – a marketplace in which the individual has access to a variety of health insurance options. These options are called “platinum,” “gold,” “silver,” or “bronze” plans, depending on the level of coverage. Many states will sponsor their own exchanges, but a federal option will be available to those that live in states without a state sponsored exchange.
• Individuals who purchase insurance through an exchange may qualify for a government-provided subsidy to help pay part of the cost of the premiums.
o Eligibility for, and the amount of the subsidy depend on the individual’s household income and family size.
o The subsidy is advanced directly to the insurance company. The individual is responsible for paying the portion of the premium that is not covered by the subsidy.
• Those who do not have or obtain health insurance coverage by 2014 may be subject to a penalty.
How the subsidy works:
• Eligibility for the subsidy will be determined when an individual signs up for insurance through an exchange. Eligibility for and the size of the subsidy depend on the “household (basically the taxpayer, spouse and their dependents) income” and family size. For more about household income and family size, see The Importance Of Filing your 2012 Tax Return
• If the individual is eligible for a subsidy, the subsidy amount is advanced directly to the health insurance provider. The amount of the premium owed will be the net amount after taking in to account the government subsidy. The individual must enroll in a health care plan to receive the subsidy.
• In most instances, information from an individual’s 2012 tax return will be used to determine subsidy eligibility. The subsidy formula is complicated but, in general, as household income goes up, the subsidy decreases and the taxpayer’s share of the premium payment increases.
• An individual who receives a subsidy must file a tax return for the year. When the individual files his or her 2014 tax return during the 2015 filing season, a “true-up” process will determine the exact amount of subsidy due.
o If the individual is entitled to a higher subsidy, the difference will be paid as a premium tax credit (PTC) on the tax return. The PTC is a refundable credit, meaning that it will be paid even if the individual has no tax liability for the year.
o If it turns out the individual’s income was higher than estimated at the time of enrollment, the individual may not be entitled to the entire subsidy that was advanced during the year. The individual may have to repay some or all of the subsidy. The amount that has to be repaid also depends on household income and family size.
• It is important to understand that the subsidy provided by the government will not be enough to pay the entire monthly premium for most individuals. The individual is responsible for paying the part of the premium that is not covered by the subsidy.
• Even individuals who are not eligible for any subsidy might find that plans offered on state exchanges are the most affordable options available. In some cases, these individuals may purchase insurance through the exchange as well, but will have to pay the entire insurance premium to the provider.

Tennessee Long Term Care Partnership program

Tennessee has a rapidly aging population and awareness of the need for Long Term Care Insurance remains low. Long Term Care Insurance covers the cost of services such as nursing homes, in-home care and assisted-living care when one is unable to care for themselves and is not covered by regular health insurance and only by Medicaid if one qualifies, which can be difficult without exhausting all of your assets. The Tennessee Long Term Care Partnership Program “is a partnership between state government and private insurance companies to assist individuals in planning their long-term care needs. Insurance companies voluntarily agree to participate in the Partnership Program by offering long-term care insurance coverage that meets certain State and Federal requirements. Long-term care insurance policies [certificates] that qualify as Partnership Policies [Certificates] may protect the [policyholder’s] [certificateholder's] assets through a feature known as “Asset Disregard” under TennCare, Tennessee’s Medicaid program.”
A recent study found that 7 in 10 Americans have made no plans for long-term care and many were not even aware of this type of insurance and what it covers. And, given that the Department of Health and Human Services estimates that 2/3 of all Americans will need long-term care at some point after they pass age 65, this does, indeed, constitute a problem to be reckoned with. Many Americans, regardless of the State in which they live, are now at risk of having to exhaust their nest egg or rely on their children or other relative to care for them in retirement should they become unable to care for themselves. Fortunately, innovative solutions like the Tennessee Long Term Care Partnership Program mean that you can tackle this problem yourself and prepare for a peaceful, secure retirement.
Residents of Tennessee are able to participate in the Tennessee Long Term Care Insurance Partnership Program via a number of policy options that meet certain State-mandated criteria. Tennessee, like many states, aims to reward those who do their part in solving this problem of Long Term Care Insurance coverage by planning ahead and protecting themselves and their assets. Basically, it works like this: those who purchase a qualifying partnership policy are eligible “Asset Disregard” which “means that an amount of the [policyholder’s] [certificateholder’s] assets equal to the amount of long-term care insurance benefits received under a qualified Partnership [Policy] [Certificate] will be disregarded for the purpose of determining the insured’s eligibility for Medicaid.” So, you can keep what you’ve worked so hard to accumulate your whole life.
Highlights and requirements of the Tennessee Long Term Care Insurance Partnership program include:
In order for a policy to qualify as a Partnership Policy, it must, among other requirements:
• be issued to an individual after February 8, 2006;
• cover an individual who was a Tennessee resident when coverage first becomes effective under the policy;
• be a tax-qualified policy under § 7702(B)(b) of the Internal Revenue Code of 1986;
• meet stringent consumer protection standards;
• and meet the following inflation requirements:For ages 60 or younger – provides compound annual inflation protection
• For ages 61 to 75 -provides some level of inflation protection
• For ages 76 and older – no purchase of inflation protection is required
The “annual inflation protection” requirements are critical here. Inflation protection insures that your policy will pay out in tomorrow’s dollars and that your covered for the care you need.
You can start planning today for your future long-term care needs and securing all that you’ve worked so hard to achieve for your retirement by purchasing a Long Term Care Insurance policy.

