Health Insurance and the 1099 Contractor

Health Insurance for CRNAs

About Me: My name is Lyubov Abrams, and I am a nationwide health insurance broker with Healthcare Solutions Team. I specialize in working with locum tenens CRNAs to provide reliable and affordable health insurance covergae.

When you take the leap to become a locum tenens employee, one of the first obstacles you have to overcome is obtaining coverage for yourself and your family. There have been many changes to health insurance in recent days, and it is my job to help you stay informed of these changes. 

 When it comes to health insurance, you have options:

1.) You can obtain coverage through the marketplace plans. This is a good option for people with major pre existing conditions. If you have had any of the following in the last five years, you should definitely consider staying with a marketplace plan: cancer, heart attack, stroke, transient ischemic attack, rheumatoid arthristis, schizophrenia, bipolar disorder, AIDS/HIV, any recent surgeries which you need coverage for. 

2.) Individual coverage can be obtained through private insurers. There are two types of plans: indemnity plans and term plans. My preference is to sell a term plan because it most closely aligns with a major medical plan and has fewer gaps in coverage. Depending on the area you live in, there are term plans ranging from 1 month to 3 years with major PPO providers. This a great option for a locum tenens CRNA because the coverage is widespread throughout the US. It boasts features such as teledoc that works with your busy schedule and the premiums are sometimes less than half the cost of marketplace plans.

3.) If you have an LLC setup, you can also look at getting group coverage. Typically you will get the best rates if you have 5 or more people in the group. Butyou can have as little as 2 people in the group. The more people the more affordable it is going to be. The group plan is ACA compliant so it will cover all pre existing conditions. 

If you are new to being a locum CRNA or if you are just interested in knowing what your options are, I would love to speak with you! Please give me a call at 404-642-2713.

Feeling Adventurous

Listen up! This is the time to really consider your future and consider starting your business. If you are looking for something in addition to anesthesia or even entertaining a business in anesthesia, this is the time. You all probably know that I am starting a laundromat, and some rental properties. I am always looking to how I can further develop and grow business in the Locum world and outside of it. I use locum anesthesia in order to have these investments. This is, however, the first time I have had to take a business loan. I thought for sure I would be raked over the coals. The contractors for the rehab are making an extensive penny or two from me. I’m still using them because of their reputation and that I know the job will get done. This is sometimes how it works in anesthesia as well. If you have a good reputation and have worked with people before, it bodes well that even with an increased rate, that you will be called over another person. It doesn’t always work that way, but you have a better chance.

I really wasn’t going to write a lot about locums except to say that you can utilize this lifestyle in order to make your entrepreneurial side hustle a real life adventure. I had no idea how I was or … if I was going to get the loans to make this Laundromat work! Here is what has happened so far. I had bids from a great contractor but it would be may before they finished. I had a bid from someone that was not exceptionally or commercially adept, and finally the bid I ultimately took which was based on recommendation and experience in commercial development. I also had the laundry equipment person out to help in design, layout, function, setup of equipment and then the company designed the necessary templates for the construction crews. I talked to a bank which was willing to help but wanted me to be in person and in place all the time so after weeks and weeks I made a switch to another bank. This banker has been awesome. He was proactive in getting the city and state co-loans processed and ultimately approval for all the rehab. The laundry equipment was fully financed by the equipment maker.

I had expected the personal guarantees as I just don’t have millions in assets and it was 100% financed. That said, I expected high interest rates and was thinking that I would be up the creek and paying for it. This is the time to get a mortgage, a business loan or go for a dream. I think it will be harder as time goes forward in the coming years and interest rates are increasing.

This business is less than $2500/month to make an amazing attempt. Yes, there are incidentals, insurance, bills, utilities and the like that will cause some creep but those are operational expenses. Did you think you could have a business with upside potential at $2500/month?

OK, if you don’t want to take on a risk like this. I completely understand. That is where your multi-level marketing companies come in.. Don’t like that?? Then consider your on-line businesses or the many opportunities for growth within anesthesia. You have to take a leap. Listen to the goals Youtube presentation again and make your audacious goals. You can do this!

Are you thinking gees I couldn’t take that risk? It’s not far off from Locum Anesthesia. One day you can have a contract at $160/hour then have a $120/hour assignment. Things change and some day you’ll look for when you can take that vacation and realize that no work = no pay and that you wish you had even a $100 coming in from some investment.

Just a couple thoughts as we are still in the new year…. but tomorrow is Feb 1 and the year will be flying by! Learn, grow, and stay on the journey. You CAN do this!

