Did you know that about 14% of people ages 45 to 64 have some amount of hearing loss?* And after age 65, that rises to 30%. As you age, it’s important to stay on top of your hearing health and get your hearing tested regularly. And don’t just wait until you realize you’re having difficulty hearing others in a crowded room or on the television. Hearing loss happens gradually, so it’s important to see a doctor regularly.

Audiologists vs. Ear Nose Throat (ENT) doctors

Should you see an audiologist, or is an ENT doctor sufficient? What’s the difference?

A Doctor of Audiology diagnoses, rehabilitates and provides other services associated with hearing, balance, tinnitus management, etc. They can diagnose hearing loss and fit you with a hearing assistive device. This is who you should see if you’re having a hard time hearing high-pitched sounds, hearing people in crowds, experience constant ear ringing, or something similar.

An ENT doctor or otolaryngolist diagnoses and treats problems with the ear, nose, voice box, throat, head and neck. This is the specialist to visit if you’re dealing with bouts of dizziness, ear pain or trauma, or balance. It’s certainly possible that your hearing loss is the result of certain medications, etc. Children dealing with hearing loss from things like ear infections or allergies might visit an ENT, but that ENT doctor might refer them later to an audiologist.

If you’re concerned about changes in your hearing, your best bet is to start with an audiologist. If you’re unsure what’s wrong, you could start with an ENT doctor, who can identify the source of your hearing loss. That doctor might end up referring you to an audiologist for further testing.

Surgery vs. hearing aid treatment

Depending on the extent of the damage to your inner ear, the audiologist might suggest surgery or a hearing aid. If you’re having problems with the ear canal, eardrum, or middle ear, you’ll likely need surgery or other medical help. If your external ear is relatively normal, a hearing aid might help.

A quick overview of hearing aids

There are two main types of hearing aids: analog and digital.** These types of hearing aids have different designs and features depending on the severity of hearing loss and lifestyle.

Analog hearing aids tend to be less expensive and simple to use. They convert sound waves into electrical signals and make them louder.

Digital hearing aids are more expensive but tend to work better because they’re more powerful and sophisticated in the way they process and amplify sound. They convert sound waves into numerical codes, then amplify those codes. Most adjust automatically and the hearing aids themselves are smaller.

As for style of hearing aids, there are canal aids (smaller, fit inside the ear either partially or completely), in-the-ear hearing aids, and behind-the-ear aids.

If you’re having hearing trouble or simply want to stay on top of this, call your doctor for a referral.

*WebMD: Hearing Tests for Adults: What to Expect

**WebMD: Hearing Aid Basics

Medicare…Medicare Advantage…Medigap…what do these terms mean and what’s the difference?

Let’s first go over the basics of Medicare, which Medicare.gov describes as a “fee-for-service health plan that has two parts.” Part A is hospital insurance and part B is medical insurance. After you pay a deductible, Medicare pays its share of the approved amount and then you pay the remaining coinsurance and deductibles.

But how can you get help paying those coinsurance and deductible amounts? That’s where Medicare Supplemental Insurance—also known as Medigap—comes in.

Medigap details and requirements

Medigap policies are sold by private companies, and some cover services that Original Medicare doesn’t. When you buy a Medigap policy, it pays whatever is left to pay after Medicare covers its share of Medicare-approved health care costs. That said, there are some requirements and important-to-knows:

• You must have Medicare Part A and B to purchase a Medigap policy.
• One policy covers one person. You’ll have to buy separate policies for you and your spouse.
• The Medigap price could change depending on what age you sign up for the plan.
• Medigap policies aren’t allowed to include prescription drug coverage. That’s covered by Medicare Part D (prescription drug plan).
• Medigap policies generally do not cover long-term care, vision, or dental care, hearing aids, eyeglasses, or private-duty nursing.
• It is illegal for anyone to sell you a Medigap policy if you have a Medicare Advantage Plan, unless you decide to switch back to original Medicare.

