Monday, October 28, 2013

How to Estimate Your Health Care Expenses

If you're trying to decide which healthcare plan is right for you and your family, it helps to estimate your expenses. I really like this tool from Wage Works. You answer a few simple questions about the plan design (comparison of ASHA plans below) and then estimate the number of office visits you'll have, the number of prescriptions you'll fill, and any other money you'll spend on health care. You quickly wind up with a neat graph that shows the difference in the cost between the plans you're considering.

If you want to take a more targeted approach, you can review your EOBs from the current plan year. If you're with UnitedHealthcare, log onto Then, click view online statements. From there, you can see the allowed amount for each claim. This is the amount you would pay with the money from an HSA before meeting the deductible in a health plan with a high deductible. For example, my visit to an orthopedic surgeon was $208, but the allowed amount was $116.32. Remember well visits are covered in full and not subject to the deductible, so don't include them in your estimates. You can also look at your EOBs to see what claims you had for lab, x-ray and other diagnostics and rehabilitative services like physical therapy.

To see what you spend on prescriptions, you can go to the UnitedHealthcare Open Enrollment site. Click on the last link at the bottom of the page to price a medication. Type in the name of the medication, accept the disclaimer and you'll see an estimate of the cost of that drug along with some lower cost alternatives that might work for you. Often being in a high deductible health plan prompts people to discuss lower cost alternatives with their prescribing doctors.

If you elect an HSA, you can set aside money for vision and dental services too. Just remember, those items won't count toward your health plan deductible. If you decide to stay with a more traditional plan, you can set aside up to $2,500 in an FSA to cover your out-of-pocket expenses. 

Friday, October 25, 2013

Four Steps to Funding Your HSA

The IRS establishes how much you can contribute to an HSA each year. In 2014, an individual can contribute $3,300 and a family can contribute $6,550. If you're older than 55, you can contribute an additional $1,000 to your account as a catch-up contribution.

The HSA limits are set for the calendar year. If you're part of an HSA for a partial year, you can prorate your contribution limit based on the number of months that you participate in a high deductible health plan. 

Wondering where you will come up with the money to fund the account? 
The deductible is only $4,000!
  1. Take note of the amount your employer will contribute. ASHA will contribute -- $1,000 for individual coverage and $2,000 for family. 
  2. Calculate the difference in the premium from the plan you're in now and our new Choice Plus with HSA. I have Choice Plus family coverage, so that's $301 a month next year. The HSA is only $104, so I'll save $197 a month or $2,364 a year. 
  3. Look at how much you're contributing to your FSA now. Mine is maxed out at $2,500. Remember you can't have an FSA if you have an HSA, so you can redirect that money. 
  4. Add up the above.
2,000 + 2,364 + 2,500 = $6,864 

I've covered my $4,000 deductible. Maxed out my contribution of $6,550 and will have $314 back in my pocket. Easy Peasy!

If you and your spouse are both HSA eligible, then there are other factors to consider. I could spell them out here, but Barb Simmons wrote a very clear and instructive post on the topic and I wouldn't do a better job of it. If you're married, read Rules and Best Practices When Spouses Are Both HSA Eligible.

Keep in mind that you can only use your HSA to pay for expenses for the family members you have covered under your plan and that you can claim as a dependent on your taxes. If you cover your young adult children, please read Why Wouldn't I Want an HSA? 

I have my 23 year old son on my plan, so I'm still weighing my options. My initial thinking was that a plan with an HSA didn't make sense for us because we couldn't use the money in the HSA for Ian's expense, but now that I've done the math, I'm finding it hard to turn away from the HSA.

