Total Benefit Solutions Inc

Calculator May Help Small Businesses Determine SHOP Eligibility

May 15, 2014Ed MacConnell

Calculator May Help Small Businesses Determine SHOP Eligibility The U.S. Department of Health & Human Services has developed a Full-Time Equivalent (FTE) Employee Calculator to help small employers determine whether they qualify for the Small Business Health Options Program (SHOP). Background SHOP is available as an option for qualified small employers to purchase employee health coverage. The federal government is running the program in states that chose not to operate their own SHOP Marketplace (Exchange). For 2014, employers are generally eligible to purchase health coverage through the federally-facilitated SHOP Marketplace if they have 50 or fewer full-time equivalent employees (FTEs), including part-time employees. (For example, 2 part-time employees… Read More

Aetna: Important updates to our Pennsylvania Small Group eligibility guidelines

May 1, 2014Ed MacConnell

This briefing is applicable to all brokers writing Pennsylvania based employers We have updated our eligibility guidelines as it relates to sole proprietors, owners, partners, W-2 employees and husband / wife groups for 2014. These updates have been made to maintain compliance with state and federal requirements. Please review the updates we have outlined below. We thank you for your continued collaboration. The following applies to Small Group Pennsylvania new business and renewals: The definition of an employer is now one W-2 common law employee. This accommodates an owner with at least one “enrolling” W-2 common law employee who is not a spouse and not an owner. Sole proprietors, owners… Read More

IBC: Individual Dental and Vision PPO’s Now Available!

April 29, 2014April 29, 2014Ed MacConnell

Please be advised that Independence Blue Cross (IBC) is offering a new portfolio of Dental and Vision Care plans for adults (aged 19 and older) featuring low out-of-pocket costs and access to a large network of providers. These plans will be available for sale online, by phone, and by mail beginning on April 30, 2014, for June 1 effective dates. Offering individual customers Specialty Services products like Adult Dental and Vision Care emphasizes customer choice and helps give members the protection they need by protecting one of their most valuable assets — wellness. 15% discount on Bundled Dental and Vision IBC offers two Dental PPO plans and two Vision Care… Read More

IRS: HSA Contributions and limits for 2015 Released

April 24, 2014April 24, 2014Ed MacConnell

The IRS has released the 2015 cost-of-living adjustments affecting HSAs and HDHPs. The 2015 IRS HSA limits are increasing for 2015. Click to download the bulletin

IBC: Special Care program ending

April 24, 2014Ed MacConnell

As you may already know, the Independence Blue Cross Special Care SM* health care plan will terminate on June 30, 2014. Because the Special Care plan is ending, the individuals who are currently enrolled in this plan will be eligible for a special enrollment period to sign up for a plan that is compliant with the Affordable Care Act (ACA). Special Care members qualify for a special enrollment period All Special Care members will be eligible for a special enrollment period , which will allow them to enroll in an individual or family health plan. Members will have from May 1 to August 29, 2014 to enroll in a health plan… Read More

Healthcare.gov Users Prompted To Change Passwords Because Of Heartbleed Risk.

April 21, 2014Ed MacConnell

The CBS Evening News (4/20, story 8, 1:55, Glor) reported Sunday night that “visitors to the to Affordable Care website are being advised to take steps to protect themselves” from Heartbleed, the online security flaw. Mark Albert reported over the weekend, healthcare.gov made the move to “reset everyone’s account password.” Saturday evening, the NBC Nightly News (4/19, story 7, 0:25, Holt) reported that people “with accounts on healthcare.gov are being told to change their passwords after review found that the website was vulnerable to the security breach bug.” The Hill (4/19, Wilson) “Hillicon Valley” blog reported that the call to change log in information for the site were “out of… Read More

