Imisebenzi yededucable yomndeni ehlukile nge-HDHP kunezinye izinhlobo zezinhlelo
Uma umshwalense wezempilo womndeni wakho uyihlelo lokuphila eliphakeme kakhulu lokudonswa, umndeni wakho ozobanjwa ungasebenzisa ngokuhlukile kunokwenza uma unomunye umshuwalense wezempilo. Uma ungaqondi kahle indlela umndeni owenziwe ngayo osebenza ngayo ohlelweni oluphezulu lokudonswa kwezempilo (HDHP), ungamangala. Umshuwalense wakho wezempilo angeke uqale ukukhokhela izinzuzo uma ucabanga ukuthi kuzokwenza, noma ilungu lomndeni elilodwa lingase lidingeke likhokhe okungaphezu kwalokho okulindele.
Uma ungacacile ngokucacile okuyisisekelo sokuthi i-deductible iyini, yini ehlonishwa ngayo, futhi kwenzekani ngemuva kokukhokha imali yakho, funda " Umshwalense Wempilo Ehlulwayo-Okuyiyo nokuthi Usebenza Kanjani " ngaphambi kokuba uhambe noma yikuphi okuqhubekayo. Uzodinga ukuqonda okuyisisekelo kwama-deductibles ngaphambi kokuthi ukwazi ukuqonda ukuthi umndeni we-HDHP ususwe kanjani ngokungajwayelekile.
Indlela Umndeni Oqedile Ukusebenza Ngayo Emkhakheni WezeMpilo Ephakeme
Ngokubanjelwa komndeni ku-HDHP, izinzuzo zezempilo zezempilo aziqali kunoma yiluphi ilungu lomndeni kuze kube yilapho yonke inzalo ekhishwe imali ikhokhwe, noma kuze kube yilapho ilungu lomndeni lithola ukwelashwa liye lafinyelela umkhawulo ovumelekile ongaphumelelanga we-pocket wonyaka (ngo-2017, lowo mkhawulo ngu-$ 7,150; ngo-2018, kungu- $ 7,350). Umkhawulo ovimbela ilungu lomndeni elilodwa ukuthi lidingeke libe ngaphezu kwe-out-of-pocket esiphezulu liye lasetshenziswa ngo-2016, futhi lichazwe ngezansi.
Njengoba ilungu ngalinye lomndeni lifaka izindleko zezokwelapha, inani abakhokhela kulezi zindleko libizwa ngokuthi lidonswe emndenini. Uma lezi zindleko zengeza kumndeni osuswe, i-HDHP inqamule futhi iqala ukukhokhela isabelo sayo sezindleko zezindleko zezempilo kwelungu ngalinye lomndeni.
Ku-HDHP, umndeni okhishiwe ungasetshenziswa ngezindlela ezimbili ezahlukene:
- Ilungu lomndeni elilodwa linemali ephakeme yokunakekelwa kwempilo. Ngokukhokhela lezo zindleko zokunakekelwa kwezempilo, ufinyelela emndenini onqunywe ukukhishwa kanye nokukhawulwa kwemikhakha yomndeni wonke. Kodwa uma umndeni udonswa kakhulu kunomuntu ovumelekile ongaphandle, izinzuzo zizokhawulela ilungu elilodwa lomndeni uma lowo mkhawulo uhlanganisiwe, ngisho noma ngabe i-deductible idumile ingakafiki.
- Amalungu omndeni amaningana anemali encane yokunakekelwa kwempilo. Umndeni udonswa uma lezi zindleko ezincane zihlanganiswa ndawonye zifinyelela inani lemali elisetshenzisiwe.
Lokho Kuhluke Kakhulu Kanjani Nomndeni Okuqedile Kuhlelo Lwangaphandle Lwe-HDHP?
Esikhathini sohlelo lwezempilo lwezobudlova, ilungu ngalinye lomndeni linomuntu ngamunye ongenakudliwa futhi umndeni wakhe wonke unomndeni owenziwe. Yonke into ekhokhelwa ukukhishwa kwezimali ngabanye ibuye ikhonjiswe emndenini okhishiwe.
Kunezindlela ezimbili lezi zinhlelo zezempilo ezingezona i-HDHP zizoqala ukukhokhela izinzuzo zomuntu othile emndenini.
- Uma umuntu ehlangene nomuntu ngamunye ehlulwayo, izinzuzo zezempilo zikhahlela bese ziqala ukukhokhela izindleko zokunakekelwa kwezempilo kulowo muntu kuphela, kodwa hhayi kwamanye amalungu omndeni.
- Uma kutholakala umndeni, izinzuzo zezempilo zempilo zikhahlelwa wonke amalungu omndeni ukuthi ngabe ahlangabezane namadokodo.
