Is Reference Based Pricing Good for Your Group Health Benefit?

Choosing an insurance plan for employees can be challenging due to the flood of options now available. One of the biggest decisions you will have to make as an employer is between fully-insured and self-insured health plans. A fully-insured plan is a more traditional option where the company pays a premium to the insurance carrier. With a self-insured (self-funded) health plan, employers can operate their own insurance plan which can save money and give them more control over their funds. Reference based pricing, or RBP is a fairly new method to price claims option for a self-funded plan. Gaining in popularity because the employer is setting the price bar, NOT… Read More

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Association health plan ruling could result in thousands losing coverage

SHELBY LIVINGSTON : Modern Healthcare . A federal judge’s decision to vacate the Labor Department’s 2018 rule expanding access to association health plans could cause thousands of people covered through such plans to lose their insurance. Whether and how soon that happens depends on the Labor Department’s appeals decision and the likelihood of the judge granting a stay of his order in the interim. A Justice Department spokesperson said March 29 the department disagrees with the ruling and is considering all options, but will “continue to fight for sole proprietors and small businesses so that they can have the freedom to band together to obtain more affordable, quality healthcare coverage.” Since the rule was finalized in… Read More

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Judge blocks Trump’s small-business health insurance plan

WASHINGTON — A federal judge has struck down a small-business health insurance plan widely touted by President Donald Trump, the second setback in a week for the administration’s health care initiatives. U.S. District Judge John D. Bates wrote in his opinion late Thursday that so-called “association health plans” were “clearly an end-run” around consumer protections required by the Obama-era Affordable Care Act. Click here to read the story

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Video: Finding your Primary Care Physician’s Tier

The Keystone Proactive HMO plans have become very popular but the number one question we get is ” how do I know what tier my doctor is in?” Finding your primary doctor’s tier on the Keystone Proactive HMO is actually fairly easy. This short step by step video will show you how! Need additional help? Call your Total Benefit Solutions Inc account manager at (215)355-2121 and we can do it for you or search a full list of physicians, facilities, hospitals or medications for you or your employees! Total Benefit Solutions, Inc. Where we work for your benefit!

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Medicare Won’t Cover This Key Expense…

Dental costs can take a huge bite out of seniors’ finances, even if they have Medicare. And many Seniors have to tap into their Retirement Funds to cover treatment.

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The Future of Employee Benefit Offerings: Student Debt Repayment Assistance

When looking for a job, the benefits offered to an Employee are definitely a big factor in consideration of accepting an offer of employment. Most people are willing to choose a company with a slight pay decrease if the benefit package compensates for the lost wages. With unemployment the lowest it has been since 2000 in the United States, attracting new talent isn’t as easy as it used to be and Employers are looking for ways to snatch up qualified applicants. When you think of benefit packages, you usually think of the basics: Health Insurance (with possibly an HSA, HRA, or FSA included), Dental and Vision coverage. “Good” benefit packages… Read More

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IBC to Reach Agreement with Providers in Our Area!

We are pleased to share that Mercy Health System, St. Mary Medical Center, Saint Francis Healthcare and Independence Blue Cross (Blue Cross) anticipate coming to an agreement on a new, long-term contract this week, meaning there should be no interruption to your care or coverage at the following facilities: Mercy Fitzgerald Hospital Mercy Philadelphia Hospital Nazareth Hospital St. Mary Medical Center Saint Francis Healthcare in Delaware We thank you for your continued support and patience throughout this process, and apologize for any anxiety or inconvenience this negotiation may have caused you or your family – that was never our intention. We look forward to continuing to provide you the care… Read More

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Why Offer an HRA to Your Employees?