Health Reform: Find out if You Qualify for a Health Insurance Coverage Exemption

April 18, 2014April 17, 2014Ed MacConnell

The Affordable Care Act calls for individuals to have qualifying health insurance coverage for each month of the year, have an exemption, or make a shared responsibility payment when filing his or her federal income tax return. You may be exempt from the requirement to maintain qualifying health insurance coverage, called minimum essential coverage, and may not have to make a shared responsibility payment when you file your next federal income tax return. You may be exempt if you: Have no affordable coverage options because the minimum amount you must pay for the annual premiums is more than eight percent of your household income, Have a gap in coverage… Read More

IBC: Specialty Services Bundling Programs now available

April 17, 2014April 17, 2014Ed MacConnell

Independence Blue Cross (IBC) has announced their Specialty Services Bundling Program is now available for fully-insured customers with 51-500 eligible employees or enrolled contracts and for large self-funded customers. For fully-insured Pennsylvania companies with 51-500 Eligibles or Enrolled Contracts: Adding bundles to medical benefit saves customers money The Specialty Services Bundling Program provides competitive product offerings and helps improve the customer experience by giving cost incentives to customers for adding dental, vision, pharmacy, and employer-paid products to their basic medical coverage plans. By promoting products beyond what is requested, customers become aware of how they can save money on IBC offerings and save the time by shopping with IBC… Read More

COMPLIANCE NOTICE: Individual Health Plans as Employee Benefits Under the Affordable Care Act (ACA)

April 16, 2014April 14, 2014Ed MacConnell

COMPLIANCE NOTICE: Individual Health Plans as Employee Benefits Under the Affordable Care Act (ACA) Released on September 13, 2013, IRS Notice 2013-54 addresses the viability of individual health insurance plans as a tax-advantaged employee benefit under the Affordable Care Act (ACA). Unfortunately, the news was not good for employers wanting to offer such plans to their employees: the IRS determined that such plans are prohibited under the ACA. PLEASE CLICK BELOW TO DOWNLOAD THE RELEASE FROM AMERIFLEX… COMPLIANCE_ Individual Health Plans as Employee Benefits Under the Affordable Care Act

SHOP for Small Group Customers Buying a plan through SHOP versus direct

April 15, 2014April 14, 2014Ed MacConnell

SHOP for Small Group Customers Buying a plan through SHOP versus direct Buying plans through the Small Business Health Options Program, or SHOP, provides an advantage only for employers with fewer than 25 employees that are eligible for a tax credit provided by the Affordable Care Act (ACA). If customers are not eligible for this tax credit, there is no advantage to purchasing a plan through SHOP. This is because… Click here to download the SHOP bulletin

Health Reform: New Guidance Clarifies Rules on Health FSA Carryovers

April 15, 2014April 14, 2014Ed MacConnell

Near the end of 2013, the IRS issued Notice 2013-47 that permits a cafeteria plan to provide for the use of up to $500 of any unused amount remaining in the health FSA in the immediately following plan year (the “carryover” provision). This provision is optional, requires a plan amendment, and cannot be offered if the cafeteria plan allows a grace period. Click here to download the bulletin

IBC and DaVita HealthCare Partners Announce Joint Venture

April 14, 2014April 14, 2014Ed MacConnell

Tandigm Health’s innovative coordinated care model will provide higher-quality care, lower costs Independence Blue Cross (Independence) and DaVita HealthCare Partners today announced the creation of Tandigm Health. This unique joint venture, based in Philadelphia, Pa., will help deliver high-quality, affordable care to the region by combining the expertise of one of the country’s largest, most innovative Blue insurers and a nationally recognized pioneer of physician-centric coordinated care. Click here to read the bulletin Click here to read the press release from the IBC website

IBC: Tobacco Status Important Questions and Answers

April 14, 2014Ed MacConnell

Why does IBC collect member-level information about tobacco use? Under the Affordable Care Act (ACA), premium rates for health insurance coverage in the individual and small group markets may be based on family size, geography, age and tobacco use. In order to follow with this guideline and accurately rate each group, Independence Blue Cross (IBC) collects member-level tobacco use information to create group premiums for new and renewing group customers. Click the link below to download the IBC document that covers the most common questions about rating tobacco users in small group in PA. Tobacco Status For Small Group Customers Flyer

