Medicare – Page 11 – Total Benefit Solutions Inc

2015 Medicare Part B premiums and deductibles to remain the same as last two years

October 10, 2014October 10, 2014Ed MacConnell

Premiums, copays and deductibles for other Medicare programs for 2015 also announced Secretary of Health and Human Services Sylvia Burwell announced today that next year’s standard Medicare Part B monthly premium and deductible will remain the same as the last two years. Medicare Part B covers physicians’ services, outpatient hospital services, certain home health services, durable medical equipment, and other items. For the approximately 49 million Americans enrolled in Medicare Part B, premiums and deductibles will remain unchanged in 2015 at $104.90 and $147, respectively. This leaves more of seniors’ cost of living adjustment from Social Security in their pockets.

Medicare: Medicare & You Online

October 3, 2014October 2, 2014Ed MacConnell

Did you know? You can go paperless and get your Medicare and You Handbook Online! As always, if you have any questions about Medicare health plans, please contact your Total Benefit Solutions account manager at (800)924-6718 or (215)355-2121.

Amerihealth: Medicare PDP RX Plans Going Away

October 2, 2014October 2, 2014Ed MacConnell

AmeriHealth® Medicare Rx PDP Non-Renewal This week, AmeriHealth Medicare Rx PDP members will receive a non-renewal notice in the mail. Coverage will end for these members on December 31, 2014. This non-renewal applies only to AmeriHealth Option I and II stand-alone prescription drug plans. Members will need to enroll in another Medicare drug plan in order to get prescription drug coverage for 2015. AmeriHealth Rx PDP members will be given a Special Enrollment Period (SEP) to enroll in a new prescription drug plan. Members can enroll in a new plan anytime from October 15, 2014 through February 28, 2015. If members do not choose a new plan during this time, they… Read More

Medicare: Video-Parts of Medicare

October 2, 2014Ed MacConnell

CMSHHSgov has uploaded Medicare & You: Different Parts Of Medicare : As always, if you have any questions about Medicare health plans, please contact your Total Benefit Solutions account manager at (800)924-6718 or (215)355-2121.

Medicare Part D: Reminder to Distribute Creditable Coverage Notice

September 19, 2014Ed MacConnell

Medicare Part D: Reminder to Distribute Creditable Coverage Notice 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. Please click the link below to read the detailed bulletin. Medicare Part D Reminder-091914R

Medicare: What are the STAR ratings?

September 15, 2014September 15, 2014Ed MacConnell

Many of our clients ask us what the STAR ratings for each health plan really mean. Medicare.gov gives us the answer as: The Overall Star Rating combines scores for the types of services each plan offers: What is being measured? For plans covering health services, the overall score for quality of those services covers 36 different topics in 5 categories: Staying healthy: screenings, tests, and vaccines: Includes whether members got various screening tests, a yearly flu shot, and other check-ups that help them stay healthy. Managing chronic (long-term) conditions: Includes how often members with different conditions got certain tests and treatments that help them manage their condition. Member experience with the health plan: Includes… Read More

United Healthcare: National Medicare Education Week

September 15, 2014October 2, 2014Ed MacConnell

Do you find Medicare confusing? If so, you’re not alone. We recently conducted a survey1 that found that nearly 60 percent of Medicare beneficiaries described their understanding of Medicare as either “excellent” or “good,” but most were not able to correctly identify the health care expenses that each “part” of Medicare covers. And many said they found certain aspects of Medicare confusing. But, there’s some good news: Anyone can master Medicare with some help and education. That’s exactly why UnitedHealthcare created National Medicare Education Week (Sept. 15 – 21), an official week dedicated to Medicare education. National Medicare Education Week is meant to encourage people to spend time learning about… Read More

Third Annual National Medicare Education Week Offers Help Before Open Enrollment Period

September 12, 2014Ed MacConnell

Educational events and online resources to help baby boomers, Medicare beneficiaries and caregivers learn more about Medicare MINNETONKA, Minn. (Sep. 08, 2014) — The third annual National Medicare Education Week begins Monday, Sept. 15, exactly one month before the start of Medicare’s annual Open Enrollment Period (Oct. 15-Dec. 7). The observance was created to help people learn more about Medicare. Since National Medicare Education Week began in 2012, thousands of people have participated in educational events during the week in more than 60 cities across the country. This year, National Medicare Education Week events will be held for the first time in Boston, Salt Lake City and Richmond, Virginia; a… Read More

Medicare Update: Medicare is no longer prevented from recognizing same-sex marriages

August 26, 2014Ed MacConnell

Medicare is no longer prevented from recognizing same-sex marriages Special Update: As a result of the June 2013 U.S. Supreme Court ruling invalidating part of the Defense of Marriage Act (DOMA), which denied federal benefits to legally married same-sex couples,Medicare is no longer prevented from recognizing same-sex marriages for determining entitlement to, or eligibility for, Medicare. The Social Security Administration is now processing requests for Medicare Part A and Part B Special Enrollment Periods, as well as reductions in late enrollment penalties, for certain eligible individuals in same-sex marriages. Click here for more information.

