Instruct: Given a question, retrieve documents that answer the question.
Query: Do you need to pay a deductible before insurance pays?
In an insurance policy, the deductible is the amount paid out of pocket by the policy holder before an insurance provider will pay any expenses.[1] In general usage, the term deductible may be used to describe one of several types of clauses that are used by insurance companies as a threshold for policy payments.
In a traditional fully insured health plan, the employer regularly pays a premium, which is a fixed rate for a given time period, and the covered employees pay a monthly contribution to the employer designed to partially offset the employer's premium. In general, the premium does not change except in certain specific instances, such as, most commonly, a change in the number of covered employees. The insurer collects the premiums and pays the health care claims based on the benefits in the health insurance policy that was underwritten and purchased. The employees are responsible to pay any deductibles or co-payments required under the policy.
In the United States, individually purchased health insurance is health insurance purchased directly by individuals, and not those provided through employers. Self-employed individuals receive a tax deduction for their health insurance and can buy health insurance with additional tax benefits. According to the US Census Bureau, about 9% of Americans are covered under individual health insurance. In the individual market, consumers pay the entire premium without an employer contribution, and most do not receive any tax benefit. The range of products available is similar to those provided through employers. However, average out-of-pocket spending is higher in the individual market, with higher deductibles, co-payments and other cost-sharing provisions. Major medical is the most commonly purchased form of individual health insurance.
The duty to indemnify is the insurer's duty to pay all covered sums for which the insured is held liable, up to the limits of coverage and subject to any deductibles, retained limits, self-insured retention, excess payments, or any other amounts of money which the insured is required to pay out-of-pocket as a precondition to the insurer's duty.
A pay-as-you-earn tax (PAYE) or pay-as-you-go (in Australia) is a withholding tax on income payments to employees. Amounts withheld are treated as advance payments of income tax due. They are refundable to the extent they exceed tax as determined on tax returns. PAYE may include withholding the employee portion of insurance contributions or similar social benefit taxes. In most countries, they are determined by employers but subject to government review. PAYE is deducted from each paycheck by the employer and must be remitted promptly to the government. Most countries refer to income tax withholding by other terms, including pay-as-you-go tax.
Deductibles are typically used to deter the large number of claims that a consumer can be reasonably expected to bear the cost of. By restricting its coverage to events that are significant enough to incur large costs, the insurance firm expects to pay out slightly smaller amounts much less frequently, incurring much higher savings. As a result, insurance premiums are typically cheaper when they involve higher deductibles. For example, health insurance companies offer plans with high premiums and low deductibles, or plans with low premiums and high deductibles. One plan may have a premium of $1,087 a month with a $6,000 deductible, while a competitive plan may have a premium of $877 a month with a $12,700 deductible. The consumer with the $6,000 deductible will have to pay $6,000 in health care costs before the insurance plan pays anything. The consumer with the $12,700 deductible will have to pay $12,700.[2]
Since the majority (85%) of Americans have health insurance, they do not directly pay for medical services. Insurance companies, as payors, negotiate health care pricing with providers on behalf of the insured. Hospitals, doctors, and other medical providers have traditionally disclosed their fee schedules only to insurance companies and other institutional payors, and not to individual patients. Uninsured individuals are expected to pay directly for services, but since they lack access to pricing information, price-based competition may be reduced. The introduction of high-deductible insurance has increased demand for pricing information among consumers. As high-deductible health plans rise across the country, with many individuals having deductibles of $2500 or more, their ability to pay for costly procedures diminishes, and hospitals end up covering the cost of patients care. Many health systems are putting in place price transparency initiatives and payments plans for their patients so that the patients better understand what the estimated cost of their care is, and how they can afford to pay for their care over time.
State healthcare is provided through the "Azienda Sanitaria Locale" national health insurance fund. All employees must register with it upon starting a job, and upon registration, are issued with a health card and number, and are automatically registered with a doctor in their neighborhood. Employers pay a contribution for each employee, deducted from their salaries, while the self-employed must pay the full contribution. Employed persons' dependent family members are covered by their insurance. Vulnerable people, such as the unemployed, aged, diabetics, and those on long-term maternity leave, do not need to register with an employer, and are entitled to free treatment without paying contributions.
On March 8, 2011, it was confirmed a settlement had been reached in the case, on the City's insurance carrier's recommendation, whereby Danbury agreed to pay the laborers $400,000 (Danbury's insurance carrier paid the settlement plus legal fees of close to $1,000,000, less a $100,000 deductible). (The federal government agreed to pay them $250,000.) As part of the settlement, the City did not admit any wrongdoing and there were no changes in the city's policies or procedures. "I know we were right," Boughton said. "If someone's civil rights were violated, as they allege, you wouldn't settle for a cash payment, but you would want some changes in policy."
