Doxcost - The Ultimate Guide To Health Insurance

#036 Power To The Patients - Why You Need To See Prices explains why Hip Hop artists Fat Joe, Rick  Ross, Busta Rhymes, Method Man, French Montana and Chuck D are spot on in the public service announcement demanding price transparency in health care.Watch the PSA here

#034 Is Your HSA Ready For Next Year explains the steps you need to take now to be prepared for January 1st so that your HSA has you 100% covered for the entire year.

#035 - Why You Need To Tell Your CEO You Want Fountain Health explains why you need to speak up so that you and your family can be healthy and well with the proactive and preventative benefits from Fountain Health compared to what you only have now.

#033 - If you don't know about Fountain Health, you are missing out on the most revolutionary idea to hit health insurance since 1965 and the advent of Medicare.   Scott W. Dowling explains how Fountain Health is better than your traditional plan - saving lives while saving money.  Learn what makes Fountain Health different and how it helps your company, your employees and their loved ones.

#032 - So How's Your HSA Look In The Middle Of The Year helps you to determine if you are short of dollars needed to cover an accident or sickness right now and the rest of the year, how you can fix that now and whether or not you need a new strategy for 2023.Scott W. Dowling explains the calculation needed to figure out if you are short of HSA funds in the middle of the year.  You may need to contribute to your HSA out of your own pocket now, he explains.And, if your employer is contributing based on the number of payroll periods during the year, you may wish to rethink your strategy for 2023 so that you are 100% covered next year and every year thereafter.Maximum Out of Pocket Cost - Current HSA Balance = (Deficit or Surplus)A Surplus means that you have enough in your HSA to cover the Maximum that you have to pay for any and all health insurance claims you are responsible for in your health plan.A Deficit means that you will be short of dollars needed to cover the Maximum Out Of Pocket costs that you are responsible for in your health plan.  Further, you'll want to determine how much you will receive from your employer towards your HSA over the remaining pay periods of the year.  If the combined total of Deficit + Remaining Employer Contribution is still less than the maximum you can contribute for the year, then you should contribute that amount immediately, using your personal savings, which can be deducted from your tax return next spring.HSA Annual Contribution - (Deficit + Remaining Employer Contribution) = Amount You Should Contribute Now From Personal Funds

#031 - HSA - How To Start Your New Year illustrates what you need to do at the start of 2022 to be 100% covered and have peace of mind no matter what health insurance claims you may incur during the year.

#030  - Why Your High Deductible Health Plan Is Not As High As You Think exposes the misperception that an HDHP is too expensive.  Scott W. Dowling provides a real world example - from close to home - that illustrates why there is no advantage to having a traditional low deductible plan and how it ultimately costs you more compared to a High Deductible Health Plan.Focus on Out Of Pocket Maximum - Not DeductibleThe total amount you may spend on an insurance claim includes the amount you pay for the insurance premium plus the total amount you pay Out Of Pocket.  Out of Pocket includes deductibles and coinsurance amounts.  The maximum Out Of Pocket cost is expressly stated in the plan description.  Make certain to locate the maximum Out Of Pocket amount in the plan description when you are comparing your options.  Even plans with $250 or $500 deductibles can have maximum Out Of Pocket amounts over $10,000 and even $15,000 annually.The Goal:  Pay the least amount of premium AND the least amount in claimsYour goal is to pay the least amount of money while ensuring you are 100% covered.  The money you pay for premium is part of the total you need to consider when comparing your options.  Lower deductible plans cost more in premium than higher deductible plans.  Out Of Pocket costs are capped at a certain amount as stated in the plan design.  The maximum Out Of Pocket states the limit that insurance plan will start to cover all of your remaining annual expenses at 100% - meaning you have nothing further to pay for claims during that annual period.  Know your Out Of Pocket maximum.A High Deductible Health Plan with a Health Savings Account costs less overallA High Deductible Health Plan (HDHP) with a Health Savings Account (HSA) costs less in annual premium than a traditional PPO or HMO plan.  Depending on your tax bracket, a traditional PPO or HMO plan can cost 20% to 30% or more for Out Of Pocket costs compared to an HDHP with an HSA.  When you pay your Out Of Pocket costs with your HSA, the money you spend has not been taxed.  When you pay your Out Of Pocket costs for a traditional PPO or HMO plan, the money you spend has already been taxed.  For example, an individual in the second lowest marginal tax bracket, 22%, will spend 28% MORE on Out Of Pocket expenses.  $10,000 paid from your HSA is the same as $12,820 if you have a traditional PPO or HMO.   A PPO or HMO costs a lot more money!I prefer Lively HSA (full disclosure, I receive a nominal fee from Lively...at no cost to you)Surprise!  Blowing Through Your Out Of Pocket Maximum On One Claim Is Very Easy To DoThis example may be relatable for many of you who either participate or are parents of those who participate in competitive athletics.  All of the kids in the family have been competitive athletes into college.  Our rugby player had an unfortunate accident that required surgery - on his thumb!  A broken thumb doesn't sound that bad, but after 3 days of visiting a clinic, getting an x-ray, a second opinion and then surgery including 9 screws and a plate, the total claim came in at over $15,000.  And that's at the network discount!  We're easily through the annual Out Of Pocket maximum......for a broken thumb!!!!Thanks, as always, for listening to Doxcost.  We appreciate you very much!  Please tell your family, friends, coworkers, boss, office manager and/or firm administrator about Doxcost.  Listen wherever you get your podcasts.www.doxcost.comHear more music from my pal, Morgan Fingleton, here!

