President Trump Signs Prescription Drug Gag Clause Legislation On Wednesday, President Trump signed into law S. 2553, the Know the Lowest Price Act, and S. 2554, the Patient Right to Know Drug Price Act. The legislation was passed by the House and Senate last month with bipartisan support and will ban “gag clauses” that prevent pharmacists from telling customers when they can save money on their prescriptions by paying out of pocket for the retail price of the drug, rather than using their insurance and making the co-payment. These bills comprise portions of President Trump’s “America First” prescription drug initiative that were released as part of a blueprint to lower drug prices in May.… Read More
Continue ReadingIBC 2019 Member Renewal Notices
October 25th: Independence Blue Cross Member Renewal Letter details Due to the subsidy disruption in some counties, Independence will be sending renewal notices in 2 waves. On October 25th 2018: • Members who do not receive a subsidy will receive their renewal notices for 2019. The notice will include benefit and premium updates for 2019 and provide a personalized URL for a website that enables them to renew plans as-is (EZ Button), or make a change to their current plan. • Members who have a subsidy will receive a letter advising that Independence is waiting for more information from the federal government regarding their subsidy dollars. Upon receipt of this information, the renewal notices will be sent.… Read More
Continue ReadingSocial Media Drive Winner Announcement!
Back in August we announced an End of Summer Social Media Drive Contest. The rules were very simple: If you left us a review, you were eligible to be entered into a drawing for an Amazon gift card valued from $25-$100… For each review you left us on one of our platforms (Google, Yelp, Facebook, Angie’s List, Linkedin, etc) you earned $25 towards that giftcard (up to four review max per person). The contest ran from August 1st, 2018 until September 30th, 2018, but today we finally got our winner. Our Front Office Coordinator, Samantha, joined me for the random drawing. Please watch the short video below to find… Read More
Continue ReadingHealth Care Reform: How should employers disburse medical loss ratio (MLR) rebates from insurance carriers?
Recently a number of clients have received notices and/or checks for their organizations’s Medical Loss Ratio, or MLR rebates. Below is some helpful information from SHRM for understanding how these rebates can be used or distributed. According to the U.S. Department of Labor’s Technical Release No. 2011-04, the employer’s responsibility for distributing the rebate to participants is dependent on who paid for the insurance coverage. If the employer paid the entire cost of the insurance coverage, then no part of the rebate would be attributable to participant contributions. However, if participants paid the entire cost of the insurance coverage, then the entire amount of the rebate would be attributable to participant… Read More
Continue ReadingHow to Protect Yourself from Medical Bankruptcy
According to a CNBC report, an estimated 2 million people were adversely affected by bankruptcies due to medical costs. In 2009, President Obama declared that someone files bankruptcies every 30seconds (or about 1million people are affected per year!). A popular Facebook meme, shown to the left said the number was 643,000 people a year. Healthcare costs make any of these stats seem realistic, but why are they so different? One reason is that people gather information from different studies made during different years. Even though most of the information comes within the last decade, there are tons of factors that affect our economy. In 2007, 822,590 consumer bankruptcies were filed, but for 2010,… Read More
Continue ReadingMedicare Part D Notification Requirements
Employers sponsoring a group health plan with prescription drug benefits are required to notify their Medicare-eligible participants and beneficiaries as to whether the drug coverage provided under the plan is “creditable” or “non-creditable” prior to October 15th, 2018. Please follow this link for more information: Medicare Part D Notification Requirements As always, if you have any questions or concerns about this notification or your specific policy, please contact us at 215-355-2121
Continue Reading5 Affordable Self-Employed Health Insurance Options When You’re on a Budget
5 Affordable Self-Employed Health Insurance Options When You’re on a Budget When you are self-employed, finding affordable health insurance options isn’t easy. There are more types of insurance policies now more than ever; However not all of those choices are affordable. So, how can you find good coverage when you’re on a budget? Continue reading below for some great options to make sure you get the benefits you need at a price you can afford! 1. Telemedicine Services and Secure Doctor Consultations A budget-friendly health insurance alternative that’s gaining popularity are Telemedicine Services. Telemedicine services are just like they sound, it’s a medical service that allows you to speak to… Read More
