AmeriHealth will stop accepting new enrollments for any Medicare Supplement plans as of April 1, 2024, the date the plans go into effect. Medicare Supplement Plans A, C, D, F, G, G-HD, and N were provided by AmeriHealth. Members who are presently enrolled in these plans will continue to receive services from AmeriHealth, guaranteeing that their coverage will not be stopped. To read more about the article click HERE We are dedicated to providing exceptional service, so please do not hesitate to contact our dedicated Total Benefit Solutions health insurance specialists at (215)-355-2121 or fill out the contact form below. We are available to answer any questions or address any… Read More
Continue ReadingClaim Processing Delays and Invoice Updates
On February 21, 2024, MVP stopped doing business with Change Healthcare and its subsidiaries, as well as all digital interactions. This was due to a cyber security breach. In compliance with national and state regulations, MVP is implementing innovative business solutions and restoring affected service functionality as needed. Processing Delays for Provider Claims : New York State Department of Financial Services encourage issuers and pharmaceutical benefit managers (PBMs) to take into account granting provider requests to halt or reverse specific administrative processes. MVP is assessing each provider’s request for suspension and tolling individually and determining whether a certification is necessary. To read more click HERE We are dedicated to providing… Read More
Continue Reading
Health Care Cyberattack
Although it does not yet know when the recovery from the Change Healthcare hack last month will be completed, UnitedHealth is testing the system to restore it. This week, the care giant said that it is testing technology for processing medical claims. It already has mostly restored systems for handling drug claims and processing payments. The technology utilized to file and handle insurance claims is provided by Change Healthcare. It works with claims from many insurers and processes around 14 billion transactions annually. Some patients might be directed to different pharmacies where billing issues are less of a concern. Industry executives have stated that delays in patient bills are possible. Progress:… Read More
Continue Reading
Cleveland Clinic will remain in our MA network in Florida and Ohio
We are pleased to announce that Cleveland Clinic will stay part of our Medicare Advantage (MA) network in Florida and Ohio after successful negotiations! This covers all specialists, ancillary providers, hospitals, and primary care physicians (PCPs). Once a contractual agreement is achieved, Cleveland Clinic services will continue to be accessible without interruption. Customers will receive letters in the upcoming weeks letting them know that Cleveland Clinic is still in network and that they don’t need to take any action right now. The PCP assignments at Cleveland Clinic are all still the same. Have any questions? call us at (215) 355-2121 or click Cigna healthcare provider directory to view the most… Read More
Continue Reading
UnitedHealthcare – RxDC Information Required by Deadline
Please assist us in answering the required questions in the CAA Pharmacy Data Collection request information that is located in the employer/broker portal. It will make sure that UnitedHealthcare can successfully submit the data report. In order for us to prepare the data for submission to CMS by June 1, 2024, we must get the information by April 10, 2024, thus your prompt answer is extremely important. To read more click HERE We are dedicated to providing exceptional service, so please do not hesitate to contact our dedicated Total Benefit Solutions health insurance specialists at (215)-355-2121 or fill out the contact form below. We are available to answer any questions… Read More
Continue Reading
2023 Premium Contribution Reporting Requirements
Federal regulation mandates that insurance providers and employer-based health plans to fully insured and self-funded—submit yearly reports to the Centers for Medicare & Medicaid Services (CMS) with respect to prescription medication and medical spending. Employer premium contribution data for the 2023 calendar year (January 1, 2023 – December 31, 2023) must now be supplied in accordance with the regulation. We require your assistance or the assistance of your clients, in order for Independent Health to meet these reporting requirements. Action required for fully insured plans The division of plan premiums paid by the employer group versus the subscriber must be disclosed by Independent Health. As a result, for the calendar… Read More
Continue ReadingAetna – Data Collection Requirement for Rx Data Collection Reporting Submission
The deadline for submitting Prescription Drug Data Collection (RxDC) reporting for the reference year 2023 is June 1, 2024. Certain data items that were not necessary for the first submission must be included in this one. As a result, Aetna has created a procedure to help our plan sponsors submit these reports. Important Update: Data Collection Requirement for Prescription Drug Data Collection Reporting Submission Read more HERE We are dedicated to providing exceptional service, so please do not hesitate to contact our dedicated Total Benefit Solutions health insurance specialists at (215)-355-2121 or fill out the contact form below. We are available to answer any questions or address any concerns you… Read More
Continue ReadingFTC to send nearly $100 million in refunds to consumers of Benefytt’s fraudulent health plans
