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HEALTHCARE: Evolve or Erode: The Need for Conversation is NOW

HEALTHCARE:          Evolve or Erode

The Need for Conversation NOW

Information is abundant. Viewpoints abound and gain attention through strident expression. Our perceptions of fact and truth are important and no easier to discern than in days past when we didn’t have the present-day leaps in technology with screen impact and effects, surround-view journalism, the continuous 24/7/365 news cycle, blaring electrons and signals invading our space and senses via handheld screens and building-size electronic, real-time signage.

As it has always been, it is up to us to use our critical better judgment to bring into focus all the stimuli, the special interests – what others want us to believe. Pressure is more acceptable in both blatant and subtle forms. Now it is time to have it coalesce into our own truth, beyond pre-digested, focus group analyzed media banter. It is up to us to make it a quest for truth good for us and for the common weal. Our own, personal, gut algorithm counts the most.

Take Healthcare Reform.

Easy to get on a bandwagon – anyone’s bandwagon. Deriding efforts to abandon the evolving system in place and you’ll have plenty of support. Put down the fact that the system is still on life support and in need of revision if not a gut rehaul? Sure. What’s needed is the conversation.

Of course, an administration wants its imprimatur on 1/5th of the economy. To evolve, the discussion must evolve. If we really want to protect people – and thus our economy and way of life – and yet expect American business to continue providing healthcare insurance to over half of America – or not, we must together discuss the matter civilly as stewards of our own and our children’s health. The country depends on it.

The challenge remains how to optimize the more efficient allocation of limited resources beyond the posturing for our own self-interests. We must seek compromise lest we dismantle a key American advantage: attracting new immigrants who represent the most enterprising and industrious to our shores. Call it “The New Heal” and create a set of expectations we can all subscribe to fairly, with everyone conceding. A good deal is one where we advance as a country and giving in on some points means a win for all.

The Next Big Thing: Beyond electronic medical records and algorithmic programming is the realization that hearing out the issues and ultimately creating compromise through true discussion is the only viable, long term resolution. The world is too small and the consequences too great for us vs. them Americanism viz a viz healthcare. We share the same ‘family budget’ and must allocate it wisely. Time to cohere for everyone’s benefit with the longer horizon in mind.

Compromise is messy especially when purposefully spun if not twisted to suit selfish purposes. Just like Big Data, it will be messy but can lead to progress if the discussion is honest. It will be heated but let it be honest.  We all need a fair deal on healthcare where our career choices and choice of where to live are not governed by severe consequences to our healthcare and insurance options. Yet business needs its profit. And an aging and longer-living public require its healthcare. It’s not too late to work together to prioritize and work towards realistic, long term, financially sound expectations. Indeed, we’ve just begun. Adults to the table now. Siren sounded.

A Final Note on Pace: No one should hurry your decisions but know that now is time to move off the square and get into the conversation in your own way. Everything is on the table, the entire gamut from minimum essential benefits and expensive state mandated benefits to both individual and employer mandates, taxes and special risk corridors (or the like) to protect against huge medical liabilities, to improvements sacred to so many garnered after literally generations of battles. It’s all on the table.

The only rush is into the conversation. Discuss the issue with friends calmly with a long term solution in mind, not an immediate line in the sand. Seek information from trusted sources. Attend a local meeting, write your state legislator or Washington representative, publish your questions and ask your questions in blog or on social media with a larger goal in mind: a robust economy and for all. Trust yourself to know what’s right and good for self, for your community(ies) and for our country long term. Learn from the exchange of ideas. It won’t be quick. We must continue to evolve.

It counts this time around, for all of us. Input needed; show up to the conversation, including the one I’ve begun here.

Healthcare Strategist Lays It Out for CPA Society: Prepare for Affordable Care Act Employer Penaltes That Pack a Punch

Healthcare Strategist-Broker Shares Insights in CPA Continuing Education:

Strategies To Protect Your Business in World of Affordable Care ‘Play or Pay’ – 2017-2018

 

Area of Certainty: Treasury’s Enforcement of Costly EMPLOYER PENALTIES

 

The unique American healthcare system is in turmoil. Even in this context of daily legislative bouts, a business owner must remain pragmatic and follow the law of the land: The Affordable Care Act.  Simply keeping track is daunting: insurers which come and go, emerging I.T. companies offering new benefits platforms, Medicaid Migration options, Professional Employer Organizations, and more permutations all the time.  Rising to the forefront now, most of all, is the question of how to remain compliant with the laws and regulations of the ACA. We will focus now on the need to comply with the “Employer Shared Responsibility” provisions or face the penalties of I.R.C. secs. 4980(H)(a) and (b).

