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Continue ReadingIn an age when more and more positions require duties to be carried out almost exclusively on
computers, and where the internet can instantly connect anyone anywhere, many employers, including ,
are offering the option of telecommuting. Telecommuting allows employees to work from home or
another alternate location and communicate with their employers electronically.
Employee Eligibility Exception for furloughed or temporarily laid off employees. As a result of the COVID‑19 outbreak, Independence will honor employer requests to continue coverage for employees furloughed or temporarily laid off as a result of impacts of COVID‑19. This exception applies to fully insured and self-funded business, and is contingent upon the following: Full premium payments continue to be made by the employer.Self‑funded employers must continue to remit invoiced amounts in full. The employer is responsible for collecting employee contributions, if applicable. No reductions to employer contributions will be allowed. Only actively at‑work employees can be added to the plan as new enrollees. Our preferred Stop Loss partner, HM Insurance Group (HMIG) HMIG will honor… Read More
Continue ReadingOn December 2, 2019, the IRS issued Notice 2019-63, which provides: • An extension of time, until March 2, 2020, for employers to provide Forms 1095-C to their full-time employees and other individuals; and • An extension of relief from penalties for the 2019 reporting year for employers and other entities that make good-faith efforts to comply with the reporting requirements.
Continue ReadingAnnual Medicare Part D reporting is required for all employers who provide health benefits with prescription drug coverage. The reporting is an online filing to the Centers for Medicare & Medicaid Services (CMS), and it lets CMS know if the prescription drug coverage available on the employer’s health plan is “creditable.” The Medicare Part D reporting helps CMS determine if a person enrolling in a stand-alone Part D plan is subject to a late enrollment penalty. Late enrollment penalties apply for individuals who delay enrollment in a Part D plan upon first becoming eligible unless they have prescription drug coverage elsewhere that is at least as good as the standard… Read More
Continue ReadingUnitedHealthcare’s policy will limit outpatient surgery payments to hospitals Kelly Gooch UnitedHealthcare has expanded prior authorization requirements and site of service medical necessity reviews for certain surgeries in an effort to shift surgical procedures to less expensive locations, according to Modern Healthcare. The outpatient surgery policy will limit the circumstances under which UnitedHealthcare will pay for certain surgeries in a hospital outpatient setting. Taking effect in November for fully insured groups in most states, UnitedHealthcare will only pay for a surgical procedure performed in an outpatient hospital setting if the insurer determines the site of service for the procedure is medically necessary, UnitedHealthcare told Becker’s Hospital Review. “Medical necessity reviews for… Read More
Continue ReadingIt’s Your Last Chance.. The Medicare Access and CHIP Reauthorization Act of 2015 eliminates all Medigap Plans that cover the Medicare Part B deductible. A deductible is an amount of money you must pay out of pocket before your plan will begin covering services. The Part B deductible in 2019 was $185 and is projected to be $197. Medicare Part B covers most of your outpatient services. Things such as Doctor visits, labs and tests, durable medical equipment, and some medications. That means, unless a preventative care visit, you would have to pay out of pocket $197 before your plan would cover you. Why would Congress decide to pass a… Read More
Continue ReadingMedicare in 2020 Everyone has heard of Medicare and over the years, here at Total Benefit Solutions have posted numerous articles explaining how Medicare works. We even wrote out a post about the history of Medicare a little over a year ago (That post can be found here ). However, nothing in the Insurance World stays still and every so often we like to revisit this sector of the Insurance Market and explain how Medicare works with some updates. This way, whether you’re new to Medicare, or you’ve been on it for a while, you are up-to-date on how your Insurance Plan works! Original Medicare (Part A and Part… Read More
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IRS explains application of employer mandate to individual coverage HRAs Federal authorities announced in June that beginning in 2020 employers could offer employees an HRA designed to reimburse individual market medical insurance policies in lieu of group medical insurance. But one piece of the puzzle was missing: How would an employer satisfy the Affordable Care Act’s employer mandate by only offering such an HRA? The IRS has now proposed rules explaining precisely how an employer can satisfy the ACA employer mandate and avoid penalties simply by offering an individual coverage HRA (ICHRA). Background ICHRAs differ significantly from the familiar and traditional HRAs. The key difference is that a traditional HRA… Read More
Continue ReadingWritten By: ERIC C. POSTED: DECEMBER 16, 2018 Every year, seniors are scammed out of tens of billions of dollars, money they’ve spent their entire lives saving only to have it stolen. The elderly have always been a prime target for Internet scams because of a perceived vulnerability, and now because Internet use among seniors is on the rise. A Pew Research Center survey showed that 67% of seniors are now regular Internet users. Internet security is something everyone should prioritize, regardless of age, so it’s important to be aware of current threats and how to deal with them. With so many people online, the magnitude of scams is increasing. Protect Your Computer Hackers are always on… Read More
Continue ReadingHealth coverage is a key benefit employers offer workers in order to attract and retain the best and the brightest. Yet employers face numerous complex regulatory rules and administrative burdens in providing health coverage to their employees. Most big employers have entire departments devoted to understanding the rules and administering health coverage. But, many smaller business owners don’t have that luxury. They alone must take on the task of navigating how to provide health coverage to their employees. This year, the Trump Administration took a big step forward in doing just that by issuing new rules expanding Health Reimbursement Arrangements (HRAs). HRAs are employer-funded accounts that workers can… Read More
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