The myHealthcare Cost Estimator from United Healthcare helps you gather the information you need to make smart choices about the health care you receive. Learn more with the video below. As always contact your Total Benefit Solutions account manager if you have any questions or concerns at (215)355-2121
Continue Reading
2016 Compliance Year In Review Digest A complete digest of all our compliance bulletins for the entire year of 2016 from our business partners at Emerson Reid. A handy guide to all of the year’s updates and changes all in one place. Download your copy now and keep it for future reference. Click to Download Compliance Digest 2016 Year in Review As always please contact your Total Benefit Solutions Account Manager at (215)355-2121 if you have any questions or concerns.
Continue Reading
United Concordia small group enrollment forms for 2017 To enroll you on United Concordia they will require the following: The rate sheet with the benefit plan circled and the sheet signed at the bottom by the business manager or owner The completed employee applications for each employee enrolling. The form needs to be complete with each dependent’s name, date of birth, etc. A company check for the first month’s premium payable to United Concordia Companies Inc. or UCCI A completed employer application form. Complete what you can and we’ll finish the rest together. Download The New Group Enrollment Kit for 2017 You can fax everything to our… Read More
Continue Reading
On December 13, 2016, President Obama signed into law the “21st Century Cures Act” which allows small employers without group medical plans to reimburse individual premiums and other medical expenses of employees under health reimbursement arrangements (“HRAs”), effective with the 2017 plan year, and provides relief from penalties to all small employers reimbursing individual premiums of employees for earlier plan years. In addition, the Cures Act provides a medical innovation package that funds medical research, accelerates cutting-edge treatments for rare diseases, and makes significant reforms to the mental health system. The Issue An employer cannot offer employees cash to reimburse the purchase of an individual policy, without regard to whether… Read More
Continue ReadingDownload a digest of our fourth quarter compliance bulletins. This digest includes the following bulletins: Transitional Reinsurance Fee Form Now Available 10/14/2016 Final 2016 Forms 1094-C and 1095-C Available 10/25/2016 November 2017 Cost of Living Adjustments 11/01/2016 Relief Extended for Premium Reimbursement Programs for Student Employees 11/02/2016 Updates Regarding the NJ Small Employer Health Benefits Program 11/07/2016 Election Results and the ACA: Preliminary Thoughts 11/10/2016 16 Extension of Deadline for 2016 Forms 1095-C 11/21/2016 Adjusted PCOR Fee for Fifth Filing Year Released 11/22/2016 December Beware of Phishing Email Disguised as HIPAA Privacy Audit Letter 12/13/2016 Click here to download the 4th quarter compliance compilation
Continue Reading
New Law Exempts Certain Small Employer HRAs From ACA Market Reforms Gaddiel Gonzalez-Brown & Brown Consulting President Obama has signed into law the 21st Century Cures Act, which, among other things, allows small employers to offer new “qualified small employer health reimbursement arrangements” to reimburse employees for qualified medical expenses, including individual health insurance premiums, for years after December 31, 2016. Small employers are defined as those with fewer than 50 full-time equivalent employees who do not offer a group health plan. Background Under prior agency guidance, stand-alone HRAs (except for retiree-only HRAs and HRAs consisting solely of excepted benefits) and HRAs used to purchase coverage on the individual… Read More
Continue Reading
The IRS has provided a limited extension of time for employers to provide Forms 1095-C (and carriers to provide Forms 1095-B) to individuals (but NOT to the IRS). Rather than January 31, 2017, the new deadline will be March 2, 2017. Download Extension of Deadline for 2016 Forms 1095-C
Continue Reading
A number of clients ask us about Blue Card PPO and how it works. Blue Card PPO is typically attached to our clients policies who are enrolled on an IBC Personal Choice PPO or National Network PPO or a Horizon Blue Cross plan with National Access. You can tell if you have this on your plan if your card has the PPO Traveling Briefcase logo: It’s important to note that members who have a Keystone HMO, Amerihealth or Horizon HMO or local EPO do NOT have Blue Card PPO. How Does the BlueCard Program Work? BlueCard® PPO Medical Plan The BlueCard… Read More
Continue Reading
On November 22, 2016, a federal district court in Texas granted a preliminary injunction that temporarily blocks the U.S. Department of Labor (DOL) from implementing and enforcing its recently revised regulations on the white collar exemptions to the Fair Labor Standards Act (FLSA). The regulations, which were released in May and scheduled to go into effect on December 1, would more than double the minimum salary requirement certain executive, administrative, and professional employees must receive in order to be exempt from overtime. Click here to read the rest
Continue Reading
On October 25 and 27, 2016, the IRS released cost of living adjustments for 2017 under various provisions of the Internal Revenue Code (the Code). Some of these adjustments may affect your employee benefit plans. These adjustments include but are not limited to the following: Cafeteria Plans Qualified Transportation Fringe Benefits Requirement To Maintain Minimum Essential Coverage (Individual Penalty) Highly Compensated Non-Grandfathered Plan Cost-Sharing Limits H.S.A. Annual contribution limitation, catch up contribution and minimum deductibles Key Employee Click here to download the bulletin As always if you have any additional questions or concerns, please contact your dedicated Total Benefit Solutions, Inc. account manager at (215)355-2121.
