Healthcare Premium Reimbursement Plan

With ZaneHealth, you…

✓ Pick the health insurance plan that best fits your family’s needs.

✓ Keep the same plan as long as you want - it’s yours!

✓ Get cash back from your employer for your premium.

One of the most valuable features of ZaneHealth is the ability to choose your own health insurance coverage, then receive a tax-free reimbursement for health insurance premiums and basic preventive care. This allows you to select an insurance policy that covers your preferred doctors and healthcare needs.

Here’s how it works:

➢ Your company sets a monthly healthcare allowance.

➢ You purchase an individual health insurance plan. Then submit a reimbursement request through ZaneHealth. Zane Benefits will review the request and notify your company of the amount to reimburse you.

➢ Your company reimburses you for the approved expense via payroll, check or direct deposit.

  
Your Zane Plan can reimburse the following types of health-related insurance premiums, provided (1) the policy is in your name, or in the name of a listed dependent on your Zane Plan, (2) the policy was not already paid for with pre-tax dollars, and (3) your Zane Plan reimburses health insurance premiums.

· Major medical individual health insurance premiums

· Limited benefit individual health insurance premiums

· Dental care premiums

· Vision care premiums

· Qualified health-related ancillary premiums

· Medicare part A or B, Medicare HMO, and employer-sponsored health insurance premiums

· Medicare Advantage and supplement premiums (e.g. prescription policies)

· Long term care insurance premiums

· COBRA premiums

· Short-Term Medical policies

A good thing for employees to ask for would be metal-tier plans, or plans that meet Minimum Essential Coverage (MEC). A plan that meets one of these criteria will always be considered eligible. Plans purchased from the health insurance marketplace are also eligible for reimbursement.

Health insurance policy premiums that are not reimbursable through your Zane Plan are:

· Life insurance policies

· Policies for loss of life, limb, sight, etc.

· Policies that pay you a guaranteed amount each week for a stated number of weeks if you are hospitalized for sickness or injury

· Policies providing payment for loss of earnings ("income replacement"), such as critical illness and disability policies

· Health care ministry sharing programs ("Medi-Share" or medical share plans)

If you are seeking reimbursement for premiums paid tax-free through a spouse’s plan, you can contact your spouse’s HR department to request the premiums are taken out on payroll post-tax. Then, you can resubmit your claim with your documentation showing a post-tax payment for the premiums.

For a complete listing, see IRS Publication 502.

PLEASE NOTE: The type of health insurance employees obtain (ex: individual health insurance, spousal coverage, coverage under parents' policy, etc.) and whether or not an employee currently has health insurance does NOT determine participation eligibility. Eligibility to participate is structured using employee classifications (classes) that are based on 1) bona-fide job criteria (job titles, full-time/part-time status, etc.) and 2) waiting periods for new hires set by your company.

Reimbursement for Basic Preventive Care

All major medical policies that meet the requirements of the ACA are required to cover 100% of the ACA preventive care services. If you are covered by an ACA approved plan, your basic preventive care is already covered.

However, if you aren’t currently covered by a policy that does NOT meet the ACA requirements OR you do not have a plan, you may submit your preventive care services for reimbursement. The list is set by the CDC and is minimal.  Preventive care services covered include:

· Blood pressure screening

· Cholesterol screening for adults of certain ages or at higher risk

· Colorectal cancer screening for adults 45 to 75

· Depression screening

· Diabetes (Type 2) screening for adults 40 to 70 years who are overweight or obese

· Diet counseling for adults at higher risk for chronic disease

· Falls prevention (with exercise or physical therapy and vitamin D use) for adults 65 years and over, living in a community setting

· Hepatitis B screening for people at high risk, including people from countries with 2% or more Hepatitis B prevalence, and U.S.-born people not vaccinated as infants and with at least one parent born in a region with 8% or more Hepatitis B prevalence.

· Hepatitis C screening for adults age 18 to 79 years

· HIV screening for everyone age 15 to 65, and other ages at increased risk

· Immunizations for adults

· Lung cancer screening for adults 50 to 80 at high risk for lung cancer because they’re heavy smokers or have quit in the past 15 years

· Obesity screening and counseling

· Sexually transmitted infection (STI) prevention counseling for adults at higher risk

· Statin preventive medication for adults 40 to 75 at high risk

· Syphilis screening for adults at higher risk

· Tobacco use screening for all adults and cessation interventions for tobacco users.

For a complete list and for additional information, go to https://www.healthcare.gov/preventive-care-adults/