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HSA: Avoid Investments in Low-Yield Options

Posted on July 6, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

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Filed under: "Ask-an-Advisor", Accounting, CMP Program, finance, Glossary Terms, Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance, Portfolio Management, Taxation | Tagged: Accounting, CMP, ETFs, finance, health savings account, HSA, HSAs, Investing, Mutual Funds, personal-finance, tax | Comments Off on HSA: Avoid Investments in Low-Yield Options

HSA: Lost Funds?

Posted on August 10, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

HEALTH SAVINGS ACCOUNT

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DEFINITION: According to Wikipedia, a health savings account (HSA) is a tax advantaged account available to taxpayers in the USA who are enrolled in a high-deductible health plan (HDHP). The funds contributed to an account are not subject to federal income tax at the time of deposit.

Unlike a flexible spending account (FSA), HSA funds roll over and accumulate year to year if they are not spent. HSAs are owned by the individual, which differentiates them from company-owned Health Reimbursement Arrangements (HRA) that are an alternate tax-deductible source of funds paired with either high-deductible health plans or standard health plans.
CITE: https://www.r2library.com/Resource

How to avoid losing out on your HSA funds

The last thing you want is to risk losing out on the money you’ve socked away in an HSA. If you make a point to keep contributing to your account, however, then that alone should be enough to keep it active.

EXAMPLE: So let’s say your goal is to reserve all of your HSA funds for retirement, and you’re only in your 40s. If you make an HSA contribution every year, that should do the trick in keeping your account active. Making investment changes in your account might do the same.

If you have an old HSA you know you haven’t put money into for quite some time and you don’t plan to make a contribution or withdrawal anytime soon, then it could pay to contact the bank holding your HSA and confirm that you wish to keep your account active. At that point, your bank should be able to tell you what steps, if any, you need to take to make sure you don’t end up forfeiting any funds.

RELATED: https://medicalexecutivepost.com/2023/09/08/hsa-an-estate-planning-con/

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Filed under: Financial Planning, Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance, Investing, LifeStyle, Retirement and Benefits, Taxation | Tagged: flexible spending account, FSA, HDHP, health savings account, HRA, HSA | Leave a comment »

DAILY UPDATE: Humana [Part C] Shrinks, HealthEquity Hacked as Technology Stocks Slump Again!

Posted on August 5, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

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Markets: After a bright start to the year, dark and stormy clouds have gathered above Wall Street. Friday’s weaker-than-expected jobs report raised concerns that cracks have formed in the US economy and the Fed is waiting too long to cut interest rates. Meanwhile, a slew of disappointing Big Tech earnings last week showed how their ginormous AI investments are not yet paying off as investors had hoped. Global stocks are getting routed this morning—Japan’s Nikkei 225 index plunged 12.4% for its worst day since “Black Monday” of 1987.

CITE: https://tinyurl.com/2h47urt5

The second-largest Medicare Advantage insurer is preparing to lose several hundred thousand members next year as Medicare Advantage benefits shrink under higher prices. Louisville, Kentucky-based Humana said it expects to lose the patients as it limits the benefits available and leaves several markets in 2025. The insurance company is making the changes in hopes to increase its profits as the government increases costs.

CITE: https://tinyurl.com/tj8smmes

Health savings account (HSA) provider HealthEquity experienced a massive data breach that has put over 4.3 million Americans’ information at risk. The company, which specializes in providing HSAs, flexible spending accounts (FSAs), health reimbursement arrangements (HRAs) and 401(k) retirement plans, confirmed threat actors stole sensitive health data using a partner’s compromised credentials. 

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Filed under: Drugs and Pharma, Ethics, Experts Invited, Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance, Information Technology, Investing, Managed Care, Marcinko Associates, Portfolio Management, Recommended Books, Sponsors | Tagged: big tech, black monday, DJIA, DOW, FSAs, health savings account, healthEquity, HRAs, HSA, Humana, Marcinko, Medicare Advantage, NASA, NASDAQ, Part C, S&P 500, textbooks, TNX, VIX, Wall Street, WSJ | Leave a comment »

HSA: An Estate Planning “CON”

Posted on June 10, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

HEALTH SAVINGS ACCOUNT

SPONSOR: http://www.CertifiedMedicalPlanner.org

By Staff Reporters

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DEFINITION: A Health Savings Account (HSA) is a tax-advantaged account created for or by individuals covered under high-deductible health plans (HDHPs) to save for qualified medical expenses. Contributions are made into the account by the individual or their employer and are limited to a maximum amount each year. The contributions are invested over time and can be used to pay for qualified medical expenses, such as medical, dental, and vision care and prescription drugs.