Continue ReadingThe History of Medicare
A brief history of Medicare in America Landmark social program now covers 58.5 million Americans By Steve Anderson Discussion about a national health insurance system for Americans goes all the way back to the days of President Teddy Roosevelt, whose platform included health insurance when he ran for president in 1912. But the idea for a national health plan didn’t gain steam until it was pushed by U.S. President Harry S Truman.On November 19, 1945, seven months into his presidency, Truman sent a message to Congress, calling for the creation of a national health insurance fund, open to all Americans. The plan Truman envisioned would provide health coverage to individuals, paying for such typical expenses… Read More
Continue ReadingPrevent Osteoporosis with Screenings
10 Facts About Osteoporosis By Kathleen Hall This silent disease significantly raises your risk for fractures and disability. 1. Losing bone density is a normal part of aging. We reach peak bone mass between ages 25 and 30, and then slowly lose begin to start losing bone mass at age 40. For women, reduced levels of estrogen after menopause accelerate bone density loss. “Women lose 1.5 to 2 percent of their bone density per year in the first 10 years after menopause,” says Laura Ryan, MD, clinical associate professor of medicine in the division of endocrinology, diabetes, and metabolism at The Ohio State University Wexner Medical Center in Columbus. 2. You don’t lose… Read More
Continue ReadingEnd of Summer Social Media Drive 2018
Please help us get the word out on social media in August & September You Could Win a $25-$100 Amazon Gift Card!!! While everyone is getting ready for the End of Season BBQs, gearing up for Back-to-School, and trying to fit in as much adventure as possible the next few weeks, we here at Total Benefit Solutions are getting ready for our busiest time of year: Open Enrollments! Your friends and family members may not be concerned with the open enrollment period.. YET, but it is quickly approaching and we’d like to help them! As always, We appreciate all the referrals and recommendations that we get online from everyone, but we… Read More
Continue ReadingNew Medicare Card Mailing Update!
Check the Status of Your New Card *Cards have finished mailing to American Samoa, the Northern Mariana Islands, Guam, and to people who get RRB benefits. Three Things To Know Your new card will automatically come to you. You don’t need to do anything as long as your address is up to date. If you need to update your address, visit your My Social Security. Once you get your new Medicare card, destroy your old Medicare card and start using your new card right away. Your new Medicare Number is a unique combination of numbers and letters. Your new number uses numbers 0 thru 9. The letters S, L, O,… Read More
Continue ReadingDo You Qualify For A Special Enrollment Period?
Have you lost your health insurance coverage due to a change in employment, a move, or another life event? Since the 2018 Open Enrollment Period is over, you can only enroll in or change a Health Insurance Marketplace plan if you have a life event that qualifies you for a Special Enrollment Period. Below are Life Events that can grant you a Special Enrollment Period. If you have any questions or would like to talk to someone here about a quote, give us a call at 215-355-2121 or click here. Life changes that can qualify you for a Special Enrollment Period -Changes in household- You may qualify for a Special Enrollment… Read More
Continue ReadingHouse Passes Legislation to Change HSAs
The House of Representatives passed two pieces of legislation that, among other things, purport to improve and “modernize” health savings accounts (“HSAs”). While the bills call for significant changes to the current rules affecting HSAs, the specific details are very different. Both pieces of legislation have been sent to the Senate for consideration. Whether the Senate will take up these bills, let alone approve them “as is,” remains uncertain. There appears to be some bi-partisan agreement to loosen the current HSA rules, which means it is possible that we may see changes to these arrangements, which could be effective as early as January 1, 2019. When more information is available, we will… Read More
Continue ReadingIntroducing Xpress Healthcare with Aetna Dental Access!
Total Benefit Solutions offers Xpress Healthcare with a great dental discount & more for Individuals, Families and Seniors! Click Here to shop, compare & enroll!
Continue ReadingThe Four Stages of Medicare Part D (2018)
The Four Stages of Medicare Part D Coverage
Continue ReadingWatch Out For Medicare Scams!