Thursday, October 17, 2013

Four Reasons You Might Not Want an HSA

You've looked at the amount of money you can save in premium. You like the idea of paying yourself instead of the insurance company. You consider yourself, or are ready to become, a savvy healthcare consumer. So, why wouldn't you want a high deductible plan with an HSA? As attractive as the model is, it's not for everyone. Here are four groups of people that might want to take a pass for now. 
  1. People entitled to medicare. You can't contribute to an HSA if you're entitled to medicare according to IRS rules. See Can I Have a Health Savings Account as Well as Medicare?
  2. People with young adult, non-tax dependent children on their health plan. Unfortunately, when benefits were extended to children through age 25 in the ACA, no one coordinated with the IRS. The IRS rule is you can only use your HSA to pay for expenses for your tax dependents. Therefore, if your young adult child needs services, you'll have to pay for those separately. You can set up a separate HSA for your child, but the money you contribute would be deductible on your child's taxes, not yours. So, that's probably not too attractive to most of us. (I have my 23 year-old son on ASHA's plan.) 
  3. People who currently have a FSA who will not have a $0.00 balance on December 31, 2013 if your FSA has a grace period (which ASHA's does.) This prohibition by the IRS is inclusive of a plan your spouse might have at his/her place of employment. So, if you're interested in establishing an HSA in 2014, spend your FSA money now!
  4. People who use a lot of out-of-network services. Unfortunately, in and out-of-network deductibles will not cross accumulate in ASHA's coverage for 2014. Therefore you would have to pay the in-network deductible on the services you obtain in-network ($2,000 individual and $4,000 family.) Then, you'll have to pay the out-of-network deductible ($4,000 and $8,000) on the services you receive out of network. Raising your exposure to $6,000 if you have individual coverage and $12,000 if you have family coverage. We hope to be able to structure this differently in 2015, so stay tuned for more info. If you're reading this and you don't work for ASHA, be sure to inquire about how your plan works. 
If you don't fall into any of these groups, seize this opportunity to learn all you can about HSAs and make an informed decision about what's best for you and your family in 2014. 

Wednesday, October 16, 2013

Introducing A New HSA Option for ASHA Staff

Image from -
In addition to our Choice Network Only plan and our Choice Plus plan with an in and out-of-network benefit, we will be offering a Choice Plus with HSA to our staff next year. All the plans will be with UnitedHealthcare and they will all use the same network of providers. The Choice Plus with HSA is a consumer driven health plan (aka CDHP) with a higher deductible than what we are used to -- $2,000 for an individual and $4,000 for a family. Participants will set up and use an HSA account to cover this deductible and other health care expenses. 

Think of a HSA like a 401k for your health care expenses. You put money into an HSA just like a 401k. It's withheld pretax from your pay checks. You choose how to invest the balance in your account and it grows tax free. You then use the money in the account to pay for your deductible and any health care costs that aren't covered by our health plan. (The same kind of things you might use your FSA to pay for now.) 

To help staff get their HSAs started, ASHA will fund half of the deductible the first of the year -- $1,000 for individuals and $2,000 for families. One of the risks you assume when you first start an HSA is that you'll incur the expense before you've built up an account balance. For example, you have to have your appendix out on January 5 and receive a bill for your deductible. ASHA will help you minimize this risk by depositing half your deductible in your account at the beginning of the year. 

Why should you consider selecting this new plan? It's simple. You're essentially paying yourself instead of the insurance company. The monthly premium for the Choice Plus HSA is so much less than our Choice and Choice Plus plans that you can use the savings each month to fund part if not all of the deductible. Over time, you can build up a healthy balance in your account. Some people use an HSA as an additional retirement savings vehicle because of the favorable tax status. There are lots of other factors for you to consider and we'll delve into all of them over the course of the next few weeks. 

We will be offering many educational opportunities during open enrollment to help you make a fully informed decision. You are welcome to invite your family members to the face-to-face sessions we have planned. Start learning more now by watching the short video below and reading this article from Forbes -- How to Get the Most Out of Your Health Savings AccountYou can also read this post where I shared how my sister chose between a traditional PPO and a HSA earlier this year. And, of course, stay tuned here for more info. 