HR360: Job Description Builder

April 14, 2014April 14, 2014Ed MacConnell

HR360: Job Description Builder A well-developed job description will help you review employee performance, and hire the best candidates. Our online Job Description Builder is so simple to use. With our efficient tool, you can transform a blank page into a professionally-developed job description in minutes. Just follow these simple steps: Choose from our comprehensive library of job descriptions Check off tasks and activities as well as skills associated with the job Select from the list of physical demands or the job/ work environment or add your own. Print out a complete job description in Word or in an Excel Spreadsheet—it’s that easy! HR360 is a web based subscription service… Read More

Health Reform: Law Repeals Deductible Limits for Small Group Plans

April 14, 2014Ed MacConnell

The Protecting Access to Medicare Act of 2014, legislation extending the “doc fix” for Medicare payments, also includes a provision that repeals the maximum deductible limits applicable to many small group health plans. As you recall, deductible limits for non-grandfathered small group plans are capped under the ACA at $2,000 for single coverage and $4,000 for family coverage effective for the first plan year on or after January 1, 2014. This legislation repeals the deductible limits as of the date health care reform was enacted (March 23, 2010). Click here to download the bulletin

2014 Group Health Plan Calendar

April 11, 2014Ed MacConnell

The 2014 Group Health Plans Notices Calendar in now available! All-in-One Health Plan Notices Calendar and Downloadable Model Notices Our 2014 calendar provides bottom line information on group health plan required notices and filings, including who must receive them, who must provide them and when notices are due. At last, the notices you need are available in one convenient location, including: Health Care Reform Notices (includes new SBC template for 2014 and information on required PCORI filings) COBRA Notices HIPAA Notices (includes information on elimination of creditable coverage certificates and new model Notice of Privacy Practices) Special Health Care Notices (Women’s Health and Cancer Rights, Mental Health Parity… Read More

Health Reform:Legislative Update-Relief for Small Groups Under the Affordable Care Act (ACA)

April 3, 2014April 2, 2014Ed MacConnell

On Monday, Congress and President Obama together repealed one of the Affordable Care Act’s most onerous provisions, which prohibited so-called “small groups” (mostly groups with less than 50 employees) from offering health plans with deductibles higher than $2,000 for single coverage and $4,000 for family coverage. This comes as very welcome news to small businesses, who are frequently the most in need of additional options and flexibility when it comes to offering employees comprehensive, affordable health insurance via higher deductibles and other cost-sharing mechanisms. It is also great news for employers wanting to couple their insurance plans with health reimbursement arrangements (HRAs), which federal agencies previously rejected as permissible ways… Read More

Ed MacConnell earns Voluntary Benefits Certification

April 2, 2014March 30, 2014Ed MacConnell

We are pleased to announce that Edward T MacConnell, President of Total Benefit Solutions has earned the certification of Certified Voluntary Worksite Professional from the National Association of Health Underwriters. Voluntary/Worksite products are not new to the employee benefit industry. However, the surge of interest in these products has accelerated as employers seek ways to help attract and retain talent. The industry has responded swiftly with new products, new features, new enrollment technologies and many changes to the underwriting rules of these products. This has created new responsibilities for agents, brokers and consultants as advising clients in this area will differentiate their value to the consumers they serve. Certified Voluntary Worksite… Read More

HR4302 Bill Passes: Repeals limitation on deductibles for employer-sponsored health plans

April 1, 2014Ed MacConnell

On March 31, 2014 President Obama signed into law Bill HR4302 – Protecting Access to Medicare Act of 2014, sometimes called the “Doc Fix” bill. While the primary purpose of this bill was to prevent the automatic cuts to physician Medicare payments, this bill also included a significant modification to the Affordable Care Act (ACA). This bill included a section that ends the limitations on deductibles that were set at $2,000/individual and $4,000/family within the ACA on small group employer sponsored health plans, and made the effective date retroactive to the original enactment of the ACA. The act states: SEC. 213. ELIMINATION OF LIMITATION ON DEDUCTIBLES FOR EMPLOYER-SPONSORED HEALTH PLANS.… Read More

DOES CMS, HHS, IRS, or The WhiteHouse CARE?

