Insurance Carrier News – Page 13 – Total Benefit Solutions Inc

An Update on Short Term Medical Plans

October 17, 2017October 17, 2017Ed MacConnell

President Trump recently signed an executive order asking the Secretaries of the Treasury, Labor and Health and Human Services to consider the expansion of availability of Short Term plans. These departments have 60 days to propose regulations or revise current guidance. We expect additional details to become available soon and will keep you updated as more information becomes available. While short term plans are not for everyone, they do meet an important need for consumers looking to avoid gaps in coverage. Of the short term plans available in the market, we encourage you to consider United Healthcare’s short term plans as they represent a name you know, and they are… Read More

Total Benefit Solutions Partners with Clover Health

October 15, 2017Ed MacConnell

New to Bucks County this year, Total Benefit Solutions is proud to announce that we have added Clover Healthg to our list of outstanding Medicare partners. Ask us during your briefing if Clover Health is a good fit for you!

Total Benefit Solutions Recertifies with Humana Medicare

September 10, 2017September 10, 2017Ed MacConnell

Once again Total Benefit Solutions will be offering Humana Medicare Advantage Plans, Medicare Supplements and Medicare Part D PDP Drug plans as we have recertified with Humana. Ask us today if a Medicare plan from Humana might be a good fit for you. Watch this short video to learn more about Humana PDP plans.

Can I Work and Have Medicare?

September 10, 2017Ed MacConnell

Some individuals, maybe even you, will still be actively employed upon becoming eligible for Medicare. Can you enroll in Medicare while you’re still in the work force, and if not, will you get a penalty? If the employer has fewer than 20 employees, you’ll probably want to enroll in Parts A, B, and D upon becoming eligible for them. In this situation, Medicare usually becomes your primary coverage. If the employer has 20 employees or more, you may want to delay Parts A, B, and/or D if you have sufficient group coverage and know you won’t incur late enrollment penalties. Medicare usually pays second to group coverage from larger employers.… Read More

Humana and Tenet have reached a new network agreement

June 12, 2017Ed MacConnell

Humana and Tenet have reached a new network agreement Humana is pleased to announce we have signed a new agreement, effective June 1, 2017, that allows Humana commercial, Medicare Advantage, Medicaid, and individual exchange health plan members to receive in-network care at Tenet hospitals, hospital-affiliated outpatient centers, and with Tenet physicians. We are currently in the process of loading Tenet providers to all applicable systems. There may be a delay in providers appearing in Physician Finder even though they are participating. For the best possible member experience, as always, we advise the member to check Physician Finder before seeking non-emergent care from a provider in order to help avoid any… Read More

IBC: Acclaris to assume HSA custodial responsibilities from Bank of America

June 12, 2017June 12, 2017Ed MacConnell

Acclaris to assume HSA custodial responsibilities from Bank of America in September 2017 Our spending account platform, Acclaris, received regulatory approval to become a non-bank health savings account (HSA) custodian and is ending its contract with Bank of America at the end of 2017. This includes custodial services Bank of America currently provides for the HSA. click here for details

Humana and Tenet have reached a new network agreement

June 9, 2017Ed MacConnell

Independence speaks out on PA Premium Tax, Treat No Transport, and recently introduced bills

May 26, 2017Ed MacConnell

Independence speaks out on PA Premium Tax, Treat No Transport, and recently introduced bills Updates from IBX Government Affairs including the proposed PA premium tax changes, Treat No Transport reimbursement, scope of practice for nurse practitioners, and proposed bills on drug transparency and prior authorization… Download the Bulletin See IBC’s breakdown of the proposed budget impact here. As always please contact your Total Benefit Solutions account manager at (215)355-2121 if you have any questions or concerns.

BREAKING: Aetna to withdraw from New Jersey Small Employer ACA market in 2018

May 15, 2017May 15, 2017Ed MacConnell

Aetna to withdraw from New Jersey Small Employer ACA market in 2018 Due to mounting financial losses and an uncertain marketplace outlook, Aetna has made the decision to leave the Individual market in New Jersey. Regrettably, this decision also impacts our New Jersey small employer ACA insured medical products. New Jersey law requires a carrier to withdraw from the insured small employer market if it is withdrawing from the individual market. As such, Aetna will withdraw all of its commercial (fully insured) medical plans offered in the small employer health insurance market. What this means Health insurance coverage for New Jersey small employer clients will end at midnight on the… Read More

Video: New Premium Saver Gap Coverage

April 5, 2017Ed MacConnell

Want more information? Call your Total Benefit Solutions account manager today at (215)355-2121.