January 2019 update

I haven’t been writing or “vlog” -ing lately.  I think it’s important to occasionally update you on the site.  Where we are and are headed can help you see the new information and point to available resources.  

we had a conversation with Bonnie about her career as a locum CRNA via Skype which was transferred to YouTube.  She comes across quiet due to recording via Skype.  In the future we’ll go back to zoom as it records better. I had a couple other recordings but CRNAs decided they would prefer not to post.  Conversations don’t have to be 45 minutes or longer!  Even a recorded question or two would be great, if you want to post for the benefit of the group!  

We are adding to the CRNAandSRNA.com site many of the resources that are part of the LocumCRNA.com site.  The Amazon Store has added books and common travel needs for CRNAs.   

We added a financial advisor with MassMutual who was at the VANA conference and have asked about some guest posts for our blog.   

On the CRNAandSRNA.com site we added CRNA owned companies that are not just CEU or recruiting agencies.  Recruiters can post on the job board that is relatively new on both sites and CEU companies (all CRNA owned) have there own static page always available to you!   

Needs:

I need people willing to discuss on the YouTube channel.  

I need to update the CEU listing for current programs. 

i need to finish all state boards of nursing and CRNA licensure requirements, all state boards are linked to their respective website but I haven’t completed listing their individual requirements.   

I’d love to get more of the CRNA owned companies on the website and maybe list by state.  I think many would be reps like R&F and I think if that’s the case we can put a primary post for the company then each individual that sells.... I can’t have 100 R&F companies as many would quit looking after one scroll.   

I, also, would love to get more information on helpful static pages.  I am going to work on one for student loans as this is always a re-post on the sites, otherwise I need to know what would be most helpful for you?  

Thats your update for January 2019!  Email me at LocumCRNAs@gmail.com if you have suggestions or want to help-out! 

Investments without large fees

Investing is not one of our best endeavors and many just don’t take the time to learn. With only a few minutes left in the year, here is some information you might not want to miss.  

I was just listening to the ChooseFI podcast and found out a few things to pass along.  First, I recommend listening to them as you journey through life whether you are planning to retire early or not.  

HSAs or Health Savings accounts for any high deductible insurance plan that is define as 1350 for an individual or 2700 for a family.   You can put away 3450 individual or 6900 for a family in an HSA TAX FREE.   Any medical expenses can be taken out TAX FREE at any time / any year!  This of course means you have to keep your receipts for your accountant for years.  After age 65, it acts like a traditional IRA or can be used for medical expenses later in life.  If your plan started dec 1 you could find the entire amount.  Fidelity now has a zero fee HSA management account (funds or investments places in the account may have some fees).  

This is way different than an FSA as those funds don’t fully roll-over year to year.   these funds are for your yearly medical expenses and are typically use or lose.

We are typically interested in low fees and trying to keep our income in our pockets.  Mutual fund investments are just about the most common across the nation and ChooseFI often touts the Vanguard total stock index fund or VTSAX which had a hefty $10k minimum which has now changed to a $3k minimum for getting started.  This opens the fund up to those who are wanting to get started investing at one of the lowest fee mutual funds on the market at an annual fee of just 0.04%! 

Some of you may know these things but the mutual fund information is pretty new.  If you are thinking of setting up the Solo401k it has to be done and funded by the end of the year and if you are looking at a sep IRA it must be done and funded by April 15.   

It’s time to get your investment on! 

Locum Travel

I love being a locum, on most days. This is definitely one of those days!! I am so happy I chose to become a Locum CRNA.

I am not traveling extravagantly; but, Francisco and I were able to take airline miles, bumped from flight $$ and get our coach tickets to Paris!  Ok, so we spent ~$150 on air United tickets. 

We packed our baggage (you can see my SwissGear luggage on the store of the website). We used the United Airlines mileage card to sit in the club for our forever long layover to have drinks and food.  We did do Starbucks as we went for our walk in the airport just before getting on the airplane. 

Unfortunately, I forgot my most loved wired Apple headphones in the car on the way to the airport.  Because I worked hard the last two weeks, I decided to get my first ever set of AirPods!  I’ve always liked the fit of apple headphones and now I like these with no wires!!!!

We are about to land and we’ll have some time to clear customs, baggage and coffee!!!! Then, it’s off to the train to London. 

Ok, so travel or really time off is a benefit of being a Locum CRNA but it’s about using the leverage of your travels as well.  If using a credit card are you taking the benefits from that?  If at a hotel, did you add your rewards number to the reservation?  The only rewards I’ve found I can’t get are the car rental rewards as the reservations with Avis was at a higher cost for adding the rewards. 

We also have two free nights in the Best Western because I had some nights that a hospital put me up at the BW.  So, we are paying food, fun, & 8 of 10 days in an AirBNB. 

This isn’t to brag about vacation, but it is to tell you that you can take more vacation, plan, and have some rewards that make it more affordable! 

