As always, please contact your Total Benefit Solutions health insurance specialists today at (215)355-2121.
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Get assistance with your PENNIE health insurance account
Already on the health insurance Marketplace and need some help? Assigning Total Benefit Solutions, Inc is easy! Download the document and follow the steps. We will get notified and start helping you right away! Need more direction? Give us a call (215)355-2121
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Inflation Reduction Act: Eliminates Cost Sharing for Adult Vaccines in Medicare Part D and Improves Access to Adult Vaccines in Medicaid & CHIP
Medicare Part D: Eliminates cost sharing for adult vaccines covered under Medicare Part D that are recommended by the Advisory Committee on Immunization Practices (ACIP), such as for shingles Medicaid and CHIP: Requires state Medicaid and CHIP programs to cover all approved vaccines recommended by ACIP and vaccine administration, without cost sharing Have any questions regarding this notice? Don’t hesitate to contact your Total Benefit Solutions health insurance specialists today at (215)355-2121.
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New Jersey State Temporary Disability Rates Released
2023 Contribution Rates Released The Maximum Employee Contribution Rate, Employee and Employer Taxable Wage Base Officially announced on October 21th, 2022, by the NJ Department of Labor and Workforce Development. The 2023 DisabilityEmployEE Contribution Rate has been withdrawn and will be set at 0%; The 2023 Disability EmployEE Taxable Wage Base for will be $156.800 The 2023 Disability EmployEE Maximum Contribution will be $0.00 or Zero for this year. The 2023 Disability EmployER Maximum Taxable Wage Base Is $41,100. The 2023 Family Leave Insurance EmployEE Contribution rate will be .06% of the taxable wage base Contributions and Wages – January 1st, 2023 Taxable Wage & Rates EmployER EmployEE Annualized Wage… Read More
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What is a Health Maintenance Organization (HMO)?
A type of health insurance plan that usually limits coverage to care from doctors who work for or contract with the HMO. It generally won’t cover out-of-network care except in an emergency. An HMO may require you to live or work in its service area to be eligible for coverage. HMOs often provide integrated care and focus on prevention and wellness. As always, please contact your Total Benefit Solutions health insurance specialists today at (215)355-2121.
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Pennie’s Open Enrollment Period for 2023 Coverage is Around the Corner
Pennie’s Open Enrollment Period for 2023 Coverage is Around the Corner: Pennie’s Open Enrollment Period will run from November 1, 2022, to January 15, 2023. As a reminder, existing Pennie customers will be receiving auto-renewal notices this week with information on their 2023 plans. Great news! Thanks to the Inflation Reduction Act, enhanced savings continue to be available for Pennie customers and those enrolling in coverage through Pennie! As always if you have any questions or concerns please contact your Pennie health insurance experts at Total Benefit Solutions Inc (215)355-2121
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What Are Medicare Guaranteed Issue Rights?
Please contact your Total Benefit Solutions Inc Medicare health insurance specialists today at (215)355-2121 with any questions.
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CIGNA Supplemental Benefits Now Available Online
CIGNA’s Medicare supplements and dental/vision plans are available to quote and enroll online for your convenience! Just click the link below to get your quotes and as always contact your Total Benefit Solutions, Inc health insurance specialists at (215)355-2121 if you have any questions or concerns! Click here
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Inflation Reduction Act: Expands Eligibility for Full Benefits Under the Medicare Part D Low-Income Subsidy Program
The Part D Low-Income Subsidy (LIS) Program helps beneficiaries with their Part D premiums, deductibles, and cost sharing. Beneficiaries qualify for full or partial benefits depending on their income and resources. Current law: Beneficiaries qualify for full LIS benefits if they have income up to 135% of poverty and lower resources (up to $9,900 individual, $15,600 couple in 2022) Beneficiaries qualify for partial LIS benefits if they have income between 135-150% of poverty and higher resources (up to $15,510 individual, $30,950 couple in 2022) Inflation Reduction Act: Expands eligibility for full LIS benefits to individuals with incomes between 135% and 150% of poverty and higher resources (at or below the… Read More
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Why Use Medicareful to Find Your Plan?
