Jewelers health insurance

Jewelry Discussion
1

Hello all!

We are in the midst of finding one additional jeweler at work. Along
with that we are trying to work with the ownership to again offer a
health plan. Hopefully we can accomplish both simultaneously! The
program at this point is a separate check ($100.00) to be used toward
the employees health insurance. That amount would fall far short of
covering the cost of a plan for that one individual. We feel the
employer should pick up the real cost of the employed persons
insurance cost. The employee would then pay for additional family
members. We are all obviously doing something different, or depending
on our spouses insurance; which group I fall into. Luckily my wife
has excellent insurance. Before I started (just over two years ago)
they had a group plan that has been let go. They still (our employer)
only paid the $100. but it went much farther due to the group rate.

When I was independent, we (our family) utilized a health program
offered by the state (Washington). Our insurance premium was based on
our income. As I recall we paid well under $400 a month for a family
of four. Some of you reading this, that are operating small business,
may want to contact your states insurance commissioners office to see
if a program is offered in your state.

Back to the issue; what I am wondering is if some of you would list
what your insurance situation is at this time. Whether you employ
people, or are employed, I would like to get a feel for what is
currently being offered in the trade. I am hoping to hear mainly from
smaller operations. Stores, shops, and the like, employing under 20
employees. All input is of course welcome. I Hope this becomes an
informative thread for all. Health insurance has become quite costly
and a real factor when considering an employment package. Hopefully
you all can shed some enlightenment!

Tim

2

One possible source for at least partial relief from the cost of
health insurance, for any who live in Massachusetts, is called
MassHealth. It’s income based relief. The URL is:
http://www.state.ma.us/dma/masshealthinfo/applmemb_IDX.htm

Christine in snowy Littleton, Massachusetts, USA, where the flakes
are big and fluffy.

3

We have a shop with two partners and three full time employees. We
offer full payment for health insurance, of one individual, as part of
our compensation plan. Currently, one of the partners and two of the
employees utilize the plan. My wife’s work pays for a family plan so
I am not on it. One of the employees was offered the option but at the
time his wife had a job that paid for their family plan. We gave him
a higher salary based on his option not to take the plan. We use a
plan offered by Aetna Insurance and it seems to be a reasonable plan.
It costs us $335.00 per month per person.

Daniel R. Spirer, GG
Spirer Somes Jewelers
1794 Massachusetts Ave.
Cambridge, MA 02140
@spirersomes

4

Hello all,

After reading Daniel Spirer's description of the options and

arrangements for health insureance at his shop, I had to chime in. I
formerly worked for a local health department with a similar mix of
those needing and not needing the health insurance. Those not
needing the the plan had the option of either taking a higher salary
or putting that amount into their cafeteria plan. Most chose the
cafeteria plan for use in dependant care or reimbursement of
medical/dental expenses. Just another option.

Judy in Kansas

5

“One of the employees was offered the option but at the
time his wife had a job that paid for their family plan. We gave him
a higher salary based on his option not to take the plan.”

Having spent the last thirty plus years in managing businesses, I
would respectfully suggest the following:

  1. Decisions made today can haunt you for many years down the
    road. Always consider the long term effects.

  2. If I had an employee who declined the insurance coverage, I
    would offer him or her an annual bonus equaling one half the premium
    cost, and pay the bonus in December when my cash flow is highest.
    Both the employee and the business come out ahead, a “win-win”
    situation.

  3. Any person’s life can change at any time. Your employee may
    not need insurance this year, but may need it next year. Are you
    going to lower their wages if they require the insurance? If the
    answer to that is yes, how will they feel about that?

  4. The higher wage becomes a yardstick that others use to gage
    their worth, and the others will forget that the insurance issue came
    into play.

  5. And finally, if you pay overtime to that employee, that
    “insurance increase” will be costing your business a great deal of
    money at the year end, much more than you originally intended. You
    also pay the employer’s share of withholdings based on the higher
    amount, did you figure that in as well?

