Total Benefit Solutions Inc

The PCOR filing deadline is August 1, 2016 for all self-funded medical plans and HRAs for plan years ending in 2015…

June 16, 2016Ed MacConnell

The PCOR filing deadline is August 1, 2016 for all self-funded medical plans and HRAs for plan years ending in 2015. The IRS has also issued FAQs that address how the PCOR fee works with a self-insured health plan on a short plan year. Please note that for those with an HRA plan, and HRA is ” self insurance” and you are required to file and pay the PCOR fee. Please download the document below for more details and links to specific resources. Download PCOR Fee Filing Reminder for Self-Insured Plans

UnitedHealthcare and Optum take action to support Orlando shooting tragedy

June 16, 2016Ed MacConnell

Those Grieving Over Orlando Can Get Free Mental Health Services Thanks To This Insurance Company: UnitedHealthcare and Optum, two health benefits companies of UnitedHealth Group, are offering free mental health services for anyone affected by the shooting in Orlando that killed 49 people over the weekend. The resources are available to anyone in the country, whether they are insured by the group or not. Optum will operate a 24/7 helpline, and users can speak to a trained mental health professional for as long as they need. click here for more information

New ACA Delays/Extensions/Eliminations Chart–Download Free

June 12, 2016Ed MacConnell

With so many different ACA provisions, HR360’s simple new chart provides you and your clients with a clear understanding of the key requirements that have been delayed, extended, or eliminated under the Affordable Care Act. Our business partner, HR360’s simple chart features important ACA delays, extensions, and eliminations, including: Eliminated automatic enrollment provisions Delay of the “Cadillac” tax Extension of information reporting deadlines Download ACA_Delays_Extensions_and_Eliminations

Departments issue new ACA FAQ’s

June 7, 2016June 6, 2016Ed MacConnell

The Departments of Labor, the Treasury, and Health and Human Services (collectively, the “Departments”) have issued the 31st set of Affordable Care Act (“ACA”) frequently asked questions (“FAQs”). This time, the Departments address a wide range of topics including preventive services, disclosure obligations, coverage in connection with approved clinical trials, reference-based pricing, the Mental Health Parity and Addiction Equity Act, and the Women’s Health and Cancer Rights Act. Below is a brief summary of the guidance issued on these topics. Click the link below to download the bulletin. Download Departments Issue 31st set of FAQs

Checking Your Employee Handbook for Benefit Provisions

June 6, 2016Ed MacConnell

Handbooks are important for many reasons such as informing employees of their rights and duties, communicating available resources, and outlining paid time off policies. With respect to health and welfare benefits, here are a few things to consider: Download Checking Your Employee Handbook for Benefit Provisions

Employers: Tell Congress to Oppose Eliminating or Capping the Employer Exclusion

May 25, 2016Ed MacConnell

NAHU (The National Association of Health Underwriters) is very concerned about current proposals in Congress that would undermine the employer-sponsored health insurance system by eliminating or placing a cap on the employer tax exclusion for health insurance. Eliminating the exclusion would also eliminate most of the advantages of employer-sponsored insurance while capping it would degrade the benefit and serve as a tax increase for middle-class Americans. Click here to take action

Medicare and Employer Coverage

May 14, 2016May 13, 2016Ed MacConnell

From the Medicare Rights Center download this excellent Q&A about Medicare Coverage, the guidelines and how it may or may not integrate with employer coverage. Part-2-QA-Current-Employer-Insurance Have more questions about Medicare and your employer coverage? Call your Total Benefit Solutions, Inc account manager today at (215)355-2121. Learn more on Medicare Interactive.

Nondiscrimination regs cover TPAs, dental and more

May 13, 2016May 13, 2016Ed MacConnell

Nondiscrimination regs cover TPAs, dental and more The U.S. Department of Health and Human Services (HHS) has completed nondiscrimination regulations that might have a major effect on insurers that sell public exchange plans but might not have much of an effect on others. The HHS Office for Civil Rights (OCR) and the HHS Office of the Secretary posted a 362-page preview version of the final regulations today. The official version of the final rule, which is based on a draft released in September, is set to appear Wednesday in the Federal Register. Read the story at Life & Health Pro