Enforcement of the so called ‘Play or Pay’ rules via Treasury’s ACA Compliance Validation System (ACV) is set to roll out this month and ‘mass-identify’ employers which may not be complying with the Employer mandates. In short, your firm may indeed be an “Applicable Large Employer” and thus be liable to pay between $2,000-$3,000 per employee should Minimum Essential Coverage and Affordable Coverage not be offered. Do you have 50 “Full Time Equivalent” employees? The regulations just to count including measurement, standardization and stabilization periods require expertise.

These stiff non-deductible penalties can stifle an enterprise. Once cited for penalties, you the employer (or, perhaps it’s your client) has the burden of proof in demonstrating compliance. These penalties (plus mounting interest) can put an “Applicable Large Employer” (A.L.E.) under a lot of pressure.

Recommendations for Immediate Action for CFO and HR Director:

– Familiarize with the already in force rules

– Include an ACA expert broker on your team with HR Director, CFO

– Establish compliance and systems to maintain compliance

– See Treasury Department’s Announcement of ACV Program progress at

https://www.treasury.gov/tigta/

 

In sum, simple advice:  Act. Act now. Contact your trusted benefits advisor. Make sure it’s a specialist who can become part of your innermost team. Give him or her a chance – you totally need them now.

Larry Presents CPA Society ‘Employer Strategies under Affordable Care Act’      2017-2018 Update

Employer Penalties have Teeth: Digital Enforcement is here

Stressing Treasury’s new ACV program penalizing non-compliant employers under ACA. Digital enforcement is… here!

 

 

 

Centercourt: EANYC Westchester Get-Together, Conceived and Coordinated

Pictured are 6 members of The Executives Association of NYC centercourt at Westchester Knicks game vs. Boston Celtics AAA rival, Maine Red Claws. Larry and Barry arranged this successful localized EA outing of courtside suite dining, tour of County Hall of Fame and business suites. Great evening for business, family and… fun!

 

 

 

Pictured l-r: Westchester Knicks beloved mascot, Hudson, Marc Karell (guest), Larry Thaul, Barry Cohen, Robert Fligel (guest), Philip Maltaghati, Rob Schiltz (guest), & Jeff Maron (the only one of us perhaps NBA-sized. Set that pick, Jeff!)

The NBA Developmental League is changing its name to the Gatorade League. Currently 22 NBA teams have a developmental league team and by 2020 all 30 teams will have one! See: http://westchester.dleague.nba.com

by Larry Thaul

How knowing the proper VALUE of your business protects your family

To My Friends, Clients, and Colleagues: A BLOG and ACTION CALL

A SERVICE YOU WILL ‘VALUE’ SERIOUSLY

The following is best read when you have a clear mind and the time to absorb its impact and usefulness to you and your business.

Growing your business (or practice) requires focus, dedicated effort, even love. We try to be cognizant of the major issues. We use the full breadth of our resources to keep on top of the priorities.  All this while trying to stay healthy, responsive and communicative with our significant others. That means being receptive to good ideas which arrive via someone we trust.

Intelligent planning only accounts for at best 80-90% of what will become of our life’s work, despite our efforts. What happens beyond the limits of our mindfulness is that restive sea of what we can neither predict nor control.

Agreed? We cannot control what is beyond our skill, intuition, resources and sphere of influence. Life has too many surprises. Allow me to submit that perhaps some new tools can help us.

Maybe if we unearth the actual financial value of what we’ve worked so hard to establish, our businesses (including therein our professional practices), we will be able to best protect ourselves and our families.  Knowing a number can be transformative.  This means identifying an actual dollar value of our business in the marketplace – the entity we’ve nurtured either into existence or into its current iteration from prior ownership or even from family ancestors before us.  If we could know this value, we would have a golden starting point to ensure with certainty that our plan can be completed in all contingencies, that we’ve done all we could to protect our entity, and, much more importantly, our families and our futures.  No event – a disabling injury or sickness, premature demise or even business curtailment could stop the self-completion of the mission to protect and provide for you and your family.

That’s where I enter. In more than a manner of speaking, I can bring you ‘value’ – a most important value, at that. Wouldn’t you like to know “The Number?” -What your business is worth $$$? Wouldn’t that help you make provision, in the appropriate range or amount, for taking care of life’s contingencies? Wouldn’t this provide peace of mind?

Let’s explore the concept of risk mitigation generally and then return for our answer.

