Total Benefit Solutions Inc

Free Series for Small Business Owners to Help Understand the Law

August 13, 2013August 13, 2013Ed MacConnell

Free Series for Small Business Owners to Help Understand the Law The U.S. Small Business Administration (SBA), together with the Small Business Majority (a national nonprofit advocacy organization), has launched theAffordable Care Act 101 Weekly Webinar Series. The webinars feature guidance on key pieces of the law for small business owners provided by SBA representatives, followed by a question and answer period. Topics being discussed in the webinars include: Small business tax credits—who is eligible and how to claim the credit; Shared responsibility (also known as “pay or play”); Cost containment; and Tools and resources available for small businesses to learn more about the law. The… Read More

What are voluntary benefits?

August 13, 2013August 13, 2013Ed MacConnell

Why are voluntary benefits a good idea to supplement your core benefits? Click here to watch this short, informative video….

Final Guidance on Contraceptive Coverage Released

August 13, 2013Ed MacConnell

The Affordable Care Act requires non-grandfathered group health plans to cover certain preventive services without cost-sharing. Effective for the first plan year that began on or after August 1, 2012, this requirement includes coverage of all FDA-approved contraceptive methods, sterilization procedures and patient education and counseling for all women with reproductive capacity, as prescribed by a health care provider. The Departments of Labor, Treasury and Health and Human Services issued a final rule addressing the contraceptives mandate for religious employers and nonprofit religious organizations, discussed briefly below. Generally speaking, the final rule follows the proposed rule, with a few modifications. Click here to download the final details on Contraceptive… Read More

Limit on Consumer Costs Is Delayed in Health Care Law

August 13, 2013August 13, 2013Ed MacConnell

WASHINGTON — In another setback for President Obama’s health care initiative, the administration has delayed until 2015 a significant consumer protection in the law that limits how much people may have to spend on their own health care. The limit on out-of-pocket costs, including deductibles and co-payments, was not supposed to exceed $6,350 for an individual and $12,700 for a family. But under a little-noticed ruling, federal officials have granted a one-year grace period to some insurers, allowing them to set higher limits, or no limit at all on some costs, in 2014. The grace period has been outlined on the Labor Department’s Web site since February, but was obscured… Read More

New Tool Provides Guidance on Health Care Changes

August 13, 2013August 13, 2013Ed MacConnell

New Tool Provides Guidance on Health Care Changes A new interactive “wizard tool” is available online from BusinessUSA to help employers understand the changes that may affect their companies under Health Care Reform. The tool is simple to use. Business owners can input information regarding company size, location, and whether they currently offer insurance to their employees. Based on the employer’s responses, the tool generates guidance on Health Care Reform changes and other health care-related resources relevant to the employer’s business. Other useful information and services for business owners can be found on the BusinessUSA website.

What’s up with Medicare these days?

August 3, 2013July 29, 2013Ed MacConnell

Let’s face it, even though Medicare provides health coverage for 49 million Americans, the program itself isn’t all that easy to understand. That’s why AARP Illinois State President Merri Dee and AARP Illinois staff member and Medicare expert Courtney Hedderman got together this week for a question-and-answer session with about 1,500 of our members through a tele-town hall. Here are some of the questions asked during the call and the answers. Q: I’ve heard that the new health care law makes changes to Medicare, can you explain those changes? Click here for the story on the AARP Medicare Blog

New notice explains effect of employer mandate changes

July 30, 2013July 30, 2013Ed MacConnell

The employer penalty provisions and two reporting requirements under the Affordable Care Act have been delayed until 2015. Although Notice 2013-45 was released, it does little to expand on the earlier announcement of the delay. The Notice does provide further guidance on the transition relief that operates to delay these provisions. It is important to note that the employer penalties and applicable reporting requirements will be fully effective in 2015. The Notice confirms the following: Click to download and read

8 components of a health care exchange

July 29, 2013July 25, 2013Ed MacConnell

As an employer, there’s a lot you need to know in order to decide whether or not to offer health care through a health insurance exchange. But before you make a decision….click to read the story