Sunday, October 13, 2013

Our Fitness Class Schedule

It's been awhile since I shared much about the exercise classes we offer on site. We do what we can to (1) encourage people to make a long term commitment to exercising, (2) make our classes affordable, and (3) maximize enrollment i.e., the number of people participating. We opened our classes up to spouses last session and we have two spouses participating. Last year, we changed our pricing structure and introduced an "all access pass" to give participants the flexibility to take any classes they're interested in for only $50 a month. Both changes have been well received, but it hasn't increased our enrollment the way we had hoped. 

We set aside a budget each year for our wellness program and we allocate a little over 60 percent of it to our onsite fitness classes. Given our current budget and level of enrollment, we can support 14 classes per week. We started off the year with 16 classes. We lost three instructors this year -- boxing, TRX and restorative yoga. We also combined two classes on Monday evenings, so we currently have 12 classes. We've been looking to add a class on Tuesday morning and Thursday afternoon. 

The challenge is to find instructors we like that are available to teach something we're looking for during one of our available time slots. We are excited to have a Dance Ballet Bar barre demo set up for next week that 20 people have signed up to try. Eileen Crowe introduced us to the instructor, Souzan Mills, and we're grateful. Souzan has a studio in the Kentlands called Booseh. We have been searching for someone to teach a class like this for about three years. The demo seems to be attracting some staff members that don't normally participate in our exercise classes, so we're optimistic that this will be a nice new addition to the array of classes we offer. 

Tuesday, October 8, 2013

In Search of Unprocessed Chocolate Bars

I like good chocolate and I know I'm in good company. I don't want to go without during October Unprocessed, so I went to Whole Foods today and read the labels. I walked away with four bars. 

  1. Amore di Mona Chocolate with Currants $3.49 -- cocoa, butter, cocoa solids, raw organic agave nectar and dried currants
  2. Sweet Riot Pure 85% Dark Chocolate $3.99 -- organic chocolate liquor, organic cocoa butter. organic cocoa, organic cane sugar, organic vanilla extract
  3. Alter Eco Dark Quinoa Organic Chocolate $3.99 -- cocoa beans, raw cane sugar, cocoa butter, quinoa-rice crisps,vanilla beans (Tastes like rice crispies in good dark chocolate. Got good marks from Lisa Leake at 100 Days of Real Food.) 
  4. Green & Black's Organic 85% Cacao Bar $3.99 -- organic chocolate, organic cocoa butter, organic cocoa, organic raw cane sugar, organic vanilla extract
I know the sugar is still not ideal, but at least none of these bars has soy lecithin like my favorite Chocolove Almonds & Sea Salt in Dark Chocolate bar. I'm still searching for my some little chocolate pieces to have on hand for my fellow October Unprocessed participants when they hit the 3:00 slump. If you've found any, please let me know. 

Monday, October 7, 2013

Pay Raises and Managing Up

I realize these topics have nothing to do with workplace wellness, but I've been involved in two things that I'd like to share. 

First, in the October issue of the ASHA Leader, there is an article I wrote called Make It Work: Manage UP. It includes six tips to help you cultivate a healthy working relationship with your boss. 

Almost everything I write appears online, so it is fun for me to see something I wrote in actual print. My son, Ian, helped me think through the content. He graduated from college a year ago and he's working with Walmart as an assistant manager. I love hearing his perspective on management issues, so writing it was fun too. Over the years, I've seen people make a lot of what I call "career limiting moves." Writing this piece gave me a chance to put together those observations with Ian's fresh perspective. 

Sarah Halzack wrote and article for the Washington Post titled In an uncertain economy, pay raises hover at a modest new normal. She interviewed me when she was working on it and includes a few quotes. We actually assign individualized salary ranges to each job (not each job category), but she captured the gist of what we do well and it's an informative article. Definitely worth reading if you work in the DC area. 

