Shown below are common terms used in healthcare and health insurance. Also explained, is how AmericaHealth Direct and other Direct Primary Care plans relate to each of these terms.
Employer Shared Responsibility
The Affordable Care Act's Employer Shared Responsibility provision requires Applicable Large Employers (ALEs) to provide an "Affordable," Qualified Health Plan to employees that provides "Minimum Essential Coverage" and "minimum value" for the employee only premiums or the employer must pay a penalty to the IRS.
Direct Primary Care plans, such as AmericaHealth Direct, are not Qualified Health Plans and therefore do not meet the ACA Employer Shared Responsibility provision. Many employers will compliment a Qualified Health Plan with AmericaHealth Direct to reduce healthcare claims.
Health Savings Account
A Health Savings Account (HSA) is a tax-advantaged trust account for saving money and paying qualified healthcare expenses. Contributions are tax-deductible, interest earned is tax-deferred and withdrawals are tax-free if used for qualified medical, dental or vision expenses. Premiums are not tax-deductible. In order to contribute to a HSA, individuals must have a High Deductible Health Plan.
Direct Primary Care plans, such as AmericaHealth Direct, are not High Deductible Health Plans and therefore individuals are not eligible to contribute towards a Health Savings Account.
High Deductible Health Plan
A High Deductible Health Plan (HDHP) is a qualified health insurance policy that meets the IRS definitions regarding deductibles and coverage requirements and limitations. Individuals and families with a HDHP are eligible for contributions into a Health Savings Account (HSA).
Individuals with High Deductible Health Plans are ideal candidates for purchasing AmericaHealth Direct, a Direct Primary Care plan, to pay for healthcare expenses subject to the health insurance plan's calendar year deductible.
Stop Loss Insurance
Self-funded health insurance policies purchase stop-loss insurance (sometimes called reinsurance) to protect the plan sponsor from large medical claims that exceed the plan's specific or aggregate deductibles. Stop Loss insurance
Direct Primary Care plans like AmericaHealth Direct, are not insurance policies and therefore do not have stop-loss insurance. Many employers will compliment a Qualified Health Plan with AmericaHealth Direct to reduce healthcare claims.
Employer Shared Responsibility
The Affordable Care Act's Employer Shared Responsibility provision requires Applicable Large Employers (ALEs) to provide an "Affordable," Qualified Health Plan to employees that provides "Minimum Essential Coverage" and "minimum value" for the employee only premiums or the employer must pay a penalty to the IRS.
Direct Primary Care plans, such as AmericaHealth Direct, are not Qualified Health Plans and therefore do not meet the ACA Employer Shared Responsibility provision. Many employers will compliment a Qualified Health Plan with AmericaHealth Direct to reduce healthcare claims.
Health Savings Account
A Health Savings Account (HSA) is a tax-advantaged trust account for saving money and paying qualified healthcare expenses. Contributions are tax-deductible, interest earned is tax-deferred and withdrawals are tax-free if used for qualified medical, dental or vision expenses. Premiums are not tax-deductible. In order to contribute to a HSA, individuals must have a High Deductible Health Plan.
Direct Primary Care plans, such as AmericaHealth Direct, are not High Deductible Health Plans and therefore individuals are not eligible to contribute towards a Health Savings Account.
High Deductible Health Plan
A High Deductible Health Plan (HDHP) is a qualified health insurance policy that meets the IRS definitions regarding deductibles and coverage requirements and limitations. Individuals and families with a HDHP are eligible for contributions into a Health Savings Account (HSA).
Individuals with High Deductible Health Plans are ideal candidates for purchasing AmericaHealth Direct, a Direct Primary Care plan, to pay for healthcare expenses subject to the health insurance plan's calendar year deductible.
Stop Loss Insurance
Self-funded health insurance policies purchase stop-loss insurance (sometimes called reinsurance) to protect the plan sponsor from large medical claims that exceed the plan's specific or aggregate deductibles. Stop Loss insurance
Direct Primary Care plans like AmericaHealth Direct, are not insurance policies and therefore do not have stop-loss insurance. Many employers will compliment a Qualified Health Plan with AmericaHealth Direct to reduce healthcare claims.
AmericaHealth makes no representations regarding the legal or tax implications of membership. Member is encouraged to seek the advice of a competent tax professional for advice regarding any related legal or tax issues.
