State Gets HSA Mandate Relief: HSA–Health Savings Account Update And Courtesy Member Service Benefit

Written by Michael G. Kirwan, ChFC, CLU
Published Spring 2004 in the Union and Morris County Newsletters


Many of our Medical Society Member Physicians have been upset to find out that the State of New Jersey (and New York) has not seen fit to approve the release of the most “cost effective” medical insurance in the market place today, HSA–Health Savings Accounts.

As many of your associates who already have an HSA (formerly known as MSA) have discovered, in spite of the requisite High Deductible (generally $3500 to $5100 per family), the premiums that they save typically “exceed” any potential deductible’s they may be required to pay, otherwise known as: “Overpaying for Well–Care!”

The controversy in New Jersey is from the State mandating first dollar coverage for pediatric screening, as well as for any indicated follow up treatment, which is outside the Treasury Department’s safe–harbor definition of preventative care, and must therefore be subject to the deductible in order for the policy to be HSA compatible.

Relief is on the way! On June 21, 2004, the US Treasury issued Notice 2004–43 providing for transition relief for individuals in states where High Deductible Health Plans (HDHP’s) are not available, because state laws require health plans to provide certain benefits without regard to a deductible or below the minimum annual deductible of section 223©(2)(A)(i).

In the interim, The Kirwan Companies, Ltd., and our subsidiary company, HSA Specialists of America, have recommended our prospective clients consideration of either a High Deductible Out–of–Network PPO or Direct Access Program, with excellent In–Network coverage (Ex: $10 to $30 co–pay) or an HRA Program be employed to substantially reduce and cauterize the blood letting of the ever escalating health insurance premiums, which are now the second or third largest item in the physicians budget.

Many offices have called us and have been functioning under the false belief that they must have the same plan for everyone in the group. The fact is that you may not only have multiple plans but you may also utilize multiple carriers. We represent all of the carriers in the State and if you fax us your Current Census, a Copy of your Current Billing and Benefits Highlight Sheet, we will prepare a Competitive Cost Comparative Analysis of your plan with several alternatives for your consideration. There is “no cost” associated with this service as a courtesy to your Society for allowing us to communicate with its members and to provide a “value–added benefit” to your membership.