Will the implementation of medical loss ratios affect the premiums I pay?
No. As a self-funded health plan, GuideStone is not subject to healthcare reform provision regarding medical loss ratios. However, GuideStone will continue to set and meet reasonable loss ratios comparable to new healthcare reform standards and aggressively manage our claims costs.
What impact will the new healthcare reform law have on 2011 rates?
The new law will have significant short-term and long-term impacts on GuideStone health plans. The short-term impact includes expanding eligibility to include dependent children up to age 26 and the elimination of pre-existing condition limitations for children.
Making eligibility or benefit changes like these to our health plans — even if the changes are required by law — involves adjusting plan design and pricing. Any change to plan eligibility or benefits creates potential cost implications.
What effect will the healthcare reform bill have on HSAs, HRAs and FSAs?
Healthcare reform will:
- Exclude the costs for over-the-counter drugs not prescribed by a doctor from being reimbursed through a Health Reimbursement Arrangement (HRA) or health Flexible Spending Account (FSA) and from being reimbursed on a tax-free basis through a Health Savings Account (HSA). (Effective January 1, 2011)
- Increase the tax on distributions from an HSA that is not used for qualified medical expenses from 10% to 20% of the disbursed amount. (Effective January 1, 2011)
- Limit the amount of contributions to an FSA for medical expenses to $2,500 per year increased annually by the cost of living adjustment. (Effective January 1, 2013)
What is the definition of the Cadillac plan?
A “Cadillac plan” is a high-cost employer-sponsored health plan under which the annual premium exceeds a threshold amount. Because this provision is not effective until 2018, we expect additional guidance to be issued in the future.
Do I qualify for a $250 rebate from the government for the Part D Donut Hole?
Effective immediately, Medicare Part D enrollees who reach the coverage gap or “donut hole” by spending at least $2,830 on prescription medications may qualify to receive a $250 rebate from the federal government. If you are enrolled in the GuideStone Care Plus or Care Basic Plan, your prescription drug coverage is considered a Medicare Part D plan. Medicare Part D enrollees who receive a low-income subsidy from the government do not qualify for this rebate.
Medicare will automatically send this one-time $250 rebate check after eligible participants reach the coverage gap in 2010. You can expect to get a rebate check that's made out to you in the mail about three months after the end of the calendar quarter in which you reach the coverage gap.
If you are enrolled in the GuideStone Care Basic or Care Plus Plan and have questions about whether or not you qualify for the rebate, you should contact Medco Health Solutions at 1-866-544-2976.
Employer related: Does the non-profit small employer tax credit apply to us?
According to the IRS, eligible small businesses can claim a tax credit starting with the 2010 tax year. Although both taxable (for-profit) and tax-exempt (non-profit) entities qualify for the credit, the IRS is still working to provide further clarity and information on what healthcare expenses are eligible for the credit and how to claim the credit.
GuideStone is working with other denominations through the Church Alliance to determine how churches participating in the GuideStone healthcare plans might best qualify for this tax credit. We will keep you up to date as more information becomes available.