8 things to know about Medigap policies

May 7, 2016Ed MacConnell

Medicare Supplements or Medigap Plans A Medicare Supplement Insurance (Medigap) policy, sold by private companies, can help pay some of the health care costs that Original Medicare doesn’t cover, like copayments, coinsurance, and deductibles. Some Medigap policies also offer coverage for services that Original Medicare doesn’t cover, like medical care when you travel outside the U.S. If you have Original Medicare and you buy a Medigap policy, Medicare will pay its share of the Medicare-approved amount for covered health care costs. Then your Medigap policy pays its share. A Medigap policy is different from a Medicare Advantage Plan. Those plans are ways to get Medicare benefits, while a Medigap policy… Read More

2017 Inflation Adjusted Amounts for HSAs

May 6, 2016May 5, 2016Ed MacConnell

The IRS released the inflation adjustments for health savings accounts (HSAs) and their accompanying high deductible health plans (HDHPs) effective for calendar year 2017. Most limits remained the same as 2016 amounts. Click the link below to download the bulletin. 2017 Inflation Adjusted Amounts for HSAs

Health Care Reform: 8 things the IRS wants small employers to know about the health care tax credit

May 5, 2016May 5, 2016Ed MacConnell

The Affordable Care Act’s small business health care tax credit is designed to encourage small employers to offer health insurance coverage to their employees. Click the link below to download the whitepaper 8 things the IRS wants small employers to know about this credit: 8 Things to Know About the Small Business Health Care Tax Credit For more information about the Small Business Health Care Tax Credit contact your Total Benefit Solutions, Inc account manager at (215)355-2121 or visit your ThinkHR library at www.thinkhr.com and log in. Watch a video below about the Small Business Healthcare Tax Credit

Sick Pay Laws to Date

April 21, 2016April 21, 2016Ed MacConnell

States are free to draft sick pay laws that uniquely and diversely affect employers. Current sick pay laws may have common characteristics, but varied application. To date, there are six States and twenty municipalities with sick pay laws. In addition, the President signed Executive Order 13706, which requires entities contracting with the Federal government to provide employees with up to seven days of paid sick leave annually. The result is a hodgepodge of regulation that creates burdensome administration and increased expense for employers. Click to Download Sick Pay Laws to Date

HIPAA Audits to Increase in 2016

April 19, 2016Ed MacConnell

On March 21, 2016, Health and Human Service’s Office for Civil Rights (“OCR”) announced the launch of the second round of national HIPAA audits. These audits are focused on covered entities (health plans and health care providers) and business associates (e.g., brokers, TPAs). The audits will target enforcement of HIPAA Privacy, Security and Breach Notification rules. Click Here to Download HIPAA Audits to Increase in 2016 – 041816R (1)

Form 1095-C Notification Reminder and Frequently Asked Questions

March 19, 2016March 20, 2016Ed MacConnell

Form 1095-C Notification Reminder and Frequently Asked Questions 2015 Forms 1095-C must be furnished to individuals by March 31, 2016. Generally, if Forms 1094-C and/or 1095-C are incorrect and incomplete, a penalty may apply if not corrected by the due date and the employer cannot show reasonable cause. Briefly, the amount of penalties can range from $50/form with a $500,000 maximum penalty/year to $250/form with a maximum penalty of $3M/year. Click here to download Form 1095-C Notification Reminder and Frequently Asked Questions – 031516R As always please contact your Total Benefit Solutions, Inc. account manager at (215)355-2121 if you have any questions or concerns about this bulletin, or any other… Read More

Obama administration backs off on ACA rules for 2017 health plans

March 8, 2016Ed MacConnell

CMS released a sweeping final rule (PDF) Monday afternoon that solidifies the Affordable Care Act’s coverage policies for 2017. The agency proposed tight network adequacy provisions and standardized health plan options in November, which fueled antipathy from the health insurance industry. Click here for the full story from Modern Healthcare As always, please contact your Total Benefit Solutions, Inc account manager at (215)355-2121 if you have any questions or concerns about the Affordable Care Act.

Navigate HCR: Excessive Waiting Periods

March 7, 2016Ed MacConnell

6. Dr Kristin Kahle’s Monday Report – Navigate HCR Welcome back to our series on the ACA Toolkit. Today’s topic is excessive waiting periods. A group health plan or issuer may not impose a waiting period that exceeds 90 days. A waiting period is the period of time that must pass before coverage for an employee or dependent who is otherwise eligible to enroll becomes effective. Eligibility conditions that are based solely on the lapse of time are permissible for no more than 90 days. However, other conditions for eligibility are permissible, as long as they are not designed to avoid compliance with the 90-day waiting period… Read More