What You Need to Know about the Small Business Health Care Tax Credit
How will the credit make a difference for you?
For tax years 2010 through 2013, the maximum credit is 35 percent for small business employers and 25 percent for small tax-exempt employers such as charities. An enhanced version of the credit will be effective beginning Jan. 1, 2014. Additional information about the enhanced version will be added to IRS.gov as it becomes available. In general, on Jan. 1, 2014, the rate will increase to 50 percent and 35 percent, respectively.
Here’s what this means for you. If you pay $50,000 a year toward workers’ health care premiums – and if you qualify for a 15 percent credit, you save … $7,500. If you save $7,500 a year from tax year 2010 through 2013, that’s total savings of $30,000. If, in 2014, you qualify for a slightly larger credit, say 20 percent, your savings go from $7,500 a year to $12,000 a year.
Even if you are a small business employer who did not owe tax during the year, you can carry the credit back or forward to other tax years. Also, since the amount of the health insurance premium payments are more than the total credit, eligible small businesses can still claim a business expense deduction for the premiums in excess of the credit. That’s both a credit and a deduction for employee premium payments.
There is good news for small tax-exempt employers too. The credit is refundable, so even if you have no taxable income, you may be eligible to receive the credit as a refund so long as it does not exceed your income tax withholding and Medicare tax liability.
And finally, if you can benefit from the credit this year but forgot to claim it on your tax return there’s still time to file an amended return.
Click here if you want more examples of how the credit applies in different circumstances.
Can you claim the credit?
Now that you know how the credit can make a difference for your business, let’s determine if you can claim it.
To be eligible, you must cover at least 50 percent of the cost of single (not family) health care coverage for each of your employees. You must also have fewer than 25 full-time equivalent employees (FTEs). Those employees must have average wages of less than $50,000 a year.
Let us break it down for you even more.
You are probably wondering: what IS a full-time equivalent employee. Basically, two half-time workers count as one full-timer. Here is an example, 20 half-time employees are equivalent to 10 full-time workers. That makes the number of FTEs 10 not 20.
Now let’s talk about average wages. Say you pay total wages of $200,000 and have 10 FTEs. To figure average wages you divide $200,000 by 10 – the number of FTEs – and the result is your average wage. The average wage would be $20,000.
Also, the amount of the credit you receive works on a sliding scale. The smaller the business or charity, the bigger the credit. So if you have more than 10 FTEs or if the average wage is more than $25,000, the amount of the credit you receive will be less.
If you need assistance determining if your small business or tax exempt organization qualifies for the credit, try this step-by-step guide
How do you claim the credit?
You must use Form 8941, Credit for Small Employer Health Insurance Premiums, to calculate the credit.
If you are a small business, include the amount as part of the general business credit on your income tax return.
If you are a tax-exempt organization, include the amount on line 44f of the Form 990-T, Exempt Organization Business Income Tax Return. You must file the Form 990-T in order to claim the credit, even if you don't ordinarily do so.
Don’t forget … if you are a small business employer you may be able to carry the credit back or forward. And if you are a tax-exempt employer, you may be eligible for a refundable credit.