Insurance for the Arts Example: Fractured Atlas FRACTURED ATLAS, a national nonprofit arts service organization, provides information you may need to help determine the most important types of insurance coverage for you and your organization, including disaster insurance. There is a fee to join. support@fracturedatlas.org.

Twane L. Duckworth Chief of the Risk Management Division The City of Jacksonville

Insurance for Artists

By Kenny Rouh of RouxArt, Inc. (IAM, NOT, ANEX, PERT)

Kate Garcia Rouh is my wife.

I retired from Corporate America to transform her art talent into an art business.

In mapping our Business Plan, a strategy for Insurance coverage was also needed.

Let’s talk about Risk.

Daily Personal Risks:

Getting out of bed. Walking in stocking feet on a carpeted

stairway. Pouring hot water into the French press. Driving your automobile to work. Name yours………YOU choose your level of

risk. You can choose to have some of your

Personal risks to be insured against a financial impact.

Business Risks, as an employee of a major company:

Sales Rep makes a new sale(or not). Customer Service Rep makes customer angry. Finance Mgr. buys a Futures contract to set

low fuel price for December. Fleet Maintenance cares for company

vehicles. Company Driver delivers product to customer. Companies choose to insure certain risks,

absorb some.

Insurance against

the financial consequences of events that have Risk to your Art business.

Risks of an Artist’s BUSINESS :

Same Personal Risks as most people.Declaring yourself to be a business-

additional risk.Market Risk – will your product sell ?Liability risk - interacting with the

public.Being under-insured – risk to your

financial basis.

Declaring yourself to be a business: Business use of home v. Homeowners insurance. Valuation of your works – Property insurance.

Natural disaster or theft. Rent or own studio space – Property insurance.

Limitations of Renter’s Insurance; value of materials inventory.

Disaster insurance – Loss of Income Insurance or Flood Insurance.

Transit insurance – works going to a show.Also: materials moving or being stored at multiple

locations or a worksite. Your Health insurance – ACA Automobile insurance to cover business activities

Interactions with your business.Public interaction – General Liability

insurance.At festivals, even if sponsor has Liability

insurance. Will you work at the show? Power tools?

Coverage of your work as a temporary display.

Your employees – State and Federal regulations.

Worker’s compensation &/or Health insurance.

Volunteers working for you – Liability insurance and Waiver.

City of Jacksonville contracts Indemnification – Hold harmless – Defend Insurance requirements as of April 2015

Must procure before and maintain for the project duration

Must have certificate issued to COJ and CCGJ

Workmen’s Compensation and Employer’s Liability

For employees or uncovered contractors.Commercial General liability insuranceAutomobile liabilityArt Floater policy or Inland Marine insurance

Covers art or materials that typically move between locations, say, studio to job site or studio to festival

City of Jacksonville contracts (continued)

Coverage of Rental equipment.Waiver of Subrogation.

IMPORTANT to review such a clause with your Liability insurance carrier.

All insurance must cover specific Named Insured in a certificate.

Insurance coverages must be primary in nature, not from a pool of other insurances.

If Artist is self-insured, City must agree to the current deductibles.

Insurance carriers must be upstanding and approved as such by COJ.

Other insurance requirements may be identified by COJ and required of Artist, depending on the scope of the project.

Advice:Get to REALLY know a good,

personable Insurance agent.Let THEM get to know YOU.

Thoroughly analyze (on paper) how you conduct your business.

Artist’s thinking v Business thinking

Identify YOUR areas of risk for impact.

Analyze potential solutions and act.

Acknowledgements: - The Business of Art: Business Insurance for Individual Artists

Posted September 10, 2013 NYFA Current via NYFA.orgToccara A. Holmes Thomas is Program Associate, NYFA Source - Sculptor MagazineJune 2004Article by Daniel Granthttp://www.sculpture.org/documents/scmag04/june04/web%20specials/grant.shtml

Health Insurance 101 andthe Affordable Care Act

November 2015

About This Presentation

• Designed to provide an overview of health insurance and the Affordable Care Act (ACA).

• Consists of two primary sections:- What is Health Insurance?- The Affordable Care Act

• Please feel free to ask questions as we go through the presentation.

Florida Blue is an Independent Licensee of the Blue Cross and Blue Shield Association. 2

What is Health Insurance?

• What is Health Insurance?• Why is Health Insurance Important?• How it Works• Selecting a Health Plan

What is Health Insurance?

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• Health insurance is a contract between an individual and a health insurance company.

• When you enroll in a health plan, the insurer agrees to pay part of your medical costs for covered services.

• After you enroll, you pay a monthly bill – called a premium – to keep your health plan.

• Health insurance covers two types of medical costs:

Keep You Healthy When You’re Sick

• Annual physical exams• Mammograms• Prescription drugs• Other preventive services

• Ambulance transportation• Hospital facility fees• Surgery• Other types of treatment

Why is Health Insurance Important?

