The Secret to Getting a Health Insurance Refund: Is Level Funding Right for You?

Here's something most small business owners don't know: there's a type of group health insurance for employers that can actually write you a check at the end of the year. Not a bill. A refund. Sounds too good to be true, right? But it's not some gimmick or marketing trick. It's called level funding, and it's one of the smartest moves a small to mid-sized business can make when traditional health insurance premiums keep climbing year after year. Let me explain how this works, and whether your business should be taking advantage of it. What Is Level Funding (And Why Don't More People Know About It)? Level funding sits right… Read More

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Stop Overpaying for Health Insurance: The Small Business Guide to Level Funded Plans

Let's be real: traditional group health insurance for employers feels like you're throwing money into a black hole every year. Premiums keep climbing (hello, 2026 rate increases), you have zero visibility into where your dollars are actually going, and you're basically betting that your insurance carrier knows your business better than you do. Spoiler alert: they don't. If you're tired of watching your health insurance costs spiral while getting nothing but vague explanations from your carrier, it's time to look at level funding. It's the insurance model that gives small business owners what they've been begging for: transparency, control, and the possibility of actually getting money back at the end… Read More

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Level Funding in 2026: What Your Business Needs to Know About Compliance and Costs

If you're a small to mid-sized business owner looking at your 2026 health insurance renewal and feeling that familiar sinking feeling in your stomach, you're not alone. Traditional fully insured premiums are climbing yet again, and many employers are searching for alternatives that won't break the bank. Enter level funding, a hybrid approach that's gaining serious traction among businesses with 10-100 employees. But here's the thing: level funding isn't just about lower monthly payments. It comes with its own set of compliance obligations that you absolutely need to understand before making the switch. What Is Level Funding, Anyway? Think of level funding as the "Goldilocks" option for group health insurance… Read More

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Level Funding 101: How Small Businesses Can Beat Rising Insurance Premiums

If you're a small business owner, you've probably noticed that your group health insurance for employers keeps getting more expensive every year. The 2026 renewals are already showing premium increases that'll make your accountant cringe. But here's something most business owners don't know: you're not stuck choosing between sky-high premiums and dropping coverage altogether. Level funding is the middle ground that's been saving small businesses thousands of dollars: and it's time more employers knew about it. What Exactly Is Level Funding? Think of level funding as the "Goldilocks" of health insurance. It's not fully insured (where you pay fixed premiums and the insurance company takes all the risk), and it's… Read More

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Medicare Secondary Payer Rules Explained in Under 3 Minutes

If you're an employer with Medicare-eligible employees on your group health plan : or you're an employee trying to figure out whether to drop your employer coverage once you hit 65 : you need to understand Medicare Secondary Payer (MSP) rules. These rules determine which insurance pays first when someone has both Medicare and employer-sponsored coverage. Get it wrong, and you could face claim denials, surprise bills, or even compliance penalties. Let's break it down in plain English. What Are Medicare Secondary Payer Rules? Medicare Secondary Payer rules determine the order in which insurance plans pay when someone has both Medicare and other coverage (like group health insurance from an… Read More

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Lost Your Job? Here's Your Complete Guide to Health Insurance Options (COBRA vs ACA vs Medicaid Compared)

Losing your job hits hard enough without worrying about losing your health insurance too. The good news? You've got options, and we're going to walk through every single one so you can make the smartest choice for your situation. Here's the reality: You have 60 days from your last day of coverage to make a decision. That might seem like plenty of time, but trust me: these 60 days fly by when you're dealing with job searches, unemployment paperwork, and everything else that comes with a career transition. The three main paths forward are COBRA (continuing your old employer's plan), ACA Marketplace plans (buying individual coverage), and Medicaid (government assistance… Read More

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7 Mistakes You're Making with Group Health Insurance Costs (and How to Fix Them)

Let's be real: group health insurance for employers isn't cheap. And if you're running a small or mid-sized business, every dollar counts. The frustrating part? Many business owners are overspending on their group health benefits without even realizing it. The good news is that most of these costly mistakes are completely fixable. You just need to know what to look for. We've helped countless employers find affordable group health insurance that actually works for their teams and their budgets. Along the way, we've spotted the same mistakes popping up again and again. Here are the seven biggest ones: and exactly how to fix them. Mistake #1: Choosing a Plan Based… Read More

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Medicare Secondary Payer Rules Explained: Your Quick-Start Guide to 2026 Compliance

If you're an employer offering group health benefits, or an employee trying to figure out how your coverage works alongside Medicare, the Medicare Secondary Payer (MSP) rules are something you absolutely need to understand. And with 2026 shaping up to be a major enforcement year, now's the time to get your compliance ducks in a row. Let's break down what the medicare secondary payer rules actually mean, when Medicare pays second, and what you need to do to stay on the right side of the regulations this year. What Are Medicare Secondary Payer Rules? Here's the deal: Medicare doesn't always pay first for your healthcare costs. In certain situations, another… Read More

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Looking For Affordable Group Health Benefits? Here Are 10 Things Small Businesses Should Know