How the ACA Helps Medicare’s Disabled Beneficiaries

July 29, 2013July 29, 2013Ed MacConnell

The Affordable Care Act, which was passed in 2010 and upheld by the U.S. Supreme Court in 2012, includes numerous provisions that impact people with disabilities through expansions of Medicaid, private health insurance reforms, new care coordination programs and efforts to transition elderly and disabled populations from institutional to home and community settings. The ACA: Click here for the story on Medicare News Group

IPad Model Can Make Health Law Sign-Up Simpler

July 25, 2013July 25, 2013Ed MacConnell

(Bloomberg) — As a central part of President Barack Obama’s health-care law, Americans will soon be able to obtain insurance through federal exchanges. But how, exactly, will people apply for coverage? Click here for the story…

SHOP Rules Finalized, Enrollment Forms Simplified

July 25, 2013February 6, 2022Ed MacConnell

The Small Business Health Options Program’s (SHOP) place along the Affordable Care Act’s (ACA) timeline. It’s now being packaged for mass consumption and soon will be stocked on store shelves across all 50 states. Click here to read more…

New York Health Exchanges Offer 50% Drop in Premiums

July 24, 2013February 6, 2022Ed MacConnell

Empire State approves plans to be sold by 17 insurers and lower expected premiums may ease fears that next year’s implementation of the biggest parts of the Affordable Care Act would send prices soaring… Click here to read the story

IBC: Important change to claims processing for PPO plans

July 22, 2013February 6, 2022Ed MacConnell

Independence Blue Cross (IBC) will begin notifying customers later this week regarding a change in how claims for certain out-of-network providers will be processed under their IBC Personal Choice® PPO health plan. This change impacts fully insured, self-funded, and Individual commercial Personal Choice® PPO plans only. There is no impact to Medicare plans. Effective November 1, 2013, members who have claims submitted by providers who participate in the Highmark Blue Shield (Highmark) professional provider network inside IBC’s five-county service area will be subject to higher out-of-pocket costs and may also be subject to balance billing. Currently, claims submitted by a participating Highmark professional provider are processed as out of network and applied… Read More

Health Reform: Research Filing Fees Due July 31

July 20, 2013February 6, 2022Ed MacConnell

The Research Fee filing deadline is July 31, 2013 for self-funded medical plans and HRAs Insurance carriers will report and pay the Fee for fully insured plans. If an employer has several self-insured arrangements with the same plan year, they are subject to a single fee. An HRA integrated with a self-funded plan providing major medical coverage will not incur a separate fee specific to the HRA if the HRA and plan are established or maintained by the same plan sponsor. Click below to download the bulletin Research Fees Due Interested in our free Health Care Reform Checklist? send an email

Health Reform: Aetna to distribute MLR rebates

July 19, 2013February 6, 2022Ed MacConnell

By August 1st, Aetna is scheduled to mail rebate notices and checks to policyholders and subscribers whose plans are due a rebate under the Minimum Medical Loss Ratio provision of the Affordable Care Act. For group plans, rebate checks will be sent to the policyholder, with few exceptions. Please click the link below to download the bulletin. Click to download

NJDOBI Issues Amendments to Rating Rules under PPACA

July 19, 2013February 6, 2022Ed MacConnell

NJDOBI Issues Amendments to IHC and SEH Rating Rules under PPACA For rates applicable to all rating periods beginning on or after January 1, 2014, carriers are directed to: Formulate rates in the IHC market to achieve a required 300 percent maximum ratio between premiums for the highest rated individual policyholder and the lowest rated individual policyholder in the State. Age factor categories should be in the following increments: children ages 0 through 20, one-year age bands for adults ages 21 through 63, and a single age band for adults ages 64 and over; Formulate rates in the SEH market without regard to gender. Age factor categories should be in… Read More

Health Insurance Marketplaces (Exchanges): Informational Video

July 17, 2013February 6, 2022Ed MacConnell

Beginning in 2014, individuals and small businesses with up to 50 employees can purchase insurance through online exchanges, also called “health insurance marketplaces.” Each exchange will offer a choice of health plans that meet certain benefit and cost standards. In 2016, businesses with up to 100 employees will be able to participate. Coventry Health/Aetna recently released this easy to understand video that may help you understand the new exchange or” marketplace” system of buying health insurance. Click here to watch the six minute long video.

