Question
Conduct a current health insurance situation analysis for the Bedos. Be sure to assess the following: a. The after-tax costs of their current plans compared
Conduct a current health insurance situation analysis for the Bedos. Be sure to assess the following: a. The after-tax costs of their current plans compared to purchasing an individual policy. b. The use of a tax-advantaged account as a health insurance planning tool. c. How COBRA impacts health insurance planning for the Bedos. d. Should one of the Bedos' employers offer the option, would another managed care plan or high-deductible health plan and HSA be a viable option for this household? What criteria would be considered in this decision?
Notes: Health insurance is provided for the entire family by a group health insurance policy offered through Tyler's work. The health provider, Peacock & Peacock, is a health maintenance organization. Tyler pays $300 a month in premiums for this coverage through his company's 125 plan. The plan allows for pretax premium payments.
The policy has an annual deductible of $450 and a stop-loss of $3,000. Under the policy, doctors' visits cost $20 per appointment to the primary care physician and $40 per visit to specialists, and for emergency treatment a $100 copayment is required. Monthly prescriptions are $10 for generic brands and $25 for other brands. There is no copayment for hospitalization in semiprivate accommodations, and private rooms are provided when medically necessary. The original lifetime ceiling for services, per family member, was $2 million; however, with the passage of the Patient Protection and Affordable Care Act limits have been removed.
Over the past several years the Bedos have averaged about $50 per month in dental and eye care expenses, which they pay out of discretionary cash flow. A flexible spending account for health costs is available through Tyler's employer. They have not funded this account in the past because of uncertainty related to "use it or lose it" rules.
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