#029 - How To Structure Your Health Savings Account gives you a list of ten (10) easy steps to ensure that you are 100% covered by your High Deductible Health Plan and Health Savings Account from the Get-Go!Enroll in a qualified High Deductible Health Plan (aka HDHP)Open a Health Saving Account (aka HSA) - click here to see the HSA I useIdentify your Enrollment and Effective Date for your plan yearReview ALL of your plan optionsCheck your existing savingsCalculate Out Of Pocket MaximumDetermine Your HSA Contribution Limit (Single, Family, 55+)Make certain your Out Of Pocket Maximum IS NOT higher than your HSA balanceUse payroll deduction for your remaining HSA contributions Plan & Prepare to have enough additional ordinary non-HSA savings to make the necessary lump-sum contribution on January 1st of the following year to top-off your HSA to match your annual deductibleAn Embedded Deductible is an important plan feature for non-single policyholders (i.e. married couples, single-parent heads of household and families.  An embedded deductible limits the deductible for anyone covered person to the individual deductible.  If the deductible for a plan is $5,000 for an individual and $10,000 for a married couple, head of household or family, anyone covered person need only meet the individual deductible of $5,000 rather than the $10,000.  Should another family member have a claim in the same year, the next person in the family must also meet another $5,000 deductible.I receive nominal compensation from Lively HSA at absolutely no cost to you.  Learn more about Lively hereOver 55 years old?  You can (and should) add an additional $1,000 every year to your HSA which is allowed by the IRS in order to allow you to catch-up as you have fewer years to contribute before reaching Medicare-eligible age.Over 55 years old AND married??   See above AND open a SEPARATE HSA account for your spouse.  Your spouse is eligible to add and additional $1,000 every year to your spouse's HSA.  The IRS does not allow you to add $2,000 to one account.  Consider opening your spouse's account where I have mine, with Lively HSA.Thanks, as always, for your support!  I appreciate you very much.  Tell your family, friends, co-workers and your boss about Doxcost.  Listen on Apple Podcasts or where ever you get your shows.

#028 - What Is A High Deductible Health Plan And How Can It Help Me?  explains what kind of health insurance plan you can have so you can open and fund a Health Savings Account.  Scott explains the basics so that you can get 100% covered and spend the least amount of money possible.High Deductible Health Plan RequirementsIn order to open and fund a Health Savings Account, the Internal Revenue Service requires that a the insured be enrolled in an eligible High Deductible Health Plan.  The requirements are straight-forward.Learn more in IRS Publication 969 linked here*To be an eligible High Deductible Health Plan, the plan must:Have an Individual Deductible no lower than $1,400 ($2,800 for spouse, dependent, family)Have an annual Individual Out Of Pocket Maximum no higher than $7,000 ($14,000 for spouse, dependent, familyDeductible must come first - NO COPAYMENT*Limits apply to 2021 tax yearHSA Rules for 2021Disconnect between HDHP and HSAs - More Education NeededThe Journal of the American Medical Association commissioned a study on Health Savings Accounts that concluded few US adults enrolled in High Deductible Health Plans are using HSAs to save for health care.  As a result, more education is needed to make HDHPs and HSAs more valuable and effective.See the JAMA study hereWe're on a mission to get you 100% covered and spend the least amount possible.  Please subscribe and tell your family, friends, co-workers, boss, office manager, HR director or firm administrator to listen to Doxcost on Apple Podcasts or wherever you get your shows.Next up, we'll talk about affordability - how to structure your HDHP/HSA to get started.I appreciate you very much!  See ya next time.....Clarence Davis, #28 Oakland Raiders - Sea Of Hands - watch hereLike the music on Doxcost?  Listen to my pal, Morgan Fingleton, here

#027 - Your employer is really your health insurance company.  Two out of every three (67%) Americans who get their health insurance through their employer are in a self-funded insurance plan - which means your employer is paying the claims, not an insurance company.2020 Kaiser Family  Foundation Survey - 2 out of 3 Employers Are Self-FundedScott considers the unfortunate comments of someone who has met their insurance plan's annual out of pocket maximum in June and wants to load up on perceived "Free" benefits that their plan provides for them over the course of the next 6 months.  Scott explains why that perception is backwards and how it harms their employer, coworkers and themself.If you have health insurance through your employer, you are not alone.  About half of the United State's population receives health insurance through their employer, which covers 157  million Americans.  If your employer has over 1,000 employees, it is nearly a certainty that your employer is your insurance company.  If you work for an employer with fewer than 200 employees, you have a 1 in 4 chance that your employer is self-funded.  More and more small employers are learning about self-funding......talk to your boss, office manager or firm administrator about getting a self-funded health insurance plan for your company.Why You Get Your Health Insurance Through Your EmployerWhen the employer is self-funded, the employer pays claims on behalf of the employee.  The employer relies on an Administrative Services Only (ASO) contract with a Third Party Administrator (TPA), which can be an independent firm or sometimes is a division or department within an insurance company.  The employer may purchase Stop Loss insurance, with which the employee is not directly involved. Learn More About Trends In Employer Self-Funded Health Plans hereThanks, as always, for your support!  Tell your family, friends, coworkers, boss, office manager and firm administrator to listen and subscribe to Doxcost on Apple Podcasts or wherever you get your shows!Next episode, we'll take a deeper look at the High Deductible Health Plans that make you eligible for a Health Savings Account. Like the music on our show?  Be sure to listen to my pal, Morgan Fingleton, here 