Most of these issues I have had to learn the hard way. I hired one
lady who wanted “a few vacation days” instead of another perk we
offered at that time. She still works for me today, twenty two years
later, and is the only employee I have that
receives holiday pay. JMF

6

Hi Dan;

Thanks for sharing that I’ve heard that Aetna is a good
value. Would you be able to tell us what it costs, approximately, to
carry one’s dependants on such a policy?

thanks,

David L. Huffman

7

JMF,

Having also spent the last thirty years running a business, I would
like to respectfully suggest the following:

  1. If you treat all your employees as you would want to be treated
    your business will always run better.

2)Offering an employee HALF of the cost of insurance is not a win-win
situation as they are NOT being compensated equivalently to the other
employees. They are then being paid less. Besides we have other
bonus plans in place based on their performance.

  1. If everything is kept in writing then, yes, if an employee’s life
    situation changes, you can refer back to the original WRITTEN
    agreement and reduce the employee’s wages to accommodate the health
    plan that might become necessary. The key here is to keep everything
    in writing. We have written, detailed, job descriptions of each
    position, including all compensation. We have written reviews at
    least once a year. We have written bonus plans that clearly state why
    an employee is getting a bonus, how the amount is figured and what
    they will have to do during the next period to get another bonus.
    Everything is signed off on by the employee.

  2. If any of my employees are getting overtime, than usually they all
    are. Also, as health insurance costs go up in a somewhat regular
    fashion this tends to balance out the issue of a higher overtime rate,
    since we do not adjust his pay based on increases in these costs.

  3. You only offer paid holidays to one employee? We offer six paid
    holidays, five paid sick days, five to ten paid vacation days
    (depending on time with the company), and six unpaid personal days as
    well. And if some of the holidays fall at the right time they
    occasionally get an extra paid holiday. Treat your employees well and
    they will treat you and your business the same way.

8

Greetings to all

Is there such thing as a jewelers health insurance group a self
employed person can be insured through.

I have Connecticare Solo presently and they just went up once
again…

Thanks for the info…
Laurie

9

Laurie-Contact the Jewelers Mutual Insurance Company…
jewelersmutual.com They offer a block policy. Is there a Kaiser
Permanente out there on the East Coast? They’re the most reasonable
health insurance on the West Coast.

Good luck.
Kim. www.kimericlilot.com

10

I checked the archives and it looks like this subject hasn’t been
brought up in a while. For those like me who are getting pretty
tired of paying ridiculous amounts of our hard earned cash for health
insurance (insert growly face here) maybe someone has some
experience with Health Savings Accounts and Medical Savings Accounts,
and could share their knowledge… I understand the idea of getting a
high deductible plan, and putting money into a HSA that will give tax
benefits. But I’ve heard good and bad, which seems to depend on the
provider and the ease (or lack of) with paperwork and getting
reimbursed. My husband and I are both self employed, in our 50’s,
pretty healthy for the most part fortunately (and rarely use our
health insurance, instead spending money on preventative care that’s
not covered by insurance). Obviously we’re not alone in looking for
a better way to “invest” our health care money. Does anyone have any
recommendations?

Cindy Crounse
Refined Designs Original Fine Jewelry
Voorheesville, New York

11

Dear Cindy,

My husband and I purchased insurance with Blue Cross and Blue Shield
with a very high deductible, which then qualifies us for a health
savings account. The health savings account was set up about a year
and a half ago with our bank. We have a checkbook and a debit card
for the health savings account, and all medical expenses are paid out
of that account. We put money into that account as needed, and those
dollars become pretax dollars, if I remember the set up correctly. We
do save our receipts from medical expenses, though we’ve never been
called on to produce them- we get a statement from the bank in
January with the total amount we’ve put into the health savings
account, and that is the number our accountant uses when figuring
taxes. If I remember correctly, our monthly insurance premiums can
not come out of this account, but all Dr. visits and medication do.