Medicare Advantage Plans vs. Medigap

So, what is a Medicare Advantage Plan? Also referred to as Medicare Part C, a Medicare Advantage Health Plan allows you to enroll in a private health insurance plan through a company that contracts with Medicare. These plans provide all of your Part A (hospital insurance) and Part B (medical insurance) benefits and usually your Medicare Part D (prescription drug) benefits. A few need-to-knows:

• Medicare Advantage Plans can sometimes offer extra coverage like vision, hearing, and dental.
• These plans can charge different out-of-pocket costs and might have different rules for how you get services. You might need to get a referral for a specialist or see doctors that belong to the plan.
• The rules can change each year
• Medigap policies can’t work with Medicare Advantage Plans and you are not allowed to pay Medicare Advantage copayments, deductibles, and premiums with your Medigap policy.

Several choices available to you

Most clients we have who are 65 or older choose one of three options when it comes to Medicare:

1. Medicare
2. Medicare with Medigap that covers the Medicare copays and deductibles
3. Medicare Advantage (private insurance)

There are pros and cons to each of these plans depending on your needs. You should consider things like your state of health, the possibility of a large hospital bill (with lots of out-of-pocket copays and other costs), and whether you’re comfortable choosing from a pre-selected network of health care providers and doctors. Also keep in mind that Medigap coverage likely has a higher monthly premium, while Medicare Advantage Plans might have lower premiums but higher out-of-pocket costs.

Bottom line is that this decision requires some analysis of your situation and needs. Review the medicare.org site carefully and call us with questions. We’d be happy to guide you through this decision to determine what coverage is best for you!

It’s been 18 months since the Tax Cut and Jobs Act (TCJA) became law. At the time of passage many pundits predicted dire consequences for the nonprofit sector, largely due to the near doubling of the standard deduction, meaning the high threshold for deducting charitable gifts (and other items such as state/local taxes and mortgage interest) would be difficult to achieve for many taxpayers.

Here are some observations of the impact and result:

Did giving increase in 2018?

Preliminary examination of available data appears to indicate a slight (1-2 percent) increase in total giving. The growth appears to come from major donors (gifts over $1,000). The fourth quarter 2018 update from the Fundraising Effectiveness Project Report (FEP) from the Association of Fundraising Professionals (AFP) indicates a sharp drop in giving in the general donor (under $250) of 4.4 percent and in the mid-level donor ($251-999) of 4 percent. Major donor giving increased by 2.6 percent.

What evidence is out there about the impact on the TCJA on giving?

Inside Philanthropy surveyed approximately 25 charities across the United States. Some of the Inside Philanthropy findings:

• United Way in Lewiston, Maine recorded $200,000 more gifts in 2018 to a total of $1.4 million.
• Arrowhead United Way in San Bernardino, California reported approximately the same level of giving ($1 million).
• United Way in Sioux Falls, South Dakota gifts increased by 2 percent in 2018.
• Jewish Federation of Greater Phoenix broke the $5 million mark in 2018 with a total of $5.2 million, up substantially from its 2017 gift revenue of $4.4 million.
• Santa Fe Community Foundation saw a 15 percent increase in 2018 gifts and raised $8 million.
• Delaware Community Foundation increased its giving by 20 percent in 2018 to $30 million (up from $24 million in 2017).
• From the Minneapolis/Saint Paul area as reported by the Star Tribune on January 19, 2019: Many Minnesota nonprofits reported no significant changes in year-end gifts, but they also note caution is warranted as the long-term effects of TCJA remain unknown.
• Union Gospel Mission in Saint Paul saw a 1 percent decrease in its $6.5 million goal for 2018.
• Walker Art Center gifts held steady in 2018.
• Loaves and Fishes experienced a precipitous decline (31 percent) in December giving after an exceptional November (perhaps Giving Tuesday in November pulled forward gifts which would normally be made in December?), yet still finished 2018 with a slight increase.

The sector should have a far more complete picture in June with the release of the Giving USA report.

Looks like the nonprofit sector did OK in the first year. Are any other warning signs out there?

Unfortunately, nonprofits still have huge problems with 1) donor retention, 2) a shrinking donor base which causes a reliance on large philanthropic gifts, 3) turnover of nonprofit executives, and 4) increasing demand for services.