Some history: An Old Concept: The insurance pool

Insurance was created as a net to protect those participating in the pool from the outlying event, be it premature sickness, injury, death, fire, casualty, or other development impeding your business.  It could be protecting your investment from a rise in inflation or the default of a muni bond.  So many of the risks we face can be mitigated if we deem them important enough to act upon and indeed take that action.

The question is: Which risks should we deem worthy of spending money on or which ones are simply the ‘vagaries of life’ we must accept? Let’s inform that discussion now.

Certainly, the profession of financial planning has always placed medical insurance and life insurance at the foundation of the pyramid of needs.  They evolved as answers to the sheer scale of the gargantuan, unaffordable cost of certain events versus the premium required to control them and thus, our fortunes. For those who can afford it, family bread winners can generally allay fears of family want by way of a few percent of their annual income. Millions of dollars can be available through private or private-government partnership to pay for medical care. Life insurance, too, is a way for the insurable to continue a business, and provide income to a family, pay taxes, and either continue a business or wind it down in an orderly, tax efficient way.

Thus, it is clear that we need to know the value of our life’s hard work – our business – in order to properly insure it and amply protect ourselves.

Now comes the hard part:

Who determines what your business is worth? Is it you alone? Won’t the IRS do this automatically in certain instances upon your demise? Can’t you and your partner(s) accomplish the same with an arms-length Buy-Sell Agreement reviewed at intervals so that you bring it up to date legally and in synch with real world expectations? Doesn’t that just happen by itself with amazing regularity?

CONCEPT: ‘Leave the valuing to an expert’

Wouldn’t it be good to have third party professionals develop and pronounce a considered determination of your business’ value using state of the art methods and alternatives under accepted GAAP procedures? What if an insurance company dedicated a team of attorneys and accountants to a department specifically set up to do this for the small-medium business owner without obligation? No, it wouldn’t be for IRS formal valuation purposes such as in an estate dispute over value. It would be for just the purposes we outlined above: to set a value on your enterprise in order to adequately protect the thing in this world which ultimately matters most to you: your family.

Some of your colleagues have begun to utilize this relatively new service from a very old line financial institution. Let me be your entrance point to the most valuable bit of information in your business planning.

Indeed, knowledge of the value of your business can help you by:

  • Having a current transition plan in place so that the business can be exited or continued on your terms
  • Attracting and retaining employees
  • Protecting the value of your business from planned or unplanned events
  • Building a secure retirement for you and your employees

THE PROCESS OFFERS:

  •  A detailed, written report prepared by the expert team PLUS
  •  A full review of your existing Buy-Sell and/or Key Person agreements with comments and recommendations.

ACTION RECOMMENDED:

  1.  Contact me to obtain your confidential, informal business valuation.
  2.  This short process begins with a 1-page form and our conversation or communication.

As independent agent and broker for over 30 years, I’ve been insuring and watching out for the bgest interests of business owners, professionals and families. The adage I created long ago rings truer today than ever:  I have time for you.

Let us begin, together.
Sincerely and respectfully proposed,
Larry

Lawrence J. Thaul CLU CLTC
Chartered Financial Consultant
Rye Brook, NY

What is YOUR Healthcare affordable ACT?

Wouldn’t you agree? .

What YOU can do to make Healthcare Affordable

Today’s ice encrusted morning here in a bleary NY helps crystallize one thing: The Affordable Care Act has focused us on the expense and associated responsibility of our own health. The main story lies beyond the individual mandate to have coverage or the penalties for non-compliance. It is the choices we each make concerning our own health which are often determinative of 2 outcomes: our health and our wealth. Our own behavior holds much of the solution – the holy grail of bending the healthcare cost curve is in our own hands more often than not.

Maybe the groundhog went back for another 6 weeks this year to contemplate his choice of: (1) How to best game the healthcare system vs. (2) How to stay healthy and thereby come out way ahead of the system. I vote for coming out way ahead with the understanding that certainly to some, health is not as much a choice as a circumstance they find themselves in. For those of us with the choice, however, The Lion King’s Old Rafiki had it right, “It is time… to develop healthy habits to save our good health and, in the process, save the many dollars we’ll need to enjoy an extended good health!” That is, of course, what the wise mandrill implied in his exhortation to Simba.

Real Cost Containment

Speaking as a career insurance agent and Chartered Financial Consultant, I listen to and engage with many individuals and business owners, solo-preneurs, employees, professionals and those from many walks of life and employment. What is singly clear is their shared perception that ACCESS to the healthcare system is most important, then surely the QUALITY and CHOICES of that healthcare, and then, of course, the COST of that Access to Quality. Healthcare ACCESS affords the peace of mind to go about earning a living, paying taxes and medical premiums, and, at claim time, paying the ‘cost share’ portion of deductibles and co-insurance. The real “play” is to achieve and maintain good health to minimize the huge outlays in our changing system (e.g. estimated at over $250,000 for a retiree). A low health insurance premium today in no way equates with low out of pocket costs over the long haul. The ‘deals’ are gone and services are expensive, no matter the plan choice, for a sufficient network.