#026 - HMO PPO EPO WTF IDK NVM Part 2 looks at how HMO and PPO networks have run their course, what approach employers are now considering and what employees can expect in the near future.Healthcare Is Not Health InsuranceThe entanglement of healthcare and health insurance has led to rampant medical inflation for decades, much higher than the rate of inflation for the overall US economy.  The genesis of the rapid increase in the rate of medical inflation can be linked to the introduction of Medicare in 1967.Can HMOs Stem Tide of Rising Costs?Only a few years after President Johnson signed the law creating Medicare, President Nixon signed a law providing for the growth of Health Maintenance Organizations (HMOs) as a way to slow the pace of rising medical costs.  HMOs proved to be financial failures.  They either went out of business or changed their business model.PPOs Pick Up Where HMOs Left OffPreferred Provider Organizations offer insured patients choice and flexibility instead of the all or nothing HMO model.  PPOs succeed in offering pricing discounts to insurance plans in return for the insurance company steering its insured customers to select hospitals and doctors.Today's PPO and HMO Plans Have Run Their CoursePPO and HMO plans no longer provider effective discounts.  To the contrary, medical providers have wasted and abused nearly $1 TRILLION ANNUALLY, according to a study by the Journal of the American Medical Association.Learn about JAMA Waste Report hereReference Based PricingEmployers who pay the vast majority of the premiums for over 150 million Americans with health insurance are tired of the antiquated HMO/PPO offer of discounts and are charting a new course.  As a result, employers are not relying on so-called networks and are negotiating the price of healthcare services up front.   Employers are engaging healthcare providers through Reference Based Pricing.Learn about Reference Based Pricing hereThe Big HeistThanks for your continued support.  I appreciate each and everyone of you very much!  Tell your family, friends, neighbors, coworkers, boss, office manager and firm administrator about Doxcost.  Listen on Apple Podcasts or wherever you get your shows.Next up, we'll look at who your health insurance company really is........Set up your Health Savings Account here....I prefer Lively HSA

#025 - HMO PPO EPO WTF IDK NVM takes a look at the health plan terms you see all of the time, but know nothing about.  Scott W. Dowling tells you what you need to know and what you don't.  This is the first of two shows discussing so-called networks and how they affect the price of your health insurance.Health Maintenance Organizations are said to have started as prepaid medical care for loggers in the Pacific Northwest dating back to 1900, but the first prominent HMO was started by Henry J. Kaiser the East Bay Area city of Richmond, California during World War II.  Kaiser built and staffed a field hospital for his shipbuilding employees.  Kaiser was an industrialist and philanthropist with steel, aluminum and other businesses across the United States.  He cared for his employees and the communities where they operated by opening fully staffed hospitals that were the original HMOs.Learn more about the first HMO herePreferred Provider Organizations started to pop up in the early 1980s as Health Maintenance Organizations fell out of favor.  The more flexible PPO offered similar savings to HMOs while allowing insured patients to see the doctors of their choice.  While the BUCA (BlueCrossBlueShield, United Healthcare, Cigna, Aetna) subsidiaries created so-called networks of providers, MultiPlan was and is the largest independent Managed Care Organization involved in the Preferred Provider Organization model's development.Learn more about MultiPlan NYSE:MPLNLong before the Health Insurance Portability and Accountability Act was signed into law by Bill Clinton or the Patient Protection Affordable Care Act was signed into law by Barrack Obama, both Democrats by the way, Republican Richard Nixon made the first move into federally mandated employee benefits with The HMO Act of 1973.  This law provided financial assistance for the further development of HMOs across the United States and required employers to offer an HMO alternative to traditional insurance if an eligible HMO operated in their area.Learn more about The HMO Act of 1973Thanks, as always, for your support.  I appreciate you very much!  Tell your family, friends, coworkers, boss and firm administrator to listen to Doxcost wherever they get their podcasts.Our next episode will be Part 2 of HMO PPO EPO WTF IDK NVM where we'll discuss what is changing and evolving in the HMO/PPO world and what it means for you, your family and your company's employees.Be sure to listen to my pal, Morgan Fingleton, at doxcost.com/musicSign up for your free Health Savings Account at doxcost.com/lively

