The 2014 Group Health Plans Notices Calendar in now available! All-in-One Health Plan Notices Calendar and Downloadable Model Notices Our 2014 calendar provides bottom line information on group health plan required notices and filings, including who must receive them, who must provide them and when notices are due. At last, the notices you need are available in one convenient location, including: Health Care Reform Notices (includes new SBC template for 2014 and information on required PCORI filings) COBRA Notices HIPAA Notices (includes information on elimination of creditable coverage certificates and new model Notice of Privacy Practices) Special Health Care Notices (Women’s Health and Cancer Rights, Mental Health Parity… Read More
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Health Reform:Legislative Update-Relief for Small Groups Under the Affordable Care Act (ACA)
On Monday, Congress and President Obama together repealed one of the Affordable Care Act’s most onerous provisions, which prohibited so-called “small groups” (mostly groups with less than 50 employees) from offering health plans with deductibles higher than $2,000 for single coverage and $4,000 for family coverage. This comes as very welcome news to small businesses, who are frequently the most in need of additional options and flexibility when it comes to offering employees comprehensive, affordable health insurance via higher deductibles and other cost-sharing mechanisms. It is also great news for employers wanting to couple their insurance plans with health reimbursement arrangements (HRAs), which federal agencies previously rejected as permissible ways… Read More
Continue ReadingEd MacConnell earns Voluntary Benefits Certification
We are pleased to announce that Edward T MacConnell, President of Total Benefit Solutions has earned the certification of Certified Voluntary Worksite Professional from the National Association of Health Underwriters. Voluntary/Worksite products are not new to the employee benefit industry. However, the surge of interest in these products has accelerated as employers seek ways to help attract and retain talent. The industry has responded swiftly with new products, new features, new enrollment technologies and many changes to the underwriting rules of these products. This has created new responsibilities for agents, brokers and consultants as advising clients in this area will differentiate their value to the consumers they serve. Certified Voluntary Worksite… Read More
Continue ReadingHR4302 Bill Passes: Repeals limitation on deductibles for employer-sponsored health plans
On March 31, 2014 President Obama signed into law Bill HR4302 – Protecting Access to Medicare Act of 2014, sometimes called the “Doc Fix” bill. While the primary purpose of this bill was to prevent the automatic cuts to physician Medicare payments, this bill also included a significant modification to the Affordable Care Act (ACA). This bill included a section that ends the limitations on deductibles that were set at $2,000/individual and $4,000/family within the ACA on small group employer sponsored health plans, and made the effective date retroactive to the original enactment of the ACA. The act states: SEC. 213. ELIMINATION OF LIMITATION ON DEDUCTIBLES FOR EMPLOYER-SPONSORED HEALTH PLANS.… Read More
Continue ReadingDOES CMS, HHS, IRS, or The WhiteHouse CARE?
Wayne Schellhaas asks a very good question, “Does CMS Care?” We need direction and we need it FAST! For most of us we are sleep deprived and some physically sick. I received phone calls up to midnight last night asking for help enrolling in healthcare.gov. Not because they were waiting until the last minute, but because the very 1800 number, CMS wants us to have people call, gave them the run around since November 2013!! We need more than this – some people never received the email saying the account was confirmed, the system stopped sending emails to confirm accounts, the system wasn’t up to even set up accounts. I… Read More
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HHS to Extend Marketplace Enrollment Deadline
The Washington Post has reported that HHS has released regulations extending the Marketplace open enrollment deadline to around mid-April for individuals who began, but did not complete, a Marketplace application. The extension appears to be based on a self-certification (honor) system, in which individuals attest that they could not timely complete the Marketplace application before the March 31 deadline. This extension may have an impact on employer-sponsored plans to the extent individuals have more time to elect Marketplace benefits and therefore may decline employer-sponsored coverage at the next OE. Keep in mind that IRS cafeteria plan rules currently do not recognize enrollment in a Marketplace plan as a qualified status… Read More
Continue ReadingMy Experience with Obamacare: A Freelancer Applies for Health Insurance
Our friends at Zane Benefits recently shared this comic and I enjoyed it so much I thought you might like it too: Click here to see the rest of the comic on zanebenefits.com Click here to see the rest of the comic on zanebenefits.com
Continue ReadingAffordable Care Act: Open Enrollment ENDS at 11:59PM EST on March 31, 2014
Open Enrollment ENDS 11:59PM EST on March 31, 2014 · 2014 Penalty is $95 or 1% of your income, whichever is GREATER · A single person making between $11,490 and $45,960 will receive a subsidy to help you purchase insurance · NO one can be turned down · NO health questions · You can enroll on the www.healthcare.gov and do everything yourself or a licensed independent broker, like Total Benefit Solutions Inc. can assist you with choosing a plan that is PERFECT for YOU, on the marketplace or off. Independent brokers are licensed, certified and insured. A Broker is also FREE & CONFIDENTIAL! Call us before the end of open enrollment 1(800)924-6718
