What is the NYHCRA Form?

What is the NYHCRA Form? For clients going into a self insured plan for the first time, this question always comes up.  The employer always has the option to participate in the pool or not but we always encourage them to participate for their own protection. This only comes into play when a member of a group seeks or gets medical treatment in New York For groups who do not elect into the Pool If there are New York state residents that incur in-patient claims in New York there is an alternative covered lives payment based on the resident’s location and this can be up to an additional 27.28% of… Read More

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Review us on Google

 At Total Benefit Solutions we strive to provide our clients with the best service and support when shopping, enrolling and servicing their health insurance all year long. We appreciate having the opportunity and as always “We Work for Your Benefit”.  If you have worked with us, please help us get some feedback by  reviewing us on Google.  You’ll need to be logged in to your Google account to do so. Click here to rate us!

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Download the 2020 Compliance Year in Review

Download our 2020 Compliance Digest Year in Review, featuring all of the released compliance bulletins for January through December. This document is a valuable resource, putting all of the latest health care reform news and updates in one location. Click Here to Download Compliance Digest 2020 Year in Review Should you have any questions about this bulletin, please contact your Total Benefit Solutions Account Manager at (215)355-2121. Note: the file is large at nearly 300 pages and may take time to download.

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Did you know? IBC offers Guest Memberships for family members away from home.

  When you know that you or a covered member of your family will be out of the area for at least 90 days, you can apply for a guest membership with a participating HMO/POS plan in your travel area, where available. The Away from Home Care program offers a comprehensive set of HMO/POS benefits through a participating plan while away from home. Options include: Long-term traveler: Six months maximum, renewable upon plan year renewal.Available to eligible subscribers and their covered dependents. This type of guest membership is typically used for long-term work assignments or for a retiree with a dual residence. Families apart: One year maximum, renewable upon expiration of guest membership.Available to… Read More

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All Savers aims to simplify IRS reporting requirements for small group plan sponsors

  Photo by Kendal on Unsplash All Savers® Alternate Funding understands how confusing health benefit taxes and reporting requirements can be to small businesses, and is committed to providing enhanced service to your All Savers small business groups. All Savers will generate the 6055 Membership Report for groups to complete their 6055 form filing. All Savers will prepopulate Forms 1095-B for all covered members in an eligible small group*. Because this service is optional, your All Savers Alternate Funding groups can access these documents by logging into their All Savers plan sponsor account. A copy of the 6055 Membership Report will be available on the myallsavers.com broker website in the… Read More

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Medicare & Coronavirus

Your health, safety, and welfare in the face of the coronavirus disease 2019 (COVID-19) is our highest priority. According to the Centers for Disease Control and Prevention (CDC), older adults and people who have severe chronic medical conditions like heart, lung, or kidney disease seem to be at higher risk for more serious COVID-19 illness. This means that most people with Medicare are at higher risk.   Click here to get the latest updates specific to people on Medicare. Specific questions? Give us a call at Total Benefit Solutions Inc (215)355-2121

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DOL FAQs Address Expiration of FFCRA Leave

On the last day of 2020, the Wage and Hour Division of the Department of Labor (“DOL”) issued two additional FAQsrelated to the Families First Coronavirus Response Act (“FFCRA”), addressing the three-month voluntaryextension of FFCRA leave into 2021, and clarifying payment of leave taken during 2020. Read the full bulletin by clicking the link to download: DOL FAQs Address Expiration of FFCRA Leave – 011221R As always please contact your Total Benefit Solutions account manager at (215)355-2121 if you have any questions or concerns about this update.

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IBC: December premium credit for small group clients

Notice From IBC: As part of our continuing effort to support small businesses in the region during this challenging time, we are pleased to provide fully insured small group (2 – 50) clients with a 10 percent medical premium credit on their December invoices. This reduction is based on October 1 enrollment, and will be reflected in the invoices groups receive in mid-November.  This premium credit is in addition to the credit on medical and dental premiums Independence provided in September. And just as in September, a message will appear on the invoice highlighting the reduction in premium. If you have any questions or concerns about this bulletin please contact your Total Benefit… Read More

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New Jersey Governor Issues Executive Order

On October 28, 2020, New Jersey Governor Phil Murphy signed Executive Order No. 192, which calls for the implementation of mandatory health and safety standards to protect all New Jersey’s workers during the pandemic. The executive order will require both private and public sector employers to follow health and safety protocols. This is to take effect starting at 6:00 a.m. on November 5, 2020. All employers will, at a minimum, require individuals at the worksite to maintain at least six feet of distance from others where possible and require both employees and visitors to wear masks when entering the worksite. Other actions in the executive order include, but are not limited… Read More

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Meet Pennie!

  Meet Pennie! Pennie is Pennsylvania’s own health insurance marketplace: We connect Pennsylvanians to coverage in an unexpectedly simple and approachable way.  Pennie was built with all Pennsylvanians in mind: For those who thought health insurance was out of reach or overwhelming, but also for those who understand the importance of insurance. All Pennsylvania health insurance consumers on the federal marketplace will need to transition to Pennie during this years open enrollment period beginning November 1st! Click to Meet PennieHave questions about Pennie and how it impacts your current coverage or this years upcoming open enrollment? Contact us at Total Benefit Solutions Inc, your Pennie trained and certified independent brokers … Read More

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From Independence: 2019 MLR rebates to be issued to group customers by September 30

  Independence is pleased to announce that we succeeded in achieving a federal Medical Loss Ratio (MLR) below the required minimums for individual, small, and large group fully‑insured QCC, as well as both large group fully insured Keystone Health Plan East and AmeriHealth PA businesses in Pennsylvania. As a result, Independence will issue affected customers a rebate of a portion of paid premiums during the 2019 reporting year. Check and notification mailing to begin week of September 14 Beginning the week of September 14, Independence will begin to mail impacted customers their rebate check, a required CMS prescribed notice, and an informative cover letter and FAQ. Their affected subscribers will receive the same required CMS prescribed… Read More

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Pennie is Pennsylvania’s new official destination for shopping for quality health insurance plans and accessing financial assistance, if eligible.