Running a small business means wearing a dozen hats, and figuring out affordable group health insurance shouldn't require a PhD in healthcare policy. Yet here you are, trying to attract top talent while keeping your budget intact. Good news: group health benefits for small business owners are more accessible than you might think. Whether you've got two employees or twenty, there are options that won't drain your bank account. Let's break down the ten essential things you need to know before making this critical decision. 1. You Don't Need a Big Team to Qualify Here's something that surprises a lot of small business owners: group health insurance typically requires just… Read More

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Is "Junk" Insurance Worth It? Understanding Short-Term Health Plans

Short-term health insurance plans have earned the nickname "junk insurance" from critics, but that doesn't tell the whole story. While these plans come with serious limitations, they can serve a purpose in very specific situations. The question isn't whether they're inherently good or bad: it's whether they're right for your particular circumstances. Let's cut through the noise and break down exactly what you're getting (and what you're not getting) with short-term health plans, so you can make an informed decision. What Are Short-Term Health Plans? Short-term medical insurance plans are temporary health coverage designed to bridge gaps between more comprehensive insurance policies. Think of them as a Band-Aid solution: they're… Read More

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Does Group Health Plan Compliance Really Matter in 2026? Here's the Truth

Let's cut right to it: if you're an employer offering group health insurance, compliance isn't optional. It's not a "nice to have." It's the law. And in 2026, the requirements are more detailed: and the deadlines more numerous: than ever before. We get it. You're busy running a business. The last thing you want to think about is a mountain of IRS forms, federal attestations, and employee notices. But here's the truth: ignoring group health plans requirements can cost you big time. We're talking fines, penalties, and potential legal headaches that no business owner wants to deal with. So does group health plan compliance really matter in 2026? Absolutely. Let's… Read More

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What Is Minimum Essential Coverage (MEC)? Understanding Your Health Plan Options

If you've ever shopped for health insurance, you've probably come across the term "Minimum Essential Coverage" or MEC. It sounds official. Maybe even a little intimidating. But here's the thing, it's actually a pretty straightforward concept once you break it down. Let's cut through the jargon and talk about what MEC actually is, why it matters in 2026, and how it affects you whether you're an individual looking for coverage or an employer trying to do right by your team. So, What Exactly Is Minimum Essential Coverage? Minimum Essential Coverage is any health insurance plan that meets the requirements set by the Affordable Care Act (ACA). Back when the ACA… Read More

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Alternatives to ACA plans

Here’s a clear, well‑organized breakdown of the main alternatives to ACA (Affordable Care Act) health insurance plans, grounded in the search results you triggered. — 🌟 Alternatives to ACA Health Insurance Plans People often look for non‑ACA options when they don’t qualify for subsidies or want lower premiums, more flexibility, or year‑round enrollment. The search results highlight several categories of alternatives. — 🧭 Main Categories of ACA Alternatives 1. Short‑Term Health Insurance – Designed for temporary gaps (between jobs, waiting for coverage, etc.)   – Lower premiums, fast enrollment   – Not ACA‑compliant → can exclude pre‑existing conditions, limit benefits, cap payouts   – Available year‑round   Sources:  — 2. Health Care Sharing Ministries… Read More

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Understanding ICHRA & Subsidy Eligibility

This resource helps employees understand how an Individual Coverage Health Reimbursement Arrangement works and how it may affect eligibility for marketplace subsidies. It explains what affordability means under ACA guidelines, walks through how to determine if an ICHRA is considered affordable, and outlines the guide is designed to make the process easier to understand so individuals can make informed decisions about their health insurance.

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Lost Your Job? Here’s Your Complete Guide to Health Insurance Options (COBRA vs ACA vs Medicaid Compared)

Losing your job hits hard enough without worrying about losing your health insurance too. The good news? You’ve got options, and we’re going to walk through every single one so you can make the smartest choice for your situation. Here’s the reality: You have 60 days from your last day of coverage to make a decision. That might seem like plenty of time, but trust me: these 60 days fly by when you’re dealing with job searches, unemployment paperwork, and everything else that comes with a career transition. The three main paths forward are COBRA (continuing your old employer’s plan), ACA Marketplace plans (buying individual coverage), and Medicaid (government assistance… Read More

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TEMPORARY SEP

Temporary SEP for year one of the Medicare Plan Finder MA Provider Directory For your awareness, CMS has a new Special Election Period (SEP) for 2026 – Code: DIR SEP. This SEP allows beneficiaries who enrolled directly through the Medicare Plan Finder (MPF) to make a plan change if the MPF Provider Directory included incorrect information and is only valid for 1/1/26-12/31/26 enrollments. The intent of this SEP is to allow an individual who relied on the MPF Provider Directory to make a change to their MA plan election to stay with their preferred providers. To use this SEP, beneficiaries must call 1-800-MEDICARE to have a representative confirm that their… Read More

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United Concordia dental

United Concordia Dental offers a digital member ID that makes accessing your dental plan information quick and easy. With your digital ID, you can view your plan details anytime on your phone, tablet, or computer. Whether you need your member ID number for customer service, submitting claims, or managing your benefits, it’s always available at your fingertips. Download the United Concordia dental or create an account online.

