Carlton Insurance LLC represents a wide variety of insurance carriers offering a broad spectrum of products serving individuals and families as well as small businesses.
If you are a small business owner, with a minimum of 2 employees working at least 17.5 hours/week, please contact us to determine whether a small business insurance product would best suit your needs. There are many questions to answer to determine the feasibility of a small business insurance plan and it is easier done on the phone than via a web site. If you are eligible, we can put together a health insurance package as well as life insurance, disability, and even long-term-care. We welcome your calls!
Health Insurance
Catastrophic Plans (major medical)
A catastrophic or major medical plan is aimed at covering a catastrophic injury or illness after you meet a deductible. In fact, these plans typically do not cover any medical expense until a deductible is met. For example, with a catastrophic plan, there is no co-pay for a doctor visit. You pay 100% of the cost of doctor visits until your annual deductible has been reached. Once you meet the annual deductible, you continue to pay a percentage of the remaining costs (called "co-insurance"), typically 20%, 30% or 50% depending on the plan, until you reach an out-of-pocket maximum, sometimes known as a stop-loss. Here's an example of how it works:
Your plan design: $1000 deductible plan, 20% co-insurance and a stop-loss of $4000
If you have medical expenses resulting from an illness or injury totaling $50,000, you will pay the first $1000 and satisfy your annual deductible. Then, you'll pay 20% of the remaining $49,000 until your 20% reaches another $4000. At that point, your insurance carrier will pay 100% of your medical expenses until January of the next year.
Comprehensive plans
A comprehensive plan includes all of the elements of a catastrophic plan PLUS coverage for other medical services with the deductible waived. For example, a comprehensive plan typically offers doctor visits with the deductible waived for a $20 - $30 co-pay for each visit.
HSAs (Health Savings Accounts)
HSA Accounts or HSA plans allow you to save money to pay for future medical expenses on an income tax-free basis. A Health Savings Account is really a combination of a health insurance policy meeting minimum US Treasury policy design requirements called a qualified High Deductible Health Plan (HDHP) and a separate custodial savings account for future medical expenses called a Health Savings Account. The qualified HDHP provides comprehensive coverage for serious illness and injury at a more affordable premium rate. An HSA is a tax- exempt account in which you accumulate savings to pay medical expenses that make up your deductible or are not covered by your plan. An HSA allows you to enjoy unique tax benefits and affordable health premiums without risking your protection. HSAs offer a way to set aside funds to pay for medical expenses for today and tomorrow. HSAs provide you with tax savings when you contribute the funds and when you use the funds. Annual contributions reduce your taxable income and funds used for qualified medical expenses are never taxed. All of the money you set aside plus the invested earnings in your HSA grows tax-deferred. At age 65, you can withdraw funds for any non-medical purpose at ordinary tax rates, or tax-free when used for qualified medical expenses.
Funds in an HSA account can be used to pay for medical expenses incurred in meeting the deductible, any required shared expenses for which you are responsible, and qualified medical expenses not covered by the health insurance plan such as vision and dental expenses. Click here for a list of eligible medical expenses, as summarized by HSA Bank. This is a partial list of eligible medical expenses. You are encouraged to view the IRS's website (Publication 502) for a complete list of eligible medical expenses.
The ideal candidate for an HSA qualified health plan is someone who needs a tax deduction. If you do not need a tax deduction, there may be a more affordable catastrophic plan that will better meet your needs and your budget.
Health Savings Accounts - 2007 & 2008 HSA Cost-of-Living Adjustments
HSA individual High Deductible Health Plan (HDHP) Requirements
2008 |
2009 |
|
|---|---|---|
| Self-only coverage, minimum deductible | $1,100 |
$1,150 |
| Self-only coverage, maximum out-of-pocket | $5,600 |
$5,800 |
| Self-only coverage, maximum HSA Contribution | $2,900 |
$3,000 |
| Family coverage, minimum deductible | $2,200 |
$2,300 |
| Family coverage, maximum out-of-pocket | $11,200 |
$11,600 |
| Family coverage, maximum HSA contribution | $5,800 |
$5,950 |
| For those 55 years of age - 65, catch up | $900 |
$1,000 |
If you already have an HSA health insurance policy and would like to open an HSA bank account, you can go to HSA Bank online to make the process simple and quick. In fact, if you click here, you will save some of the bank fees!
Click here for information on Life, Disability, Long-Term-Care and Medicare Supplements