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The Basics -- MSAs offer self-employed a viable health care option - MSN Money
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The ultimate tax shelter: owning your own business Deducting your car expenses You deserve a tax break on your home office costs You can have your business lunch and deduct it, too You can combine business with pleasure, and deduct it, too Finally, You Can Start a Business Without Risking All You Own Tax tip for the self-employed: MSAs How to set up a business to pay less in taxes Tax-deferred plans: Save now, pay later (and less) If a tax shelter isn't profitable, don't bother How to exercise stock options and keep taxes lean
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The Basics
MSAs offer self-employed a viable health care option
Now the self-employed have the option of using pre-tax money to pay for contact lenses and root canals just like their friends who work for corporations.
By Mary Rowland
Recognize yourself in this picture?
You left your corporate job to set up your own shop a couple of years ago and spent the first 18 months fretting that you wouldn't be able to pay the bills. The good news is that the money started rolling in. The bad news is that you've been using a big chunk of it to replace the benefits package you left behind.
Finding -- and paying for -- benefits, particularly medical insurance, is the dark side of most successful one-person businesses, mine included. Many people "go bare," as they say in the insurance industry, taking their chances with no coverage at all. Others opt for the highest deductible health care policy they can find, reasoning that it will cover them in a catastrophe. If you are among them, you should be looking carefully at the medical savings account, a new tax-advantaged health insurance program for self-employed individuals and workers at businesses with 50 or fewer employees.
How they work
Congress approved medical savings accounts, combined with a high-deductible insurance policy, in 1997. Here's how they work: You get a tax deduction for money contributed to the account each year. Then you pay your medical expenses by withdrawing funds from the account. If expenses exceed your insurance policy's deductible amount, the policy kicks in and pays the additional costs. If you spend less than the amount you contributed, the difference stays in the account and earns interest.
"For the self-employed business person, this is the best chance you've had in a long time to take care of yourself," says Lee Tooman, assistant vice president of Golden Rule Insurance Co. in Lawrenceville, Ill.
Misunderstood and unwanted
Richard Stover, a health care actuary with Buck Consultants in New York, says taxpayers have not been opening them as quickly as expected. "There's no incentive for a broker to sell them," Stover says, "and many people still don't understand how they work."
Since brokers have little incentive to sell them, it's also difficult to find MSAs in every state.
Big businesses have been using flexible spending accounts -- or FSAs -- for years. But they have not been available to the self-employed. And the new medical savings accounts have a compelling advantage: The money is allowed to roll over and build up in the account if you don't spend it. That offer doesn't exist in FSA's. And rather than lying dormant in low interest-bearing savings accounts, you can invest it in mutual funds, stocks or other investment vehicles that typically offer much higher returns over the long run. Whatever you don't spend can be used to supplement retirement income. In contrast, the flexible spending accounts offered by large employers have a "use-it-or-lose-it" provision. Whatever is not used by the end of the year is lost to you.
Rules and limits
The government set some rules for the MSA accounts. There is a range for the deductible on the insurance policies: $1,500 to $2,250 a year for an individual; $3,000 to $4,500 a year for a family. Above that amount, the insurance program might cover 100% of expenses. Or it can provide for some type of co-payment by participants, say 20% of all covered expenses in excess of the deductible. The government also set limits on total out-of-pocket medical expenses (deductibles plus co-payments) with a maximum of $3,000 for a single person and $5,500 for a family.
The employee -- or the employer -- can make pre-tax contributions that can total 65% of the deductible for an individual, 75% for a family. So if you buy a single policy with a deductible of $1,500, you can contribute $975 (65% of that amount) to a medical savings account. The money can be used to pay those medical expenses you incur before you reach the deductible as well as other eligible costs like eyeglasses and dental care.
If you spend the entire $975, you have to pay after-tax dollars for medical expenses until you hit the deductible. If you spend less, the money builds up in your account. You roll it over at the end of the year and you can make another contribution next year.
You must pay tax and a 15% penalty on money that is withdrawn from your account for any use other than medical expenses before age 65. After age 65, withdrawals for non-medical purposes are still taxable but no penalty applies. An analysis in the June issue of the Journal of Financial Planning concluded that such accounts could be used to accumulate a nice retirement nest egg. A person who puts in about $1,500 a year for 25 years could make almost $1.5 million, assuming a 12% annual rate of return.
Of course, few people will sail through 40 years without spending any money on health care.
