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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Be Prepared for Medical Appointments

Are you going to a new Doctor? Get a recent diagnosis? Or looking into new Hospital Systems? There are tons of important questions to ask when dealing with your health, but most don’t know where to start.  The Agency for Healthcare Research and Quality has put together the important questions to ask for many health-related issues. Please click here to find out which questions you should be asking!

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If companies could give employees tax free money to buy health insurance on their own, how many would do so?

If companies could give employees tax free money to buy health insurance on their own, how many would do so?

We’re about to find out

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Medicare vs. Medicaid: The Basics

We know everyone has heard of “Medicaid” and “Medicare” but most people don’t know exactly what these Government programs do, or confuse the two. Some even think they are the same thing, when they are both completely different types of programs. Each program is designed for specific populations, controlled by different areas of the Government (one on the State level and one in the Federal level) and both offer different “perks” for those enrolled. The short answer is that Medicare is designed usually for people over 65, while Medicaid is an incomes based insurance.. but it’s a little bit more than that and some people can be eligible for both.… Read More

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Quick Updates in the World of Insurance

Extension of Deadline for 2018 Forms 1095-C The IRS has issued Notice 2018-94, which provides a limited extension of time for employers to provide 2018 Forms 1095-C to individuals. It also extends good-faith transition relief from certain penalties for the 2018 reporting year. To find out more, please click here.   Wellness Program Considerations for 2019 Wellness programs have faced unique challenges and scrutiny in 2018. Click for an update on the status of wellness program incentives and the Department of Labor’s enforcement activity on wellness programs tied to group health plans. For more information on how the plans are changing, please click here.   New Jersey: Premiums in the… Read More

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Over Half of Americans Delay or Don’t Get Healthcare Because They Can’t Afford It

Over Half of Americans Delay or Don’t Get Healthcare Because They Can’t Afford It   With open enrollment for many medical plans in full swing, health care is top of mind for millions of Americans. But health care is still too expensive for most: A majority of U.S. adults have to delay getting the care they need, or put it off completely, because they can’t afford it, data from financial website Earnin shows. According to the research, which combined Earnin-user data with data from a Harris Poll survey of more than 2,000 adults, 54 percent of Americans say they’ve delayed care for themselves in the past year because of cost, and another 23 percent delayed care for more… Read More

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The Six Common Types of Health Plans

With the Marketplace making Health Insurance products more accessible and affordable than ever before, people have the opportunity to choose from MANY different policies, as opposed to before when most people just took whatever insurance an Employer may have offered them. While most people are familiar with or have heard of HMOs and PPOs, newer types of policies have become increasingly popular. So what are the main six kinds of Health Insurance Plans? Health Maintenance Organizations (HMOs) An HMO has all of your health services go through a network of healthcare providers and facilities. If your Doctor/facility is not in the HMO Network, then the Insurer will not cover your… Read More

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Trump Administration Issues New guidance on ACA Provisions

According to advice issued Thursday by federal health officials, states should be free to redefine the use of  subsidies, which began in 2014. They represent the first help the government ever has offered middle-class consumers to afford monthly premiums for private insurance. States could allow the subsidies to be used for health plans the administration has been promoting outside the ACA marketplaces that are less expensive because they provide skimpier benefits and fewer consumer protections. In an even more dramatic change, states could let residents with employer-based coverage set up accounts in which they mingle the federal subsidies with health-care funds from their job or personal tax-deferred savings funds to… Read More

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The Top 3 Reasons Employers Offer Supplemental Insurance Plans

Why Employers Offer Supplemental Insurance Plans Employers everywhere have become more and more interested in offering Supplemental Insurance Plans. These Voluntary Benefits are insurance products employees can elect to add to their plans to fill the gaps in their health insurance policy. These plans help with the costs associated with medical bills and missed time at work. So why are Employers offering these policies more and more? Here are the Top 3 Reasons Why Employers Offer Supplemental Insurance Plans:   Recruit New Employees and Up Morale More than ever, supplemental insurance plans are an important part of an attractive employee benefits offering. A LIMRA study finds that 7 in 10… Read More

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Friendly Reminder: Enrollment Periods End Soon!

Open Enrollment for Medicare ends on December 7th while the ACA Marketplace/ Obamacare Enrollment Period runs until December 15th. With all the hustle and bustle happening with the official beginning of the Holiday Season, these are important dates to know. If you have yet to choose a plan or have questions about plans available to you, now is a great time to get answers and get enrolled.  Please Click Here for information on how to Enroll in either of these plan types. For those that want to choose a Marketplace policy, CMS has put together a helpful list of things you should have readily available for your plan selection. Having all of… Read More

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Total Benefit Solutions gave you $5.00 in Lyft credit towards your first ride in Philadelphia!

Make It to the Table: Don’t Drink & Drive this Thanksgiving Eve   “Thanksgiving Eve,” is associated with drinking and is a big night for bars. More than 800 Americans died in alcohol-impaired crashes during the days surrounding Thanksgiving over the past four years (6:00 p.m. Wednesday to 5:59 a.m. Monday), making it the deadliest holiday on our roads. If you plan on drinking PLEASE plan a head. There’s no need for senseless tragedies. Lyft has issued coupon code “TotalBenefits” for $5 off their ride service this holiday for new users. Enjoy your holiday responsibly!! Click Here to be taken to the promo page. Or simply download the app and use… Read More

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