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Crozer-Keystone Health System No Longer In Network with Cigna-Healthspring MAPD Plans
Please be advised of a change in the Cigna-HealthSpring provider network which may impact some of your customers. Starting May 1, 2014, Crozer-Keystone Health System will no longer be available to Cigna-HealthSpring members for hospital, home health or ancillary (surgery and other similar treatments) services. In a few days, we will mail the attached letter to the affected membership to advise them of this change. Please note that Crozer-Keystone health system primary care and specialty group doctors are still part of the Cigna-HealthSpring network. Only hospital, home health and ancillary services are leaving the network beginning May 1, 2014. Cigna-HealthSpring members currently under an active treatment plan may continue to… Read More
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Small Business Health Care Tax Credit FAQs
Small employers that pay at least half of the premiums for employee health insurance coverage under a qualifying arrangement may be eligible for the small business health care tax credit. The credit is specifically targeted to small businesses and tax-exempt organizations that primarily employ 25 or fewer workers with average income of $50,000 or less ($50,800 for calendar year 2014). To be eligible, you must cover at least 50 percent of the cost of single (not family) health care coverage for each of your employees. You must also have fewer than 25 full-time equivalent employees (FTEs). Those employees must have average wages of less than $50,000 (as adjusted for inflation… Read More
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Client Review: Media Components
My company has been with Total Benefits Solutions for years. Ed and his knowledgeable team of brokers is a great resourc…e for all type of medical insurance and coverage. Thanks for the great service throughout the years! -Denis Sinelkov, President Media Components, Inc
Continue ReadingClient Testimonial: Mike Hilbert
Ed, thank you for your recent endorsements. And especially thank you for helping my wife and I sail through the new Affordable Care Act. You and your team made the complicated seem simple and select the plan best suited for our health insurance needs. Thanks again!! Mike Hilbert Sales Pros for Hire PS- I have already received and paid my April payment and can print temporary insurance cards from the website.
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Humana: My Medicare Answers
Humana introduces mymedicareanswers.com MyMedicareAnswers.com is an unbiased online community intended to educate, engage and capture conversations around the Medicare decision making process, ultimately offering clear, concise guidance to users – See more at: https://www.mymedicareanswers.com
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2014 Updated Medicare Deductibles & Official Medigap Handbook
Click the link below to download an updated sheet with the Medicare deductibles for 2014. Download also includes the official CMS Handbook Choosing a Medigap Policy: A Guide to Health Insurance for People with Medicare. Click this link to download: BA9917ST (04-13)_lo res
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The Truth Agents/Brokers & FFM Navigators The Patient Protection and Affordable Care Act
The Truth Agents/Brokers & FFM Navigators The Patient Protection and Affordable Care Act Shared with permission from B. Ronnell Nolan, HIA, CHRS-President/CEO – HAFA Financial Media Group, LLC, Centennial, CO, compiles this information annually. There are approximately 1.2 million licensed insurance agents nationally. The 1.2 million does not include the staff of licensed agents employed throughout the United States. After adding the staff, imagine the millions of people that Agents represent, educate and protect on a daily basis! With the passing of the ACA, Health Agents for America, Inc. was formed to create a tool box for Agents to use in educating the citizens of their local communities. HAFA is known to… Read More
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Feds: Navigators don’t need E&O coverage
Enclosed in the 279 pages of proposed rules released Friday by the Department of Health and Human Services for the public health insurance exchanges is an answer, sort of, to a question brokers have raised for more than a year — who will be liable for navigators’ mistakes? n the section of the rules discussing navigators, the Obama administration’s document says “a state or an exchange must not require that all navigators be agents or brokers or carry errors and omissions coverage.” Further, the rule says that if navigators were to be required to carry E&O insurance, this would disqualify them from being considered a “community and consumer-focused nonprofit group.” Federal law… Read More
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IBC: Important Changes Regarding Medicare Part B Exclusion
From IBC November 2013: We are writing to let you know that we will be contacting your group customers to communicate the Medicare Exclusion and application of this exclusion to their benefit plan. What is the Medicare Exclusion? The Medicare Exclusion applies to members for whom Medicare would be the primary payer but they have not elected to enroll. These members will be responsible for paying their doctor, hospital, or other medical professional the amount Medicare would have paid and any applicable copayments, coinsurance, and deductibles. In turn, their group health benefit plan will only pay the remaining balance on claims submitted as if the member had enrolled in Medicare… Read More