Continue ReadingIRS Extends Due Date for Furnishing Form 1095-B/C. As applicable large employers and employers with self-funded health plans are working on their Affordable Care Act compliance preparations, the IRS announced an extension of a key ACA deadline. Notice 2016-70 extends the due date for furnishing Form 1095-B and Form 1095-C from January 31, 2017 to March 2, 2017. The Notice also extends transition relief from penalties if an employer makes a “good faith effort” to comply with reporting requirements. This relief is welcome news for employers who are still working on their compliance approach. A copy of the notice can be downloaded here.
Continue ReadingWith the outcome of the 2016 elections now official, the Republicans will hold the majority in both chambers of Congress and control of the White House beginning in 2017. Since President-elect Trump ran on a platform of “Replace and Repeal” of the Affordable Care Act (ACA), we anticipate that acting on this campaign promise will be one of the top priorities of the new Trump administration. We anticipate there will be significant disruption for individuals, employers, brokers and carriers across the country. Click here to read the latest bulletin
Continue Reading
Important Information About 2017 Member Renewal Letters In the coming weeks, members will be receiving renewal letters for their 2017 plans that include updated rate and product information, as required by ACA Guidelines. This letter will show the member’s updated 2017 premium with their 2016 subsidy amount. Because Independence will not obtain updated subsidy amounts until after November 1, we are not able to include the estimated 2017 subsidy amount in the first mailing. This information will be included in the second mailing which will be sent in mid-November. It is anticipated that subsidies, on average, will increase in 2017 for most members. • Updated renewal letters with 2017 subsidy… Read More
Continue Reading
In a July Independence Edge article, we shared that the U.S. Department of Health and Human Services (HHS) had issued a final rule for the nondiscrimination provision (section 1557) of the Affordable Care Act (ACA). While the nondiscrimination provision itself is not new, the final rule provides expanded clarity on coverage for gender reassignment surgery and related services. In addition, it provides guidance on treating individuals consistent with their gender identity, and not denying or limiting health services usually only available to individuals of one gender. Beginning with renewals on or after January 1, 2017, the exclusion for gender reassignment surgery has been removed from all commercial plans. Members… Read More
Continue Reading
As many people know by now there are many big changes with individual and family plans for open enrollment 2017. For anyone who is currently enrolled on one of the following your plan will NOT be renewed for 2017 and you will have to pick a new plan and/or a new insurer: Aetna: all plans cancelling in PA/NJ/NC/FL Aetna plans only remain in Delaware in our service area United Healthcare: All ACA plans cancelling. Short term plans are still available Oscar: All plans in NJ cancelling Health Republic: All plans in NJ cancelling Highmark and Capitol Blue Cross: No longer paying broker compensation Geisinger: No longer paying broker compensation Independence Blue… Read More
Continue Reading
Total Benefit Solutions is pleased to announce that we are participating in the Independence Blue Cross Medicare/ CVS Pharmacy retail program for the upcoming open enrollment period. What this means to our clients is that we will be on site at our local CVS Pharmacy during the AEP. Starting on Saturday October 15th and continuing through open enrollment we will be on site nearly each Monday, Wednesday and Friday at the CVS Pharmacy in Feasterville from Noon to 2 PM each day. Please feel free to stop in without an appointment to get your questions answered and pick up your 2017 plan information from Independence Blue Cross. We will… Read More
Continue Reading
2017 ACA ” Obamacare” plans open enrollment important update. The annual open enrollment period opens on November 1st 2016 and ends January 31st 2017. Independence Blue Cross will be the only insurer available in 2017 in the Philadelphia 5 County Area. With the passing of the Affordable Care Act changes come annually or even more often. Unfortunately not all of those changes are benefiting the consumer. This year here are some major changes that our clients on Individual Non Medicare plans need to be aware of… If you are a enrolled on an ACA compliant plan with Aetna or United Healthcare your plan is going away. Neither Aetna or United… Read More