Pennie is Pennsylvania’s new official destination for shopping for quality health insurance plans and accessing financial assistance, if eligible. When is open enrollment? Open enrollment is November 1, 2020, to January 15, 2021. During this time period, anyone living legally in Pennsylvania can apply for health insurance through Pennie. Individuals with qualifying life events can enroll at any time of the year. Who can help you enroll? They have several options to assist you in enrolling in a health insurance plan. Don’t try completing the enrollment process by yourself, the experts at Total Benefit Solutions, Inc are Pennie-certified Brokers. Where can I learn more about financial assistance and if I… Read More

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FAQs Address School Reopening and FFCRA Leave

Photo by Deleece Cook on Unsplash Click Here to Download FAQs Address School Reopening and FFCRA Leave The Department of Labor’s Wage and Hour Division (“the Department”) added three new FAQs to clarify when benefits are available under the Families First Coronavirus Response Act (“FFCRA”) as the school year begins. The FFCRA provides eligible employees of covered employers (less than 500 employees) up to 12 weeks of expanded family and medical leave when they are unable to work (or telework) because they are caring for a son or daughter whose school or “place of care” has been closed or whose childcare provider is unavailable due to COVID-19-related reasons. During the… Read More

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Confused About Medicare & Your Options?

Medicare is a federal health insurance program for people who are 65 or more years old or have certain qualifyingdisabilities. However, the complexities of the Medicare marketplace often leave consumers wondering if they have made the right decisions after enrollment. Our approach is truly a multi-level evaluation of all your options! Reach out to us today and we will help ! (215)355-2121.Click here to download OUR APPROACH      

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Could an ICHRA be the answer to your group health insurance challenges?

The individual coverage health reimbursement arrangement (ICHRA) is a new way for small businesses and other organizations to offer employees group style health benefits. It has been said to offer the most flexibility for employers and employees alike, the “ best of both worlds” if you will. This allows the employer to help fund the cost of healthcare but not take on the administration of the benefits. It gives the employee more freedom to choose a plan that works with their provider of choice, but to ensure that the employee understands the plan and benefits, it is helpful to work with an independent broker. The broker will educate and assist your employee… Read More

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Medicare Supplements & Advantage Plans are Different!

Medicare Advantage Plans and Medicare Supplement Plans( also known as Medigap) are different! If you know someone is is on Medicare or turning 65 soon it’s important to know the difference! Here are some of the simple explanations of Medicare Advantage vs Supplement… Medicare Supplements work in tandem with Original Medicare, Part A, & Part B, and will help pay for various costs that Original Medicare will not cover, (gaps). These plans do not give stand-alone coverage; you need to be enrolled in Medicare Part A & Part B for your primary coverage. If you want prescription drug coverage, you have to purchase a separate Medicare Prescription Drug Plan (Part… Read More

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United Concordia providing premium refunds to small groups in August

United Concordia Dental has taken strong measures to support small and large groups during this difficult time. I’m pleased to share that United Concordia will also be issuing premium refunds to fully insured clients. United Concordia will refund 50% of an average monthly dental premium payment. Refunds will be in the form of a check and issued in August*. And as a valued partner, it is important to note that your commission won’t be impacted by this refund. United Concordia is required to notify recipients prior to issuing actual refunds. So, the week of July 27, they’ll mail postcards notifying small groups (under 100 enrolled) about the refunds they can… Read More

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Who is PENNIE?

Do you have individual health insurance and live in Pennsylvania or New Jersey? For this upcoming 2021 open enrollment period, Pennsylvania has officially transitioned to a state-based exchange – PENNIE! This full conversion to a SBE is slated to occur for the beginning of the 2021 open enrollment period. The open enrollment period that opens on November 1, 2020. That’s approaching fast! Our intent is to make this transition with our clients, with an aim to minimize disruption  as much as possible. We anticipate that there may be some speed bumps in this transition! Regardless of what you want, if you are currently enrolled on an individual health insurance plan through … Read More

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Independence to provide premium credits and other support to clients and members

From: Independence Blue Cross In our continued commitment to our clients and members throughout the COVID‑19 pandemic, Independence is offering medical and dental premium credits and other financial support to our fully insured clients. As a result of the COVID‑19 pandemic, Independence has experienced a lower volume of health care services being delivered to our members than was anticipated when current plan prices were set. Moreover, our members have been unable to access some types of routine health services — from preventive screenings to dental cleanings — and many elective procedures have been delayed or cancelled. We know many of our clients are having difficulties managing costs during this time when business has been interrupted, and… Read More

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How Does Short Term Medical work?

Total Benefit Solutions, Inc works with many clients who are in between jobs, in good health or people who just want to pay less for their health plan insurance plan. As your impartial health insurance broker we can quote multiple carriers to find the best fit for our clients! .Ask us today of a short term medical plan could be a good solution for you! Just give us a call at 215-355-2121.

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