Your new Medicare card is on the way, so if someone calls and says you need to give them your personal information or money to get the new card, hang up! It’s a scam. Medicare will never call uninvited and ask for personal information or money for you to get your new Medicare Number and card.Learn what to do if you get a suspicious call like this. If you haven’t gotten your new Medicare card yet, don’t worry. Mailing cards to each group of states takes at least a month, so you might get your card at a different time than friends or neighbors in your area. In the meantime, keep… Read More
Continue ReadingTrump Administration Expands Access To Short-Term Plans That Do Not Meet ACA Requirements
The New York Times (8/4 Pear) reports that on Wednesday, the Trump Administration unveiled “a final rule…that clears the way for the sale of many more health insurance policies that do not comply with the Affordable Care Act and do not have to cover prescription drugs, maternity care or people with pre-existing conditions.” These new options “will help people struggling to afford coverage under the 2010 law, said James Parker, a senior adviser to” HHS Secretary Alex M. Azar II. On its front page, the Washington Post (7/31, A1, Goldstein) reports that these policies, which are intended “to fill brief gaps in coverage, will be available for 12 months at… Read More
Continue ReadingNew Jersey Out-of-Network Bill
On June 1, 2018, New Jersey Gov. Murphy passed the Out-of-Network Consumer Protection, Transparency, Cost Containment and Accountability Act (the “OON Act”). In general, the OON Act applies to emergency services and other care provided by out-of-network physicians in in-network settings (i.e. hospital-based physicians). It takes effect on September 1, 2018. Click the link below to download the full story: Click to Download For more information or if you have any questions, please feel free to contact your Total Benefit Solutions Account Manager at 215-355-2121
Continue ReadingYour New Medicare Card is on the way! Watch out for scams!
Watch out for scams Your new Medicare card is on the way, so if someone calls and says you need to give them your personal information or money to get the new card, hang up! It’s a scam. Medicare will never call uninvited and ask for personal information or money for you to get your new Medicare Number and card. Learn what to do if you get a suspicious call like this. If you haven’t gotten your new Medicare card yet, don’t worry. Mailing cards to each group of states takes at least a month, so you might get your card at a different time than friends or neighbors in your area.… Read More
Continue ReadingAssociation Health Plans: What Do New Guidelines Mean for Healthcare?
From our PEO partners at Extensis… Back in October, President Trump signed an executive order intended to help make healthcare more affordable to individuals and small employers.This executive order marked the administration’s continued efforts to undo aspects of the Affordable Care Act (ACA). It also encouraged the use of Association Health Plans (AHPs) on a much larger scale (county, state, region, or even nation-wide) to potentially lower the costs of healthcare for individuals and smaller businesses. At the time, the President directed the Labor Department to study how to make AHPs a feasible option. Click here to read the story
Continue ReadingMedicare Part D Donut Hole Closing Sooner!
Did you know? The Bipartisan Budget Act of 2018 moved up the date for closing the so-called donut hole for brand name drugs to 2019. It was previously 2020. For 2019 and every year after, the beneficiary cost sharing for brand name drugs after the initial coverage limit is 25% — the same as after the deductible and before the initial coverage limit. In 2020, the beneficiary cost sharing for generic drugs will also be 25%. Ask your Total Benefit Solutions Account Manager for more information at (215)355-2121. Total Benefit Solutions Inc. is your Medicare health insurance specialist! We work for your benefit!
Continue ReadingCMS Expands the Extension of Needed Relief for Marketplace Enrollees Who Missed Medicare Enrollment
CMS is offering assistance to certain individuals enrolled in both Medicare Part A (and/or Part C) and the Exchange for individuals and families to drop their Exchange coverage and enroll in Part B without penalty. Further, CMS is offering assistance to certain individuals who dropped or lost their coverage from the Exchange and are paying a Part B late enrollment penalty from their subsequent enrollment into Part B. These eligible individuals can have their penalty reduced. Individuals can apply for the special enrollment and reduction in late enrollment penalties during a limited time – it is available now and ends September 30, 2018 Read Blog Post from MedicareRights.org CMS SHIP… Read More
Continue ReadingFour Stages of Medicare Part D
It’s easy to see why Many people are confused by the Medicare part D plan coverage deductibles, limits and the donut hole. We have provided this graphic for you, our clients and friends to make it a little easier to see in a pie chart. Click the link below to download this graphic bulletin. 2018 Four Stages Of Medicare Part D Want to compare part D plans in your area quickly? Click here Have more questions? Call us today at (215)355-2121.
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