GovAlert: Oppose H.R. 5719 HSA Provision

The House Ways & Means Committee passed The Taxpayer Assistance and Simplification Act (H.R. 5719) that would, among other things, impose documentation/substantiation requirements on tax-free payments of medical expenses from Health Savings Accounts (HSAs). The HSA documentation/substantiation provision is a pay-for (an offset to make up for the revenue loss in other parts of the bill).

AHIA and NAIFA are opposed to the HSA provision in H.R. 5710 that would create additional complexity and cost to HSA account holders.

The bill is expected to be on the House floor next week. Please contact your Members of Congress today and ask them to oppose H.R. 5719, which would negatively impact the offering of affordable health care.

Go to NAIFA's Legislative Action Center at http://capwiz.com/naifa to send an email or find the phone numbers you need.

Sample Comments: It always has a greater impact if you use your own words when submitting comments. The following sample language can be used as the text of your email or as a guideline for your phone call:

Dear Senator or Congressman/Congresswoman:

The proposed Health Savings Account (HSA) substantiation requirements contained in H.R. 5719 would add enormous costs to HSAs if enacted. HSAs used in conjunction with high deductible health plans have offered a number of my clients an affordable health care solution. Please vote against H.R. 5719.

The establishment of a department to administer the expense verifications or utilization of an outside administrator would require a charge to the consumer to cover the additional administration costs. This additional expense would slow the growth of HSA plan implementations and may cause individuals and groups to cancel existing High Deductible Health Plans (HDHPs). This would be a step backwards in the attempt to control rising health care benefit plan costs.

A requirement that expenses that can be paid on a tax-free basis must be documented and substantiated is reasonable. However, current IRS procedures for tracking HSA expenditures are sufficient.  Financial Institutions file the 1099 SA to report distributions, the 5498 SA to report contributions received and fair market value. Employers file W-2s which contain specific HSA contribution information, and the account holder files the 8889 form for self reporting contributions and distributions. HSA account activity is subject to audits from the IRS and account holders are advised to retain their receipts documenting qualified medical expenses.   

Please allow my clients the option of this affordable coverage and vote against H.R. 5719.

Technical Assistance? If you have technical questions about using NAIFA's Legislative Action Center, please contact Vicky Dobbin at 703-770-8113, communications@naifa.org.

Thank you in advance for your help on this issue!

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The Sky May Not Be Falling, but the Clouds Have Moved In

Recent activities on both the state and federal levels have consistently undervalued the role of the agent in the health care delivery system. Just last week, Senators Durbin (D-IL), Snowe (R-ME), Lincoln (D-AR) and Coleman (R-MN) introduced the Small Business Health Options Program (SHOP) bill S. 2795 to make health insurance more accessible for small businesses and the self-employed. What’s of particular interest is its feature to simplify shopping for insurance. SHOP and any state purchasing pool will provide “a voluntary, one-stop alternative to the bewildering, current market, with a web site providing comparative information about a variety of plans. Trade associations and other groups may serve as “navigators” – a trusted starting point through whom employers and the self-employed can learn about and enroll in SHOP.”  When questioned about the role of agent, Congressional staff responded that the legislation did not prohibit the use of an agent and if consumers have available funds, they could consult with an agent.

Numerous states are looking to create purchasing pools similar to the Massachusetts Connector and some are turning to more draconian measures such as a single payer system.  What these well-intentioned advocates are missing is that the health care reform challenge includes both access and cost. Of course, these two challenges are related and one cannot be solved without tackling the other. The current efforts address access, but do little to address the cost of care which drives the cost of insurance.

The April 5th issue of the New York Times exposed some of the pitfalls of the Massachusetts plan including the shortage of primary care doctors.  Massachusetts family physician Dr. Katherine J. Atkinson’s first opening for a physical is early May of 2009. In the article, Dr. Atkinson shared that for every Medicare patient she sees, it’s the financial equivalent of handing them a $20 bill.