Refunds are being sent by the Federal Trade Commission to customers it claims purchased fraudulent health plans that Benefytt Technologies misrepresented as Obamacare plans or Affordable Care Act. Benefytt, which operated under several identities, including Health Insurance Innovations, used deceptive websites and aggressive marketing to trick people looking for health insurance into purchasing fake policies that came with expensive monthly premiums, according to the FTC’s August 2022 complaint. “Benefytt pocketed millions selling sham insurance to seniors and other consumers looking for health coverage,” Samuel Levine, director of the FTC’s Bureau of Consumer Protection, said in a statement at the time the original complaint was filed. Qualified for the refund: Click HERE to… Read More
Continue Reading
CONSENT FOR HEALTH INSURANCE BROKER ASSISTANCE
CONSENT FOR BROKER ASSISTANCE FORM AS REQUIRED UNDER THE 2023 CMS-9899-F AMENDMENT OF 45 CFR § 155.220 Click here to complete the consent form This consent form outlines your rights. Please read it carefully. As a licensed Health Insurance Broker, Ed MacConnell of Total Benefit Solutions Inc has completed the annual Affordable Care Act certification by the Marketplace in your state. With this yearly training, and an individual or family’s formal consent, brokers are authorized to search for and assist households with their Marketplace account. The purpose of this form is to receive your informed written consent. Terms of Consent I give my permission to Total Benefit Solutions Inc, and/or their staff… Read More
Continue Reading
A Voluntary Benefits Strategy
The Issue One of our clients approached us during a pre-renewal meeting to ask how they can further control costs without drastically impacting the well-being of their employees…click here to continue
Continue Reading
Understanding the Coding of Health Plans from MEC to Metallic
Choosing the right insurance plan for you (and your family) is not an easy task. The Affordable Care Act (ACA) has introduced major changes to the way carriers traditionally marketed their health plans to the public and introduced a volume of new terms, requirements and complexities, many of which may sound confusing to the general public. From terms like “minimum essential coverage” to the various metallic plan categories of Bronze, Silver, Gold and Platinum, a solid foundation of knowledge is essential in order to find the coverage required at an affordable price. The health insurance experts at Total Benefit Solutions Inc are well versed on these terms so when you… Read More
Continue Reading
Aetna: Transparency in Coverage Rule Update
The Transparency in Coverage rule requires health plans and insurers to disclose pricing information via MRF by July 1, 2022. Health plans must generate two MRFs that contain Negotiated rates for in-network providers Billed charges and allowed amounts paid for out-of-network providers We’ll publish this information on Aetna.com on July 1, 2022 for fully insured (51-100) and small group Aetna Funding AdvantageSM (2-100) groups. By posting the MRFs for small small group Aetna Funding Advantage clients, we’re taking work off their plate. Aetna will update the files each month and this link will remain active with the most up-to-date information.
Continue Reading
2022 PCOR Fee Filing Reminder for Self-Insured Plans
The Patient-Centered Outcomes Research (PCOR) fee filing deadline is August 1, 2022, for all self-funded medical plansand HRAs for plan years ending in 2021. The IRS issued Notice 2022-04 announcing the adjusted fee amount for this year. please download the bulleting below for more details and contact your Total Benefit Solutions, Inc. health insurance specialist at (215)355-2121.
Continue Reading
Top 10 Questions to Ask Your Benefits Broker
Analyzing these ten critical questions in relation to your organization’s needs will help you make a more informed decision about your benefits broker
Continue Reading“I’m paying for Health Insurance I don’t even use!”
You hear it all the time: “I’m paying for Health Insurance I don’t even use!” But, Health insurance isn’t only for when you’re sick! You can use it to maintain your healthy status, you can use it for Preventative Care and you can also use this time to learn how your coverage works before you get sick. Also, many Health Insurance Plans offer things such as discounted gym memberships and rewards for healthy lifestyle choices (such as quitting smoking). Some plans even offer vision or dental benefits, so you can take advantage of an eye screening or 6 month dental check-up. Take advantage of free insurance benefits anytime Get preventive services,… Read More
Continue ReadingHealth Advocate: Medical Health Advisor
Total Benefit Solutions, Inc now offers the Medical Health Advisor benefit! Watch this short video and ask us how your organization can benefit from offering this personal health advocate service to your employees!
Continue Reading
Total Benefit Solutions is your Marketplace Navigator
What do you get with Total Benefit Solutions as your Marketplace Navigator? A broker who is Unbiased and objective Trained Local Certified Licensed Insured Up to date Representing you Part of a team of dedicated professionals Click here for more information and to see our “Marketplace Navigator” brochure: Individual Enrollment Navigator Brochure
Continue Reading
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 Reading
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
Continue Reading
Client Testimonial: Kristine Kreisher
We received this email from one of our clients this week, Kristine Kreisher, and wanted to share: Dear Ed: I spent a month and a half calling Blue Cross, getting the run around, and given incorrect information. I make a phone call/send an email to you both and within a couple hours everything is taken care of and corrected!!! You guys are awesome!!! Thank you soooooo much for getting this all taken care of!!!! Kris Kreisher February 2014 We love happy clients!
Continue Reading
You must be logged in to post a comment.