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• Everyone will need to use the health care system at some point – whether for routine care, to treat an illness, or after an accident.

• Health insurance provides you with the ability to get medical carewhen you need it and protects you from high treatment costs.

• Average treatment costs for common conditions include:

• Emergency room visit (Level 1) – $610

• Surgery to repair a broken leg – $9,623

• Prenatal care and childbirth (normal delivery) – $9,526

• Hip replacement – $21,472

Cost estimates from Healthcare Bluebook using ZIP code 32246 https://healthcarebluebook.com/page_ConsumerFront.aspx

How it Works

A health plan includes different types of member cost-sharing when youget medical care:

• Deductible is the dollar amount that you must pay each year before your insurance coverage begins to pay for covered benefits

• Copayment is a fixed dollar amount you pay for medical services

• Coinsurance is the part (or percentage) you pay for services after you meet the plan’s deductible

• Out-of-Pocket Maximum is the most you will pay for covered healthcare services during your plan’s coverage period

DeductibleCopayment

and/or Coinsurance

Out-of- Pocket

Maximum

Florida Blue is an Independent Licensee of the Blue Cross and Blue Shield Association. 24

Example of Plan Benefits

Sample of how plan benefits are displayed on www.healthcare.gov:

Annual deductibles for medical services and

prescription drugs

Annual out-of-pocketmaximums

Copayment and coinsurance amounts for covered medical

services and prescription drugs

Florida Blue is an Independent Licensee of the Blue Cross and Blue Shield Association. 25

Selecting a Health Plan

You should consider key things when reviewing health plans and compare them in order to determine the “total cost of ownership” and choose the health plan that best fits your needs.

Premium: The monthly amount you pay for your health plan. In general, plans with lower premiums have higher cost- sharing amounts (deductibles, copayments, and coinsurance).

Member Cost-Sharing: The out-of-pocket expenses you will pay, such as the deductible, copayments, coinsurance, and out-of-pocket maximum. Consider these costs for care you currently receive (office visits, prescription drugs, etc.).

Provider Network: The group of doctors, hospitals, pharmacies, and other health care providers that are contracted to provide services for a health plan.Your out-of- pocket costs will be lower if you see an in network provider. Florida Blue is an Independent Licensee of the Blue Cross and Blue Shield Association. 2

6

The Affordable Care Act (ACA)

Key ACA Provisions:

• Changes in Health Plans• Essential Health Benefits• Metal Level Benefit Plans• How Premiums are Calculated

Health Plan Characteristics:

No denials for pre-existing conditions

Everyone who applies for coverage must be accepted

Coverage for Essential Health Benefits with no lifetime maximums or annual dollar limits

Choice of plans at different cost sharing (“metal”) levels

Premiums based on age, location of residence, smoking status

Financial assistance based onhousehold income

Changes in Health Plans

Florida Blue is an Independent Licensee of the Blue Cross and Blue Shield Association. 10

Essential Health Benefits (EHB)

Plans must cover these benefits with no annual or lifetime dollar limits:

Graphic Source: AHIP

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Metal Level Benefit Plans

Four Metal Level categories of health plans are available:

• Each metal plan covers the same set of Essential Health Benefits

• A plan’s Metal Level is based on what a plan will pay, on average, for covered services and reflects differences in cost-sharing and out-of- pocket expenses for these services

• Plans at all metal levels are available in all 67 Florida counties

Platinum Gold Silver BronzeHigher Premium Lower Premium

Florida Blue is an Independent Licensee of the Blue Cross and Blue Shield Association. 30

How Premiums are Calculated

Premiums for families will be the sum of the rate for each personto be covered, with a cap of 3 children ages 0 – 20.

Age• Adult rates increase with age and cannot exceed a 3:1 ratio• Children ages 0 – 20 will have the same rate

Location• Premium will vary based on the county the applicant lives in• Medical costs in area directly affect premium

Tobacco Usage• Rates may be up to 50 percent higher for tobacco users• Tax credits do not apply to tobacco surcharge

The cost of a health plan depends on:

Florida Blue is an Independent Licensee of the Blue Cross and Blue Shield Association. 31

Health Insurance Marketplace(Individuals)

• Marketplace Overview• Types of Financial Assistance• Advance Premium Tax Credits• How the Premium Tax Credits Work• Cost Sharing Reductions• Individual Mandate and Penalties• 2016 Open Enrollment Dates

Health Insurance Marketplace Overview

Allows consumers to determine eligibility for financial assistance and access information to evaluate and enroll in health plans.

