5 years ago
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by
Joyce Insurance ·
Comments Off on Medicare Supplement & Medigap Plans for Pennsylvania Residents
Medicare Part A and Part B, although quite encompassing, have out-of-pocket costs that you still have to pay for — that is if you don’t have the right Medicare Supplement Insurance plan.
Medigap is a Medicare Supplement Insurance that helps fill “gaps” in Original Medicare and is sold by private companies. Original Medicare pays for much, but not all, of the cost of covered health care services and supplies. A Medicare Supplement Insurance (Medigap) policy can help pay some of the remaining health care costs, such as:
- Co-payments
- Co-insurance
- Deductibles
Medicare Supplement Features
- Help fills in the gaps associated with “original” Medicare
- See any doctor who accepts Medicare patients
- No referrals are needed to see a specialist.
- Nationwide coverage
- Coverage remains in force for life as long as premiums are paid
Medigap vs. Medicare Advantage
The primary difference between the Medigap and Medicare Advantage plans come at a different cost. Generally speaking, Medigap plans have higher premiums than Medicare Advantage plans. However, Medicare Advantage plans often cover fewer expenses than Medigap — potentially resulting in more out-of-pocket expenses.
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Every Medigap policy must follow federal and state laws designed to protect you, and it must be clearly identified as “Medicare Supplement Insurance.” Insurance companies can sell you only a “standardized” policy identified in most states by letters. All policies offer the same basic benefits but some offer additional benefits, so you can choose which one meets your needs.
There are 10 Different Medicare Supplement Insurance plans that are denoted by Plans A through N. Each Medicare Supplement insurance plan offers a different level of coverage, but each lettered plan must include the same standardized basic benefits regardless of insurance company and location. Medicare Supplement insurance plans do not have to cover vision, dental, long-term care, or hearing aids, but all plans must cover at least a portion of the following basic benefits:
* Plans F and G also offer a high-deductible plan in some states. With this option, you must pay for Medicare-covered costs (coinsurance, copayments, and deductibles) up to the deductible amount of$2,490 in 2022 before your policy pays anything. (Plans C and F aren’t available to people who were newly eligible for Medicare on or after January 1, 2020.)
** For Plans K and L, after you meet your out-of-pocket yearly limit and your yearly Part B deductible, the Medigap plan pays 100% of covered services for the rest of the calendar year.
*** Plan N pays 100% of the Part B coinsurance, except for a copayment of up to $20 for some office visits and up to a $50 copayment for emergency room visits that don’t result in inpatient admission.
Medicare Supplement Insurance Plan (Medigap) Costs
Why is it so important to shop for your Medicare Supplement Insurance? Although the plans are standardized, insurance companies can charge different premiums for the exact same Medigap plan and coverage tier. That is why shopping for a policy is so important. There are also different ways carriers calculate premiums now and going forward.
- Community no-age-rated: Premiums are the same across the board regardless of age.
- Issue-age-rated: These plans base their premiums on your age when you first enrolled in the policy and remain the same.
- Attained-age-rated: Premium is based on the age you were when you first bought a policy and increases as you get older.
- Please note that no matter what rating method an insurance company uses, premiums may increase over time for reasons other than age, such as inflation.
Medicare Supplement Insurance Plan Enrollment and Eligibility
The best time to enroll in a Medigap policy is during your 6-month Medigap Open Enrollment Period. This begins when you start the month you turn age 65 AND enroll in Part B. To be eligible for a Medigap plan you must be enrolled in parts A & B.
If you chose to enroll at this time, you have a guaranteed-issue right to join any Medicare Supplement insurance without having to answer any medical questions and you may not be denied based on pre-existing medical conditions****.
If you miss this enrollment period and attempt to enroll in the future, you may be denied basic benefits or charged a higher premium based on your medical history.
**** A pre-existing condition is any personal illness or health condition that was known and existed prior to the writing and signing of an insurance contract.
The product and service descriptions, if any, provided on these web pages are not intended to constitute offers to sell or solicitations in connection with any product or service. All products are not available in all areas and are subject to applicable laws, rules, and regulations. This website and its contents are for informational purposes only. Nothing on the website should ever be used as a substitute for professional medical advice. You should always consult with your medical provider regarding diagnosis or treatment for a health condition, including decisions about the correct medication for your condition, as well as prior to undertaking any specific exercise or dietary routine.
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5 years ago
·
by
Joyce Insurance ·
Comments Off on COVID-19 Update: Paycheck Protection Program
Starting April 3, 2020, small businesses can apply for the Paycheck Protection Program. The program is designed to keep small business workers employed and provide small businesses with capital through the nation’s banks and other lending institutions.
The Paycheck Protection Program (“PPP”) authorizes up to $349 billion in forgivable loans to small businesses to pay their employees during the COVID-19 crisis. All loan terms will be the same for everyone.
The loan amounts will be forgiven as long as:
- The loan proceeds are used to cover payroll costs, and most mortgage interest, rent, and utility costs over the 8 week period after the loan is made; and
Employee and compensation levels are maintained.
- Payroll costs are capped at $100,000 on an annualized basis for each employee. Due to the likely high amount of subscriptions, it is anticipated that not more than 25% of the forgiven amount may be for non-payroll costs.
- Loan payments will be deferred for 6 months.
When can I apply?
- Starting April 3, 2020, small businesses and sole proprietorships can apply for and receive loans to cover their payroll and other certain expenses through existing SBA lenders.
- Starting April 10, 2020, independent contractors and self-employed individuals can apply for and receive loans to cover their payroll and other certain expenses through existing SBA lenders.
- Other regulated lenders will be available to make these loans as soon as they are approved and enrolled in the program.