• Donor retention remains a huge problem for the nonprofit sector with the ability to retain first-year donors continuing to hover at an unsustainable level. According to the FEP’s data, first-time donor retention rate is 20.2 percent.
• The fourth quarter FEP report, which covers 2018, shows the overall retention rate at 44.5 percent, which leads to the next topic: the shrinking donor base.
• While overall giving has risen to over $410 billion in 2018, fewer people are making charitable gifts. A University of Michigan study notes a steep decline in the percentage of U.S. households giving to nonprofit organizations—from a highpoint of 67.6 percent to 55.5 percent in the past 14 years. The reliance on receiving more dollars from a smaller pool of donors represents a clear warning to nonprofits—the sector must work harder for the same, or higher, levels of gifts.

I run a small nonprofit. What are some takeaways for me?

You have limited time to devote to fund development activities. The following steps may provide you with a game plan to provide the best opportunities for success:

• Focus on donor engagement. Why do your donors give to your organization? What are their values and goals for their personal philanthropy? What difference do their gifts make in advancing your mission? Ask them. For your major donors, can you or a board member personally meet with each? Consider surveying your donors and report back the results.
• Master the art of storytelling. Put your donor at the center of the story—only the donor makes the programs work and the successes happen. How has the donor’s generosity impacted those served by your organization? Show how without those gifts, your community would not be as vibrant.
• Empower your board to tell your story. Encourage your board to ask donors why they chose your agency. What inspired their gift? Board members have enormous credibility in conversations with donors.
• Place a concerted emphasis on building a monthly giving program. Monthly gifts of $10, $20, or $50 can make powerful impacts on your services and smooth out monthly cash flow valleys. Demonstrate the value of monthly giving through giving circles, for instance.
• Make a mobile presence happen NOW! Just as online giving has become widely accepted in our sector, mobile giving is poised for a similar trajectory. According to Nonprofits Source, 25 percent of donors complete their donations on a mobile device.

How has the TCJA boosted large gifts?

One need only look at the growth in the Donor Advised Fund (DAF) industry. The Chronicle of Philanthropy (Chronicle) 2017 top 10 recipients of charitable giving were six DAFs, including two of the top five.

Closing thoughts…

• Philanthropic giving and the performance of the U.S. economy are intensely correlated. As the economy goes, so does giving. In June of 2018, the National Association for Business Economics predicted economic growth of 2.7 percent in 2019 but also voiced concerns over a new recession in 2020.
• Estate giving traditionally is slow to respond to tax changes. The doubling of the exemption to $11 million for individuals and $22.4 million for couples results in fewer estates being subject to estate taxes. Donors who face estate tax liability may increase their giving during their lifetime, create testamentary gift vehicles, or a combination.

A final word to nonprofit executives. Concentrate your efforts on donor engagement and crafting the infrastructure to allow the broadest array of communications and means of making gifts possible. Focus on relationships, not transactions!

This is an abbreviated version of “Tax Cut and Jobs Act Impact on Nonprofits,” News & Research, April 8, 2019. by John Gilchrist, Personal Fundraising Coach and Managing Principal of Philanthropy Focus LLC (dba Fundraiser Strategies).

Here’s a stunning observation from the book and multimedia project, Brain Rules: According to researchers, one of the greatest predictors of a person’s successful aging is their avoidance of a sedentary lifestyle.

That’s right: the more active you are, the more likely you are to age successfully.

The difference between being wheelchair/walker bound and thriving physically and mentally as you age is directly related to exercise. In cognitive tests measuring long-term memory, reasoning, attention, problem-solving skill and “fluid intelligence tasks,” which test the ability to reason quickly and improvise, seniors who exercised outperformed couch potatoes in cognitive tests.

A little exercise goes a long way

If you’re not eager to take up running or CrossFit, here’s some great news. Exercise doesn’t have to be strenuous to be beneficial. In fact, Brain Rules reports that:

• Just walking several times a week benefits the brain.
• Moderate exercise is better than no movement at all.
• The “gold standard” is aerobic exercise for 30 minutes, three or more times a week.
• Adding weight training provides even more cognitive benefit.

Benefits of exercise

Further, there are some impressive benefits of a regular exercise habit for your brain and well-being, not just your heart:

• A 20-minute walk each day cuts your risk of stroke by 57%.
• Exercise is highly successful in treating depression and anxiety.
• Aerobic exercise just twice a week halves your risk of general dementia and cuts your risk of Alzheimer’s by 60%.
• Exercise decreases your risk for heart disease and diabetes.