Medicare insurance can seem complex on your own. We’re here to help! Medicareful is an easy-to-use Medicare plan finder that compares some of the available plans in your area and connects you with a licensed sales agent who will guide you through enrollment. Whether it’s a Medicare Supplement, Medicare Advantage Part C Plan, or a Medicare Part D drug plan, we’ve got you covered. https://medicareful.com/totalbenefitsolutions
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Blue KC: Employer/Group Open Enrollment Dates – Mark Your Calendar
Blue KC is pleased to offer two open enrollment deadlines – one for physical ID cards and one for digital ID cards – to provide flexibility to new and renewing groups. Benefit information and open enrollment files/eligibility updates must be submitted to Blue KC based on the following schedule to ensure new ID cards are available to members by January 1, 2023: November 1, 2022 – Paperwork Deadline November 21, 2022 – Eligibility File – Physical ID Card December 16, 2022 – Eligibility File – Digital ID Card Please note: Small groups that make plan changes after this timeframe will receive updated ID cards once their plan changes have been… Read More
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Inflation Reduction Act: Limits Monthly Copayments for Insulin in Medicare
Beginning in 2023, limits copayments to $35 per month per prescription for covered insulin products in Medicare Part D plans and for insulin furnished through durable medical equipment under Medicare Part B, with no deductible. For 2026 and beyond, limits monthly Part D copayments for insulin to the lesser of: $35 25% of the maximum fair price (in cases where the insulin product has been selected for negotiation) 25% of the negotiated price in Part D plans Please call your Total Benefit Solutions Medicare health insurance specialists with any questions or concerns at (215)355-2121.
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What is the Marketplace?
Shorthand for the “Health Insurance Marketplace®,” a shopping and enrollment service for medical insurance created by the Affordable Care Act in 2010. In most states, the federal government runs the Marketplace (sometimes know as the “exchange”) for individuals and families. On the web, it’s found at HealthCare.gov. Some states run their own Marketplace at different websites. Fill out a Marketplace application and you’ll find out if you qualify for lower monthly premiums or savings on out-of-pocket costs based on your income. You may find out if you qualify for Medicaid or the Children’s Health Insurance Program (CHIP). You can shop for and enroll in affordable medical insurance online, by phone,… Read More
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Additional Guidance on New Prescription Drug Reporting Requirement
As previously reported in 2021, Section 204 of the Consolidated Appropriations Act, 2021 (“CAA”) requires plan sponsors of group health plans to submit information annually about prescription drugs and health care spending to Centers for Medicare and Medicaid Services (“CMS”) on behalf of the Departments of Health and Human Services (“HHS”), Labor (“DOL”), and the Treasury (collectively, the “Departments”). The first deadline is December 27, 2022. CMS recently updated guidance related to this reporting requirements that proves some helpful clarification. Have any questions regarding this notice? Please contact your Total Benefit Solutions health insurance specialists today at (215)355-2121.
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Independence: What are Preventative Plus Providers?
Preventive Plus Preventive Plus providers are participating freestanding ambulatory surgical centers (ASC) and a select group of gastroenterologists and colorectal surgeons who perform preventative colonoscopy for colorectal cancer screenings at a freestanding ASC. For certain plans, the Member’s cost-share for this service will be $0 when performed by Preventive Plus providers. Please refer to your benefits booklet or contract to determine if your plan includes the Preventive Plus benefit. For updated or more detailed information regarding Preventive Plus providers, visit our website at ibx.com/provider finder, or call Customer Service at 1-800-ASK-BLUE (1-800-275-2583), Monday through Friday, 8 a.m. to 6 p.m. ET For further questions or concerns please contact your Total… Read More
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Inflation Reduction Act: Capping Medicare Part D Out-of-Pocket Spending and Other Part D Benefit Changes
Changes would lower beneficiary spending, reduce Medicare’s liability for high drug costs, and increase Part D plan and manufacturer liability for high drug costs. Beneficiaries: Eliminates 5% coinsurance for catastrophic coverage in 2024 Caps out-of-pocket drug spending at $2,000 beginning in 2025 Allows spreading out of out-of-pocket costs over the year Limits premium growth to no more than 6% per year for 2024-2030 Medicare: Lowers share of costs above the out-of-pocket spending cap (“reinsurance”) Part D Plans: Increases share of costs above the out-of-pocket spending cap Modifies share of costs below the out-of-pocket spending cap Drug Companies: Requires a price discount on brand-name drugs above the out-of-pocket spending cap Modifies… Read More
Continue ReadingDid you know about Humana’s Neighborhood Centers?