Compliance Bulletin & Reform Center

March 13, 2017March 10, 2017Ed MacConnell

Health Care Compliance and Reform Education Center A fundamental change in the way the United States handles health care has arrived. Benefit rules and coverage change faster today than they used to in ten years! Our Compliance and Health Reform Education Center is where we will keep a copy of our health care reform bulletins throughout the year, in an easy to view format where you can download a brief summary or watch a short informative video. Click here to visit totalbenefitscomply.com Please contact your Total Benefit Solutions account manager at (215)355-2121 if you have any further questions.

MEDICARE PART D: CMS NOTIFICATION REMINDER

March 10, 2017Ed MacConnell

Employers sponsoring a group health plan need to report information on the creditable status of the plan’s prescription drug coverage to the Centers for Medicare and Medicaid Services (CMS). Watch a video overview Download a bulletin

Talking with your doctor about Keystone HMO Proactive

January 18, 2017Ed MacConnell

A Keystone HMO Proactive plan with a tiered network gives you the opportunity to look for the best value when you receive care. Tell your primary care physician (PCP) you have a tiered network plan so you can discuss your health care decisions and work together to make the best choices for you. Download this document for more information. As always please contact your Total Benefit Solutions, Inc, account manager at (215)355-2121 if you have any questions or concerns.

Health4Me Mobile Application

January 13, 2017January 10, 2017Ed MacConnell

UnitedHealthcare’s Health4Me provides instant access to you and your family’s critical health information — anytime/anywhere. Whether you want to find physicians near you, check the status of a claim or speak directly with a nurse, Health4Me is your go-to resource for everything related to your health. Learn more by watching the video below. As always if you have any questions please contact your Total Benefit Solutions Inc account manager at (215)355-2121.

United Healthcare Cost Estimator

January 11, 2017January 10, 2017Ed MacConnell

The myHealthcare Cost Estimator from United Healthcare helps you gather the information you need to make smart choices about the health care you receive. Learn more with the video below. As always contact your Total Benefit Solutions account manager if you have any questions or concerns at (215)355-2121

United Concordia Enrollment Forms 2017

January 9, 2017January 13, 2017Ed MacConnell

United Concordia small group enrollment forms for 2017 To enroll you on United Concordia they will require the following: The rate sheet with the benefit plan circled and the sheet signed at the bottom by the business manager or owner The completed employee applications for each employee enrolling. The form needs to be complete with each dependent’s name, date of birth, etc. A company check for the first month’s premium payable to United Concordia Companies Inc. or UCCI A completed employer application form. Complete what you can and we’ll finish the rest together. Download The New Group Enrollment Kit for 2017 You can fax everything to our… Read More

What is Blue Card PPO and How Does it Work?

December 9, 2016January 9, 2017Ed MacConnell

A number of clients ask us about Blue Card PPO and how it works. Blue Card PPO is typically attached to our clients policies who are enrolled on an IBC Personal Choice PPO or National Network PPO or a Horizon Blue Cross plan with National Access. You can tell if you have this on your plan if your card has the PPO Traveling Briefcase logo: It’s important to note that members who have a Keystone HMO, Amerihealth or Horizon HMO or local EPO do NOT have Blue Card PPO. How Does the BlueCard Program Work? BlueCard® PPO Medical Plan The BlueCard… Read More

IBC: Important Information About 2017 Member Renewal Letters

October 26, 2016October 25, 2016Ed MacConnell

Important Information About 2017 Member Renewal Letters In the coming weeks, members will be receiving renewal letters for their 2017 plans that include updated rate and product information, as required by ACA Guidelines. This letter will show the member’s updated 2017 premium with their 2016 subsidy amount. Because Independence will not obtain updated subsidy amounts until after November 1, we are not able to include the estimated 2017 subsidy amount in the first mailing. This information will be included in the second mailing which will be sent in mid-November. It is anticipated that subsidies, on average, will increase in 2017 for most members. • Updated renewal letters with 2017 subsidy… Read More