CITE: https://www.r2library.com/Resource

THE “CON”

A Health Savings Account [HSA] can be a good or bad investment to pass on, depending on who the estate planning heir is in relation to you. If you leave it to a spouse, they’ll be able to continue using the money for medical expenses with no taxes or penalties, said Pam Horack, CFP at Pathfinder Planning LLC of Lake Wylie, South Carolina.

“However, if you leave an HSA to your child, estate or other organization, it may be considered income in the year it is received,” she said. “They are not allowed to use the tax advantages for their own healthcare and the income could inadvertently throw your heirs into a higher tax bracket.”

MORE: https://www.irs.gov/pub/irs-pdf/p969.pdf

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Filed under: "Ask-an-Advisor", Accounting, CMP Program, Estate Planning, Experts Invited, Health Economics, Health Insurance, Healthcare Finance, Taxation | Tagged: Certified Medicakl Planner, CFP, CMP, health savings account, HSA, Pam Horack | Leave a comment »

HEALTH SAVINGS ACCOUNTS: No Longer a Banking Industry Pariah

Posted on May 13, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

The High Deductible Insurance Competition Heats Up

By Dr. David Edward Marcinko; MBA MEd CMP

[Editor-in-Chief]

As ME-P readers are aware, I’ve had a High Deductible Healthcare Plan [HDHP] coupled with a Health Savings Account [HSA] for my family, and consulting firm, for more than a decade. We’ve been very pleased with it thus far. No significant health problems along the way; just a few scares that proved costly, but benign, because of physician over-protection, over-reaction, or liability phobia; i.e., its better to be safe, than sorry!.

Still, having some economic skin in the insurance game because of the high-deductible feature, makes one an informed consumer. It also provides a sense of empowerment which, while ultimately illusionary for mortals, does offer a bit of self-control. After all, while we can’t mitigate against drunk-drivers and catastrophic diseases, we can live a healthy lifestyle and pay out of pocket for true health “maintenance” … much as we self-pay to maintain our cars and homes, etc. We can do our best … and hope for the rest.

Of course, the savings portion [HSA] has always been a secondary after-thought relative to the actual re-insurance coverage terms, exclusions and conditions. I personally remain focused on the indemnity or PPO type with full coverage, no co-payments and few restrictions. After all, if I use up my high-deductible for an adverse health incident, I figure I have far more problems to worry about than economic. My health, well-being and probably life are significantly in peril.

Nevertheless, as a health economist, I have always appreciated the above market rates given to my cash HSA account; 5% to 4.0% historically; and now 7.0%. Compared to the paltry 0.29% in my FDIC protected bank money market deposit account, or the 0.8% in my non-FDIC protected money market mutual fund [brokerage] account; this is a great deal.

Oh the Irony! 

So, it comes as some surprise that after more than a decade, and the recent health insurance reform political re-debacle, that there is a surge of interest in the HSA companion. This time however, interest comes not from the insured’s – but the insurers. And, not from the health insurance industry, but rather from the affiliated [and desperate] banking industry.

How so – and why?

Well, it now seems some insurance companies actually desire the business of folks like me who are willing to bear a higher deductible in return for lower premiums, or who are willing to research CPT® code prices and question the efficacy of the procedures they negotiate with physicians in a collaborative fashion; or who are willing to watch their weights and abstain from over-indulgences for their own good. How novel; and again, why?

It’s the HSA pot-o-gold; Duh!

The Proof

Below, is a copy of an email I personally received from eHealthInsurance soliciting my separate health savings account [HSA] business; not my health insurance coverage business:

Dear David,

Did you know that your health insurance plan can be complemented by a Health Savings Account (HSA)? If you haven’t opened an HSA yet, it’s not too late! An HSA allows you to:

  • Use funds to pay for copays, deductibles, prescription drugs, dental services, vision care and more
  • Save money by deducting 100% of your HSA contributions from your taxable income
  • Earn tax-free interest on the funds that accrue in your account over time
  • Grow your account from year to year – the money you contribute won’t expire; you can even use an HSA as a secondary retirement savings account

There are no penalties or taxes when you use your HSA funds to pay for qualified medical expenses. Take advantage of your health plan’s benefits and open an HSA today! eHealthInsurance has partnered with nationally recognized, highly-rated HSA banks to offer you industry leading choices:

  • The Bancorp Bank
  • HSA Bank
  • JPMorgan Chase Bank
  • OptumHealth Bank
  • Sovereign Bank
  • Wells Fargo Bank

We’re with you every step of the way

Our representatives are also available for online chat 24 hours day.

Gary Matalucci
Vice President of Customer Care

The Question Is?

Such the deal; NOT!

So, any thinking HDHP participant [like me] must logically ask why such “nationally recognized, highly-rated HSA banks” would offer above market rates during these times of essentially high interest rate levels.  Why the interest at all? Are they trying to loose money; or are they just befriending me?