Like, you, we’ve been pretty healthy, for which we’re very grateful.
The health savings account has worked well for us.

Good luck.
Brenda
Nesheim Fuller Designs
www.sunrisejewelryoriginals.com

12

Cindy:

You bring up a question that can’t be answered very easily. Health
insurance seems go up every year & is one of the biggest concerns we
have today. I have used an HSA for several years with good experience
as it has been

cost effective while providing health insurance with a high ($5000
deductible). What I found was that the savings portion that I set
aside can be used for many medical procedures not generally covered
by typical HMO or PPO insurance. For instance, I go to a doctor of
choice and pay it out of the HSA, I pay my dental bills with my HSA,
any meds you might need can be paid out of the savings account and
one of the biggest benefits is to negotiate the price based on the
insurance carriers agreement. This is in addition to the tax
deduction you can take for the savings you put into the account each
year (similar to an IRA).

As far as being reimbursed?? etc. I have never had that problem.
With the HSA you get a debit card (if you are using the savings
portion) & the doctor, etc., takes the money directly out of your
HSA. Easy!

Many people seem confused as to what actually is an HSA. The HSA
comes in two parts

  1. The health insurance part -generally the major medical or high
    deductible. You pay for this like regular health insurance and

  2. The HSA or the savings portion that you contribute money into like
    an IRA. Please note that these are two separate accounts - One is
    with the insurance company & the savings portion in my case is with a
    bank the insurance company is affiliated with.

If you are looking for referrals I would suggest you do some
research for NY State HSA’s as each state will have different rates.

Hope this helps.
Scott Lewis
Arizona.

13

My wife and I have used an MSA for years. Overall I like it. Yes it
is a high deductible but, you can build up extra savings if you are
not using it. You can use it to pay for eyeglasses, dental and
prescriptions. Two years ago my wife was real sick and we met our
deductible. They paid everything they were supposed to and they paid
on time. I use Assurant Health. Here is a link to their website.
http://www.assuranthealth.com/corp/ah

Ron Carter

14

Although plans vary by carrier, the idea behind an HSA is as a fund
that can pay for your qualified care as well as a retirement
instrument similar to an IRA that can help you on your current taxes
and your retirement income. It requires a high deductible premium
health care plan (mine is Blue Cross/Blue Shield but I know that
others exist). After my deductible has been reached, my plan will
pay for my incurred expenses. My HSA pays for most of the deductible
expenses I might incur as well as other medically related expenses
such as dental care. The key is to fund the HSA to the maximum
possible each year. That gives you the best tax deductions and
allows the fund to grow over time. Since the maximum of my deduction
is less than the maximum that I could invest, under ideal conditions
I would have a carryover for the next year of more than $1000 towards
my retirement. Don’t worry about going with the HSA plan that your
health care insurance provider might recommend. A lot of the larger
banks offer their own HSA accounts that are still legal and work
with any health care plan you might have.

BBR - Sandi Graves
Stormcloud Trading Co (Beadstorm)
Saint Paul, Minnesota
651-645-0343

15

Hi Cindy,

We have a Blue Cross Blue Shield policy that sounds very similar to
Brenda’s. We got our policy through an independent insurance agent.
We tried on our own and found it to be very confusing, very, very
expensive, and virtually impossible to find anything that would work
for us. When we found our agent, he fixed us up in about six weeks,
for about one quarter of what it was going to cost us to procure
insurance on our own. Between BCBS, our agent and his office staff,
we have really good, very affordable, and incredibly responsive
medical insurance for the whole family and our employees.

Probably the best thing you can do is to find a good independent
(the key word – you should probably avoid “company sales staff”)
insurance agent. You don’t have to figure this all out by yourself.
If you can’t locate anyone in your area, contact me off-list and I’ll
get you in touch with our agent and he might be able to steer you
right.

Our agent was able not only to explain all of the different
companies and types of plans (and there are many subtle and not so
subtle differences) but was able to explain how to fill out the forms
so that we would get the best coverage for the least money. The guy’s
good. I never could have gotten the coverage we have without his
expertise.