New Apple EarPods  

A long trip in coach... we survived! 

Eurostar to London

LocumCRNA.com and a new investing page?

I’m thinking it might be interesting to go through investments?  We work hard and make a decent income. What do we do with that income, or how do we invest and protect our investments? 

I’m thinking about using my continuous growth in showing what I have been up to on the investment space.  I can show the websites and what I’m working on in that space.  I can go through real estate holdings and what that looks like.  Not to forget sep IRA V’s Solo 401k and stock market investments.  Then businesses and the different types of investments that I look at and consider. 

I wonder if this is something you would want as a page as it only somewhat relates to our site because locums is the way I finance life and the investments?  

Credentialing, A Recruiter Perspective

I asked questions of an agency for their views on credentialing.

Credentialing is a beast and can cause major headaches for the CRNA as well as the recruiter.  I’m taking time to ask a recruiter some big questions.  

What is internal credentialing and how does it vary from the facility credentialing?

 --Often times there is internal credentialing for the agency which just looks to make sure all items are up to date and in hand for presenting an Anesthetist to a facility. A cursory look that all information is up to date and filled in is just the start.  

The credentialing packet that is recommended by LocumCRNA.com at https://www.locumcrna.com/credentialing/is a great start and the FREE CV template available at the bottom of https://www.locumcrna.com/store/are a great set of tools to provide a recruiter.  

It’s highly recommended to put all documents in a folder on your laptop or iPad so it can easily be sent to a recruiter or hospital administrator.  For example Dropbox is one place.  

Is there a credentialing packet for the hospital too?  

--Yes, some agencies will have someone to pre-fill data for you and others will send you the packet and have you fill out the packet with an overnight return envelope.  The faster and more complete the information the more likely all will be submitted and done on-time!  

Does TIVA pre-fill in data?

--Yes, our credentialing team will pre-fill our internal on-line app as well as any hospital applications.  Some facilities have a pre-app as well as a hospital application.

How long does internal credentialing take and what is the estimated time for most Sheridan facilities to finish credentialing?

-- Internal credentialing with TIVA is about 2 weeks and the facilities range from 45 days to 90 days from the time the hospital application is back to the MSO. 

 Does a group ever tell a credentialing department how long they have to approve or deny credentialing? 

--The group does not dictate the time to credential; that comes from the Medical Staff Office and the hospital by-laws.  Having everything together and in with the first submission will make it significantly easier for everyone. 

Robert Moore – Senior Recruiting Consultant/Key Contributor

Ads now on the job board at LocumCRNA.com

Office 954-939-7010

Cell 954-232-5323

Robert.Moore@tivahealthcare.com

www.tivahealthcare.com

Packing List for CRNA Locums

Have you ever had luggage show up late or been to your destination to realize you don’t have the basics of what you need? Have you gone on vacation or to your assignments and realized you brought too much stuff? This goes with my YouTube video: Here’s my basic packing list:

Things I do:

1. Pack for just 7 days.

2. Have a set of dress casual clothes for day 1 at work.

3. Have my laptop and phone fully charged and have the cables.

4. Pack imperative items for the first day of work in my carry-on luggage.

5. Have all my assignment details either memorized or printed. It’s horrible to get in the rental car and not know where your going because your phone died as you were listening to that amazing audio-book on the plane.

6. Have something you love to do with you.

7. If you work out everyday but forgot your favorite gear. That will make you alter your routine or put you in a funk from the beginning.

8. Make sure you unpack on arrival and know exactly what you have to go to work with in the morning. Take the time to have your paperwork printed and ready to go.

9. Follow a routine so when you are packing you have checked your list and not just brought everything from home that you won’t use.

10. Don’t over analyze and pack for unlikely contingencies. Pack your everyday items for one week.

When you are booking a hotel for a long term stay.

I put a video up about this topic at locumCRNA.com under videos.  However, I forgot to mention ... 

Don’t forget hotel taxes.  Hotel taxes and fees can be significant.  So add that cost into your calculations.  Also, be sure to ask when those are refunded.  Typically on a long term stay those are refunded or a portion is refunded when you become more of a long-term VS transient guest.  

This is of course if you are not checking out for weekends but might be a good way for you to keep a portion of what your negotiated fees are for housing or if you negotiate an all-inclusive rate you can keep more of your hourly when not having significant taxes and fees taken by the hotel.   

As far as I know the fees and taxes will stay the same for AirBNB and VRBO but those would need to be scrutinized so you have a true idea of the expenses.  

If this is helpful please subscribe to the YouTube channel and if you want to support us ... next time you are purchasing on Amazon click on one of our links in the store and any purchase on Amazon for 24hours will give us a small commission.  Have a great day and let us know how we can provide more content you like at locumCRNAs@gmail.com