Hope you'll forgive the diversion. I usually rein in my impulses to write posts that are off topic, but what's the point of blogging if you can't exercise a point of personal privilege now and then. 

Friday, October 4, 2013

Flu Shot Clinic at ASHA October 9

​If 92% of our staff are vaccinated, we could basically stop the spread of the flu within our workplace. Please consider getting a flu shot to protect yourself and those around you. 

Our clinic will be held on October 9. Shots for staff members are free. Family members can receive a shot for $22. This flyer from LifeWork Strategies explains what you should expect.

If you have coverage through our health plan, you have additional options for obtaining a flu vaccination for free. Please see the second flyer below.

Tuesday, October 1, 2013

Day 1 of October Unprocessed

Today kicks off our October Unprocessed challenge. If you haven't signed up yet, or you have and you're still wondering what to do, this is where you should start. First off, keep in mind that this is an exercise in awareness! I encourage you to read labels and make well informed, conscious decisions about what you choose to eat. This is not a test or a diet. We're in this to learn and maybe experiment a bit with some new foods. Still hesitant to commit? Here are a couple things that might ease your concerns.  

  1. The 80/20 rule. Make a commitment to eat unprocessed foods 80 percent of the time and don't worry about the rest.
  2. The deliberate exception. This could be that you'll drink Gatorade on runs over 6 miles or that you'll indulge in a piece of chocolate cake on your son's birthday. You could even choose a day each week where you'll indulge in some of your processed favorites. Just establish your exceptions before starting the challenge so they are a deliberate choice and not a default reaction to a habit. 
Here's what you need to do to get started:
An unprocessed version of my oatmeal
cookies from Red Mountain Spa. Recipe below.
  1. Go to the Eating Rules website and sign the pledge. I also recommend that you subscribe to their email alerts.
  2. If you're a member of the ASHA staff, go to ASHAnet and add your name to the list. This is simply so we know who to invite to our October Unprocessed events like the kick off we have planned for tomorrow. (You're not going to get any of the cookies pictured unless you sign up.) 
  3. Read this Do's and Don'ts post. I also encourage you to explore the Eating Rules website and 100 Days of Real Food. They include tons of great resources. 
  4. Think about sharing your experience with others. Post a comment to our Facebook page. Chat with your colleagues that are participating. Or, best of all, share your thoughts in a blog post. 
  5. Subscribe to this blog, so that you don't miss any of the riveting content ;-) All the posts related to October Unprocessed will appear under the October Unprocessed tab.
Twenty ASHA staff members have signed up so far. We have a kick off planned for tomorrow at 3:00 in the lunchroom. On October 8, we will host a informational session with a nutritionist. Please pass along any ideas you have for how we can support you during this challenge. 

Spa Cookies

I adapted this recipe from Red Mountain Spa. They were orginally called Oatmeal Fruit Cookies. This should make about 5 dozen cookies. 


3 eggs, well beaten
1 C dried Tart Montgomery Cherries (Trader Joe's)
1 t vanilla extract
1 C canola oil
1 C organic Mascobado cane sugar (in lieu of brown sugar)
1 C coconut palm sugar (in lieu of white sugar)
2 C white whole wheat flour (in lieu of regular flour)
1 t sea salt
1 t ground cinnamon
2 t baking soda
2 C oats (Bob's Red Mill)
¾ C toasted slivered almonds

  • Combine eggs, dried fruit, and vanilla and let stand for 1 hour, covered with plastic wrap. 
  • Combine mascobado and coconut palm sugars and cream with oil. 
  • Add flour, salt, cinnamon and baking soda to sugar mixture; mix well.
  • Blend in egg-fruit mixture, oats, and chopped pecans. Dough will be stiff. 
  • Drop by heaping teaspoons onto ungreased cookie sheet. 
  • Bake @ 350 for 8 minutes.

Kelly made pumpkin bread for the kick off that was delicious. She posted the recipe to our October Unprocessed Pinterest board