No one wants to come out of pocket.

What is the best way to avoid out of pocket costs? The maximum out of pocket costs in your plan (referred to now as the “M.O.O.P.”) can be as high as $6,350/year for all in-network services… the plan you choose simply spells out how quickly you’ll get to your maximum. Staying healthy is the absolute best way to avoid it all. Aside from genetic intervention, here we go in all simplicity:

Join the healthy, ‘Fit Bit’ -style generation – Make a habit out of regular exercise AND control your diet while making it a group effort where possible. Select healthier foods, keep hydrated and get the sleep your body’s immune system needs. Find a “fit-mate” to exercise with – guaranteed you’ll do more exercise. I’ve found that even the complaining burns a few more calories if your friend can tolerate it!

What we as humans in the most affluent country can do to Afford ourselves the care we require is to Act. Let’s get through winter in good health and well managed wealth. Let YOUR affordable care ACT be what actions you take to be ABLE to AFFORD the healthcare you need.

In other words, The Affordable Care Act is not some inexorable trap or scarcity-based cost we must accept but truly a call to ACT now to establish the healthy habits needed to help us keep our money and enjoy it long, long term.

What do YOU think? Like to hear your thoughts on this.

Larry

Lawrence J. Thaul, CLU, ChFC, CLTC

Your Health and Wealth

Your Health and Wealth

On financial planning for our mature years:
Long Term Care and How to Get Started

A Time To Act

By Larry Thaul, CLU, ChFC, CLTC

So much has been written about preserving our lifetime accumulation of assets. Look at the many legal instruments and financial and insurance vehicles scrutinized by the public. What is needed is human connection. Getting good individual advice begins with relationships to others. Articles by experts tell us to build our own personal advisory panel by trust and affiliation. Now comes the time to act and create a plan for our harvest years.

To act means taking a step. Your first step may be talking with your spouse, children, advisor or friend about what you feel are the challenges of aging well here in Westchester. Once the silence is broken what emerges is that your concerns are shared by others. This is an emotionally charged subject which most people have had a direct experience with either personally or close at hand. The relative who lived independently till age 85 and now resides in a facility. The spirited neighbor who will live to 100 at home with a personal aide covered by a policy. It is truly amazing how similar our concerns really are and the stories we share – if we take that step and reach out of ourselves to someone else of our choosing.

For instance, while in a conversation with a cousin about what happened to an elder relative, you may learn about a newly available home care service or a new nearby adult day facility within your budget or covered by county services or a Long Term Care Insurance (LTCI) policy. The morsel of information you gain may be about an approachable, competent elder law specialist, an important term to demand in an LTCI policy, the name of a licensed care coordinator who can lend expertise or compassion to your quest for clarification to writing a plan of care with your physician. “How am I going to stay independent as long as I can in this expensive county?” becomes answerable one step, one conversation at a time.

The next step may be to visit a nearby facility for information only. Make the local home health agency or assisted living facility a friendly place. Remove the threat that lives in your head. You could bring a friend to experience it with you and discuss matters over coffee. Information will flow from the admissions or marketing officer (a planned meeting may be beneficial). Each of us needs to delve into this forbidden area filled with our own denial and aversion. Only we can overcome our own individual set of fears. But we can have the help of others who care about us. After all, don’t we trust our friends, relatives and advisors as much as we’ll have to trust our aides one day?

Just remember that this is a long term process and proper closure will take time. Grant it 3-9 months before all parties involved are comfortable, and any and all documents and financial vehicles are fully set up. Understanding that periodic review is necessary
and also takes time. It will happen but it is a process.

Ultimately, it is preferable for most of us to put our own, self-designed, affordable plan together for our own care one day. We can learn to control procrastination and take delight in controlling our destiny. The choice becomes whether we take charge or allow chance to take over.

So liberating is the feeling of having addressed a difficult area like Long Term Care planning head-on that the relief is indescribable. Imagine that you found an expert attorney to consider, plan and draft the necessary plans and documents for you. You yourself located a competent and certified LTC broker with interest in your situation who took time to do the right thing through to completion. Other affiliated, trusted experts helped get you past all the hurdles you learned were present.

Now permit yourself the opportunity to relax and truly know that you yourself have done everything possible to “take care of business” while the sun was shining. Isn’t the feeling worth it?