• Consumer provides demographic, income, and dependent information

• Marketplace provides eligibility results and amount of premium tax credit available

• Enrollment and tax credit information sent to issuer of selected plan

Consumer completes Marketplace application

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Marketplace makes eligibility determination

Consumer enrolls in health plan

Types of Financial Assistance

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This table outlines the Federal Poverty Level (FPL) income ranges that will qualify for financial assistance for enrollment in 2016 coverage:Household Size 100% FPL 250% FPL 400% FPL

1 $11,770 $29,425 $47,080

2 $15,930 $39,825 $63,720

3 $20,090 $50,225 $80,360

4 $24,250 $60,625 $97,000

Each add’l person Add $4,160 Add $10,400 Add $16,640

• Household incomes below 100% FPL do not qualify for state orfederal financial assistance to obtain health insurance coverage

• Household incomes between 100 – 400% FPL qualify for Advance Premium Tax Credits to offset premium costs

• Household incomes between 100 – 250% FPL also qualify for Silver plans that have Cost Share Reductions (lower out-of-pocket costs)

Financial Assistance – Advance Premium Tax Credits

Tax credits must be used to purchase coverage through the Marketplace.

Advance Premium Tax Credits (APTCs) – also known as “subsidies” – are available to applicants based on a combination of:

HouseholdIncome

Family Size

County ofResidence

Cost of Silver Plans

Available for incomes between 100 – 400% of

the Federal Poverty Level (FPL)

Florida Blue is an Independent Licensee of the Blue Cross and Blue Shield Association. 35

Based on the number and ages of

people covered

Subsidy based on second-lowest cost Silver plan in county

Each of Florida’s 67 counties has separate

rating factors

How the Premium Tax Credits Work

• The tax credits are paid directly to the insurance company each month to offset premium costs for the health plan an individual selects.

• The insurance company then sends a monthly bill to the individual for any balance due.

• The individual pays the insurance company any balance due.

MonthlyPremium Tax Credit

ConsumerOwes

$218 $74 $144Example based on a 27-year old in Duval county with an annual income of

$25,000 (214% FPL) who purchases the second lowest cost 2016 Silver plan.

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Apply and Enroll

• Advance payment amount calculated by the Marketplace• Amount based on next year’s projected income, family size,

and cost of second lowest cost Silver plan in the county

During the Calendar Year

• Issuer reduces premium by premium tax credit amount• Member notifies Marketplace of income, family size

changes

When Preparing Tax Return

• Tax credits are reconciled with the advance payments• Repay IRS if income was higher than projected• Receive tax credits if income was lower than projected

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Premium Tax Credits Calculation and Reconciliation

Financial Assistance – Cost Sharing Reductions

Florida Blue is an Independent Licensee of the Blue Cross and Blue Shield Association. 20

• Certain Marketplace plans include Cost Sharing Reductions (CSRs) that reduce out-of-pocket expenses for covered health services.

• To be eligible for these CSR plans, an individual must:• Have a household income between 100 – 250 percent FPL• Receive the Advance Premium Tax Credit• Enroll in a specific Silver plan through the Marketplace

2016 Plan 1410 1410A 1410B 1410C

IncomeOver 250% FPLOver $29,425

200-250% FPL$23,540 - $29,425

150-200% FPL$17,655 - $23,540

100-150% FPL$11,770 - $17,655

Deductible $6,100 $4,300 $0 $0

OOP Max $6,850 $4,500 $2,250 $950

Primary Care

1 visit at $0, then$65 Copay

2 visits at $0, then$65 Copay

2 visits at $0, then$2 Copay

2 visits at $0, then$1 Copay

Specialist Ded then $90 $85 Copay $25 Copay $10 CopayER Ded then $600 $600 Copay $500 Copay $100 Copay

RxDed then

$30/45/160/200

$20 Generic;Ded then

$45/150/200 $16/45/80/200 $2/5/40/75

Individual Mandate and Penalties (Fees)

• As of 2014, individuals who do not have health insurance must pay a fee

• The amount will be the greater of a flat fee or a percentage of income

• The fee will be phased in from 2014 to 2016

• Exemptions exist for individuals who meet financial hardship criteria

Graphic Source: UnityPoint Health

Florida Blue is an Independent Licensee of the Blue Cross and Blue Shield Association. 39

2016 Open Enrollment Dates

For coverage beginning January 1, 2016, your open enrollment dates vary based on

the type of coverage you enroll in:

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Type of Coverage Open Enrollment DatesOn the Marketplace

(may include financial assistance)November 1, 2015 to

January 31, 2016

Off the Marketplace(will not include financial assistance)

October 1, 2015 toJanuary 31, 2016

Medicare October 15, 2015 toDecember 7, 2015

Renewal of 2015 Coverage (On or Off the Marketplace)

Renew by December 15, 2015 to avoid a gap in coverage

Questions?

Florida Blue is an Independent Licensee of the Blue Cross and Blue Shield Association. 41

Future Workshopso Finance Matters: Taxes and Banking December 1, 2015 SIGN UP TONIGHT! o Going for the Gold: Grant Writing-February 2, 2016o Sell Yourself: Professional Branding – March 1, 2016o Show Your Work: Portfolio Development – April 5, 2016