As tennis player John McEnroe might say: are you serious!

Assessment

Yes John, the high rates are a serious loss-leader for more expensive products.

These banks want to make money; not from the interest rate spread on your HSA cash, but by enticing us to place this growing cash horde into their “investment vehicles.”  In the recent past, some of us mortgaged our homes chasing the stock market or were goaded into flipping houses. And now, these same bankers are encouraging us to mortgage our health insurance on whatever high-priced, low-quality, fee-ridden, load bearing, snarky “investment vehicles” they can pawn off on us.

Of course, the health insurance companies get a fat sales commission or percentage cut, as well. A win-win situation for all but us – the insured.

Think AARP.

My Personal Advice

Do not do it. Do not take the bait.

The HSA portion of your HDHP is for paying premiums and future medical care in the event of a health catastrophe. It is for savings, not for investing in a risk-bearing vehicle. Far too many of us realized too late that a home is a place to live – not an investment. Likewise, a health savings account is for your health, and health insurance – not risky investing.

Assessment

Well, that’s my opinion as a retired surgeon, former insurance agent and financial advisor. Your own thoughts are appreciated.

Conclusion

Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, urls and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.

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Filed under: Health Economics, Health Insurance, Op-Editorials, Retirement and Benefits | Tagged: banks, Dr. Marcinko, eHealthInsurance, Gary Matalucci, HDHCP, HDHP, health savings account, high deductible health plan, HSA, HSA Bank, JPMorgan Chase, Marcinko, MSA, OptumHealth Bank, PPO, Sovereign Bank, The Bancorp Bank, Wells Fargo Bank | 11 Comments »

PERCENTAGE of Covered Employees Enrolled in Account-Based CDHP’s

Posted on January 4, 2022 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

In the United States, a high-deductible health plan is a health insurance plan with lower premiums and higher deductibles than a traditional health plan. It is intended to incentivize consumer-driven healthcare. Being covered by an HDHP is also a requirement for having a health savings account. Some HDHP plans also offer additional “wellness” benefits, provided before a deductible is paid.

High-deductible health plans are a form of catastrophic coverage, intended to cover for catastrophic illnesses. Adoption rates of HDHPs have been growing since their inception in 2004, not only with increasing employer options, but also increasing government options. As of 2016, HDHPs represented 29% of the total covered workers in the United States; however, the impact of such benefit design is not widely understood.

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% Covered Employees Enrolled in Account-Based CDHP’s

 •  2021: 40%
 •  2020: 38%
 •  2019: 36%
 •  2018: 33%
 •  2017: 30%

Note: Percentage enrolled in high-deductible Consumer-Directed Health Plans, primarily Health Savings Account-eligible plans.
Source: Mercer National Survey of Employer-Sponsored Health Plans, December 2021

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https://www.healthitanswers.net/wp-content/uploads/2019/12/blog-healthcare-coverage.jpg

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CITE: https://www.r2library.com/Resource/Title/082610254

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Filed under: "Advisors Only", Accounting, Breaking News, Glossary Terms, Health Economics, Health Insurance, Healthcare Finance, LifeStyle | Tagged: Accounting, CDHPs, consumer directed healthcare plans, HDHPs, health savings account, high deductible health plans | Leave a comment »

PODCAST: High Deductible Health Plans

Posted on July 16, 2021 by Dr. David Edward Marcinko MBA MEd CMP™

HSA Update 2021

By Michael Thompson

High-deductible health plans have been popular, but it’s becoming clear they are not right for all employees, said Michael Thompson, president and chief executive officer of the National Alliance of Healthcare Purchaser Coalitions.

MOAA - Do HSAs Work With TRICARE?

PODCAST: https://www.healthsharetv.com/content/michael-thompson-use-high-deductible-health-plans

Your thoughts are appreciated.

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Filed under: Experts Invited, Financial Planning, Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance, Touring with Marcinko, Videos | Tagged: By Michael Thompson, david marcinko, health savings account, high deductible health care plans, HSA, HSAs | 2 Comments »

2013 Year End Tax Planning Update

Posted on October 16, 2013 by Dr. David Edward Marcinko MBA MEd CMP™

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For Individuals [Doctors] and Businesses [Medical Practices]

By Perry D’Alessio CPA

[D’ALESSIO TOCCI & PELL CPA]

perry-dalessio-cpawww.DaleCPA.com

For individuals, these year-end 2013 tax planning strategies include: the option to deduct state and local sales and use taxes instead of state and local income taxes; the above-the-line deduction for qualified higher education expenses; and tax-free distributions by those age 70-1/2 or older from IRAs for charitable purposes.