#024- Traditional PPO vs. High Deductible Health Plan With Health Savings Account answers the question posed by an anticipated Dad to be.  Is it better to switch from a high deductible health plan (HDHP) with Health Savings Account (HSA) to a traditional PPO plan due to a possible family addition?  Listen in to what Scott has to say!Most people do not understand how Health Savings Accounts work, nor how they help you save REAL money.Would you light a match to a dollar bill?  Then why are you not using a Health Savings Account?  Because lighting a match to your money is what you do when you enroll in a traditional health plan. Learn the rules for Health Savings AccountsTraditional PPO vs. High Deductible Health Plan With Health Savings Account highlights some easy to understand but often misunderstood concepts.Eligible High Deductible Health Plans can have a deductible as low as $1,400Anyone can contribute to your Health Savings Account - not just youYou are not required to use the HSA provider through you employerYou are not required to contribute only through payroll deductionYou can contribute a lump sum to your HSA at anytime during the year Not all HSA providers allow for funds to be invested or offer limited optionsMany HSA  providers charge you a fee -  choose one that is free!Scott prefers Lively HSA - it is FREE, ONLINE with FULL INVESTMENT optionsTo calculate the amount you save on every dollar you spend with a Health Savings Account, divide 1 by 1 minus your tax rate  or  1 / (1 - Your Tax Rate)  For the 22% bracket the calculation would be1 / (1 - .22)  or  1 / .78 = 1.28Rather than  earning $1.28, paying Uncle Sam tax at 22% of $1.28 or 28 cents and having $1.00 left to pay the doctor or hospital,Using a Health Savings Account, you earn $1.28, pay Uncle Sam 0% tax on $1.28 or NOTHING and have $1.00 left to pay the doctor or hospital and STILL HAVE 28 CENTS IN YOUR POCKET TO SAVE AND INVEST UNTIL WELL AFTER RETIREMENT!Learn your Federal Income Tax Rate hereAs always, I appreciate you!  Tell your family, friends, co-workers, boss and firm administrator to listen to Doxcost!In the next episode, we'll cover all the things you don't know about HMOs, PPOs and EPOs.   See ya then!

#023 - Reprise: Why You Save By Getting Your Health Insurance Through Your Employer is an encore presentation of one of our most listened to episodes.    Learn the advantages and reasons why you win, your employer wins and the insurance company wins when your employer provides health insurance as an employee benefit.History Of Employer Sponsored Health InsuranceIn Dallas, one of the earliest known employer sponsored  health insurance plans was arranged by Baylor Hospital to benefit public school employees at the time of the Great Depression.  Baylor had a hospital full of empty beds.  To stimulate demand for its services, spread its risk among a large number of people and efficiently sell its product, Baylor offered a monthly pre-paid hospital benefit to the numerous teachers in Dallas.  We know that plan as Blue Cross.Similarly, at the turn of the 20th Century, groups of physicians offered their services to the logging and mining communities of Oregon and Washington on a prepaid basis.  We know that plan as Blue Shield.Baylor Hospital and the PNWEmployers Pay The Majority Of Health Insurance Premiums For Their EmployeesWhether employees know it or not, when they get their health insurance through their employer, the employer is paying most, if not all, all of the health insurance premium on their behalf.  The most recent Kaiser Family Foundation Health Benefits Survey shows that 157,000,000 (one hundred and fifty-seven million) people in the United States get their insurance through their employer.  The survey further states that employers pay 80% of the premium for single employees and nearly 60% for employees their families.  This fact is why many people are so surprised when they separate from employment and are faced with paying 100% of their premium under COBRA.Kaiser Family Foundation 2020 Employer Health Benefits SurveyMake The Most Of Your DeductibleSingle employees (i.e Employee Only in insurance jargon) only have to worry about one deductible per year.  Employees with a spouse, a child or both have to face a deductible twice as high as single employees.  This is especially true for High Deductible Health Plans.  Their is an easy solution for families to reduce their deductible to the same as a single employee, however.  It is called an Embedded Deductible.Embedded deductibles allow families to meet only the individual deductible when a single family member has a claim.  If two family members (or more) have claims in the same year, each is subject to the single deductible, until each reaches the single limit or all reach the family limit.*When working with a High Deductible Health Plan and a Health Savings Account, make certain that the deductible is at least $2,800 for an individual - otherwise the IRS will not allow you to deduct your HSA contributions for that year.Embedded Deductible ExampleThanks, as always, for listening!  I appreciate you very much.  Support us by telling your family, friends, co-workers and your boss!Listen to our theme music and lots of other great songs from Morgan Fingleton hereTalk to you next Thursday!

#022 - Reprise of Health Insurance Open Enrollment Make It Simple, Episode 2. Get ready for Open Enrollment now so that you have the fundamentals down….get out ahead….don't wait until October when stress will be highest and you might make a poor choice.For some employees, this show is quite timely because many employers have renewal dates on July 1st.  Ask your employer the date that your health insurance renews so you can be properly prepared!Doxcost Episode 2Get Health Insurance Plan Documents/Enrollment Kit from your employer to consider your optionsIdentify three key items:PremiumDeductibleCoinsurance RateSee example of table in Episode Two show notes at Doxcost.comMake certain you tell your employer that you want a plan that is eligible for a Health Savings Account (HSA).  Plans that are eligible for HSAs are called High Deductible Health Plans.  Don't fear the high deductible…..it can be as low as $1,400 annually and still qualify for use with an HSA.When considering your lowest cost options, you need to add all of your expenses.  Your expenses are all of the cash coming out of your pocket to pay premiums, deductibles, coinsurance AND taxes withheld from your paycheck!Traditional PPO and HMO plans require that you pay tax to Uncle Sam first before you pay your deductible and coinsurance.HSA eligible plans save you the same amount of taxes that traditional plans make you pay.  Depending on the plan, that could mean thousands of dollars you can save each and every year.IRS detailed information on Health Savings AccountsThanks, as always, for your support.  Tell your family, friends coworkers about Doxcost.  If your employer needs help, I am happy to connect with them.Tell your employer to contact me here (link to Doxcost contact)Next episode I cover the benefits of getting your health insurance through your employer.And if you like the music on Doxcost, hear more from my pal Morgan Fingleton, click here