Medicare: What Will Happen to Doctors’ Fees and Income Under the Affordable Care Act (ACA)?

July 17, 2013February 6, 2022Ed MacConnell

Q:What Will Happen to Doctors’ Fees and Income Under the Affordable Care Act (ACA)? A: Business income has increased for doctors because many people on Medicare are now using free screenings and an annual “wellness visit” provided through the Affordable Care Act (ACA). Through Oct. 6, 2011, the government said, 20.5 million people enrolled in Medicare had received the free screenings or the annual visit, which is also free. Medicare is now offering a 10 percent bonus payment on the fees charged for primary care services, and a 10 percent bonus payment to surgeons who work in areas where there are shortages of doctors. For 2013 and 2014, Medicaid payments… Read More

New Employee Assistance Plan PLUS!

July 17, 2013Ed MacConnell

Our Employer & Employee Assistance Program is more than an EAP, it’s like having 5 specialized consultants in 1 – and on call 24/7, AND it’s available for groups down to only 2 employees! Click the link below for the details. EAP BROCHURE 2013

Total Benefit Solutions Newest Brochure

July 11, 2013February 6, 2022Ed MacConnell

Download our latest brochure to read all about the valuable services we provide for our clients! Download our latest employee benefits brochure

Final Wellness Regulations Issued for Health Reform

July 11, 2013Ed MacConnell

The Departments of Treasury, Labor and Health and Human Services issued final regulations regarding nondiscriminatory wellness programs in group health coverage under the Affordable Care Act. The final regulations generally apply to group health plans and carriers for plan years beginning on or after January 1, 2014. There are some exciting components to the benefits of having a group wellness plan as part of your benefits package after January 2014! Click here to download Final Wellness Regulations Update

PPACA employer mandate delayed until 2015

July 2, 2013February 6, 2022Ed MacConnell

PPACA employer mandate delayed until 2015 The Obama administration unexpectedly announced Tuesday it is delaying the employer mandate under the Patient Protection and Affordable Care Act until 2015. The mandate — which requires mid-sized and large employers to offer health insurance coverage to their workers — was one of the main requirements of the health care overhaul that was set to go into effect Jan. 1, 2014. But the Treasury Department announced Tuesday that it would delay its enforcement an entire year after hearing numerous concerns from employers about the challenges of its implementation. “We have heard concerns about the complexity of the requirements and the need for more time to implement… Read More

Prodigy Learning Center’s Executive Director is a Happy Client

June 15, 2013February 6, 2022Ed MacConnell

Hi Ed, I just wanted to let you know how great (our account manager) has been with our insurance issues. She has been so helpful to me. I don’t know if people take the time to tell you when your staff is doing a great job, but I wanted to let you know. She is great!! Thanks. Christine Viteo, R.N. Executive Director Prodigy Learning Center Philadelphia, Pa.19132

EMA Group to become Total Benefit Solutions Inc!

June 15, 2013February 6, 2022Ed MacConnell

The health insurance industry is on its way to a major overhaul by the end of this year. With the implementation of the Patient Protection and Affordable Care Act (PPACA), nearly every American will be affected by the new law and many already have. With this in mind, we have decided to refocus our efforts to better serve our clients in alignment with the new world of health benefits. We are proud to announce that beginning August 1, 2013; EMA Group Inc. will be known as Total Benefit Solutions Inc. Although our name is changing; our commitment to provide top notch guidance and support to our clients will never change.… Read More

IBC Requesting tobacco data

June 15, 2013February 6, 2022Ed MacConnell

Under the Affordable Care Act (ACA) and effective January 1, 2014, insurers are permitted to use the following four categories to determine premiums: Age Family Size Geography Tobacco To comply with this provision, IBC will be implementing a new process to collect tobacco usage as part of their rating methodology for groups with 2-50 employees and sole proprietors. Over the next several days, IBC will send letters to employers with January 1, 2014 renewal dates to gather this information. In the mailing, there will be a letter and a Tobacco Use Form, that must be completed for each of their employees and dependents age 21 and over… Read More

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