 Brain Rules said it best: “Physical activity is cognitive candy.”

It’s never too young to begin an exercise habit…and also never too late

No surprise, Brain Rules says that young children benefit from exercising in many ways. They identify visual stimuli faster than sedentary children, are less disruptive, feel better about themselves, have more self-confidence, and are less depressed and anxious. If that’s not a reason to get your grandchildren exercising, what is?

That said, if you’ve never been big on exercising, now is the time—and as mentioned already, just about any physical activity counts. Start walking and take note of how it clears the mind and fuels the soul. Pick up an easy-entry sport like pickle ball, golf, or tennis. Start that garden you’ve always wanted. Find something you like to do that involves moving and reap the benefits.

Share this article with your clients

Business owners, share these findings with your customers/clients. Better yet, form a group open to anyone that takes aerobic walks two or three times a week. And don’t forget your employees. Incorporating exercise into their workday will reduce healthcare costs and boost the collective brainpower of an organization. Brain Power suggests giving employees access to treadmills and showing them how to walk (or bicycle on a stationary bike) slowly while composing e-mails. What a concept!

Tips to fit in exercise

Try defining a successful day as one in which you get some form of exercise. Make it your #1 priority every day, and try getting it done as early in the day as possible so the day doesn’t get away from you. That way, no matter what else happens, your day was a success. Other tips to squeeze in a little exercise every day:

• When you make phone calls, hop on the treadmill or take a walk.
• Do jumping jacks while you wait for water to boil or veggies or meat to sauté.
• Keep hand weights in places where you’re normally seated and do a few reps whenever you need a mental break.
• Walk places more often.
• Take the stairs more often.
• Move (then move some more) while watching TV.

Without question, the payoff from relatively low levels of exercise is significant. It’s hard to argue that your efforts won’t be worthwhile in their impact on both your physical- and mental well-being. Make 2019 the year of your health. Get out there and do something good for your body!

The New Year has begun. Are you keeping your resolutions? One good resolution is increasing or beginning to save. Savings in any form is wise, but retirement account savings, in particular,  have some extra tax advantages, and here is the great news: the IRS has increased allowable contribution limits to many retirement account options. Here are the new year 2019 limits:

• 401(k), 403(b), and most 457 – Annual employee contributions up to $19,000, and if you’re 50+, you can make additional catch-up contributions of $6,000
• IRAs – Annual contributions up to $6,000, and if you’re 50+, you can make additional catch-up contributions of $1,000

Now, here is a quick retirement account recap:

401(k) – You’re probably familiar with the 401(k), which is a workplace retirement account that allows you to contribute money, pre-tax, straight from your paycheck. So, if you earn $100,000 and contribute $15,000 toward your 401(k), you’d only be taxed that year on $85,000.

403(b) – A 403(b) is another tax-advantaged retirement savings plan, but for public education organizations and government organizations.

What you need to know about both the 401(k) and the 403(b): 

• Investment gains grow tax deferred until you withdraw.
• Withdraw before 59 ½ and you’ll pay a penalty.
• Many companies offer a generous employee match contribution toward employees’ 401(k) plans.
• Some plans have a Roth option (which means employees can designate some or all of their elective deferrals as taxable in the year of contribution rather than the year you withdraw. The Roth tax advantage comes later when the withdrawals are never, ever taxed. 

457 – A 457 plan is offered to certain state and local public employees and certain tax-exempt entities. It works almost exactly like the 401(k) plan and has the same contribution limits, but it offers a big benefit. If your company also has a 401(k) plan, you can contribute up to the maximum into both plans. And unlike with 401(k) and 403(b) plans, the IRS will not penalize you for making withdrawals before age 59 ½. 

IRA – An Individual Retirement Account (IRA) is available to anyone, even those whose companies offer a 401(k) already. It also offers tax-deferred growth on investments (meaning assets will not be taxed until withdrawn), but you’re limited to $6,000 a year (plus an additional $1,000 if you’re 50+).