Adding Dental to Your Family’s Health Plan

March 4, 2016March 4, 2016Ed MacConnell

Adding a great dental plan, like Delta Dental to your family’s benefit plans is now easier than ever! Click on the link below to quote, compare and enroll today! http://totaldentalsolutions.net/

HR Insights Newsletter March 2016

March 1, 2016March 1, 2016Ed MacConnell

Click the link to view the March 2016 issue of HR Insights from Think HR View as web page HR Advice When You Need It Have an HR question that needs the human touch? Call the Live Hotline team for answers and advice at 1-855-775-7750 brought to you by Total Benefit Solutions Inc.. ThinkHR provides expert, practical human resource guidance to businesses of all sizes, helping them avoid costly risk and liability and save time. 4457 Willow Road, Ste. 120, Pleasanton, CA 94588 855.271.1050 © 2016, ThinkHR. All rights reserved. T

GAO Report: PPACA- CMS Should Act to Strengthen Enrollment Controls and Manage Fraud Risk

February 29, 2016February 26, 2016Ed MacConnell

During undercover testing, the federal Marketplace approved subsidized coverage under the act for 11 of 12 fictitious GAO phone or online applicants for 2014. The GAO applicants obtained a total of about $30,000 in annual advance premium tax credits, plus eligibility for lower costs at time of service. The fictitious enrollees maintained subsidized coverage throughout 2014, even though GAO sent fictitious documents, or no documents, to resolve application inconsistencies Click here for the highlight sheet Click here for the full report

Reminder to Notify CMS

February 27, 2016February 26, 2016Ed MacConnell

Employers sponsoring a group health plan are required to report information on the creditable status of the plan’s prescription drug coverage to the Centers for Medicare and Medicaid Services (CMS). Download the bulletin below for details and specific links for employer reporting Download Medicare Part D – Reminder

2016 Federal Poverty Guidelines Updated

February 18, 2016Ed MacConnell

Large employers may be subject to the employer penalty under the Affordable Care Act if they do not offer affordable, minimum value coverage to all full-time employees and at least one full-time employee receives a subsidy in the Exchange. The Federal Poverty Line (“FPL”) is relevant to this penalty in two ways. Please click the link below to download the bulletin with he new guidelines. 2016 Federal Poverty Guidelines If you have any additional questions regarding this bulletin, or the Affordable Care Act please contact your Total Benefit Solutions, Inc account manager at (215)355-2121.

How do I appeal a Marketplace decision?

February 15, 2016January 30, 2016Ed MacConnell

You can request an appeal of any Marketplace decision, including decisions about Your eligibility to buy coverage in the Marketplace Your eligibility for, or the amount of, premium tax credits or cost sharing reductions Your eligibility for an exemption from the penalty for not having health insurance Untimely (late) notice from the Marketplace about a decision To make your appeal, start by reviewing the Marketplace’s decision. You will have received the decision (called a determination notice) online if you initially applied online, or in the mail if you submitted a paper application. So far, in the federal Marketplace, the notice will not provide much detail to explain the reasons… Read More

IBC: What is Medicare Video

February 14, 2016November 9, 2021Ed MacConnell

A Simple video from Independence Blue Cross explaining Medicare. As always please contact Total Benefit Solutions, Inc if you have any questions or concerns about Medicare health insurance or supplements at (215)355-2121.

Download: Medicare Made Clear

February 13, 2016February 13, 2016Ed MacConnell

Download Medicare Made Clear: From our partners at United Healthcare and Medicare Made Clear, download the 2016 version of the Show Me Guide for an impartial overview of Medicare plans as well as eligibility, glossary, frequently asked questions and more. A virtual Medicare training in one handy workbook! Download Show Me Guide 2016 As always, if you have any questions about Medicare health plans, eligibility and more, contact you Total Benefit Solutions account manager at (215)355-2121.

Now Available: Empower Me Benefits Private Exchange

February 13, 2016February 13, 2016Ed MacConnell

Total Benefit Solutions has partnered with Empower Me Benefits to provide our clients with best in industry benefits technology that‘s customizable for even the smallest employer. The EmpowerMe Benefits Exchange allows you to remain complaint with the Affordable Care Act (ACA), easily manage benefits, and control health care costs with a single solution. The EmpowerMeBenefits Exchange is an online benefit marketplace and benefits administration platform designed specifically to meet the needs of small and mid-sized companies. The Exchange provides employers with an enrollment and administration platform that aids employers in ACA compliance. This web-based solution allows you to offer any medical coverage next to pre-selected ancillary, voluntary, and TPA products.… Read More

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