AHIA has developed principles that would support a workable solution to our health care problems. The Rx for Health Care plan would help lower costs and ensure coverage is available to all citizens – without resorting to new government programs or jeopardizing the high quality of care we enjoy and expect as American consumers.

Eliminating the cost shifting that Dr. Atkinson described in the New York Times article is one of the recommended principles of reform. Others include tax incentives and deductibility of premiums as well as allowing affordable coverage. While mandated benefits make health insurance more comprehensive, they also make it more expensive. The Council for Affordable Health Insurance estimates that mandated benefits currently increase the cost of basic health coverage from a little less than 20% to more than 50%, depending on the state and its mandates. AHIA believes insurers should be allowed to offer low-cost, basic benefit packages which are exempt from costly benefit mandates.

In addition to failing to address the cost side of the health care reform equation,  lawmakers and others are failing to recognize that licensed, regulated, fairly compensated insurance agents offer a cost effective means of achieving personal and professional assistance in the selection of insurance coverage for individuals and employers of all sizes in all market.

The role of the agent is often misunderstood. AHIA staff is actively involved in meeting with members of Congress and their staffs to explain the valuable role of the agent. However, your help is needed to spread the message to the 435 members of Congress, the numerous members of your state legislature, governors, their staffs and consumers.

Here’s how you can help:

• Share the Role of the Advisor with your elected officials. Use the Advocacy Guide to identify and send information to your elected officials.


• Send a letter to your local paper explaining that cost & access must be addressed in health care reform efforts. Use the Media Guide to identify contacts and distribute your message.


• Recruit a member – many of your colleagues would suffer if adverse legislation were to be adopted. AHIA depends on the support of membership to continue providing advocacy and education.  Have them join at http://www.ahia.net/join/join.cfm.


• Contribute to the AHIA War Chest – funds can be used to increase lobbying, form coalitions, enhance public relations and educate consumers. Recent distributions from the War Chest were sent to Maine to assist with their state challenges.


• Get involved in the APIC

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AHIA – NAIFA Health & Employee Benefits Kudos

There are a number of state and local NAIFA associations making a difference in the health and employee benefits arena. Following is a recent example:

NAIFA Washington under the leadership of President Sharon Sparling is building a coalition with like-minded government and business associations to tackle the well-financed effort to enact a single payer health care system.

AHIA Director Chris Schneeman and his NAIFA Minnesota colleagues have convinced Governor Pawlenty to withdraw his support for an insurance exchange in Minnesota, a concept he advanced with fanfare during the 2007 session. The concept  of developing a method to allow an agent the ability to work with those eligible for public programs continues to be advanced under the popularized name of "super-broker."

Georgia consumers, employers, and insurance companies could receive a tax credit equal to the monthly premiums on high-deductible health plans under a bill (H.B. 977) approved by the Georgia Senate and expected to be signed by Gov. Sonny Perdue.  Under the bill, insurance companies would be able to claim an exemption from state and local insurance premium taxes for premiums collected on such plans. Small employers that offer such plans could receive a tax credit of $250 per employee in a high-deductible plan.

Share how your association is favorably influencing the health and employee benefits arena by sending an email to ahia@naifa.org. In addition to reading about state successes periodically in Health Insurance Matters, AHIA has developed a means for states to request and share information on given health reform efforts. Read the following article to learn more about this new initiative.

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AHIA State Legislative Information Network

Once again health care reform efforts are expected to dominate discussions in state legislatures. Sweeping health care proposals are being considered in at least half the states. Similar to the Massachusetts’ plan enacted in 2006, these proposals include an individual mandate, an employer play or pay component, premiums subsidies and a “connector” to facilitate the purchase of coverage.

State associations across the country truly serve as AHIA’s “eyes and ears” on state legislative matters. When AHIA is contacted by a state association regarding a specific legislative proposal of concern to health insurance agents, it is AHIA’s responsibility to analyze the proposal and provide opinion and comments on the proposal to the state association; suggest specific amendments, as necessary; make a recommendation regarding the position the state association should adopt regarding the proposal; assist the state association in developing a strategy to either support, oppose or amend the proposal; assist the association in contacting and working cooperatively with other groups and organizations in their state who share the association position; provide the state association with insights on the broader national outlook and trends with respect to the particular issue in question and, in limited instances where AHIA has the financial means and the issue is one that has potential national consequences, provide financial assistance.