Continue ReadingIBC: Small Group Metallic Plans Mapping
Upon renewal in 2014 small groups will be automatically “mapped” to a new ACA compliant metallic plan. Find your new recommended 2014 Blue Solutions plan using the chart below. To make your renewal even easier we’ve identified the plan that most closely matches your current plan. Or you can choose from among 36 other options to suit your needs. More comprehensive coverage Blue Solutions health plans now cover Essential Health Benefits like pediatric dental and vision. Your health plan also continues to cover doctor visits, hospital admissions, emergency room treatments, maternity care, lab tests, X-rays, prescriptions, and vision benefits for both children and adults. Click the link below to download the… Read More
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IBC: Medicare as Secondary Payer
Medicare Secondary Payer (MSP) requirements determine when Medicare is the primary insurance payer. If your company has 19 or fewer full- and part-time employees, Medicare is almost always primary. If your company is larger, various rules apply to determine whether your group plan is the primary or secondary payer. MSP requirements also apply for Medicare-eligible employees who are disabled or have endstage renal disease. The following information provides a summary of the MSP requirements. This information may help you to correctly target benefits for your Medicare-eligible participants and avoid potentially costly penalties and litigation. You should, of course, also refer to the actual laws and regulations with the assistance of your own legal counsel. Click… Read More
Continue ReadingHow Does a Group HRA Work?
A GroupHRA allows you to use your payroll to bring your employees better, more affordable employer health benefits. Your employees have a high deductible group health insurance policy and receive tax-free reimbursements through their payroll for medical expenses. In addition to payroll reimbursement, you can also make same-day reimbursements to employees by cash, check or direct deposit. Total Benefit Solutions Inc has partnered with Zane Benefit services to provide our clients an affordable, easy, electronic administration solution. What makes an HRA an attractive solution for your organization? The fact that you are in control! Download the report :How A Group HRA Works Click here for more HRA information
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Health Reform: Regulations Issued on Waiting Periods
For plan years beginning on or after January 1, 2014, a group health plan and an insurance carrier offering group health insurance coverage may not apply any waiting period that exceeds 90 days. This rule applies to both grandfathered and non-grandfathered plans. It should be noted that nothing in the Affordable Care Act requires a group health plan or carrier to have a waiting period Click here to download the bulletin
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IBC: New Lab Provider Effective July 1-IMPORTANT NOTICE
Independence Blue Cross (IBC) has selected Laboratory Corporation of America® Holdings (LabCorp), as its exclusive, nationally-based provider of laboratory services, effective July 1, 2014. The change applies to all Personal Choice®/PPO and Keystone Health Plan East product lines, and affects all individual, group commercial, and Medicare members, for services rendered in the Philadelphia five-county area, and in the contiguous counties. Effective July 1, 2014, Quest Diagnostics laboratories will be an out-of-network provider for Personal Choice and Keystone Health Plan East. IBC will continue to contract with certain local and regional laboratories… Click to download the bulletin
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IBC: July 1 rate increase for individual medically underwritten plans
IBC: We want to let you know that the monthly rates for our individual medically underwritten plans will increase in July 2014. We are notifying members muchearlier than is required to give them the opportunity to enroll in a plan that is compliant with the Affordable Care Act (ACA). The reason for the rate increase. We understand that it can be difficult to afford quality health insurance coverage. While we continue to work hard to keep costs down, the cost of health care continues to rise along with our member utilization. This is why it’s necessary for Independence Blue Cross (IBC) to implement an 11.5 percent rate increase. Click the link below to read… Read More
Continue ReadingImportant: Change to PACE and PACENET Income Limits
Effective February 7, a new law was passed that greatly benefits Medicare beneficiaries who may be eligible for PACE and PACENET. Although the annual income limits will remain the same, the Medicare Part B premium ($104.90 per month for most beneficiaries) is no longer part of the countable income of a Medicare beneficiary. This new law will result in thousands of additional beneficiaries becoming eligible for prescription drug coverage. What this means for beneficiaries Beneficiaries who may have been over the PACE/PACENET income limits by $1,259 or less, may qualify under the new law and should reapply. If a beneficiary reapplies and now qualifies for PACE/PACENET then the beneficiary is… Read More
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Client Testimonial: Aaron G
We love making our clients happy! I received this email just the other day and I wanted to share. This client had an abundance of trouble enrolling through the healthcare.gov website until we got involved: Dear Jennifer – thanks so much for everything! I’m so happy to be insured and I couldn’t have done it without you! Aaron G
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