I know BCBS gets some bad press from time to time, but you know they
have to have at least something on the ball. They had the good taste
to have Daniel Spirer do a TV spot for them recently. That speaks to
their good judgment, no?

Dave

16

I’ve seen raves about the HSA’s from folks who say how wonderfully
healthy they are… anyone out there using one who isn’t fabulously
healthy? My family has had years where we had met our deductible and
out of pocket by the end of the first month of the plan year… so
"healthy" is NOT a term anyone would associate with any of us!

Just wondering how beneficial this type of plan would be in that
situation.

As usual, love all the great advice and ideas!

Beth in SC

17 
I've seen raves about the HSA's from folks who say how wonderfully
healthy they are... anyone out there using one who isn't
fabulously healthy?

That would be me. :slight_smile:

I am decidedly NOT fabulously healthy. In the last twelve months,
I’ve had my gall bladder removed, had a test for a spinal cord
stimulator, had the spinal cord stimulator implanted permanently,
and my chronic prescription meds run about $2000 a month, retail.
(Diabetes, blood pressure, cholesterol, thyroid, migraines, pain,
etc.) I also see a specialist for sleep apnea, get labs done 3-4
times a year for my diabetes, thyroid, and cholesterol stuff…
yeah. I do okay, thoroughly treated, but without my medications, it
would be a rough road.

I chose the high-deductible plan, with an HSA, and a special-purpose
FSA. This plan year, with all that stuff, I paid $2,500 for medical
care. That’s my out-of-pocket maximum, so that’s all I paid. (There
are no co-pays on most high-deductible plans.)

I’m not a full-time jewelry artisan just yet, I still have a
day-job. I’m a programmer, and I work for the local BCBS affiliate,
so I do know more than a little about health insurance.

If you have high medical expenses, and either all of your family has
health issues or you don’t have dependents, and you have the option
of a high-deductible plan that has a reasonable out-of-pocket annual
maximum, it is likely a good choice. (There can be interesting
catches if you have healthy dependents and/or spouses, it can be
difficult to reach the deductibles. Check your plan carefully.)

If you can afford to fund an HSA and leave the money in there, and
you are in a position where you aren’t eligible to contribute to an
IRA in a tax-advantaged way, it is a FABULOUS choice. That money can
be used now to pay pre-tax for medical expenses (including many
medical expenses that health insurance won’t cover), or it can be
kept for after retirement, when it can be used, untaxed, for whatever
you want it for. No restrictions, it doesn’t even have to be
distantly related to medical needs. It’s like a second IRA, with
fewer restrictions. Leave as much money in there as you can afford
to!

Critical Disclaimer!!!

From what I understand, the rules of when your HSA and FSA may be
used (to pay expenses related to deductibles and such) may vary
according to your plan’s rules, so you DO need to read YOUR plan
booklet to be sure you know what you’re getting into. FSA money
especially tends to be “use it or lose it”, you MUST use it in the
plan year, or it’s GONE. Please read your plan’s documents VERY
carefully!

18

Well, here’s the deal Beth. After you have hit the limit of your
deductible, your actual health insurance should be kicking in and
paying for any additional expenses. Your HSA account would be able to
be used if you have an additional deductible expense that you needed
to pay for, but usually you don’t need to access your HSA account
after you have maximized your deductlble for the year. I think you
are confusing the two different entities: the actual insurance itself
(Blue Cross, Blue Shield or other insurance) and the HSA account (an
independent fund that you create with your bank or other institution
and contribute to on an annual basis that will work similarly to an
IRA or other retirement account after you turn the appropriate age
but that can be accessed to help pay certain medically related
expenses without penalties up to the limit of your insurance
deductible on an annualized basis).

Sandi Graves, Beadin’ Up A Storm
Stormcloud Trading Co (Beadstorm)
http://www.beadstorm.com
Saint Paul, Minnesota USA
651-645-0343