Total Benefit Solutions Inc

Medicare Coverage of Diabetes Supplies, Services, & Prevention Programs: Booklet

August 24, 2023July 12, 2023Wendy Lopez

This booklet explains Medicare coverage of diabetes supplies and services in Original Medicare and with Medicare drug coverage (Part D). Original Medicare is fee-for-service coverage. The government usually pays your health care providers directly for your Medicare Part A (Hospital Insurance) and/or Part B (Medical Insurance) benefits. If you have other insurance that supplements Original Medicare, like a Medicare Supplement Insurance (Medigap) policy, it may pay some of the costs for some.services described in this booklet. For a comprehensive understanding of Medicare coverage for diabetes supplies and services, download this informative booklet today! As always if you have any questions or concerns about this bulleting please contact your Medicare health… Read More

Understanding the Plan Annual Notice of Change (ANOC) in Medicare

August 23, 2023August 23, 2023Wendy Lopez

Staying informed about your healthcare coverage is vital, especially when it comes to Medicare plans. One key document that plays a significant role in this process is the “Plan Annual Notice of Change” or ANOC. What is the ANOC? If you’re enrolled in a Medicare plan, the ANOC is your compass for upcoming changes. Every fall, your plan sends you this crucial document, detailing any adjustments that will take effect in January. These changes encompass a range of aspects, from coverage modifications to shifts in costs and more. When Can You Expect It? Mark your calendars for September. This is the month when the ANOC usually arrives, providing you with… Read More

Medicare Coverage of Home Health Care: Booklet

August 23, 2023July 12, 2023Wendy Lopez

This booklet describes the home health care services that Medicare covers, and how to get those benefits through Medicare. If you get your Medicare benefits through a Medicare health plan (not Original Medicare) check your plan’s membership materials and contact the plan for details about your Medicare-covered home health benefits. Download the Medicare Coverage of Home Health Care: Booklet to help you understand the home health services that Medicare covers and much more. As always if you have any questions or concerns about this bulleting please contact your Medicare health insurance experts at Total Benefit Solutions, Inc (215)-355-2121

Are You Up To Date on Your Preventive Services?

August 22, 2023August 22, 2023Wendy Lopez

Medicare covers a full range of preventive services to help keep you healthy and find problems early when treatment works best. Ask your doctor what services are right for you and use the document below to track appointment dates, times, and other important information. Download our Medicare check list sheet below to help you keep track of your Preventive Services! If you have any questions or concerns, please contact your Total Benefit Solutions, Inc Medicare health insurance specialist at (215)-355-2121.

4R’s for Fighting Medicare Fraud

August 21, 2023July 11, 2023Wendy Lopez

This comprehensive and insightful factsheet is specifically designed to equip individuals who are enrolled in Medicare with invaluable knowledge and effective measures to actively combat Medicare fraud. With a focus on promoting awareness and prevention, this factsheet not only educates beneficiaries about the various types of Medicare fraud but also offers practical advice and actionable steps to detect, report, and prevent fraudulent activities. By implementing the recommended measures outlined in this factsheet, individuals can actively participate in safeguarding the integrity of the Medicare program, ensuring that their healthcare benefits are utilized for their intended purpose while mitigating the risk of falling victim to fraudulent schemes. This factsheet provides a person… Read More

What’s New in the 2023 ACA Open Enrollment?

August 21, 2023August 21, 2023Wendy Lopez

The 2023 Affordable Care Act (ACA) Open Enrollment period is upon us, marking a significant milestone as Health Insurance Marketplaces open their doors for the tenth year. From November 1, 2022, to January 15, 2023, individuals and families have the opportunity to secure comprehensive healthcare coverage. In this blog post, we’ll delve into the key changes and updates for this year’s open enrollment, focusing on insights gathered from the Kaiser Family Foundation’s informative article titled “Nine Changes to Watch in Open Enrollment 2023” [source: www.kff.org/policy-watch/nine-changes-to-watch-in-open-enrollment-2023/]. As the ACA Open Enrollment enters its tenth year, changes abound, ensuring improved access, affordability, and assistance for individuals and families seeking healthcare coverage. Staying… Read More