Total Benefit Solutions to partner with ThinkHR

August 22, 2014August 22, 2014Ed MacConnell

In another effort to enhance our client experience and bring value to our small business clients, Total Benefit Solutions is proud to announce that we have entered into an agreement to provide Think HR. Soon our clients will get an introductory e-mail with instructions on how to access their complimentary ThinkHR account. We expect to have this resource available to our clients in September 2014, just in time for this year’s open enrollment period! Think HR will help our clients: Stay up to date with the latest news and resources Remain compliant with best practices from HR professionals Build tools like job… Read More

UnitedHealthcare is introducing a new wellness initiative

July 3, 2014Ed MacConnell

UnitedHealthcare is introducing a new wellness initiative called ‘At Your Best’ as a pilot program to New Jersey consumers who are enrolled in an AARP® Medicare Supplement Insurance Plan, insured by UnitedHealthcare Insurance Company. This new pilot program, which was introduced in mid-June, is a personalized health and wellness solution designed to help AARP Medicare Supplement insured members improve their overall health and wellness. Please note: All ‘At Your Best’ program communications will take place after the member is enrolled. About the ‘At Your Best’ program The ‘At Your Best’ program is for insured members of an AARP Medicare Supplement Insurance Plan. The program offers support through online health resources,… Read More

What is Critical Illness Insurance?

June 30, 2014February 8, 2015Ed MacConnell

Why Critical Illness as a “wrap” plan Because: They’re more affordable than you might think. They’re available for employer groups, individuals and seniors. They make selecting a health plan easier. They provide peace of mind against a catastrophic event and large out of pocket expenses. They’re person and portable, it doesn’t matter where you get your health insurance from, having your own critical illness plan makes it better. Many clients have asked how they can supplement their employees coverage when they get enrolled through the affordable care act healthcare.gov marketplace. Employers are permitted to offer wrap plans that consist of “excepted benefits”, meaning they are not regulated by the affordable… Read More

HR4302 Bill Passes: Repeals limitation on deductibles for employer-sponsored health plans

April 1, 2014Ed MacConnell

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

Crozer-Keystone Health System No Longer In Network with Cigna-Healthspring MAPD Plans

March 24, 2014Ed MacConnell

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

Humana: My Medicare Answers

March 19, 2014March 18, 2014Ed MacConnell

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

2014 Updated Medicare Deductibles & Official Medigap Handbook

March 18, 2014Ed MacConnell

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

IBC: Important Changes Regarding Medicare Part B Exclusion

March 18, 2014September 9, 2014Ed MacConnell

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

IBC: Medicare as Secondary Payer

March 17, 2014Ed MacConnell

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

IBC: New Lab Provider Effective July 1-IMPORTANT NOTICE

March 12, 2014Ed MacConnell

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

Important: Change to PACE and PACENET Income Limits

March 8, 2014Ed MacConnell

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

IBC Group Medicare Security 65 Billing Issues

December 28, 2013December 28, 2013Ed MacConnell

Security 65 Invoices Security 65 groups that are transitioning to our new operating platform effective January 1, 2014 are receiving premium invoices that reflect a zero-dollar balance. These invoices were sent in error and new invoices reflecting the appropriate premium due and membership information are being generated. Please be assured that this was an invoice issue only and did not affect membership. All members are currently active and there is no impact to access of care.

Final Rules on Additional Medicare Tax

December 4, 2013December 3, 2013Ed MacConnell

Effective November 29, 2013, final rules provide guidance for employers relating to the implementation of Additional Medicare Tax.Click here for more information.

Learn about Medicare Medical Savings Accounts

October 31, 2013Ed MacConnell

Medical Savings Account Plans: MSA Plans combine a high-deductible Medicare Advantage Plan and a trust or custodial savings account (as defined and/or approved by the IRS). The plan deposits money from Medicare into the account. You can use this money to pay for your health care costs, but only Medicare-covered expenses count toward your deductible. The amount deposited is usually less than your deductible amount, so you generally have to pay out-of-pocket before your coverage begins. Medicare MSA Plans don’t cover prescription drugs. If you join a Medicare MSA Plan, you can also join any separate Medicare Prescription Drug Plan. There are additional restrictions to join an MSA plan,… Read More

Medical Savings Accounts for Medicare Members

October 4, 2013Ed MacConnell

Questions about Medicare medical savings accounts, or Medicare MSA’s? Click here to learn more about: Geisinger Gold MSA Click here for Frequently Asked Questions: FAQs about MSAs Want more information? Have more questions? Is a Medicare MSA plan the right fit for you? Call us today at (215)355-2121 to find out more!

Medicare and You 2014 now available

September 25, 2013September 26, 2013Ed MacConnell

The Medicare and You guide for 2014 is now available. This official government booklet tells you: Summary of Medicare benefits, coverage decisions, rights and protections, and answers to the most frequently asked questions about Medicare. Click here to download your copy. Click here to order a printed version to be mailed to you Have questions about your Medicare coverage or Medicare supplements? Call us today at 215-355-2121

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