Continue Reading
On September 6, 2016, the Department of Health and Human Services (“HHS”) issued an interim final regulation that adjusts civil penalties for inflation. The interim final regulation does not follow the usual procedures that offer a notice and comment period. As such, a Notice of Proposed Rulemaking has not been issued and a comment period is not provided due to potential delay in the applicability of the regulation. Click to download this bulletin For more information please contact your Total Benefit Solutions account manager at (215)355-2121
Continue Reading
Employers who sponsor 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.” This notification must be provided prior to October 15th each year. Download medicare-part-d-reminder-to-distribute-creditable-coverage-notice-
Continue Reading
NJDOBI Announces Health Republic Insurance of NJ Will Not Offer Coverage for 2017 On September 12, 2016, the New Jersey Department of Banking and Insurance (NJDOBI) announced that Health Republic Insurance of New Jersey (HRINJ) has consented to be placed in rehabilitation due to its deteriorating financial condition. If approved by the court, the rehabilitation will enable the Department to preserve the assets of the carrier so that consumers continue to receive the care to which they are entitled and medical providers are paid. Under this rehabilitation plan, current policies will remain in force through December 31, 2016, but HRINJ will not offer coverage for 2017. The Department and… Read More
Continue ReadingThe IRS recently issued proposed regulations that (among other things) address affordability determinations for individuals who are eligible for employer-sponsored health coverage. Building on earlier guidance, the proposed rules describe the effect an opt-out waiver has on affordability. Should you have any questions, please contact your Total Benefit Solutions account manager directly at (215)355-2121. Click here to download this bulletin
Continue ReadingOscar to Withdraw from NJ Market Effective Jan. 1, 2017 In a recent release, Oscar has announced that they have decided to withdraw their plans from the New Jersey market beginning on January 1, 2017. They have concluded that instability in the market will make it challenging for them to operate effectively and to continue to deliver quality healthcare to all their members across the country. Oscar would like to highlight a few key points in regards to this announcement: Oscar will continue to serve their other existing markets without change, including New York, Long Island, San Antonio, Los Angeles and Orange County. Oscar remains financially stable—they have raised… Read More
Continue Reading
Many Medicare beneficiaries are unaware that original Medicare coverage has significant deductibles and co-pays. Part A helps cover medically necessary inpatient care in hospitals. In 2016, for each benefit period (typically 60 days as defined by Medicare) in a year, beneficiaries pay: $1,288 deductible and no coinsurance for a stay of up to 60 days $322 coinsurance per day for days 61-90 of a hospital stay $644 coinsurance per “lifetime reserve day” after day 90 each benefit period (up to 60 days over your lifetime) All costs for each inpatient day beyond 150 days At Total Benefit Solutions, Inc we specialize in Medigap programs that are affordable and cover most or… Read More
Continue Reading
From cnn.com: The insurer will stop offering policies on the exchanges in 11 of the 15 states where it currently operates, according to a press release it issued Monday evening. Aetna (AET) will only sell Obamacare products in Delaware, Iowa, Nebraska and Virginia… Click here for the story on CNN
Continue Reading
New Small Group ACA termination policy effective October 1, 2016 RE: renewal policy changes from Aetna…. Starting October 1, we must receive written confirmation of customer renewal acceptance in advance of the customer renewal date for all Aetna small groups. This means that beginning with all October 1 renewal dates, we must receive written confirmation in advance of the policy renewal date. Written confirmation may include signed renewal acceptance from the customer delivered by mail, fax or email. Note: premium payment received in advance of the renewal date will also be considered renewal acceptance. If we haven’t received written acceptance of the renewal, or renewal alternates, from the customer in this… Read More
Continue Reading
You must be logged in to post a comment.