Roth IRA – Taxpayers can choose a Roth IRA instead of an IRA, or contribute to both an IRA and a Roth IRA as long as the combined amount doesn’t exceed the $6,000 for 2019 (plus $1,000 for those 50+). Reminder: Roth distributions are tax free (you’re paying tax upfront), whereas traditional IRA distributions are subject to taxation when you take those distributions. 

SEP IRA – A Simplified Employee Pension (SEP) plan is available to any size business and allows for contributions of up to 25% of each employee’s W-2 earnings. Its maximum contribution limits are $56,000 for 2019 (plus an additional $3,000 catch-up contribution for those 50+). Down the road, you can convert your SEP IRA to an Individual 401(k).  

SIMPLE IRA – A Savings Incentive Match Plan (SIMPLE) IRA acts a lot like a traditional IRA but has a contribution limit of $13,000, with a catch-up contribution of $3,000. Elective deferrals work just like a 401(k) plan. These plans are only available to companies with 100 or fewer employees, and once they’re set up, employers have to make certain contributions to their employees’ accounts every year.

That’s a quick rundown of some of the most common retirement plans, but there are others: defined benefit plans, money purchase plans, and governmental plans, to name a few. Questions? Contact us, 720.635.3180 or send an email via the web interface to learn more about the different types of retirement plans and what might work best for your company.

If you’ve been contributing to a traditional IRA or other defined contribution plan, you will want to pay close attention to the rules regarding distributions. While you can withdraw money from your IRA anytime, you need to be under age 59 ½ to do so without the 10% tax penalty.

But how about required minimum distributions? When do those begin and what do you need to know?

At age 70 ½, you must start taking annual distributions. You need to do this by April 1 following the year that you turn 70 ½ and by December 31 of later years. This number is calculated based on your retirement account balance and a distribution period that comes from the IRS’s Uniform Lifetime Table (other tables are used depending on your age and whether you inherited the IRA or were the original owner).

If you don’t take the required withdrawal after you turn 70 ½, the penalty is 50 percent of the amount that should have been withdrawn. When you take these distributions, they are taxable…unless you make a charitable contribution.

Giving to an eligible charity is a great way to meet the annual minimum distribution requirement while supporting organizations that you support already. You can transfer up to $100,000 a year directly to a charity without paying income tax. If you’re filing a joint tax return, the figure is $200,000. You must make these charitable contributions by December 31. The distribution is called a QCD, a Qualified Charitable Deduction.

A few things to keep in mind:

• Doing this satisfies the annual minimum distribution requirement for your IRA.
• There is no minimum distribution requirement for Roth IRAs, but the requirement stands for traditional IRAs, SEP IRAs, SIMPLE IRAs, 401(k) plans, 403(b) plans, 457(b) plans, profit sharing plans, and other defined contribution plans.
• You cannot double dip and claim a charitable contribution tax deduction when you make a distribution to a charity from your IRA.
• You can only make this charitable contribution tax free from your IRA, not from a 401(k) or similar type of retirement account.
• If you have money in a 401(k), you could transfer the money into an IRA and then make a tax-free charitable contribution from there.
• If you have inherited an IRA, there are a few things to consider, so be sure to reach out to let us know. You’ll use a different table to calculate your minimum distribution amount if you are 10 or more years younger than the IRA’s owner, and rules are different if you were not a spouse of the IRA owner. Call us to discuss.

Questions about the annual minimum distribution requirement? Contact us today.

Barbara Bush, who died on April 17, 2018, at the age of 92, led a rich, fascinating life.  She was known for her compassion and wit. Historian Jon Meacham said that during her final days in the hospital, Bush jokingly asked a nurse if she wanted to know “why George W. turned out the way he had.” Her reply: “I smoked and drank while I was pregnant.”

The story most often used to illustrate her kindheartedness is when she encouraged her husband to visit an AIDS clinic during his 1988 campaign for the presidency—at a time when there were many misconceptions about the disease. The following year as First Lady, she spent time at Grandma’s House, one of the first homes created to care for infants infected with HIV. Mrs. Bush’s efforts did a great deal to change public perception and remove some of the stigma and misunderstanding about HIV/AIDS.

