Scroll down for Medicare, Medigap, Medicaid & Social Security information.
S.I.M.P.L.E. - SEP - 401-K Solo - IRA
The limits apply for 2020. The IRS usually announces new limits in late October.
Savings Incentive Match Plan (S.I.M.P.L.E.), available since 1997, allows employers of fewer than 100 employees to offer a 401-K type salary deferral plan to employees. (Self employed persons can participate, as well).
Up to $15,500 annually can be deferred from federal tax; the employer must provide a small match (3% of employee's annual compensation (as low as 1% and 2% the initial two years)). Persons over 50 may defer $19,000.
A Solo 401-K allows, for a single participant, $22,500 or $30,000 if over age 50. The SEP maximum is $66,000 (2023) (no catch-up) and the Traditional IRA allows $6,500 or $7,500, if over age 50 . Certain income phase out limits apply depending on employment and particiation in another qualified plan. The above are for 2019 unless indicated differently.
Easy to set up using Model or Prototype readily available adoption documents. No annual 5500 returns to file in most cases; simple to administer.
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Q. What is Medicare?
A federal health insurance program for people 65 or older, people under 65 with certain disabilities and people with end-Stage renal disease.
Q. Is Medicare free?
There are three parts to Medicare. Parts B and D require that people pay monthly premiums. Standard Part B premium will cost $170.10 per month for most folks in 2022. It is usually withheld from Social Security payments. The cost is higher for new enrolled recipients and for upper income persons. The Part D premium for prescription drugs is paid to health care plans. The monthly cost varies depending on the level of plan selected. Part A is provided through deductions from your earnings during your working years.
Q. What is covered?
Part A is hospital insurance; Part B is medical insurance; Part D is prescription drug insurance.
Q. Must everyone sign up when they become 65?
If you paid Medicare taxes while you worked, you will be eligible for Part A. If you did not pay Medicare taxes, you may get help from your state to buy the coverage. If you are already receiving Social Security benefits when you turn 65, you will be automatically covered for Part A. If you are under age 65 and disabled, you will get Medicare Part A after 24 months of collecting Social Security benefits. If you are getting close to age 65 and not yet collecting Social Security benefits, you must apply for Part A.
Part B, (non-hospital coverage) is your choice. If already receiving Social Security benefits, you will be automatically enrolled in Part B. You can opt out of coverage and not pay the monthly premium; however, if you wish to enroll later, you will have to pay a penalty for each month you deferred. There are exceptions for people who have coverage through an employer group. The penalty provision is designed to encourage everyone to enroll - not just sick people.
Part D is prescription drug coverage that became law in 2006. Everyone must enroll unless they already have coverage that the government deems creditable. Penalties apply for failure to enroll.
Medicare Advantage plans are available through participating insurance companies. The federal government pays insurance companies a flat amount to sign up and provide health insurance coverage to individuals. Insured persons under this arrangement do not have traditional Medicare as described above. Your Medicare Advantage plan may have no monthly premiums for you to pay or it may have various premiums depending on the extent of coverage offered, the level of co-pays and deductibles. Be sure you know what you are getting.
Q. What is Medigap?
Part B covers only 80% of Medicare approved amounts for services. People can purchase private insurance to cover the other 80% as well as deductibles. If Medigap coverage is not purchased, individuals are responsible for charges not paid by Medicare.
Q. If I purchase a Medigap policy that includes prescription drug coverage am I excused from enrolling in Part D?
No. The drug coverage in Medigap policies is not considered creditable. If you have prescription drug coverage through an employer group plan, it probably is creditable.
Q. Why do some Medigap policies include drug coverage. New policies sold since 2006 cannot include the coverage. People with pre 2006 Medigap policies should probably change to a policy that excludes drug coverage.
Q. Does it matter if I or my spouse continue working after age 65 for an employer who provides health insurance coverage?
Yes, in that case, Medicare coverage would be secondary and the private coverage would be primary.
Q. Is Medicare available through private insurance companies? Yes, Medicare Advantage Plans are sold by private companies. Examples would be Keystone Senior Blue and Freedom Blue. The federal government pays private insurance companies an annual fee for each Medicare recipient they sign up.
Q. Where can I find additional information?
Visit www.medicare.gov or call your local social security office.
Q. What is Medicaid?
Medicaid is a state administered benefit program for the needy, that is overseen by the federal government. In 2006 the program was drastically overhauled with the result that it is more difficult for persons to give away their assets to family members in order to qualify for Medicaid's long tem care.
For example, the state now looks back 5 years, not 3 years, in determining the value of assets given away and the period of time you are delayed in obtaining assistance. It is possible for a person to be in a nursing home, have exhausted their savings, but not become eligible to receive Medicaid benefits for many months or years.
It is advisable to consult an attorney who specializes in elder law.
Q. What is social security (SS)?
Sometimes called Old Age Insurance, SS is a federal government administered retirement program. During your working career you contributed through mandatory payroll deductions or, if self-employed, by quarterly payments. To be eligible to collect monthly SS retirement benefits as early as age 62, you need to have paid in for at least 40 quarters during your lifetime. Certain exceptions apply.
Your retirement benefit is based on your highest 35 years of coverage. You can begin collecting as early as age 62; if you start at age 62, your monthly benefit will be approximately 70% of the benefit had you waited to age 66, your full retirement age. For younger folks, the age requirement may be 66 years and 10 months, as an example If you defer starting SS benefits to age 70, your monthly amount will be 130% of your age 66 benefit.
Can I collect on my spouse's earnings record? To collect a monthly benefit if you did not work, you can collect on your current spouse's earnings record only of your current spouse has begun collecting. You can collect on the record of an ex-spouse, if you were married to him/her for at least 10 years and have not re-married. This will not reduce the benefit of your ex-spouse and he/she need not have commenced collecting SS retirement benefits.
Can children and disabled persons collect SS benefits? Yes under certain circumstances benefits will be paid to children and the disabled. These rules can be complex, however.
Can I start then stop collecting benefits? Yes, however the benefits collected must be paid back with interest. More liberal rules were repealed in November, 2015.
When should I begin the process of filing for SS benefits? Approximately 3 months in advance you should create an account at www.ssa.gov and initiate the process.
Are SS benefits taxed by the IRS? Yes, but only if your other income exceeds a specific amount. If you or a spouse are working or have substantial investment or rental income, up to 85% of your SS benefits will probably be taxed. PA and NJ do not tax SS benefits. You may elect to have federal income tax withheld from your benefits.
If my spouse dies, can I collect my benefit plus my deceased spouse's benefit? No. You should contact SSA, however. Your benefit will be the higher of your own benefit or the benefit you are entitled to based on your spouse's record.