For businesses, tax breaks that are available through the end of this year but won’t be around next year unless Congress acts include: 50% bonus first-year depreciation for most new machinery, equipment and software; an extraordinarily high $500,000 expensing limitation; the research tax credit; and the 15-year writeoff for qualified leasehold improvements, qualified restaurant buildings and improvements and qualified retail improvements.

High-income-earners have other factors to keep in mind when mapping out year-end plans.

For the first time, they have to take into account the 3.8% tax surtax on unearned income and the additional 0.9% Medicare (hospital insurance, or HI) tax that applies to individuals receiving wages with respect to employment in excess of $200,000 ($250,000 for married couples filing jointly and $125,000 for married couples filing separately).

The surtax is 3.8% of the lesser of: (1) net investment income (NII), or (2) the excess of modified adjusted gross income (MAGI) over an unindexed threshold amount ($250,000 for joint filers or surviving spouses, $125,000 for a married individual filing a separate return, and $200,000 in any other case). As year-end nears, a taxpayer’s approach to minimizing or eliminating the 3.8% surtax will depend on his estimated MAGI and NII for the year. Some taxpayers should consider ways to minimize (e.g., through deferral) additional NII for the balance of the year, others should try to see if they can reduce MAGI other than unearned income, and others should consider ways to minimize both NII and other types of MAGI.

The additional Medicare tax may require year-end actions. Employers must withhold the additional Medicare tax from wages in excess of $200,000 regardless of filing status or other income. Self-employed persons must take it into account in figuring estimate tax. There could be situations where an employee may need to have more withheld toward year end to cover the tax.

For example, consider an individual who earns $200,000 from one employer during the first half of the year and a like amount from another employer during the balance of the year. He would owe the additional Medicare tax, but there would be no withholding by either employer for the additional Medicare tax since wages from each employer don’t exceed $200,000.

Also, in determining whether they may need to make adjustments to avoid a penalty for underpayment of estimated tax, individuals also should be mindful that the additional Medicare tax may be over-withheld. This could occur, for example, where only one of two married spouses works and reaches the threshold for the employer to withhold, but the couple’s income won’t be high enough to actually cause the tax to be owed

We have compiled a checklist of additional actions based on current tax rules that may help you save tax dollars if you act before year-end. Not all actions will apply in your particular situation, but you will likely benefit from many of them. We can narrow down the specific actions that you can take once we meet with you to tailor a particular plan.

In the meantime, please review the following list to help determine which tax-saving moves to make.