Healthcare Reimbursement Arrangement, typically referred to as an HRA, can be utilized by employers to reduce their overall healthcare costs without placing additional financial burden on their employees. An HRA allows the employer to pay for eligible expenses with pre-tax dollars. The employer decides what expenses are eligible, within the IRS guidelines, leaving a lot of flexibility in plan design. Typically an HRA is coupled with a High Deductible Health Plan and the HRA pays for either the entire deductible or a portion of the deductible. With this type of a plan the premium savings often outweigh the potential claims that the employer would have to pay if every employee… Read More

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Benefit Notices By Company Size: Your Cheat Sheet

Ever wonder exactly which benefit notices your company was required to distribute to employees? Ever notice that some of them are only needed when your business is a specific type of business or organization or size? Wonder no more thanks to our partners at HR360! Download your complimentary copy of the 2-19 employee guide below that includes links and descriptions to all of your required notices for employers between 2-19 employees! Have more specific needs or a cheat sheet for a larger organization? Ask us today how partnering with total benefit solutions and HR360 can deliver this type of powerful information that you need, when you need it. Stay ahead… Read More

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MURPHY MOVES NJ TO STATE-BASED HEALTH EXCHANGE TRENTON — New Jersey will move to a state-based health care exchange starting in 2021 as a result of an executive order signed Friday by Gov. Phil Murphy.The Democratic governor made the announcement at Saint Barnabas Medical Center in Livingston on the 9th anniversary of the passage of the Affordable Care Act. He said offering access to high quality, affordable health care is one of society’s greatest responsibilities and a “basic right.

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New Jersey Small Employer Stop Loss Bill

A bill has been introduced in New Jersey in both the Senate and Assembly that, if passed, would prohibit insurance carriers or other insurers subject to the insurance laws of New Jersey or any other state from offering, issuing or renewing any stop loss insurance policy of any kind to small employers. Stop loss insurance provides reimbursement for catastrophic, excess or unexpected expenses and is used by small employers to self-insure part of the health insurance coverage they provide for employees. Under New Jersey law, in connection with a group health plan, a small employer means an employer with 2-50 eligible employees on business days during the preceding calendar year. If passed,… Read More

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The Hidden Costs of Smoking

It’s easy to loose track of the actual costs associated with smoking. When you look behind the scenes, you will realize why the utilization of Smoker Cessation Programs are important and how Employees and Employers can benefit from this type of Wellness Program . Healthcare $3,400 in excess expenses each year in the form of premium pricing, deductibles or copays/insurance due to conditions associated with one person’s use. Smoke Breaks (Average) 1.25/hrs per day 6.25/hrs per week 291/hrs per year Family Health Parents who smoke have a higher rate of children with Respiratory and ENT issues. They are also more likely to become smokers themselves. Lifetime Costs On average, a… Read More

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10 Companies with Innovative Benefits Packages

From retirement and health plans to unlimited paid time off, work flexibility and hot new benefits such as student loan repayment and professional development, these 10 companies are leading the pack when it comes to innovation in the field. Here’s what they are doing differently.         Netflix Their unique offering: Unlimited paid time off Perks include: Up to one year of paid time off to new mothers and fathers, and unlimited-time-off for vacation and sick days. Why they do it: “Netflix’s continued success hinges on us competing for and keeping the most talented individuals in their field. Experience shows people perform better at work when they’re not worrying about home,”… Read More

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What are PEO Solutions?

PEOs & the Philadelphia Area As you may be aware Independence Blue Cross recently introduced a PEO offering into the Pennsylvania market/Greater Philadelphia area through a partnership with Clear PEO. As a leading independent broker in the Northeast, Total Benefit Solutions, Inc.  has experience with PEOs and helping group clients find the best choices to put you in the strongest possible position to shop and compare PEO’s and traditional health benefits. In fact, Total Benefit Solutions, Inc. has already been partnering with established PEO’s for a number of years in the Pennsylvania market as well as the surrounding area. THE BASICS OF PEOs PEO is an acronym for Professional Employer… Read More

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Is your plan subject to the $110 Per Day ERISA Health Plan Documentation penalty?

Is your health plan group ERISA compliant? Health plans subject to the Employee Retirement Income Security Act (ERISA) must make available information about the plan to participants. The plan participants have a right to know about plan rules, financial data, plan operation and plan management. Many small employers fail to realize that they need to meet this requirement. The departments of labor have been coming to more employers and asking for this document more often, but typically the DOL audit is the direct result of an employee ( or former employee) grievance. When a member first becomes covered under an ERISA-covered health plan, the individual must receive an SPD (Summary Plan… Read More

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How Does Level Self Funded Health Insurance Work?