Many state associations are fully equipped to analyze the legislation and are aware of the position that state should adopt. AHIA has learned that what is needed is the ability to directly share information with other states experiencing similar challenges.

To take advantage of the network, associations simply send an email to AHIA at ahia@naifa.org with SLIN in the title and clearly state the health issue of concern. AHIA will facilitate getting the message to the AHIA State Health Chairs who will respond directly to the inquiring association. Associations will provide the status of the initiative in their state, convincing arguments used to sway legislators, unexpected questions, coalition partners, effective and ineffective strategies.

As the bridge to intelligence sharing, AHIA is certain that the network will position the state associations as the strongest advocates on behalf of the interests of health insurance advisors in the state legislatures and with state insurance departments.

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Medicare Fiscally Unfit

Each year the Trustees of the Medicare trust fund report on the current and projected financial status of the program. The 2008 report  finds the financial condition of the Medicare program remains problematic. Projected long run program costs are not sustainable under current financing arrangements. This year Medicare’s Hospital Insurance (HI) Trust Fund is expected to pay out more in hospital benefits and other expenditures than it receives in taxes and other dedicated revenues. The difference will be made up from general revenues that pay for interest credits to the Trust Fund. Growing annual deficits are projected to exhaust HI reserves in 2019.In addition, the Medicare Supplementary Medical Insurance (SMI) Trust Fund that pays for physician services and the prescription drug benefit will continue to require general revenue financing and charges on beneficiaries that grow substantially faster than the economy and beneficiary incomes over time.

Total Medicare expenditures were $432 billion in 2007, and are projected to rise in the future at a pace faster than either workers' earnings or the rate of economic growth, according to the report.

For Medicare to be brought into actuarial balance over the next 75 years, a 122 percent increase in the payroll tax, a 51 percent reduction in program outlays, or some combination, would be needed, the trustees said.

Employers and employees each pay 1.45 percent of wages to support Part A, while the self-employed pay 2.9 percent of wages.

For the second consecutive year, a “Medicare funding warning” is being triggered, signaling that non-dedicated sources of revenues—primarily general revenues—will soon account for more than 45 percent of Medicare’s outlays.

The trustees conclude that the financial difficulties facing Social Security and Medicare pose enormous challenges. The sooner these challenges are addressed, the more varied and less disruptive their solutions can be. The trustees urge the public to engage in informed discussion and policymakers to think creatively about the changing needs and preferences of working and retired Americans.

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Promoting AHIA and the Role of the Advisor

In addition to its regular communication with members and leadership, AHIA Board members continue to spread the AHIA message through appearances in various press and industry magazines as well as participation in state and local NAIFA chapter meetings, and various conferences and forums. Recent visits/appearances include:

• AHIA President Elect Robelynn Abadie – WIFS, Mississippi State University Insurance Day, Senate briefing on SHOP legislation.


• AHIA Membership Chair Ed Anderson – Taste of MDRT, Missouri


• AHIA Executive Diane Boyle – Senate briefing on SHOP legislation and various congressional meetings.

Here are a few way in which you can help communicate your association’s message:

• Contact AHIA Marketing Coordinator Caitlin Kubler to request the AHIA Booth for an upcoming meeting.


• Download the AHIA Rx For Health Care PPT and present at a local civic or business group (remember to view in the notes format for a ready-to-use script).


• Forward an application to a non-AHIA member.

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'08 Health Care Debate

AFL-CIO leaders state comprehensive reform must be a top issue in the presidential election, referencing the 2008 Health Care for America Survey which found 95 percent of respondents - both insured and uninsured - are concerned about their ability to afford health insurance in coming years.

The report will be distributed to all candidates in the 2008 election, as part of a broader effort to push health care reform to the top of the agenda in 2009, according to John Sweeney, AFL-CIO president. While AHIA’s recommended reform efforts are likely to differ from the AFL-CIO, it’s interesting to note the primary concern is “cost.”