MD defeated by property taxes

Year-End Tax Planning Moves for Individuals

  • Increase the amount you set aside for next year in your employer’s health flexible spending account (FSA) if you set aside too little for this year.
  • If you become eligible to make health savings account (HSA) contributions in December of this year, you can make a full year’s worth of deductible HSA contributions for 2013.
  • Realize losses on stock while substantially preserving your investment position. There are several ways this can be done. For example, you can sell the original holding, then buy back the same securities at least 31 days later. It may be advisable for us to meet to discuss year-end trades you should consider making.
  • Postpone income until 2014 and accelerate deductions into 2013 to lower your 2013 tax bill. This strategy may enable you to claim larger deductions, credits, and other tax breaks for 2013 that are phased out over varying levels of adjusted gross income (AGI). These include child tax credits, higher education tax credits, the above-the-line deduction for higher-education expenses, and deductions for student loan interest. Postponing income also is desirable for those taxpayers who anticipate being in a lower tax bracket next year due to changed financial circumstances. Note, however, that in some cases, it may pay to actually accelerate income into 2013. For example, this may be the case where a person’s marginal tax rate is much lower this year than it will be next year or where lower income in 2014 will result in a higher tax credit for an individual who plans to purchase health insurance on a health exchange and is eligible for a premium assistance credit.
  • If you believe a Roth IRA is better than a traditional IRA, and want to remain in the market for the long term, consider converting traditional-IRA money invested in beaten-down stocks (or mutual funds) into a Roth IRA if eligible to do so. Keep in mind, however, that such a conversion will increase your adjusted gross income for 2013.
  • If you converted assets in a traditional IRA to a Roth IRA earlier in the year, the assets in the Roth IRA account may have declined in value, and if you leave things as-is, you will wind up paying a higher tax than is necessary. You can back out of the transaction by recharacterizing the rollover or conversion, that is, by transferring the converted amount (plus earnings, or minus losses) from the Roth IRA back to a traditional IRA via a trustee-to-trustee transfer. You can later reconvert to a Roth IRA.
  • It may be advantageous to try to arrange with your employer to defer a bonus that may be coming your way until 2014.
  • Consider using a credit card to prepay expenses that can generate deductions for this year.
  • If you expect to owe state and local income taxes when you file your return next year, consider asking your employer to increase withholding of state and local taxes (or pay estimated tax payments of state and local taxes) before year-end to pull the deduction of those taxes into 2013 if doing so won’t create an alternative minimum tax (AMT) problem.
  • Take an eligible rollover distribution from a qualified retirement plan before the end of 2013 if you are facing a penalty for underpayment of estimated tax and the increased withholding option is unavailable or won’t sufficiently address the problem. Income tax will be withheld from the distribution and will be applied toward the taxes owed for 2013. You can then timely roll over the gross amount of the distribution, as increased by the amount of withheld tax, to a traditional IRA. No part of the distribution will be includible in income for 2013, but the withheld tax will be applied pro rata over the full 2013 tax year to reduce previous underpayments of estimated tax.
  • Estimate the effect of any year-end planning moves on the alternative minimum tax (AMT) for 2013, keeping in mind that many tax breaks allowed for purposes of calculating regular taxes are disallowed for AMT purposes. These include the deduction for state property taxes on your residence, state income taxes (or state sales tax if you elect this deduction option), miscellaneous itemized deductions, and personal exemption deductions. Other deductions, such as for medical expenses, are calculated in a more restrictive way for AMT purposes than for regular tax purposes in the case of a taxpayer who is over age 65 or whose spouse is over age 65 as of the close of the tax year. As a result, in some cases, deductions should not be accelerated.
  • Accelerate big ticket purchases into 2013 in order to assure a deduction for sales taxes on the purchases if you will elect to claim a state and local general sales tax deduction instead of a state and local income tax deduction. Unless Congress acts, this election won’t be available after 2013.
  • You may be able to save taxes this year and next by applying a bunching strategy to miscellaneous itemized deductions, medical expenses and other itemized deductions.
  • If you are a homeowner, make energy saving improvements to the residence, such as putting in extra insulation or installing energy saving windows, or an energy efficient heater or air conditioner. You may qualify for a tax credit if the assets are installed in your home before 2014.
  • Unless Congress extends it, the up-to-$4,000 above-the-line deduction for qualified higher education expenses will not be available after 2013. Thus, consider prepaying eligible expenses if doing so will increase your deduction for qualified higher education expenses. Generally, the deduction is allowed for qualified education expenses paid in 2013 in connection with enrollment at an institution of higher education during 2013 or for an academic period beginning in 2013 or in the first 3 months of 2014.
  • You may want to pay contested taxes to be able to deduct them this year while continuing to contest them next year.
  • You may want to settle an insurance or damage claim in order to maximize your casualty loss deduction this year.
  • Purchase qualified small business stock (QSBS) before the end of this year. There is no tax on gain from the sale of such stock if it is (1) purchased after September 27, 2010 and before January 1, 2014, and (2) held for more than five years. In addition, such sales won’t cause AMT preference problems. To qualify for these breaks, the stock must be issued by a regular (C) corporation with total gross assets of $50 million or less, and a number of other technical requirements must be met. Our office can fill you in on the details.
  • If you are age 70-1/2 or older, own IRAs and are thinking of making a charitable gift, consider arranging for the gift to be made directly by the IRA trustee. Such a transfer, if made before year-end, can achieve important tax savings.
  • Take required minimum distributions (RMDs) from your IRA or 401(k) plan (or other employer-sponsored retired plan) if you have reached age 70-1/2. Failure to take a required withdrawal can result in a penalty of 50% of the amount of the RMD not withdrawn. If you turned age 70-1/2 in 2013, you can delay the first required distribution to 2013, but if you do, you will have to take a double distribution in 2014 the amount required for 2013 plus the amount required for 2014. Think twice before delaying 2013 distributions to 2014 bunching income into 2014 might push you into a higher tax bracket or have a detrimental impact on various income tax deductions that are reduced at higher income levels. However, it could be beneficial to take both distributions in 2014 if you will be in a substantially lower bracket that year, for example, because you plan to retire late this year.
  • Make gifts sheltered by the annual gift tax exclusion before the end of the year and thereby save gift and estate taxes. You can give $14,000 in 2013 to each of an unlimited number of individuals but you can’t carry over unused exclusions from one year to the next. The transfers also may save family income taxes where income-earning property is given to family members in lower income tax brackets who are not subject to the kiddie tax.