But these accounts offer a good deal on the health-care side of the equation, too. I've often wondered why those of us who are self-employed didn't have the option of using pre-tax money to pay for contact lenses and root canals like our friends who work for corporations. Now we do.
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Health Insurance for the Self-Employed
As
a self-employed person, you need health insurance just as much as anyone else
does. If you are a sole proprietor, your health insurance need is probably greater
than the average person, because an extended illness or hospitalization could
easily deplete your personal assets and endanger your business.
Most people get their health insurance
through their employers. However, because you are self-employed, this option
is not available to you. You're your own boss, but that also means you have
to supply your own benefits. In terms of health insurance, your options may
be limited to:
Individual health insurance coverage
purchased directly from a provider
Group coverage purchased through
a professional association or civic group (i.e., trade group, chamber of commerce)
Individual health insurance
Individual health insurance
covers medical expenses on an individual basis. When you apply for individual
insurance, you may be evaluated in terms of how much risk you present to the
insurance company. This is generally done through a series of medical questions
and/or a physical exam. Your risk potential determines whether you qualify for
insurance and how much your insurance will cost. Individual insurance is somewhat
more risky for insurers than group insurance, because group insurance allows
the insurer to spread risk over a larger number of people.
Anyone can apply for individual health
insurance, so this may be your best option for obtaining health insurance. You
should contact several insurance companies, in order to compare coverage and
prices. The cost will vary from one insurer to the next, but individual coverage
will undoubtedly cost more than group coverage. In some states, in very limited
circumstances, an individual may be able to purchase individual health insurance
without medical underwriting. Check with your state insurance department or
insurance agent for details.
Learn More
Group health insurance
With group health insurance,
a single policy covers the medical expenses of many different people. Unlike
individual insurance, where each person's risk potential is evaluated and used
to determine insurability, all eligible people can be covered by a group policy
regardless of age or physical condition. The premium for group insurance is
calculated based on characteristics of the group as a whole, such as average
age and degree of occupational hazard.
Group insurance is typically provided
by employers. In your case, you will have to seek out a group that offers health
insurance, and which you are eligible to join. If you are a member of a trade
association or chamber of commerce, find out whether it offers a group health
insurance plan.
Learn More
Deductibility of unreimbursed medical expenses
In general
If you itemize deductions and your unreimbursed medical expenses exceed 7.5 percent
of your adjusted gross income (AGI) in any tax year, you may deduct the amount
by which your unreimbursed medical expenses exceed this 7.5 percent threshold. Unreimbursed
medical expenses include premiums paid for major medical, hospital, surgical,
and physician's expense insurance, and amounts paid out of your pocket for treatment
not covered by your health insurance.
Special rules for the self-employed
In addition to the general rule of deducting premiums as medical expenses, self-employed
individuals can deduct a percentage of their health insurance premiums as business
expenses. These deductions aren't limited to amounts over 7.5 percent of AGI as are
medical expense deductions. The definition of self-employed individuals includes
partners and 2 percent S corporation shareholders. If you meet the definition of a
self-employed individual, you can deduct the following percentages of premiums
for insuring yourself, your spouse, and your dependents:
2000 - 2001
60%
2002
70%
2003 and thereafter
100%
This deduction is limited to amounts less
than your earned income. Also,
if you or your spouse were
eligible for an employer-sponsored health plan for any part of the tax year,
then health insurance costs you paid during that time cannot be used to calculate
this deduction.
Archer MSA--a way to save for health-care expenses
Archer MSAs (previously called medical savings accounts) are
tax-advantaged individual savings accounts that work much like an IRA. However,
instead of saving for retirement, funds in an Archer MSA are used to cover health-care
expenses.
As a self-employed individual (or
the spouse of a self-employed individual), you may be eligible to open an Archer MSA
if you currently have a high-deductible health insurance plan. A high-deductible
plan is defined as one in which:
The deductible is between $1,600 and $2,400 for individuals ($3,200 to $4,800 for families), and
The annual out-of-pocket expenses
do not exceed $3,200 for individuals ($5,850 for families).
In most cases, you are not eligible
to open an MSA if you have additional coverage under a health plan that is not
a high-deductible plan. This includes Medicare coverage. However, there are
exceptions to this rule.
The biggest challenge in setting
up an Archer MSA may be finding a company that offers them. Many insurance companies
are still developing qualified high-deductible insurance plans and products
with a savings component. In fact, in some states, insurers are running into
problems with state laws that prohibit such high-deductible plans. Many financial
institutions are also still in the development stage with their Archer MSA account
products.
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