Tag: No Surprises Act
Kick Your Health Benefits into High Gear
December 1, 2022
As open enrollment season kicks into high gear, millions of people will have an opportunity to choose their 2023 health benefits.
Employers’ Healthcare Costs
Employers’ healthcare costs are rising, with large companies forecasting up to an 8 percent increase for 2023. The main difference with previous years will be higher prescription drug costs, which will jump 10 percent, the highest in the past decade.
Many companies will try to limit the share they pass along to their workers, as benefits are seen as a key attraction and retention tool in a tight job market.
Employees’ Healthcare Costs
For 2022, annual family premiums for employer-sponsored health insurance averaged $22,463, up slightly from $22,221 in 2021, according to the 2022 benchmark KFF Employer Health Benefits Survey. On average, workers contributed $6,106 toward the cost of family premiums, with employers paying the rest. The average premium for single coverage was $7,911 (up from $7,739 in 2021), with employees paying $1,327 annually, according to the survey. Nine percent of covered workers, including 21 percent of covered workers at small firms, are in a plan with a worker contribution of $12,000 or more for family coverage.
While premium data for 2023 generally won’t be available until after the new year begins, workers may see larger increases than in recent years.
Triple-Tax Advantaged HSAs
Some tools can help you manage your healthcare costs. More than three-quarters of large employers offer Health Savings Accounts (HSAs) that offer triple tax advantages: money contributed is pre-tax, it grows on a tax-free basis, and then can be withdrawn tax-free to pay for qualifying medical expenses now or in the future, all the way through retirement.
You can contribute to an HSA only if you’re enrolled in a qualifying high-deductible health plan. Average annual premiums for workers enrolled in HSA plans are lower than the overall average, but workers shoulder higher costs until they meet their deductible.
Employees can contribute up to $3,850 to their HSA for individual coverage for 2023, up from $3,650 this year; for family coverage, workers can contribute up to $7,750, up from $7,300 this year, per an announcement by the Internal Revenue Service. Catch-up contributions for those 55 and over remain $1,000.
Many HSAs give account holders the option to invest a portion of their money in the stock market. But fewer than 10 percent do so, as opposed to leaving their money just sitting in cash. If you can afford to pay your medical bills through your regular cash flow, your HSA funds will likely grow over time in the market and can be used in retirement to pay for a range of qualifying medical expenses.
HSAs are portable and remain with the owner through plan and job changes. If you are no longer enrolled in a qualifying high-deductible health plan, you can no longer contribute to your account, but you can still tap it to pay qualifying medical costs. Flexible-spending accounts (FSAs), by contrast, are linked to a particular employer; unlike HSA funds, money in an FSA must be spent down or forfeited within a certain period.
Health Insurance Plans under the Affordable Care Act
Outside of the employer market, open enrollment began on November 1 on Healthcare.gov for individual and family health insurance plans under the Affordable Care Act. In most states, open enrollment ends on January 15, although you must enroll by December 15 if you want coverage to begin on January 1. The Inflation Reduction Act extended the enhanced premium subsidies for ACA enrollees through 2025; for many, that may offset the moderate average increases expected to premiums.
Impact of Rising Drug Costs
There are two main reasons drug costs are rising: First, pharmaceutical companies are introducing better, but more expensive drugs for several important conditions. In most years, total drug cost would be tempered by other brand name drugs that were being replaced by generics, but in 2023, there will be fewer of these than usual.
Second, pharmaceutical companies are raising the prices they charge to private health insurance plans because they anticipate having to lower the prices they charge to Medicare. The recent Inflation Reduction Act allows Medicare to negotiate drug prices for the first time. Currently, only 10 drugs are on the negotiation list, but these are widely used. The list will rise to 20 drugs in the future.
The “No Surprises” Act
The “No Surprises” Act that went into effect in January 2022 is having its intended effect of lowering surprise out-of-network charges to patients who get emergency care, non-emergency care from out-of-network providers at in-network facilities, and air ambulance services from out-of-network providers.
After you determine your healthcare insurance coverage for 2023, file your decisions at insureyouknow.org. Keep aware of government mandates that can affect your healthcare expenses for prescription drugs, out-of-network charges, changes in Medicare, increases in premiums, and your HSA and FSA contributions and withdrawals.