#021 - Reprise: Don't Fear The High Deductible is an encore presentation of our most popular show.  Health Savings Accounts (HSAs) work with High Deductible Health Plans (HDHPs) save you the most money, period.In order to open a Health Savings Account, you must be enrolled in an eligible High Deductible Health Plan.  Most people see High Deductible and get scared away.  High Deductible Health Plans go as low as $1,400 for an  individual in 2021 and $2,800 for households with two or more.Learn more about HSA and HDHP limits for 2021Don't Pay Tax And Keep Money In Your PocketMoney deposited in a HSA account is not taxed.  Money deposited in a regular savings account (or checking or investment account) is taxed - often referred to as after tax because Uncle Sam takes his tax out of your paycheck and what is left is after tax.Learn more about Health Savings Accounts hereOur family has utilized Health Savings Accounts since they started in 2004.  I prefer Lively.Visit Lively here - I receive a nominal fee for recommending LivelyAs I always, I appreciate you very much!  Tell your family, friends, coworkers and your boss about Doxcost!Next episode we'll take another look at why you get your health insurance through your employer....

#020 - Your money is being taken from you and you don't even know it.  Your health insurance premiums are higher, in part, because you sign away your health insurance benefits to third parties who act in their best interest, not necessarily yours.Assignment of Benefits (AOBs) is essentially demanded by hospitals, doctors and pharmacies before they will serve you.  You probably don't even know it, either.  You are presented a bunch of documents, don't read them, sign bottom of the page and then they proceed.  What you signed basically gives the provider direct access to the money that the insurance company is contractually obligated to pay to you.  Your money is being taken from you.Once you sign your benefits away, you lose control.  Providers enlist their attorneys to author AOBs with the intent to seize control over your benefits so that they make sure that they get paid at whatever amount they deem appropriate.  The AOB is specifically written so that you cannot reverse the decision you make - it is irrevocable, irreversible.   Name any other thing that you purchase where you actually allow someone to push you aside while they decide what happens with your money?State lawmakers and regulators will probably start to scrutinize these arrangements.  The State of Florida passed a law to regulate Assignment of Benefits related to property insurance.  As the Center For Medicare and Medicaid Services (CMS) starts to scrutinize transparency, AOBs will likely be considered, as well. Check out my pal Whitney Johnson here:Disrupt Yourself PodcastYou have question and we have answers!  Let us know your questions here:Your Questions For DoxcostThanks, as always, for listening.  Tell your family, friends, co-workers!  We're here for you!Next episode....we'll look at networks, break them down so you can understand how/why they  were put together and why they cost you more in your insurance premiums and how they may become obsolete.When football was football and not a passing league!  Nobody finds daylight like #20!Barry Sanders

#019 - I Hate Insurance and other comments about health insurance and healthcare are highlighted in a snapshot look at how people view their current situation within the health insurance and healthcare systems as exclaimed on Twitter.Follow @doxcost on TwitterLots of angst and anguish can be found on Twitter.  We decided to take a look and see what is really bothering people about  health insurance and healthcare.  Scott puts "I Hate Insurance" in the search box.  Some comments are amusing, some is unfortunate and some is disturbing.   I respond in an honest and helpful way or at least put things in context.Lots of people misunderstand health insurance. The tangling of health insurance and healthcare is on full display.Why You Save By Getting Your Health Insurance Through Your Employer - Episode 3A  couple of doctors, obviously well-educated, display their ignorance regarding their profession's direct contribution to the "thousands and thousands of dollars insurance companies have convinced people to spend on their health insurance".  Payments to providers (i.e. Doctors, Hospitals, Pharma) are the single largest component of the cost of your health insurance premiums.How Health Insurance Is Priced - What Makes Up A Dollar of Premium - Episode 11 I appreciate you very much!  Tell your family, friends and colleagues - especially small business owners - to listen to Doxcost wherever they get their podcasts.  Follow us on Twitter @doxcostNext up, we'll explain the cancer that is Assignment of Benefits and how that single-handedly takes you out of the loop with your doctor and your insurance.  You won't want to miss it next Thursday!

#018 - Learn how an HSA will earn you a quick and easy return by making an eligible deposit before you file your taxes.An HSA is  like getting free money!Don't Pay FICA or Federal Income Tax(some states still tax your HSA deposits)FICA = Social Security Withholding AND Medicare Withholding = 7.65% of your paycheckFederal  Income Tax Withholding = 10% to 37%Maximum HSA Deposit in 2021Individual - $3,600Head of Household/Married/Family -  $7,200 per yearYou keep the money instead of paying Uncle Sam$3600 x .0765 = $275$3600x .22 = $792$1,067 stays in your pocket!  Why give it away when you do not have to?  If you're a family, you'll keep even more of your hard-earned paycheck!I've utilized the benefits of Health Savings Accounts since their inception. I prefer Lively HSALearn about Lively HSA hereThanks, as always, for your support!  Please share Doxcost with your family, friends and colleagues.  Visit doxcost.com to learn more.Open Enrollment Workshop coming late summer 2021!