Income tax is deducted at the source, which is called pay-as-you-earn (PAYE). Each employee has a personal tax credit of 53,895 ISK per month (2018) which is deducted from calculated taxes. Unused credit may be transferred to one's spouse. Mandatory employee pension insurance is 4% of gross income (employer provides a minimum of 8%) and another 4% of total income may be deducted for private pension insurance (if so, the employer is obliged to pay additional 2% premium for the benefit of the eployees) .
Interest incurred on indebtedness has historically been deductible, (although the deduction of "personal" interest was largely eliminated in 1986), and in the 1950s a type of "leveraged insurance" transaction began being marketed that permitted an insurance owner to in effect deduct the cost of paying for insurance by (1) paying large premiums to create cash values, (2) "borrowing" against the cash value to in effect strip out the large premiums, and (3) paying deductible "interest" back to the insurer, which was in turn credited to the policy's cash value as tax-deferred earnings on the policy that could fund the insurer's legitimate charges against policy value for cost of insurance, etc.
Third-party liability coverages including auto liability, general liability, garagekeepers, inland marine, professional liability and workers compensation are also written with deductibles. These deductibles on commercial liability policies are known as third party deductibles or liability deductibles. Because the insured and claimant are not the same entity, insurers cannot pay the claim minus the deductible. This creates a receivable owed from the insured to the insurer. Due to the complexity of identifying these third party deductible receivables, many are often missed by the insurer causing millions of dollars to go uncollected.[4]
The second is excess-pre-hospitalization which refers to an insurance exception that is (often interchangeably but wrongly) referred to also as an excess or a deductible. It is "the first amount of the claim which the insured has to bear. If the insured has an excess of $500 and the total repair costs $3,000, then the insured has to pay $500 while the insurer pays the remaining $2,500."[3]
In China, the payroll tax is a specific tax which is paid to provinces and territories by employers, not by employees. The tax is deducted from the worker's pay. The Chinese Government itself requires only one tax to be withheld from paychecks: the PAYG (or pay-as-you-go) tax, which includes medicare levies and insurances.
The pay for a private ALT is usually less than a full-time Eikaiwa teacher and far less than a teacher from the JET Programme (¥3.36 to ¥3.96 million depending on year in the program), with some of the lowest salaries around ¥180,000 per month (¥2.16 million annually)
The Interac company ALTs/ dispatch staff make approximately ¥3600 (US $32) per hour, BUT, the ALT receives approximately half of that amount ¥1800( US$16 ) per hour before tax. Interac deducts approximately half of the monthly earnings with its justification being that it trains ALTs and incurs other administrative costs.In reality most Interac ALT's receive 5days of actual training before being dispatched to teach at schools. It is therefore a lucrative business for such companies, minimal initial investment, but constant monthly cashflow from the 3000+ active ALTs at Interac in Japan alone.If requested to attend 3 monthly briefing meetings, the pay is ¥900 per hour( US $7.00).In Japan almost every business which employs a person for 30 hours(or more ), has to pay for the employees monthly health insurance. Interac dodges having to pay health insurance for workers claiming to the government that its employees work only 29.5 hours per week instead of 30 hours. But in REALITY, employees are actually stuck at a school site or at a desk for 40hours(or more) per week {cn|date=October 16th 2018}}. Benefits and workload also vary.Elementary school ALTs are the most exhausted because they require extra 'Genki' energy to engage students and recently focus has changed with new MEXT ideologies as of March 2018 . JHS and Highschool are less energy consuming but focus more on grammar and practical use of English . Some companies pay their ALTs between semesters and some do not. Some provide benefits, such as access to employer subsidized health insurance, paid holidays, paid vacation/sick leave and unemployment insurance, and some do not.
According to Yavlinsky the global financial crisis of 2008-09 happened because of the appearance of insurance issued loans, that dramatically increased their number and volume. Since once you prove to be insolvent, your creditors will be paid the insurance. So it created an impression that the loans were safe. But the reliability of borrowers declined. When too many extremely unreliable loans were issued in the United States, at some point a lot of borrowers proved to be insolvent at the same time, so it was impossible to pay the insurance, and money no longer could return to its lenders. Thus the biggest banks and investment companies became bankrupt. To explain it in simple terms, all that is a gigantic "financial pyramid" (Ponzi scheme). It's when you take money from someone, and for some reason it doesn't work for you, but you need to pay for it, to pay interest. You borrow from someone else paying interest, then, to pay it, you borrow more, and so on and so on until it ends in failure. The enormous scale of the "financial pyramid" became possible because of too soft financial regulation on the part of the government.