Where can I apply?
- You can apply through any existing SBA lender or through any federally insured depository institution, federally insured credit union, and Farm Credit System institution that is participating. Other regulated lenders will be available to make these loans once they are approved and enrolled in the program. You should consult with your local lender as to whether it is participating. Visit www.sba.gov for a list of SBA lenders.
Who can apply?
- All businesses – including nonprofits, veterans organizations, Tribal business concerns, sole proprietorships, self-employed individuals, and independent contractors – with 500 or fewer employees can apply. Businesses in certain industries can have more than 500 employees if they meet applicable SBA employee-based size standards for those industries (click HERE for additional detail).
- For this program, the SBA’s affiliation standards are waived for small businesses (1) in the hotel and food services industries (click HERE for NAICS code 72 to confirm); or (2) that are franchises in the SBA’s Franchise Directory (click HERE to check); or (3) that receive financial assistance from small business investment companies licensed by the SBA. Additional guidance may be released as appropriate.
What do I need to apply?
- You will need to complete the Paycheck Protection Program loan application and submit the application with the required documentation to an approved lender that is available to process your application by June 30, 2020. Click HERE for the application.
What other documents will I need to include in my application?
- You will need to provide your lender with payroll documentation
Do I need to first look for other funds before applying to this program?
- No. They are waiving the usual SBA requires that you try to obtain some or all of the loan funds from other sources (i.e., we are waiving the Credit Elsewhere requirement).
How long will this program last?
- Although the program is open until June 30, 2020, we encourage you to apply as quickly as you can because there is a funding cap and lenders need time to process your loan.
How many loans can I take out under this program?
What can I use these loans for? You should use the proceeds from these loans on your:
- Payroll costs, including benefits; Interest on mortgage obligations, incurred before February 15, 2020
- Rent, under lease agreements in force before February 15, 2020
- Utilities, for which service began before February 15, 2020.
What counts as payroll costs?
Payroll costs include:
- Salary, wages, commissions, or tips (capped at $100,000 on an annualized basis for each employee)
- Employee benefits including costs for vacation, parental, family, medical, or sick leave; an allowance for separation or dismissal; payments required for the provisions of group health care benefits including insurance premiums; and payment of any retirement benefit
- State and local taxes assessed on compensation
For a sole proprietor or independent contractor: wages, commissions, income, or net earnings from self-employment, capped at $100,000 on an annualized basis for each employee.
How large can my loan be?
- Loans can be for up to two months of your average monthly payroll costs from the last year plus an additional 25% of that amount. That amount is subject to a $10 million cap. If you are a seasonal or new business, you will use different applicable time periods for your calculation. Payroll costs will be capped at $100,000 annualized for each employee.
How much of my loan will be forgiven?
- You will owe money when your loan is due if you use the loan amount for anything other than payroll costs, mortgage interest, rent, and utilities payments over the 8 weeks after getting the loan.
- Due to the likely high amount of subscriptions, it is anticipated that not more than 25% of the forgiven amount may be for non-payroll costs.
You will also owe money if you do not maintain your staff and payroll.
- Number of Staff: Your loan forgiveness will be reduced if you decrease your full-time employee headcount.
- Level of Payroll: Your loan forgiveness will also be reduced if you decrease salaries and wages by more than 25% for any employee that made less than $100,000 annualized in 2019.
- Re-Hiring: You have until June 30, 2020 to restore your full-time employment and salary levels for any changes made between February 15, 2020 and April 26, 2020.
How can I request loan forgiveness?
- You can submit a request to the lender that is servicing the loan. The request will include documents that verify the number of full-time equivalent employees and pay rates, as well as the payments on the eligible mortgage, lease, and utility obligations. You must certify that the documents are true and that you used the forgiveness amount to keep employees and make eligible mortgage interest, rent, and utility payments. The lender must make a decision on forgiveness within 60 days.
What is my interest rate?
When do I need to start paying interest on my loan?
- All payments are deferred for 6 months; however, interest will continue to accrue over this period.
When is my loan due?
Can I pay my loan earlier than 2 years?
- Yes. There are no prepayment penalties or fees.
Do I need to pledge any collateral for these loans?
- No. No collateral is required.
Do I need to personally guarantee this loan?
- No. There is no personal guarantee requirement. ***However, if the proceeds are used for fraudulent purposes, the U.S. government will pursue criminal charges against you.***
What do I need to certify?
As part of your application, you need to certify in good faith that:
- Current economic uncertainty makes the loan necessary to support your ongoing operations.
- The funds will be used to retain workers and maintain payroll or to make mortgage, lease, and utility payments.
- You have not and will not receive another loan under this program.
- You will provide to the lender documentation that verifies the number of full-time equivalent employees on payroll and the dollar amounts of payroll costs, covered mortgage interest payments, covered rent payments, and covered utilities for the eight weeks after getting this loan.
- Loan forgiveness will be provided for the sum of documented payroll costs, covered mortgage interest payments, covered rent payments, and covered utilities. Due to the likely high rate of subscriptions, it is anticipated that not more than 25% of the forgiven amount may be for non-payroll costs.
- All the information you provided in your application and in all supporting documents and forms is true and accurate. Knowingly making a false statement to get a loan under this program is punishable by law.
- You acknowledge that the lender will calculate the eligible loan amount using the tax documents you submitted. You affirm that the tax documents are identical to those you submitted to the IRS. And you also understand, acknowledge, and agree that the lender can share the tax information with the SBA’s authorized representatives, including authorized representatives of the SBA Office of Inspector General, for the purpose of compliance with SBA Loan Program Requirements and all SBA reviews.
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