Tax

Year-End Tax-Planning Moves for Businesses & Business Owners

  • Businesses should consider making expenditures that qualify for the business property expensing option. For tax years beginning in 2013, the expensing limit is $500,000 and the investment ceiling limit is $2,000,000. And a limited amount of expensing may be claimed for qualified real property. However, unless Congress changes the rules, for tax years beginning in 2014, the dollar limit will drop to $25,000, the beginning-of-phaseout amount will drop to $200,000, and expensing won’t be available for qualified real property. The generous dollar ceilings that apply this year mean that many small and medium sized businesses that make timely purchases will be able to currently deduct most if not all their outlays for machinery and equipment. What’s more, the expensing deduction is not prorated for the time that the asset is in service during the year. This opens up significant year-end planning opportunities.
  • Businesses also should consider making expenditures that qualify for 50% bonus first year depreciation if bought and placed in service this year. This bonus writeoff generally won’t be available next year unless Congress acts to extend it. Thus, enterprises planning to purchase new depreciable property this year or the next should try to accelerate their buying plans, if doing so makes sound business sense.
  • Nail down a work opportunity tax credit (WOTC) by hiring qualifying workers (such as certain veterans) before the end of 2013. Under current law, the WOTC won’t be available for workers hired after this year.
  • Make qualified research expenses before the end of 2013 to claim a research credit, which won’t be available for post-2013 expenditures unless Congress extends the credit.
  • If you are self-employed and haven’t done so yet, set up a self-employed retirement plan.
  • Depending on your particular situation, you may also want to consider deferring a debt-cancellation event until 2014, and disposing of a passive activity to allow you to deduct suspended losses.
  • If you own an interest in a partnership or S corporation you may need to increase your basis in the entity so you can deduct a loss from it for this year.

Assessment

These are just some of the year-end steps that can be taken to save taxes.

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The 2013 Tax Hike Means it’s Time for Doctors to Revisit Available Tax Breaks

Posted on August 20, 2013 by Dr. David Edward Marcinko MBA MEd CMP™

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A Mid-Year Tax Round-Up for Medical Professionals

By Andrew D. Schwartz CPA

Andrew SchwartzThe American Taxpayer Relief Act of 2012 rescued the vast majority of Americans from the tax edge of the “fiscal cliff” and the steep tax increases scheduled to kick in as the Bush tax cuts expired at the end of 2012.

This legislation, however, did not entirely spare high-income earners; like some doctors and other medical professionals.

Key Provisions of ATRA 2012

Here are the key provisions of the Act passed on January 1, 2013 and strategies you can implement to minimize your tax burden under these new rules:

Threshold for 39.6% Bracket:

The American Taxpayer Relief Act raised the top federal marginal income tax rates from the 35% max in place since the Bush 2003 tax cuts to 39.6% for taxable income exceeding the following thresholds:

###

Filing Status Tax Bracket Starts
(at taxable income)
Married Filing Joint $450k
Head of Household $425k
Single $400k
Married Filing Separate $225k

###

Increased Tax Rate on Long-Term Capital Gains and Corporate Dividends

The top tax bracket was not the only increase to federal income taxes. For long-term capital gains and qualified corporate dividends, the tax rate increases by one-third – from 15% to 20% – based on the same taxable income thresholds as apply the 39.6% bracket, effective 1/1/13.

Higher Medicare Taxes:

There are two new increases to the Medicare tax. One upped the Medicare tax that you’ll pay on your earned income from 1.45% to 2.25% for single individuals earning more than $200k or married couples whose combined earned income exceeds $250k.

Keep in mind that your employer will match Medicare taxes withheld from your pay at a rate of 1.45%, so the federal government now gets 3.8% on your earned income that exceeds the applicable threshold.

New 3.8% Medicare Tax On Unearned Income:

The new 3.8% Medicare tax on unearned income kicks in at the $200k of Adjusted Gross Income (AGI) for single individuals and $250k of AGI for married couples. Unearned income includes interest, dividends, capital gains, annuities, royalties, and rents. This is the first time that unearned income has ever been subject to Medicare taxes.

###

Tax

###

Strategies to minimize your tax bill in light of these new rules: 

Plan Your Revenue & Expenditures

Most healthcare professionals are on the “Cash Basis” of accounting, which means that:

  • Income is reported when fees are collected
  • Deductions are claimed when bills are paid

By planning your billing and your expenditures, especially as the year winds down, you might be able to flatten out profit fluctuations from year to year, which could help minimize the portion of your income that will be taxed at higher rates.

Invest in retirement

Always a good idea, socking away money in retirement accounts is even more valuable now when it means saving 39.6% in federal income taxes and allowing your investment to grow tax-deferred. You should also consider rebalancing your portfolio, putting less tax-efficient investments in your tax-advantaged accounts while keeping index funds, ETFs, non-dividend paying stocks, and tax-exempt bonds and bond funds in your taxable accounts.