• Of the more than 26,000 respondents to the survey, 77 percent are in families with insurance. Of those, more than half reported being unable to afford, or not having, coverage for care they need; such as prescription drugs, specialists, tests, and preventive care.


• Twenty-four percent reported having to choose between paying for health care and paying for other essentials such as a mortgage, rent, or utilities, while 57 percent of the uninsured reported making that choice.


• Of those with insurance, 95 percent are dissatisfied with health care costs


• Seventy-nine percent say health care is a very important election issue


• Ninety-seven percent plan to vote in the fall.

Though the respondents were self-selected, choosing to take the online survey after it was featured on the AFL-CIO Web site and promoted by other labor groups and organizations, the results are similar to those from other health care surveys, according to Guy Molyneux, a partner at Peter D. Hart Research Associates, which analyzed the data.

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Employee Benefits Educational Symposium — September 2008

The Association of Health Insurance Advisors (AHIA) – NAIFA’s health and employee benefits advocate - is hosting an Employee Benefits Educational Symposium in September 2008. This program, held in conjunction with the NAIFA Annual Convention and Conference, will provide attendees with the knowledge to improve even the most successful employee benefits practice.

Members can register for the symposium on the NAIFA Convention Registration form. Please visit www.naifa.org/convention to register online. More information and additional links to registration options are available on the AHIA website. Register before June 27th to receive special reduced registration fees!

Sponsored by

Friday, September 5

Employee Benefits Symposium Breakout Sessions

Choose from a variety of workshop sessions focusing on employee benefit issues including HIPAA, COBRA, HSAs, Flex Plans and Wellness Programs. Participants will attend three workshop sessions in the morning and two in the afternoon.

Sponsored by

Employee Benefits Symposium Luncheon Presentation: When Everything Goes WRONG!

A dramatic presentation of an HR/Benefits department at it’s worst! Come to enjoy lunch, have a few laughs, and see what can go wrong in the world of employee benefits.

Sponsored by

Employee Benefits Symposium Wine and Cheese Reception

Join the speakers and panelists from the Employee Benefit Symposium as well as other attendees for networking and refreshments!

 

Sponsored by

Saturday, September 6

Breakfast Presentation-Tom Carter, Vice President, Sales and Broker Relations, Kaiser Permanente California

Sponsored by

Employee Benefits Symposium Expert Panels

Join us for two expert panels; “Building Your Agency” puts the focus on alliance building, cross-selling life and employee benefits, and handling transitions such as retirement. “Meeting Expectations” will address the expectations small group, large group and carriers have of the employee benefit agent. A legislative update and discussion on the status of health reform at the state and federal level will be held between the panels.

Monday, September 8

AHIA Annual Meeting & Luncheon

Featuring keynote speaker Roger Schultz: “Building a Million Dollar Practice.”



Roger Schultz, CLU, is a national speaker and trainer on employee benefits and has published more than 50 articles on the subject. He is the founder of the nation’s first administrator of direct reimbursement plans for dental and vision care; a model now used by more than 3,000 employers. Schultz established 250 direct reimbursements plans covering 200,000 participants in 21 states. As a practical expert in the highly complex and competitive field of employee benefits, Schultz helps other agents develop innovative services, products and concepts.

Sponsored by

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Need CE?

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For information on other AHIA Product and Services visit our website at www.ahia.net/store.

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2007-2008 AHIA Board of Directors

PRESIDENT

Thomas J. Vander Wal

PRESIDENT-ELECT

Robelynn H. Abadie, LUTCF, CSA, RFC, RDA

SECRETARY

William J. Foudy, LUTCF

TREASURER

Sam J. Cunningham, CLU, ChFC, RHU

IMMEDIATE PAST PRESIDENT

Lawrence E. Lounds, CLU, ChFC, LUTCF

DIRECTORS

Christopher K. Schneeman, CLU, LUTCF

Ed Anderson, CLU, LUTCF

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