April 1, 2014April 1, 2014Ed MacConnell

Wayne Schellhaas asks a very good question, “Does CMS Care?” We need direction and we need it FAST! For most of us we are sleep deprived and some physically sick. I received phone calls up to midnight last night asking for help enrolling in healthcare.gov. Not because they were waiting until the last minute, but because the very 1800 number, CMS wants us to have people call, gave them the run around since November 2013!! We need more than this – some people never received the email saying the account was confirmed, the system stopped sending emails to confirm accounts, the system wasn’t up to even set up accounts. I… Read More

HHS to Extend Marketplace Enrollment Deadline

March 31, 2014Ed MacConnell

The Washington Post has reported that HHS has released regulations extending the Marketplace open enrollment deadline to around mid-April for individuals who began, but did not complete, a Marketplace application. The extension appears to be based on a self-certification (honor) system, in which individuals attest that they could not timely complete the Marketplace application before the March 31 deadline. This extension may have an impact on employer-sponsored plans to the extent individuals have more time to elect Marketplace benefits and therefore may decline employer-sponsored coverage at the next OE. Keep in mind that IRS cafeteria plan rules currently do not recognize enrollment in a Marketplace plan as a qualified status… Read More

My Experience with Obamacare: A Freelancer Applies for Health Insurance

March 25, 2014March 25, 2014Ed MacConnell

Our friends at Zane Benefits recently shared this comic and I enjoyed it so much I thought you might like it too: Click here to see the rest of the comic on zanebenefits.com Click here to see the rest of the comic on zanebenefits.com

Affordable Care Act: Open Enrollment ENDS at 11:59PM EST on March 31, 2014

March 24, 2014Ed MacConnell

Open Enrollment ENDS 11:59PM EST on March 31, 2014 · 2014 Penalty is $95 or 1% of your income, whichever is GREATER · A single person making between $11,490 and $45,960 will receive a subsidy to help you purchase insurance · NO one can be turned down · NO health questions · You can enroll on the www.healthcare.gov and do everything yourself or a licensed independent broker, like Total Benefit Solutions Inc. can assist you with choosing a plan that is PERFECT for YOU, on the marketplace or off. Independent brokers are licensed, certified and insured. A Broker is also FREE & CONFIDENTIAL! Call us before the end of open enrollment 1(800)924-6718

Crozer-Keystone Health System No Longer In Network with Cigna-Healthspring MAPD Plans

March 24, 2014Ed MacConnell

Please be advised of a change in the Cigna-HealthSpring provider network which may impact some of your customers. Starting May 1, 2014, Crozer-Keystone Health System will no longer be available to Cigna-HealthSpring members for hospital, home health or ancillary (surgery and other similar treatments) services. In a few days, we will mail the attached letter to the affected membership to advise them of this change. Please note that Crozer-Keystone health system primary care and specialty group doctors are still part of the Cigna-HealthSpring network. Only hospital, home health and ancillary services are leaving the network beginning May 1, 2014. Cigna-HealthSpring members currently under an active treatment plan may continue to… Read More

Small Business Health Care Tax Credit FAQs

March 24, 2014March 24, 2014Ed MacConnell

Small employers that pay at least half of the premiums for employee health insurance coverage under a qualifying arrangement may be eligible for the small business health care tax credit. The credit is specifically targeted to small businesses and tax-exempt organizations that primarily employ 25 or fewer workers with average income of $50,000 or less ($50,800 for calendar year 2014). To be eligible, you must cover at least 50 percent of the cost of single (not family) health care coverage for each of your employees. You must also have fewer than 25 full-time equivalent employees (FTEs). Those employees must have average wages of less than $50,000 (as adjusted for inflation… Read More

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