Contribute to a 529 plan

With investment income taxes higher in 2013, take the opportunity to invest in a 529 plan to begin planning for your child’s college education. All earnings in a 529 plan are tax-free, provided that the funds are used to pay for college. And many states even allow you to deduct a 529 contribution on your state tax return. The annual maximum contribution into these tax-advantaged college savings plans is $14,000 per child per year for Gift Tax purposes (or $28,000 for spouses splitting gifts), however, you can frontload five year’s worth of contributions all in one year. Don’t forget to file a Gift Tax Return if you contribute more than $14k ($28k if married) into 529 accounts in one calendar year on behalf of a child.

Purchase needed equipment and machinery for your practice

With the fate of the $500K Section 179 deduction up in the air past 2013, it might be in your best interest to buy big-ticket equipment and machinery during the year to take advantage of the immediate deduction.

Employ your spouse and children

If there’s extra work to be done at your practice, putting your children and spouse on your payroll can be a great way to shift income to a lower tax bracket (in your child’s case) and enable your spouse to put away the maximum ($17,500 for 2013) pre-tax into a 401k retirement fund. Moreover, your child can fund a Roth IRA with the money they earn, up to a maximum of $5,500 in 2013.

Establish a Health Savings Account

If you have a qualified high-deductible health insurance plan, take advantage of the opportunity to pair it with a Health Savings Account (HSA). Contributions to an HSA are tax-deductible and grow tax-deferred.  Plus, HSAs allow tax-free distributions to cover your family’s health care costs and any money remaining in the HSA is available penalty-free to supplement your retirement once you reach age 65. The maximum contribution into an HSA for 2013 is $6,450 for married couples and $3,250 for single individuals.

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Filed under: Accounting, Financial Planning, Retirement and Benefits, Taxation | Tagged: 3.8% Medicare Tax, 401k retirement fund, 529 plan, AGI, American Taxpayer Relief Act of 2012, Andrew D. Schwartz CPA, Cash Basis" accounting, Corporate Dividends, gift tax, health savings account, IRA, Long-Term Capital Gains, Revenue & Expenditures, Section 179 deduction | 6 Comments »

Supreme Court Upholds the PP-ACA Tax

Posted on August 15, 2012 by Dr. David Edward Marcinko MBA MEd CMP™

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More Tax Increases In Store for 2013

By Andrew D. Schwartz, CPA

On June 28 2012, the Supreme Court upheld most of the provisions of The Patient Protection and Affordable Care Act. Here are some of the tax increases that might affect you starting in 2013:

Increased and Expanded Medicare Taxes

High-income taxpayers will be paying higher Medicare taxes. Under the current rules, individuals have Medicare taxes withheld from their salaries at a rate of 1.45% on each dollar earned at work. Since employers match the amount withheld, Medicare receives a total of 2.9% for each payroll dollar paid out. And, unlike Social Security taxes which max out at $110,100 (in 2012), there is no cap for Medicare taxes. Self-employed individuals also pay Medicare taxes at a rate of 2.9% on all of their net earnings.

Starting in 2013, the employee portion of the Medicare tax jumps by a whopping 62% – from the current rate of 1.45% to 2.35% – on earned income in excess of $200k for single individuals and $250k for married couples filing a joint tax return. As of now, the employer match is slated to remain at 1.45%, which means the total Medicare tax will be 3.8% for high-income taxpayers.

Example:

For example, if you’re single, and earn $500k from your job, expect to pay $2,700 in additional Medicare taxes (($500k – $200k) * .9%) for 2013.

For more information, check out the IRS’s Questions and Answers for the Additional Medicare Tax, which explains:

The statute requires an employer to withhold Additional Medicare Tax on wages or compensation it pays to an employee in excess of $200,000 in a calendar year. An employer has this withholding obligation even though an employee may not be liable for the Additional Medicare Tax because, for example, the employee’s wages or other compensation together with that of his or her spouse (when filing a joint return) does not exceed the $250,000 liability threshold. Any withheld Additional Medicare Tax will be credited against the total tax liability shown on the individual’s income tax return (Form 1040).

To increase taxes for high-income individuals even more, the Medicare tax will also apply to unearned income for the first time since this tax was enacted. People over the $200k or $250k threshold should expect to pay Medicare taxes at a rate of 3.8% on interest, dividends, capital gains, and net rental income beginning in 2013. You will pay this tax in addition to any federal and state income taxes due on this income. We’ll provide you a link to this form when it becomes available.

Reduced Tax Breaks for Medical Expenses

Many employers offer their staff the ability to pay for their family’s healthcare costs with pre-tax dollars through a Flexible Savings Accounts (FSA) included as part of their benefits package. Starting in 2013, the maximum amount of money that you can set aside in an FSA will be cut in half to $2,500 per year. Plus, medical expenses you can pay through the FSA will exclude certain items currently allowed, including OTC medications. Please note, if you are married, both you and your spouse can put away the full $2,500 through your respective employer’s FSA.