The law sets out a system of public funding for health services by means of a progressive health tax, administered by "Bituah Leumi", or the National Insurance Institute, Israel's social security organization, which transfers funding to the Kupot Holim according to a certain formula based on the number of members in each fund, the age distribution of members, and a number of other indices. The Kupot Holim also receive direct government funding. Wage-earners and the self-employed must pay 3.1% of their monthly salary up to NIS 5,804 and 5% of anything earned above that. Employers are legally obligated to deduct insurance contributions from their employees' salaries, while the self-employed must arrange payment on their own. Pensioners have contributions deducted from their pensions, as do those receiving unemployment benefits. Those who are not working but have income must pay 5% of their income in health premiums, while those who are not working and have no income must pay NIS 170 a month. Only a select few categories of people are exempt from paying health premiums. Dependent minors are exempt. Housewives who do not work are exempt unless they receive a pension or their spouse receives an increment to a pension. In addition, people who immigrate to Israel under the Law of Return, and Israeli citizens who were born abroad or left as minors, and who settle in Israel are entitled to one year of free health insurance if they are not working, subject to some exceptions.
In health insurance, coinsurance is sometimes used synonymously with copayment, but copayment is fixed while the coinsurance is a percentage that the insurer pays after the insurance policy's deductible is exceeded, up to the policy's stop loss. It can be expressed as a pair of percentages with the insurer's portion stated first, or just a single percentage showing what the insured pays. The percentage due from the insured can range up to 100% (100% meaning the insured pays all costs until reaching the out of pocket maximum). Once the insured's out-of-pocket expenses equal the stop loss the insurer will assume responsibility for 100% of any additional costs. 70–30, 80–20, and 90–10 insurer-insured coinsurance schemes are common, with stop loss limits of $1,000 to $3,000 after which the insurer covers all expenses.
Before considering the payroll taxes, it is necessary to talk about the basic formula for the Net Pay. From gross pay (the salary paid to the employee) one or more deductions are subtracted, to arrive at Net Pay. Thus the employee's gross pay (pay rate times number of hours worked, including any overtime) minus payroll tax deductions, minus voluntary payroll deductions, is equal to Net Pay. Payroll tax deductions play a critical role and because they are provided by law they are known as Statutory payroll tax deductions.
Some credit card issuers (Visa, MasterCard, etc.,) offer insurance for theft or damage to rented cars. A few of the cards (noted in the table below) offer "primary" insurance, so the driver does not need to file a claim with his or her personal insurance. More cards offer "secondary insurance." This means that if the renter has personal or business vehicle insurance with appropriate coverage, then that insurance will pay first. Then the credit card issuer will pay the primary insurance's deductible and will address any large claims above the primary insurance limit.
A payslip, pay stub, paystub, pay advice, or sometimes paycheck stub, is a document an employee receives either as a notice that the direct deposit transaction has gone through, or is attached to the paycheck. Each country has laws as to what must be included on a pay slip, but which would typically include details of the gross wages for the pay period and the taxes and any other deductions the employer is required to make by law; as well as other personal deductions such as retirement plan or pension contributions, insurances, garnishments, or charitable contributions taken out of the gross amount to arrive at the final net amount of the pay, also including the year to date totals in some circumstances.
Charles Krauthammer, Columnist and Political Commentator:
"The real issue here is the fairness argument – that if you're an old fashioned store, you have to have your customers and you pay the sales tax and online you don't. Which, I mean, you're already at a disadvantage if you're an old fashioned store: you have to have, you have to cover rent, you have to cover insurance and all that. So I think you want to have something that will level the playing field. You can do it one of two ways. You abolish all sales taxes for real stores and nobody pays. Or you get the Internet people to pay the sales tax as well. I think the second one is the only way to do it, obviously." 
PAYE in Ireland includes deduction of income tax and PRSI (Pay Related Social Insurance) by employers from payments to employees. The amount is determined by employers based on a Certificate of Tax Credits and Standard Rate (Certificate) provided by Ireland Revenue (Revenue). 
Canada requires tax deduction at source on payments of compensation by employers. The deduction is required for Federal and provincial income taxes, Canada Pension Plan contributions, and Employment Insurance.
In terms of using such a plan, unlike an HMO plan, which has a copayment cost share feature (a nominal payment generally paid at the time of service), a PPO generally does not have a copayment but offers a deductible and a coinsurance feature. The deductible must be paid in full before any benefits are provided. After the deductible is met, the coinsurance benefits apply. If the PPO plan is an 80% coinsurance plan with a $1,000 deductible, the patient pays 100% of the allowed provider fee up to $1,000. The insurer will pay 80% of the other fees, and the patient will pay the remaining 20%. Charges above the allowed amount are not payable by the patient or insurer but written off as a discount by the physician.