HOW PEOS ARE HELPING SMBS MEET MARKET DISRUPTORS HEAD ON

August 19, 2023August 19, 2023Ed MacConnell

The modern world is driven by convenience and customization, SMBs included. Digitization, remote-friendly roles, and a generational shift in the workforce all impact today’s employee experience. When this experience is lacking, it can be costly to companies in more ways than one. click here to read the story from PEO insider Total Benefit Solutions Inc is dedicated to providing a comprehensive selection of solutions for the small business owner including the comparison of PEO’s to the typical employee benefits experience. Contact us today at (215)355-2121 to inquire about the possibility of using a PEO for your organization.

What’s Medicare Supplement Insurance (Medigap)?

August 19, 2023August 18, 2023Ed MacConnell

Medicare Supplement Insurance (Medigap) is extra insurance you can buy from a private health insurance company to help pay your share of out-of-pocket costs in Original Medicare. You must have Original Medicare – both Part A (Hospital Insurance) and Part B (Medical Insurance) – to buy a Medigap policy. Ask us today if you have questions about Medigap enrollment, rates or coverage at (215)355-2121.

Independence Blue Cross aims to get more Black patients screened for colorectal cancer

August 17, 2023August 18, 2023Ed MacConnell

The COVID-19 pandemic drove a significant reduction in the number of Black patients who were getting screened for colorectal cancer, and Independence Blue Cross is aiming to change that in its home turf of Philadelphia… https://www.fiercehealthcare.com/payers/philly-blues-program-aims-get-more-blacks-screened-colorectal-cancer

Exploring the Traits of Medicare MSA Plans

August 16, 2023August 16, 2023Wendy Lopez

As the healthcare landscape continues to evolve, so do the options available for Medicare beneficiaries. One such option gaining traction is the Medicare Medical Savings Account (MSA) plan. Designed to provide a unique blend of control, flexibility, and financial freedom, the MSA plan is worth considering for those seeking a personalized approach to their healthcare needs. 1. High Deductible Health Plan (HDHP): Balancing Costs and Coverage At the core of the Medicare MSA plan is the High Deductible Health Plan (HDHP). This plan structure offers beneficiaries a way to balance out-of-pocket expenses with coverage. The idea behind the HDHP is that you’ll have a higher deductible to meet before your… Read More

Decoding Medicare Supplement Charts

August 15, 2023August 15, 2023Wendy Lopez

So, you’re on the quest to unravel the complexities of Medicare supplement plans, and in your journey, you’ve stumbled upon the elusive “Medicare Supplement Comparison Chart.” It’s like a mosaic of options, donning a variety of colors and fonts, yet each one is strangely reminiscent of the other. But what exactly are these charts? What secrets do they hold? Well, that’s what we’re here to uncover today. Cracking Open the Chart Imagine this: you’re face-to-face with a Medicare Supplement Comparison Chart. But what’s beneath the surface? Every column you see represents one of the ten available Medigap plans up for grabs – think Plans A, B, C, D, F, G,… Read More

Pros and Cons of PEO’s

August 13, 2023August 13, 2023Ed MacConnell

A Professional Employer Organization (P.E.O.) is a company that provides comprehensive HR outsourcing services to small and medium-sized businesses. As your independent broker, Total Benefit Solutions, Inc can shop and compare various PEO’s to help determine which one might be the best fit for your organization, if any. Just like we can do with insurance carriers ad TPA’s! We have had a lot of questions about PEO’s so we created these pro and com quick tips to give you a quick overview of the top points about PEO’s that are asked the most often. The professionals at Total Benefit Solutions are independent and can evaluate the PEO offerings of multiple… Read More