Ungafunda kabanzi mayelana nokuthi umndeni okhishwa kanjani ekusebenziseni izinhlelo ezingezona i-HDHP ku-" Indlela Umndeni Owuqedile Ngayo Imisebenzi ."
Umehluko phakathi kohlobo lwendabuko lwenqubo yomshuwalense wempilo yomshuwalense kanye nomndeni owenyulwayo ohlelweni lwezempilo lwe-HDHP wukuthi ukukhishwa komuntu ngamunye kukhishwa emkhakheni we-HDHP womndeni . Kukhona indlela eyodwa kuphela yokuthi uhlelo lwezempilo lwe-HDHP luzoqala ukukhokhela izinzuzo kunoma yiluphi ilunga lomndeni: ukudilizwa komndeni kuye kwafinyelelwa. Kodwa ngaphansi kwemithetho emisha eyaqala ukusebenza ngo-2016, izinzuzo zizokhawulela ilungu lomndeni ngamunye uma ehlangana nomkhawulo ongaphandle kwesikhwama salo nyaka, ngisho noma umndeni owenziwe imali ungakabikho.
Ngokuphambene nalokho, ngecebo elingelona i-HDHP, umndeni owenziwe imali awukwazi ukuhlangabezana nezindleko zokunakekelwa kwempilo yelungu lomndeni elilodwa. Kuthatha ama-deductibles angeziwe amalungu omndeni amaningana ndawonye ukuze afinyelele emndenini owenziwe.
Imithetho Yashintshwa Ngo-2016
UMnyango wezeMpilo noHulumeni lwaBantu uye wenza imithetho emincane yezinhlelo zezempilo ezingenasisetshenziswa ngokusebenzisa i-deductible ephelele. Lokhu kuthinta izinhlelo eziningi zezempilo ze-HDHP zomndeni. Ukwenyuka okungeziwe yilokhu: uhlelo lwezempilo alukwazi ukufuna ukuthi umuntu akhokhe i-deductible ephakeme kunomkhawulo wesifundazwe ongaphandle kwe-pocket esiphezulu sokwenza umsebenzi ngamunye, ngisho noma lowo muntu ehlanganiswa ngaphansi komndeni ophelele. Ngo-2016, ukukhishwa kwe-pocket okungaphezulu komuntu kulinganiselwa ku-$ 6,850.
Isibonelo: Asho ukuthi inqwaba edalulwayo ohlelweni lwakho lomndeni we-2016 yi-$ 12,000. Uma ilungu lomndeni elilodwa likhokhile u-$ 6,850 ngokulinganisa inani lemali elidonswayo, ukukhokhelwa kwalowo muntu ngamunye kufanele ukukhawule ngaphandle kokudinga ukwabiwa kwezindleko ezifana ne-copays noma i-coinsurance. Ukukhishwa kwalowo muntu ukukhahlela ngoba manje usefinyelele umkhawulo ongaphandle kwezomthetho womuntu ngamunye. Noma kunjalo, ukufakwa kwamanye amalungu emndenini wakho ngeke usabalale kuze kube yilapho kutholakala yonke imali yomndeni eseduzane.
Lokhu kulungiswa kwemithetho kwenzeka ngokushesha nje lapho uhlelo lwakho lomshuwalense wezempilo luvuselela ngo-2016. Kuze kube yileso sikhathi, uhlelo lwakho lwezempilo luzolandela imithetho edala. Uhulumeni uphakamisa umkhawulo ongaphezulu kuma-maximum angaphandle kwe-pocket kancane ngonyaka ukuze kulandelwe ukukhuphuka kwemali.
Uyazi kanjani ukuthi yimuphi umndeni wakho owenziwe imisebenzi?
Iningi le-HDHP lisebenzisa uhlelo lokudonswa kwemindeni lapho kungekho khona amadokhumenti ngabanye futhi akukho muntu emndenini othola izinzuzo kuze kube yilapho kukhishwa umndeni. Lokhu kwaziwa njenge- aggregate deductible .
Kodwa futhi, lokho manje kuncike ekutheni umndeni weductible uphakeme noma uphansi kunomkhawulo ophezulu ongaphandle kwe-pocket wokuthunyelwa ngabanye kulowo nyaka. Isibonelo, uma umndeni i-HDHP unomndeni weR $ 6,000, ilungu lomndeni elilodwa lingadingeka ukuthi lihlangabezane ne-deductible egcwele ngo-2017. Kodwa uma umndeni ususwe ngu-$ 10,000, ilungu lomndeni elilodwa ngeke lidingeke lichithe ngaphezulu kwamaRandi angu-7,150 ngaphambi kokuba kukhishwe wayezokhalela lowo muntu, naphezu komndeni okhishwe wona engakafiki. Ngakho-ke noma ngabe lesi simiso esisha sishintsha noma yini mayelana nokuthunyelwa komndeni wakho kuncike ekutheni i-deductible yakho ephakeme kangakanani.