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New legislation expands benefit accounts

Here’s what you need to know about HSA and DC-FSA changes. New legislation in the H.R.1 Bill, more commonly known as the One Big Beautiful Bill Act (OBBBA), expanded the rules around Health Savings Accounts (HSAs), including enrollment eligibility and eligible expenses, and Dependent Care Flexible Spending Accounts (DC-FSAs). Most changes will go into effect Jan. 1, 2026, however one change regarding telehealth services is retroactively effective to Jan. 1, 2025.  As a result of this legislation, regulatory guidance will be issued over the next few months, and HSA Bank’s forms, educational resources and more will be updated to reflect these changes. In the meantime, use this summary and guidance… Read More

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2026 Medicare Parts A & B Premiums and Deductibles

Each year, the Medicare Part B premium, deductible, and coinsurance rates are determined according to provisions of the Social Security Act. The standard monthly premium for Medicare Part B enrollees will be $202.90 for 2026, an increase of $17.90 from $185.00 in 2025. The annual deductible for all Medicare Part B beneficiaries will be $283 in 2026, an increase of $26 from the annual deductible of $257 in 2025 Your Total Benefit Solutions, Inc experts, can help you compare and choose the best Medicare supplement coverages for you. Contact us today at (215)355-2121 or www.totalbenefits.net Prefer to shop and research on your own? Click here: https://planenroll.com/?purl=Edward-MacConnell Click here to download the fact… Read More

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Individual Coverage HRA: Choice and affordability

Choosing the right health insurance can be overwhelming, but the new Individual coverage HRA(ICHRA) option makes it easier for employers and employees to find affordable, flexible coverage that fits their needs. With an ICHRA, businesses of any size can reimburse employees for the individual health insurance plan that works best for them creating more choice, more control and often more savings. To learn more or explore the ICHRA plan options, click here: Total Benefit Solutions, Inc. – Flex Plan Solutions

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Part D Premiums Are Decreasing for Many Stand-Alone Drug Plans

CMS has just released information about Medicare Part D plans for 2026, including plan availability and premiums for the coming year. As this year’s Medicare open enrollment period approaches, there’s some good news for Medicare Part D enrollees when it comes to monthly PDP premiums – lower on average, according to CMS – even as the total number of PDPs available drops yet again. The headline of CMS’s press release emphasized stability in the Part D marketplace, but a quick review of the data shows that the total number of stand-alone drug plans available in 2026 will fall for the third year in a row, as plan sponsors scale back their PDP offerings (for… Read More

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Gag Clause Attestation Due December 31, 2025

As previously reported, insurance carriers and plan sponsors of group health plans must submit information annually to the Centers for Medicare and Medicaid Services (“CMS”) attesting that their plans do not include prohibited gag clauses by December 31st each year. The next attestation is due by December 31, 2025. A gag clause is a contractual term that directly or indirectly restricts specific data and information that a plan or issuer can make available to another party. These clauses may be found in agreements between a plan or carrier and any of the following parties: A gag clause may also be found in the downstream agreements of the service provider. Carriers and… Read More

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Highmark Updated Billing Addresses in Pennsylvania

What do I need to know?  Effective immediately, we’re consolidating billing addresses across all Pennsylvania markets. This change will streamline many steps in the billing process and allow for clearer communication to the market. It applies to clients in the following Highmark companies in small and large group:  Clients in Northeastern and Southeastern Pennsylvania aren’t impacted by this change – they’re already using the newer addresses.  For clients who pay premium by mail: All Pennsylvania premium payments that are mailed should go the new address: PO Box 382146, Pittsburgh, PA 15251-8146. This address has been updated on invoices and throughout other materials. Premium payments sent to the old address will be… Read More

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Allegheny Health Network and Heritage Valley Health System Sign Affiliation Agreement

Organizations Pledge Expanded Access to High-Quality Care in western Allegheny County and greater Beaver County as Heritage Valley’s Hospitals, Outpatient Clinics and Physician Practices become part of AHN and Highmark Health. Beaver, PA (Oct. 16, 2025) – Officials from Heritage Valley Health System (HVHS), the Heritage Valley Health System Foundation, Highmark Health and Allegheny Health Network (AHN) joined community leaders and hospital employees today to celebrate the signing of an affiliation agreement that will strengthen and expand the services that HVHS provides to residents in western Allegheny County, greater Beaver County and the surrounding region. Pending government approval of the transaction, the affiliation will establish Heritage Valley Beaver and Heritage Valley Sewickley as AHN’s 15th and 16th… Read More

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2026 Cost of Living Adjustments

The IRS has released cost of living adjustments for 2026 under various provisions of the Internal Revenue Code (“Code”). Some of these adjustments may affect your employee benefit plans. Cafeteria Plans – Health Flexible Spending Arrangements Annual contribution limitation For plan years beginning in 2026, the dollar limitation under Code Section 125(i) for voluntary employee salary reductions for contributions to health flexible spending arrangements (“health FSAs”) increased from $3,300 to $3,400. Annual maximum carryover For cafeteria plans that permit the carryover option, the maximum unused amount from a health FSA that can be carried over to the following plan year is $680 for plan years beginning in 2026 (up from… Read More

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