Exploring PEOs: Efficiency and Compliance Solutions

August 8, 2023August 14, 2023Wendy Lopez

In today’s business landscape, optimizing operations and compliance is an ongoing challenge. Enter PEOs – Professional Employer Organizations. PEOs offer outsourcing solutions that reshape how companies handle HR and administrative tasks. Let’s dive into the world of PEOs and unveil their potential advantages and drawbacks. A “PEO,” or Professional Employer Organization, forms a strategic partnership where businesses team up with experts to manage HR and admin functions. This collaboration lets companies offload tasks like payroll, benefits, and compliance, ideal for small to mid-sized businesses aiming to streamline while focusing on core activities. Pros of PEOs: Cons of PEOs: In conclusion, PEOs provide a promising avenue for businesses aiming to bolster… Read More

CMS announces lower Medicare Part D premium for 2024

August 4, 2023August 2, 2023Wendy Lopez

According to an official statement by the Centers for Medicare and Medicaid Services (CMS) on Monday, the projected average total premium for Part D beneficiaries is anticipated to decrease by 1.8% in 2024. This reduction would bring the average monthly premium down to $55.50 from the 2023 figure of $56.49. The computed average monthly premium for Medicare Part D coverage in 2024, at $55.50, encompasses the combined average basic premium and the supplementary premium for plans featuring enhanced coverage. CMS emphasizes that this projection offers the most precise estimate of individuals’ 2024 Part D premium expenses. In addition to this update, CMS has disclosed several other important figures for the… Read More

IRS Addresses COVID-19 Testing and HDHP Treatment

August 3, 2023August 3, 2023Wendy Lopez

As a result of the COVID-19 pandemic, high deductible health plans (“HDHPs”) can provide coverage for COVID-19 testing and treatment before the minimum deductible is satisfied without jeopardizing an individual’s ability to have tax-favored contributions made to their health savings account (“HSA”). This relief remains in effect pending future IRS guidance.On June 24, 2023, the IRS issued Notice 2023-37, announcing that this relief will sunset with respect to plan years ending on or before December 31, 2024. In addition, IRS Notice 2023-37 states that HDHPs may continue to provide first-dollar coverage for preventive care with an “A” or “B” rating by the United States Preventive Services Task Force (“USPSTF”), prior… Read More

Unlock Your Best Health: 5 Must-Know Tips & Tools!

August 2, 2023August 2, 2023Wendy Lopez

Five major tips and resources for maintaining overall health and wellness: Remember, it’s important to personalize these tips to your individual needs and consult with healthcare professionals before making significant changes to your lifestyle. We’re committed to providing exceptional support, so please don’t hesitate to reach out to our dedicated Total Benefit Solutions health insurance specialists at (215)-355-2121. We’re here to answer any questions or address any concerns you may have.

Orlando Health Patients Face Coverage Loss Amid Contract Dispute

August 1, 2023August 1, 2023Wendy Lopez

UnitedHealthcare’s contract with Orlando Health is set to expire on July 31. If an agreement is not reached before the deadline, most services will no longer be covered for individuals on various plans, starting from August 1. The affected plans include employer-sponsored and individual plans, Medicare Advantage (including the Group Retiree PPO plan), and Medicaid (including the Dual Special Needs Plan). Both parties have been engaged in months of negotiations to establish new terms. With less than two weeks remaining, tensions have escalated, and accusations of delaying negotiations, disseminating misleading information, and proposing unreasonable terms have been exchanged by both sides. United Healthcare has taken proactive measures to notify approximately… Read More

Top 10 Ways to Make Your Health Benefits Work for You

July 31, 2023July 31, 2023Wendy Lopez

Unleash the Full Potential of Your Health Coverage! Are you making the most of your health benefits? The Employee Benefits Security Administration (EBSA) administers crucial health benefit laws that cover employer-based health plans. These laws safeguard your rights to essential information about your health plan, guide you on qualifying for benefits and making claims, ensure continued health benefits during job transitions, and offer protections for special medical conditions. Start by exploring your health coverage options, delving into different plans, and matching them with your needs. Not sure if your plan covers mental health or substance use disorder services? We’ve got you covered with essential information on these benefits too! Your… Read More

Why Short Term Heath Insurance is not “ JUNK” insurance.