IBC: Plans to remove exclusions for gender reassignment surgery coverage

October 25, 2016October 25, 2016Ed MacConnell

In a July Independence Edge article, we shared that the U.S. Department of Health and Human Services (HHS) had issued a final rule for the nondiscrimination provision (section 1557) of the Affordable Care Act (ACA). While the nondiscrimination provision itself is not new, the final rule provides expanded clarity on coverage for gender reassignment surgery and related services. In addition, it provides guidance on treating individuals consistent with their gender identity, and not denying or limiting health services usually only available to individuals of one gender. Beginning with renewals on or after January 1, 2017, the exclusion for gender reassignment surgery has been removed from all commercial plans. Members… Read More

Individual and Family Open Enrollment-2017 Important Updates

October 25, 2016Ed MacConnell

As many people know by now there are many big changes with individual and family plans for open enrollment 2017. For anyone who is currently enrolled on one of the following your plan will NOT be renewed for 2017 and you will have to pick a new plan and/or a new insurer: Aetna: all plans cancelling in PA/NJ/NC/FL Aetna plans only remain in Delaware in our service area United Healthcare: All ACA plans cancelling. Short term plans are still available Oscar: All plans in NJ cancelling Health Republic: All plans in NJ cancelling Highmark and Capitol Blue Cross: No longer paying broker compensation Geisinger: No longer paying broker compensation Independence Blue… Read More

Total Benefit Solutions participating in CVS Retail Locations During Medicare Open Enrollment

October 9, 2016October 8, 2016Ed MacConnell

Total Benefit Solutions is pleased to announce that we are participating in the Independence Blue Cross Medicare/ CVS Pharmacy retail program for the upcoming open enrollment period. What this means to our clients is that we will be on site at our local CVS Pharmacy during the AEP. Starting on Saturday October 15th and continuing through open enrollment we will be on site nearly each Monday, Wednesday and Friday at the CVS Pharmacy in Feasterville from Noon to 2 PM each day. Please feel free to stop in without an appointment to get your questions answered and pick up your 2017 plan information from Independence Blue Cross. We will… Read More

ACA Individual 2017 Open Enrollment Important Update

October 8, 2016October 27, 2016Ed MacConnell

2017 ACA ” Obamacare” plans open enrollment important update. The annual open enrollment period opens on November 1st 2016 and ends January 31st 2017. Independence Blue Cross will be the only insurer available in 2017 in the Philadelphia 5 County Area. With the passing of the Affordable Care Act changes come annually or even more often. Unfortunately not all of those changes are benefiting the consumer. This year here are some major changes that our clients on Individual Non Medicare plans need to be aware of… If you are a enrolled on an ACA compliant plan with Aetna or United Healthcare your plan is going away. Neither Aetna or United… Read More

Reminder to Distribute Creditable Coverage Notice

September 18, 2016September 26, 2016Ed MacConnell

Employers who sponsor a group health plan with prescription drug benefits are required to notify their Medicare-eligible participants and beneficiaries as to whether the drug coverage provided under the plan is “creditable” or “non-creditable.” This notification must be provided prior to October 15th each year. Download medicare-part-d-reminder-to-distribute-creditable-coverage-notice-

Health Republic Insurance of NJ Will Not Offer Coverage for 2017

September 15, 2016September 15, 2016Ed MacConnell

NJDOBI Announces Health Republic Insurance of NJ Will Not Offer Coverage for 2017 On September 12, 2016, the New Jersey Department of Banking and Insurance (NJDOBI) announced that Health Republic Insurance of New Jersey (HRINJ) has consented to be placed in rehabilitation due to its deteriorating financial condition. If approved by the court, the rehabilitation will enable the Department to preserve the assets of the carrier so that consumers continue to receive the care to which they are entitled and medical providers are paid. Under this rehabilitation plan, current policies will remain in force through December 31, 2016, but HRINJ will not offer coverage for 2017. The Department and… Read More

Oscar to Withdraw from NJ Market Effective Jan. 1, 2017

September 10, 2016Ed MacConnell

Oscar to Withdraw from NJ Market Effective Jan. 1, 2017 In a recent release, Oscar has announced that they have decided to withdraw their plans from the New Jersey market beginning on January 1, 2017. They have concluded that instability in the market will make it challenging for them to operate effectively and to continue to deliver quality healthcare to all their members across the country. Oscar would like to highlight a few key points in regards to this announcement: Oscar will continue to serve their other existing markets without change, including New York, Long Island, San Antonio, Los Angeles and Orange County. Oscar remains financially stable—they have raised… Read More

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