#017 - Healthcare.gov review is a cursory look at the current exchange portal.   The site provides access to insurance plan options for the 50 states and District of Columbia.  Links can be found for both the federal website and individual state exchanges.Go to Healthcare.gov hereThis Healthcare.gov review still keeps in mind that the goal is to get 100% covered and spend the least amount possible on your health insurance.  This is best done utilizing a High Deductible Health Plan (HDHP) along with a Health Savings Account (HSA).  It makes sense to review our episode on HDHPs and HSAs!Don't Fear The High DeductibleHealthcare.gov review highlights the fact the exchanges are not for everyone.  Nearly half of the US population gets their health insurance through employer sponsored plans.  Another 35% of people get their health insurance through the military, Medicaid or Medicare.  About 5% of people have individual plans.  About 10% choose to be self-insured or do not believe they can afford health insurance.  Healthcare.gov does a great job of informing people how to get help and how much financial assistance they can get.Why get your health insurance through your employer?Tax Day is now May 17, 2021!  Get an immediate return on your savings by contributing to your HSA before May 17.Learn how to get an immediate return on your savingsThanks, as always, for your continued support.  Please tell your colleagues, friends and family about Doxcost.  Follow us on Twitter @doxcost and at doxcost.com

#016 Insurance company transparency is required by both the Affordable Care Act and the new Hospital Price Transparency rule that took effect on January 1, 2021.  Learn how insurance companies are complying and how (if) that helps you. The Patient Protection Affordable Care Act, aka Obamacare, requires insurance companies to publish the prices they negotiate and amounts they pay to doctors, hospitals, pharma and other providers.Learn about the PPACA hereInsurance company transparency required by Obamacare includes publishing Medical Loss Ratios (MLR).  An MLR is the percentage of paid claims plus reserves (IBNR)  relative to the total  premium an insurance company receives.  Obamacare requires that the percentage representing claims be at least 80% of total premium.  While apparently meeting the federal government requirements, insurance companies do not present any of the information in a consumer friendly way, which is truly unfortunate.  Accessing the data is cumbersome.  The insurance jargon used is worthless to the average consumer.  While the politicians can claim they did something for their constituents and the insurance companies can claim that they are dutiful and compliant in meeting the needs of consumers, the information is worthless.  Further, the time and money spent producing the data is part of the administrative expense added to the premium you pay....so your insurance costs more with nothing to show for it.See how insurance companies meet Obamacare requirements hereCMS, the Center for Medicare and Medicaid Services, requires insurance company transparency, at least from what the former Secretary of Health and Human Services says.  From the HHS site: The rule requires that most health plans and health insurers not only provide easy-to-understand personalized information on enrollee cost-sharing for healthcare services, but must also publicly disclose the rates they actually pay healthcare providers for specific services.  Still, what insurance companies really need to disclose and publish is what their rates are, what their loss ratios are, what their expenses are and what their profit is.....and don't be fooled....not-for-profits make lots of money......See the  statement including Insurance Company Transparency hereBottom line is that you need to take control.  Stick with me and we'll get it done!Next episode, we'll look at the healthcare exchanges and see what might be usable and useful to you, a friend or a family member.Thanks, as always, for listening.  I appreciate you and the time and support you afford me.  Tell your family, friends and colleagues.....we're all in this together!

#015 Learn how Hospital Price Transparency rule, as directed by Obamacare,  Trump administration rule and Biden administration execution,  will  help you take control and save on your health insurance  premiums and out of pocket costs.As of January 1, 2021, hospitals must publish and provide consumers the price of the services before providing their services.You, the consumer and patient, need to ask (demand...nicely) that the doctor inform you of the cost of the procedure before you agree to undergo the procedure or otherwise be treated by the doctor.  The CMS asks you to report complaints if you do not get what you expect.Visit CMS Hospital Price Transparency pageVisit healthcare.gov Patient Protection Affordable Care Act pagesNo different than anything else you buy, you should want to comparison shop.  And the information to comparison shop should now be readily available from the doctor.Why shouldn't you see a menu of prices for services provided by hospitals?  The answer is you should!  And you should demand it if you don't!  Or at least find another hospital that does, like Surgery Center of Oklahoma.....they publish their prices!  You may just find that a short plane ride to Oklahoma City for surgery is cheaper than staying home where they won't tell you what it will cost.....wonder why they won't tell you.......!  #makethemcompeteUnfortunately, the way that some hospitals are attempting to comply with the transparency law leaves much to be desired.  I am confident that market competition from yet-to-be-discovered sources will find great opportunity in the incumbent's complacency in much the same way that a guy selling books forever changed the way we purchase all kinds of items from lots of now defunct retail stores.In the next episode, we'll cover how insurance companies address transparency and what you need from them.As always, thanks for listening!  Tell your colleagues, friends and family about Doxcost!  Follow on Twitter @doxcost and at doxcost.com

#014 - Providers of health care - hospital, doctors, pharma - operate to make a profit, whether they say so or not.  Are you paying too much?  Yes.While insurance companies are often the recipient of consumer ire for the rising cost of health insurance, the cost inputs to those insurance premiums - most notably paid claims (aka the cost of doctors, hospitals, pharma and other providers) have the most significant effect on the price of your health insurance premiums.  These input costs need to be equally, if not more, scrutinized!This episode illustrates how hospitals and other providers are equally driven by profits.  And there is nothing wrong with profits.  Value is created when the product or service meets the lowest price possible when the buyer and seller have a meeting of the minds.Your call to action is to purchase health insurance as you would any other consumable product.  Identify the cost ahead of your purchase.  Don't just take whatever they give you.  And if you just say to yourself, "oh, insurance will pay for it....no big deal....."  STOP!  You are paying for it....you just don't realize it and the system likes it that way.Become an informed and rational consumer of health care.  It starts now!Easily research data, from industry publications such as Becker's Hospital Review:Ascension records $1B annual lossHappy Saint Patrick's Day!  Be sure to check out surfing in Bundoran!Bundoran Surf Company IrelandWe'll continue on with helping you to be a better consumer of healthcare.  Next we'll look further at the new rules handed down by CMS for transparent pricing.Tell your family friends about Doxcost!  We're growing!  Catch us on Spotify or wherever you get your shows.See ya next time!