The Patient Protection Act also makes it even tougher for individuals to deduct their medical expenses. Starting in 2013, you can only deduct your family’s medical expenses to the extent the allowable expenses exceed 10% of your adjusted gross income. That’s an increase of one-third over today’s threshold of 7.5% of AGI.

This new rule may not impact your taxes, however, thanks to the dreaded AMT. Since the current threshold for deducting medical expenses under the AMT is already 10% of AGI, many people who are hit by this tax every year might not see any tax increase due to this change.

Steps to Consider to Minimize These Taxes:

As with most other tax rules, there are ways to minimize the tax bite that will be caused by soon to be implemented changes to the Tax Code:

  • Take a look at a Health Savings Account for your family. Money contributed into an HSA is tax-deductible, and money withdrawn for your family’s medical expenses is tax-free. We wrote about HSAs in our May 2012 Newsletter.
  • Consider selling appreciated investments in 2012 if you would otherwise sell them in 2013. No one knows whether the tax rate on long-term capital gains will be higher than 15% in 2013. Add to this the 3.8% Medicare tax you’ll pay once your income exceeds $200k if single or $250k if married, and you could save a decent amount of taxes by selling by December 31st.
  • Consider accelerating income into 2012 to reduce your 2013 income. This strategy includes one-time income generators, such as Roth Conversions.

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HSA and MSA Contribution Limits for HDHCPs

Posted on May 16, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

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Tabular Charts of Dollar Amounts for FAs and MDs

[By Staff Reporters]

IRS Requirements for 2008

Single Plan

Family Plan

Minimum Deductible

$1,100

$2,200

Maximum Out-of-Pocket

$5,600

$11,200

Contribution Limit

$2,900

$5,800

Catch-Up Contribution (55 or older)*

$900

$900

* If a spouse is 55 or older, a second HSA/MSA may be established and a second catch up up contribution of $900 may be made to that account if desired.

 

IRS Requirements for 2009

Single Plan

Family Plan

Minimum Deductible

$1,150

$2,300

Maximum Out-of-Pocket

$5,800

$11,600

Contribution Limit

$3,000

$5,950

Catch-Up Contribution (55 or older)*

$1,000

$1,000

* If a spouse is 55 or older, a second HSA/MSA may be established and a second catch up up contribution of $1000 may be made to that account if desired.

 

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Medical Office Cash Collection Procedures

Posted on March 17, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

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Going Green and Getting the Cash

[By Staff Reporters]green-ladies

According to Shannon Doyle, an independent consultant for the MGMA Health Care Consulting Group on March 9, 2009, the continued growth of high-deductible health insurance plans and health savings accounts has caused medical practices to increasingly rely on front-desk personnel to collect from patients.

Three Modern Collections Rules

The following medical practice procedures will markedly increase upfront office collections: 

 

  • Train staff to handle exceptions. What is your policy if the patient payment is significant? Will you allow 25% payments—one today and three over the next three months? Communicate your policy to all staff. What will you do if a patient shows up without an insurance card? There will be other exceptions. Train employees to call the appropriate practice-management contact when an exception does not fit in the categories you provide and make sure those managers are responsive.
  • Understand that not everyone will shine in collections. The value of this new front-desk function should be reflected in job descriptions and wages. Track staff performance and hold employees accountable for collection goals. The most successful practices collect in the 90% range.
  • Provide professional signage that states your basic policy: “Payments are due at time of service.” Avoid typewritten, lengthy explanations taped to walls or desks that look like clutter.

Assessment

Furthermore, Mr. Doyle suggested that physician-executives and office managers recognize that significant changes in front-desk procedure require staff training. But, even before that, you must develop a template to help employees quickly get the information they need.

For example, according to Rachel Pentin-Maki; RN, MHA of www.MedicalBusinessAdvisors.com make and update a matrix-guide reflecting the health plans that cover 80% of office patients. Include each plan’s variable components like co-insurance, deductibles and services that require pre-authorization. Then, create a list of names and phone numbers for staff to verify coverage and amounts. Be sure to include examples of plans’ insurance cards and highlight the pertinent information. By following these few guidelines, it is hoped that collection percentages can be improved in the challenging future.

Link: http://www.modernhealthcare.com/apps/pbcs.dll/article?AID=/20090309/MODERNPHYSICIAN/303019984/-1/newsletter06&nocache=1

Does this post change the meaning of the term “going green?”

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Filed under: Career Development, Health Insurance, iMBA, Practice Management | Tagged: cash medical practice, cash value practice, HDHPs, Health Insurance, health savings account, HSAs, Inc., institute of medical business advisors, medical savings account, MSAs, rachel pentin-maki | 2 Comments »

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