We have received a lot of questions regarding the new level funding health benefit programs so we prepared this video to make it a little easier to understand. Ask us today if Level Funding might be a good for for your health plan!

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Important News From Independence Blue Cross: Trinity Health termination

February 11th 2019: For the past several months, we have been negotiating the terms of our agreements with Trinity Health (Trinity), which includes the following entities, as well as their professional providers, subsidiaries, affiliates, and divisions: Mercy Health System of Southeastern Pennsylvania, including Mercy Fitzgerald, Mercy Philadelphia, and Nazareth hospitals St. Mary Medical Center, including St. Mary Rehabilitation Hospital, Saint Francis Healthcare, including Saint Francis Hospital, Wilmington, Delaware. We continue to engage in good‑faith negotiations, but we want to explain how customers and members could be affected if we are unable to reach a new agreement by March 31, 2019. How members would be affected If we are unable to reach a new agreement, Trinity will no longer be… Read More

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Do You Need an Rx? Best Treatments for Top 7 Health Issues

Pharmaceutical Companies spent $5.6 billion in 2015 for advertisements.. and those advertisements seem to work. 1 in about 7 people who take at least one Rx have admitted they specifically asked their Doctor about a medication they heard on the Tv, Radio, online, or in print. 2/3rds of those Doctors wrote the prescription for the drug requested. The problem with advertisements is that you do not know if this more expensive drug works better than a less expensive generic or if you can achieve the same results with simple lifestyle changes.  Consumer Reports has piled tons of research, recommendations and reviews from credible sources to compile what they deem are… Read More

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Walgreens agrees to pay $269 million in fraud accord

Walgreens Boots Alliance agreed to pay $269.2 million to settle U.S. claims that the drugstore chain defrauded a federally funded health care program over insulin drugs and a consumer-discount initiative. The two settlements, announced Tuesday, cover allegations over improper billing. In the first one, the company agreed to pay $209.2 million to resolve claims it billed Medicare, Medicaid and other programs for hundreds of thousands of insulin pens it distributed to people who didn’t need them. In the second, Walgreens said it would pay $60 million for overbilling Medicaid by not disclosing lower prices it offered in a discount program. To read more, click here.

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Beware of Phishing Email Disguised as HIPAA Privacy Audit Letter

The Office of Civil Rights (“OCR”) of the Department of Health and Human Services (“HHS”) has posted an alert warning employers, and others, of a fake communication involving the OCR audit program under HIPAA. The email falsifies HHS departmental letterhead and the signature of the OCR Director and directs individuals to a non-governmental website marketing the cybersecurity services of a firm that is not associated with HHS or OCR. This phishing email originates from the email address OSOCRAudit@hhs-gov.us and directs individuals to a URL at http://www.hhs-gov.us. This is a subtle difference from the official email address for the real HIPAA audit program, OSOCRAudit@hhs.gov Phishing is a scam typically carried out… Read More

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Total Benefit Solutions Partners with Aliera Healthcare

Aliera Healthcare is an innovative healthcare organization offering both traditional healthcare and health sharing plans, which are an alternative to traditional insurance. At the core of Aliera plans is a concentration on the patient using our “Core 4” Patient Centered Medical Home Model of Care. Employer Group plans range from ACA compliant ‘Minimum Essential Coverage” to Self-Funded Minimum Value Plans. Our Individual plans are supported by our Healthcare Sharing Ministry Partner, Trinity HealthShare. Click here to find our more about the benefits, rates and programs available and then call us at (215)355-2121!     

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IBC: PEO offering now available

Independence is pleased to partner with CLEAR Employer Services to provide a Professional Employer Organization (PEO) offering to companies looking to outsource many of their HR‑related functions, beginning with 1/1/2019 business. This solution supports primarily small and mid-size businesses by handling a variety of human resources and administrative functions, freeing company leaders to focus on growing their businesses through increased attention on strategy, innovation, and operations. Total Benefit Solutions inc., as one of the area’s leading brokers is excited to offer this  as a potential solution for our clients! Through the establishment of a PEO Master Health Plan, the PEO will be a single Large Group customer with membership consisting of… Read More

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