Izinhlelo eziningi zezempilo ezingezona i-HDHP zisebenzisa uhlelo lapho izinzuzo ziqala khona abantu abahlangabezana nomuntu ngamunye abadonswe ngaphambi kokuba umndeni ususwe. Lokhu kwaziwa njenge- deductible embedded . Ungakhumbula leli gama uma ucabanga ngalo njengamadokhumenti amaningana ahlanganiswe ngaphakathi komndeni omkhulu.
Izincwadi zakho zohlelo lwezempilo kufanele zikutshele indlela umsebenzi wakho owenziwe ngayo umndeni. Kungase isebenzise izibonelo, noma ingasebenzisa imigomo ehlanganisiwe yokudonswa ngemali ehlanganisiwe. Uma kungacacile, shayela uhlelo lwezempilo bese ucela noma, uma ngabe umshuwalense wempilo esekelwe emsebenzini, hlola nomnyango wakho wezibonelelo zabasebenzi.
Uma isifinyelelo sakho se-HDHP sezinzuzo nezinzuzo zihlunga isamba esisodwa esisetshenzisiwe kanye nesamba semali esinqunyiwe , ungacabangi nje ukuthi isebenzisa uhlelo lokudonsa okuhlanganisiwe. I-deductible eyodwa ingaba ngabanye abangabhalisi umndeni wonke kunabantu ngabanye ngaphakathi kwenqubomgomo yomndeni.
Yikuphi okungcono, i-Dgucate Deductible noma i-Deductible ehlanganisiwe?
Njengomthetho ojwayelekile, ama-deductibles ashumekile athambekele ekusindiseni imindeni ngezindleko ezingaphandle kwezezimali ngoba ukuhlinzekwa kwezempilo kukwehla kwamanye amalunga omndeni ngaphambi kokuba yonke inzalo idonswe. Lokhu kubangela amalungu omndeni ogula kakhulu anenzuzo yomshuwalense wezempilo okukhawulwayo-kungekudala nomndeni ohlanganisiwe ongakuthola ukwedlula ukube ukhethe-ekusebenziseni indlela ye-HDHP yomndeni ophelele owenziwe.
Kodwa-ke, ukuthi amalungu omkhaya ngamunye ngamunye asebenzisa kanjani izinsizakalo zokunakekelwa kwezempilo ahlukile. Yahlulela ukuthi uhlelo lusebenza kangcono emndenini wakho ngokusekelwe emaphethini okusebenzisa umshwalense wempilo yomndeni wakho.
Qaphela-Akuwona wonke amacebo aphezulu okudonswa yi-HDHPs
Ungacabangi ukuthi, njengoba une-deductible ephezulu, kumele ube nehlelo eliphezulu lokudonswa kwezempilo. I-HDHP uhlobo oluthile lomshuwalense wezempilo (i- HSA-afanelekayo ), hhayi nje noma yiluphi uhlelo oludala olunokudonswa okukhulu. Njengoba i-HDHPs ikufanele ukuba ubambe iqhaza kwi- Akhawunti Yokulondoloza Impilo Ekhethwa intela, ineminye imithetho ekhethekile eyahlukanisa nezinhlelo ezingekho ze-HDHP. Nakuba ungase ube ne-HDHP PPO noma i-HDHP EPO, izobe isilandela yonke imithethonqubo ekhethekile eyenza i-HDHP, hhayi nje i-deductible enkulu.
Uma uhlelo lwakho luyi-HDHP ngempela, izincwadi zakho zezempilo kumele zibheke njenge-HDHP noma uhlelo oluphezulu lokunakekelwa kwempilo. Ukwengeza, kungase kubhekisele ekuxhumaneni nomshuwalense wakho wezempilo nge-HSA.
Ukubukeka Kwezempilo Okumnyama Vs HDHP - Akuyona Into Efanayo Njalo
> Imithombo:
> I-Federal Register. UMnyango wezeMpilo kanye nezinsizakalo zabasebenzi. Isivikelo Sokubekezela kanye Nomthetho Wokunakekelwa Ongathintekayo, Isaziso Sokuzuza Nezikhawulelo Zokukhokha ngo-2016. Ngo-February 27, 2015.
> I-Federal Register. UMnyango wezeMpilo kanye nezinsizakalo zabasebenzi. Ukuvikelwa Kwabeziguli kanye noMthetho Wokunakekelwa Ongathintekiyo, Isaziso Sokuzuza Nezikhawulelo Zokukhokha ngo-2017. Mashi 8, 2016.
> I-Federal Register. UMnyango wezeMpilo kanye nezinsizakalo zabasebenzi. Ukuvikelwa Kweziguli Nomthetho Wokunakekelwa Okungathintekiyo, Isaziso Sokuhlomula Nezikhawulelo Zokukhokha Zonyaka ka-2018. NgoDisemba 22, 2016.