July 29, 2023July 29, 2023Ed MacConnell

Short-term health insurance, also known as temporary health insurance, is a type of health coverage designed to provide temporary medical insurance for a limited duration, typically ranging from a few months to a year. While short-term health insurance may not be suitable for everyone, it does offer certain benefits for specific situations. When people label Short Term health as “ JUNK” it is clear they do not understand that many people still need short term health insurance coverage. The ACA solved many problems when it comes to access to coverage, but first problem is the COBRA prohibition which specifically disallows ACA tax credits for people who can get on COBRA.… Read More

IRS Regulations Expand Requirement to File Electronically

July 27, 2023Wendy Lopez

Final regulations issued by the Internal Revenue Service (“IRS”) expand the requirement to electronically file certain returns and other documents with the IRS. This new requirement will impact employers who file Forms 1094-C, 1095-C, 1094-B and 1095-B. It will take effect for returns due to be filed on or after January 1, 2024. Please note that the information provided in the document is of a general nature and is not intended to interpret laws or regulations or address specific client situations. Employers are advised to seek advice from an attorney or tax professional before taking any action based on the information in the document. For more information and to read… Read More

CMS Issues Final Rule, Making changes to MA and Part D

July 27, 2023July 27, 2023Ed MacConnell

In April, the Centers for Medicare & Medicaid Services (CMS) issued a Final Rule regarding the Medicare Advantage (MA) and Part D programs. The Final Rule includes changes related to various aspects of those programs, including utilization management (UM) programs, Star Ratings, marketing and communications, health equity, provider directories, and network adequacy. Click here to read the bulletin

Making HSAs Work Smarter

July 25, 2023July 24, 2023Wendy Lopez

In the dynamic world of employee benefits, leaders have come to grasp the immense potential benefits hold in achieving their key goals. One approach that has gained significant traction is the combination of High Deductible Health Plans (HDHPs) with Health Savings Accounts (HSAs), a powerful duo that not only reduces benefits costs but also empowers employees with greater control over their healthcare expenses. However, despite the evident advantages, the journey to unlocking the full potential of HDHPs + HSAs is far from over. There lies an untapped opportunity to optimize plan design and elevate employee education, enabling companies to enhance their workforce’s well-being while achieving cost-effectiveness. If you are eager… Read More

Are Health Insurance Premiums Tax Deductible?

July 24, 2023July 24, 2023Wendy Lopez

Health insurance premiums can be tax-deductible under certain conditions in the United States. However, please note that tax laws and regulations can change, so it’s essential to consult a tax professional or the latest IRS guideline for the most up-to-date information. Typically, if you are self-employed or have health insurance coverage through your employer and pay your premiums with after-tax dollars, you may be eligible to deduct the premiums on your federal income tax return. This deduction is generally reported on Schedule 1 of Form 1040, which is used to calculate your Adjusted Gross Income (AGI). Keep in mind that there are specific requirements and limitations for deducting health insurance… Read More

What is Health Insurance for?

July 20, 2023July 20, 2023Wendy Lopez

Health insurance is a type of insurance coverage that helps individuals and families manage the costs of medical expenses and healthcare services. It provides financial protection against the high costs of medical treatments, hospitalizations, prescription drugs, and other healthcare-related services. Health insurance is designed to help people access the medical care they need without facing significant financial burdens. Health insurance provides a safety net against unexpected and costly medical events, allowing individuals to seek necessary medical care without facing crippling financial burdens. It also promotes preventive care, encouraging people to get regular check-ups and screenings to detect potential health issues early. It’s important to note that the coverage and cost-sharing… Read More

Will health insurance cover a swimming pool?

July 18, 2023July 18, 2023Wendy Lopez

Health insurance typically does not cover the cost of a swimming pool for personal use. Health insurance is designed to provide coverage for medical services, treatments, and supplies that are necessary for the diagnosis and treatment of illnesses or injuries. Swimming pools are a comfort item and are generally not considered medically necessary. However, there may be some exceptions in certain cases where a swimming pool is prescribed as part of a medical treatment plan for specific conditions such as physical therapy or rehabilitation. In such cases, coverage for a swimming pool may be possible, but it would require a thorough evaluation and approval process by the insurance company. It’s… Read More

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