#013 - Learn why the amounts paid to doctors, hospitals, pharma and other providers are the single biggest factors in the cost of your health insurance.Understand how underwriters and actuaries use historical paid claims to forecast future claims, establish reserves and keep pace with inflation.  These amounts are then utilized to create the health insurance rates that you pay.Paid claims are the amounts paid, on behalf of members of the employer group or individual pool, to doctors, hospitals, pharma and other providers.  IBNR (aka Incurred But Not Reported) is a reserve amount insurers must hold back to pay claims from the current year that are paid in the future - next year or years after.  IBNR is calculated as a percentage of paid claims.Trend is an amount that provides the ability of insurance premiums to keep pace with inflation.  Medical trend (medical inflation).  Trend is different than general inflation and has risen at much higher levels than general inflation over the past few decades.  Trend is applied to paid claims and reserves.See the following link from PWC that illustrates their methodology in considering 2020 and 2021 medical trend.2021 Medical Cost Trend - PwCWe celebrate International Women's Day!  Follow some great women here:NCAA Women's Basketball  Tournament - every game on ESPNNext episode we continue to tackle how your insurance is priced and the factors that affect its price.Thanks, as always, for your continued support!  Doxcost continues to grow by leaps and bounds.  Tell your family and friends to catch Doxcost on Apple Podcasts or where ever you get your shows.See ya next time!

#012 - Learn what everyday stuff underwriters use to price your health insurance.Control what you can and forget the stuff that underwriters use, everyday stuff, like your age, sex and ZIP code, that is arbitrary and you cannot change.If you live in New York or California, your rates are likely to be much higher than the person that lives in Nebraska or Mississippi.  It's not your fault, just an economic reality.  If you  live in a low cost state, expect lower claims cost....if most of the employees live in a low cost state.If your company is full of accountants or actuaries, expect a lower rate, in general, than if your company is a high performance racing team that participates in speed games.  Truth is that I worked for a company whose Chief Actuary spent his leisure time as a driver racing at Watkins Glen....so it is not always a perfect assumption!And, as for profit, which we discussed in Doxcost Episode 11, here is a link to a report on a publicly traded company, which owns hospitals, that announced its financial results for 2020.  The company announced over $500 Million in profit in 2020 on nearly $12 Billion in revenue (aka the claims you incur and that the insurance company pays and reserves for).CHS sheds 18 hospitals, swings to $511M profit Also, I did like this author's characterization of Not For Profit companies.....Not For Profit sounds nice, but don't be fooled.  Read the post here:How Non-Profit Hospitals Are Driving Up The Cost of Health CareThanks, as always, for your support.  It's all about Knowledge Experience Education and Information.  Tell your family, friends and coworkers about Doxcost!Next episode we will tie together all of the aspects of pricing so that you understand how what the actuaries and underwriters consider affects the price you pay for your health insurance.I appreciate you very much!

#011 - Learn the components that affect the price you pay for your health insurance so you can save your hard-earned dollars.This is Scott Dowling's second in a series of episodes that will help you understand how your health insurance is priced.  Scott presents the cost components in easy-to-understand way.  Get the episode freebie here:DOWNLOAD: What Makes Up A Dollar Of Your Insurance PremiumIn the next episode, we'll look the specific variables that underwriters look at when pricing your specific risk, whether as an individual or as part of a group.As always, I appreciate you very much.  Tell your family, friends and co-workers to give Doxcost a listen.We're all in this together!

#010 - Learn how your health insurance is priced by actuaries and underwriters as they look at group vs. individual risk.Health Care is not health insurance!  Our mantra!  Our cry!Don't let anyone fool you......your health insurance coverage is for you, not anyone else.  Your health insurance transfers your risk of financial burden to the insurance company in the event of an unforeseen accident or sickness.  The payment is to you by way of your contract with the insurance company or your employer's contract with the insurance company.Think of actuaries as fashion designers like Versace, Dior or Ralph Lauren.Think of underwriters as the tailors who mold the fashions specifically to each man and woman who wear each and every design.Get the Doxcost infographic that illustrates how each dollar of your premium is allocated to each player in the delivery or your policy and payment of your claim.Join us next time as we continue to discuss how your health insurance is priced and why it matters to you.Thanks, as always, for your support.  Don't be shy to ask your questions!  And Tell A Friend!

#009 - Know what you have! Grab your policy or the plan outline  provided by your employer and review your coverage now, at the beginning of the year.Understand what you will have to spend if and when a claim arises and set money aside, as best as you can, to cover the total.Know the following:Deductible amountYour percentage share of CoinsuranceYour Out of Pocket Maximum (OOP)Your premium - over the course of the year, not just for one month or one pay periodIf you have a spouse and/or children, check to see if your deductible/OOP is double or moreIf  you have a Health Savings Account (HSA), know your annual maximum contribution and fully fund your HSA as best as you can  - over 55 years old.....contribute an additional $1,000 and open a separate HSA for a spouse and contribute another $1,000I recommend Lively HSA.  Lively is free, online and paperless.  I receive nominal compensation from Lively at no cost to you.https://doxcost.com/livelyI appreciate you very much!  Thanks, as always, for your support.  Subscribe and tell your friends!In the next show, we'll discuss how health insurance is priced and why you need to pay attention to how much you are charged by your doctor, hospital, pharmacy and other providers.