Planning ahead in the hardest times

Nobody likes thinking about their death, but Mrs. Bush was thoughtful about her own end-of-life desires. Before she died, her family released a statement that she had made her wishes clear, and she would spend her final days at home with her family utilizing “comfort care,” which is more commonly known as palliative care.

What is palliative care?

Palliative care is specialized medical care for people with a serious illness. It focuses on delivering relief from the symptoms. Instead of seeking continued medical treatment for her congestive heart failure and chronic obstructive pulmonary disease, Mrs. Bush sought comfort in her final days.

According to reports, her decision did not come as a surprise to her family. After all, Mrs. Bush assisted in founding the hospice program at the Washington Home for chronically ill patients. Still, her decision has put both palliative care and the need for end-of-life planning in the national spotlight.

Open the lines of communication with your family

It isn’t easy to talk with your family about end-of-life matters, but it is so important. Leaving this topic undiscussed could put your family in the dark and force them into a difficult, uncomfortable situation. Worse, if your family is unaware of your intentions or unclear on who should handle certain medical decisions, arguments can erupt and even lead to unfortunate legal battles.

Don’t put your family in a difficult position. We admire Barbara Bush’s approach to the end-of-life matters that so many of us are afraid or uncomfortable to broach. If we can help, don’t hesitate to contact the team at Moran & Long.

1. Get copies of statements. It’s a good idea for you to have copies of recent statements, and if possible, login and password information for your parent’s bank and other investment accounts. Monitor these accounts periodically for any abnormal purchases or other areas of concern.
2. Confirm all legal documents are up-to-date. Offer to keep copies of your parent’s will, power of attorney, and health care proxy information. This will give you the opportunity to check whether these items are current—or whether your parent has them in place at all.
3. Set up automatic banking and bill pay. Certain tasks like sorting mail and keeping track of bills can overwhelm older parents as they age. Offer to assist by putting a few systems in place that make things easier and ensure important financial documents don’t get misplaced or overlooked.
4. Discuss financial scams. Sadly, millions of older Americans fall victim to scammers every year. Talk with your parent about the types of fraudulent situations to be aware of: people claiming to be calling from the IRS, the bank, the credit card company, or even the government, or people showing up at their front door asking for personal financial information.
5. Sit down once a month. When all else fails, offer to sit down with your parent once a month to go through any piles of mail, review bank statements, and discuss any concerns. It’s natural that your parent might feel hesitant to give up control of this aspect of their life. Initially, simply offer to help.

Your obvious goal is to act in your parent’s best interest, but take a “baby step” approach. Assure your parent that your intent is to help and make things easier on them, not take over. If you need assistance, contact Moran & Long. We’d be happy to offer ideas and suggestions for how to start this important conversation.

When developing your will and estate plan, you’ll need to designate various fiduciary roles including guardian, custodian, executor, trustee, and agent. Here’s a quick overview of these different designations (thanks to the American Bar Association glossary):

Guardians are most commonly referenced in a person’s will when they name the person(s) who will care for the financial and physical well-being of their minor-age children when they die. However, a guardian could also be appointed by court order when a person becomes incapacitated, or a considered a “protected person” who has demonstrated behavioral deficits regarding their estate affairs. An example might be someone with dementia who is no longer able to manage their affairs.

Custodians, on the other hand, are appointed to manage the assets of a child until the child is of the appropriate age to do so themselves. This role exists because minor children cannot inherit money or assets outright, making the custodian necessary.

Executor – The individual appointed to carry out the terms of a will and administer your estate when you die (also called a personal representative).

Trustee – The individual (or bank or trust company) designated to hold and administer any trust property (also called a fiduciary). The trustee has the duty to act in the best interests of the trust.

Agent – This refers to the person who is authorized under a power of attorney agreement to act in your place as agent or attorney-in-fact with respect to all legal and financial matters. In a health care power of attorney, for example, the agent could make any health care decisions should you be incapacitated.

There’s a lot to understand when it comes to estate plans. If you’re reviewing yours now to ensure it covers your bases now and in the future, it’s smart to consult an attorney. Call Moran & Long if you need help connecting with a legal representative who understands estate planning for seniors, federal and state estate tax laws, “elderlaw”, and related matters.