Humana Neighborhood Centers give participants a safe, friendly place to enjoy personalized health and wellness programming, connect with peers and get compassionate customer service from our world-class support team. Whether they’re visiting one of our in-person centers or taking part in our virtual offerings, members can always expect a warm, welcoming experience that provides whole human care. Watch the video below and contact your Total Benefit Solutions, Inc health insurance and supplememnt specialists for more information at (215)355-2121. Click here for more about Humana Neighborhood Centers
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Get ready for the Medicare Annual Enrollment Period with our centralized guide to AEP.
Every year, the AEP is your opportunity to enroll in or switch to a Medicare plan that fits your ever evolving health care needs. This special enrollment window only runs October 15 to December 7, so it’s important to be prepared to accomplish anything you’d like to during that time. If reviewing or changing your coverage seems a little daunting with all the different plans and benefits on the market and decisions to make, don’t worry! You don’t have to go it alone. Get Your Guide to the Medicare Annual Enrollment Period and Get ready for the Medicare Annual Enrollment Period with our centralized guide to AEP. Click here to… Read More
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Does an MSA Health Insurance Plan (Medical Savings Account) cover prescription drugs?
Does an MSA health insurance plan cover drugs? No. You A Medicare MSA Plan cannot cover prescription drugs. To cover prescription drugs when you have an MSA you must enroll in a separate policy with prescription drug coverage. You can also join a Medicare Prescription Drug Plan to help with your drug costs. As always please ask your Total Benefit Solutions, Inc health insurance expert about your Medicare prescription drug plan options at (215)355-2121 or you can shop and compare online by clicking here.
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What is a premium?
The amount you pay for your health insurance every month. In addition to your premium, you usually have to pay other costs for your health care, including a deductible, copayments, and coinsurance. If you have a Marketplace health plan, you may be able to lower your costs with a premium tax credit. When shopping for a plan, keep in mind that the plan with the lowest monthly premium may not be the best match for you. If you need much health care, a plan with slightly higher premium but a lower deductible may save you a lot of money. After you enroll in a plan, you must pay your first… Read More
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Reminder: New Cost-Sharing Disclosure in 2023
Another compliance deadline is quickly approaching. For plan years that begin on or after January 1, 2023, group health plans must provide for advance disclosure of cost-sharing information to enrollees seeking health services, upon request and to the extent practicable. The format of the disclosure is through an internet-based self-service tool, telephone, or paper format (upon request). The tool allows the enrollee to compare the amount of cost-sharing that he or she would be responsible for with respect to a discrete covered item or service by billing code or descriptive term. The required information relates to geographic region and in-network and out-of-network providers and initially addresses 500 items and services.… Read More
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3 Types of Medigap Rating Structure
Attained-Aged: Premium based on current age when policy is issued. Premium goes up as you get older AND may go up due to a rate increase. All Medigap Freedom plans are Attained-Aged rated. Issued-Aged: Premium based on the age you are when you buy (are issued) the Medigap policy. Premium DOES NOT go up as you get older AND may go up due to a rate increase. Community: Same premium is charged to everyone who has the Medigap policy, regardless of age. Premium DOES NOT go up as you get older AND may go up due to a rate increase. Call your Total Benefit Solutions, Inc Medicare health insurance specialists… Read More
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Inflation Reduction Act: Requires Drug Manufacturers to Pay Rebates for Drug Price Increases Above Inflation
Requires drug manufacturers to pay a rebate if drug prices increase faster than the rate of inflation (CPI-U) for: Single-source drugs and biologicals covered under Medicare Part B All covered drugs under Medicare Part D except those where average annual cost is <$100 2021 is the base year for measuring cumulative price changes relative to inflation The rebate amount is based on units sold in Medicare multiplied by the amount that a drug’s price in a give year exceeds the inflation-adjusted price Price changes are measured based on the average sales price (for Part B drugs) or the average manufacturer price (for Part D); these measures include prices charged in… Read More
Continue ReadingTotal Benefit Solutions, Inc appoints with Lasso Medicare Medical Savings Accounts Plans for 2022-2023 Open Enrollment Season
What is a Medicare Medical Savings Account (MSA) Plan? – A Medicare Medical Savings Account (MSA) plan is a type of Medicare Advantage plan that combines a high-deductible health plan with a medical savings account. Enrollees of Medicare MSA plans can initially use their savings account to help pay for health care, and then will have coverage through a high-deductible insurance plan once they reach their deductible. Medicare MSA plans can provide Medicare beneficiaries with more control over health care utilization, while still providing coverage against catastrophic health care expenses. Ask your Total Benefit Solutions, Inc. Medicare health insurance specialist of a Medicare Medical Savings Account could be worth considering… Read More
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