#008 - Health Questions posed by Jamie Crosier of Organize Like A Pro podcast.  Jamie and her listeners have questions just like you!  Doxcost is here to help.  Learn why your premiums are lower and you save when you Organize Like A Pro and utilize a High Deductible Health Plan.  When you have a Health Savings Account, you can budget and plan to be 100% covered and spend the least amount of money every year for health care expenses.You have questions!  Submit your questions @ https://doxcost.com/askVisit Jamie Crosier and Organize Like A Pro @https://doxcost.com/organize Listen to our next podcast to learn what you need to do now in 2021 to make the most of your health insurance dollar...

#007 - By filling up your HSA now, with the maximum contribution for 2020, you will virtually eliminate any surprises for 2021.  Plus, you'll get a nice return on the money you contribute now when you file your 2020 taxes in a few weeks.  By maximizing your contribution to your Health Savings Account, you can help ensure you have 100% of your deductible covered for 2021.Doxcost is all about getting 100% covered and lowering the cost of your health insurance.  Stick with Scott W. Dowling as he shows you how!When you get your High Deductible Health Plan (HDHP), get your Health Savings Account with the HSA provider Scott uses, Lively! Click here for Lively Health Savings AccountNext Episode:  What to do to start 2021 on the right foot....As always thanks for your support!  Subscribe and Tell A Friend!

#006 - It's the Thanksgiving Show, but it's after Thanksgiving.  Parents and Grandparents will definitely learn some good stuff!  Scott W. Dowling discusses some of the things that came up in discussion with recent college graduates who have new employee benefits with their new employer.  Since it is the end of 2020, Scott tells you how you can earn an easy (and healthy) return on your savings just by contributing to your Health Savings Account before the end of the year.You can have more than one Health Savings Account. You do not need to use the one provided by your employer.  See if it has the lowest fees, is easiest to use, is online and paperless, and gives you the full capacity and all of the options to make the investments that are right for your personal risk tolerance level. Scott uses Lively HSA.  It is FREE.  It is EASY to use.  It is PAPERLESS.  It offers full investment OPTIONS.  Learn more by clicking the link below:https://livelyme.pxf.io/2Ox2QThanks, as always, for your support.  Tell a friend about Doxcost - subscribe on Apple Podcasts or wherever you get your podcasts.  Next show, we'll cover a little more on HSAs and why relying on your employer for payroll deduction may do more harm than good!  You can always visit us on Twitter @doxcost or on the web: https://doxcost.comLet us hear from you!

#005 - Learn the rules for Health Savings Accounts and High Deductible Health Plans for 2021.Learn how to qualify for a Health Savings Account, what the contribution limits are for 2021 and how the deductible and out of pocket costs for the High Deductible Health Plan are limited, both high and low.Thanks for listening and subscribing to the show!  Tell your friends and family, too!  It is time well spent.Our next show gives thanks for the opportunity to take care of our families and ourselves.....it's Thanksgiving week!  So long for now!

#004 - A High Deductible Health Plan (HDHP) plus a Health Savings Account (HSA) is far less expensive than a traditional lower deductible PPO plan like you probably have now.With a High Deductible Health Plan and and HSA:The premium you pay is likely far lowerThe amount of your out of pocket expenses is likely far lowerif you need help, visit:https://scottwdowling.com/contact/Your questions are always welcome!  Ask away:https://doxcost.com/questions/Coming up on the next episode how to make sure you are in the right High Deductible Plan so you're legal and socking away the most money for yourself.As always, thanks for listening!  Hit subscribe to always get the latest and save the most on your health insurance.Like the music?  Find my pal, Morgan Fingleton, here:https://morganfingleton.com

#002 - You want to be 100% Covered by your health insurance plan.  Learn what you need to know and ignore the rest.Learn how to tackle open enrollment by getting organized.  I'll help you remove the unnecessary clutter that accompanies your enrollment into your new health insurance plan.  Set up your plan so that you are 100% covered while paying the least amount for your health insurance coverage.www.doxcost.comBe sure hit the Subscribe button to stay up on the latest info.Thanks for listening and always holler when you need help!  https://scottwdowling.com/contact/

#003 - Know why you get insurance through your employer and how it saves you money overall.  Learn a brief lesson as to how employer-based insurance got its start and build your foundation of understanding all of the advantages available to you from your health insurance  that would not be available if you were left all on your own.Plus........get a helpful tip on how to make the most of your deductible.https://doxcost.comThanks for listening.  if you need help, give me a shout!  I am here to help!https://scottwdowling.com/contact/

#001 - Take control of your health insurance!  Scott W. Dowling is on a mission to put you back in control of your health insurance so that you can save more of your hard-earned money while staying 100% covered.  I've got 30 years of industry experience to share, including all of the tricks and tips to put you in control.  Become part of the program by asking your questions here:https://doxcost.com/questions/I hope that you enjoy the first episode.  Like I say, it is short and sweet.  You'll be glad to spend a brief amount of time with me while I educate and inform and hopefully save you a bunch of money while keeping you and your family 100% covered.  Join the program and hit subscribe.  And don't forget to tell your family, friends and neighbors.....plus your co-workers and your boss!