Each year, the Medicare Part B premium, deductible, and coinsurance rates are determined according to provisions of the Social Security Act. The standard monthly premium for Medicare Part B enrollees will be $202.90 for 2026, an increase of $17.90 from $185.00 in 2025. The annual deductible for all Medicare Part B beneficiaries will be $283 in 2026, an increase of $26 from the annual deductible of $257 in 2025 Your Total Benefit Solutions, Inc experts, can help you compare and choose the best Medicare supplement coverages for you. Contact us today at (215)355-2121 or www.totalbenefits.net Prefer to shop and research on your own? Click here: https://planenroll.com/?purl=Edward-MacConnell Click here to download the fact… Read More
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Highmark – Important Update Regarding Plan Availability on External Enrollment Platforms
At Highmark, we value the trust you place in us and are committed to providing timely and transparent information. As we look ahead to 2026, we want to inform you that we are adjusting plan availability on external quoting and enrollment platforms. This decision has been carefully considered to ensure that our broker partners are prioritizing plans that offer a long-tenure with Highmark. Further details regarding our 2026 plan offerings will be shared as we approach AEP. We are dedicated to providing exceptional service, so please do not hesitate to contact our dedicated Total Benefit Solutions health insurance specialists at (215)-355-2121 or fill out the contact form below. We are… Read More
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Medigap Plans: Comparing Costs
When selecting a Medigap policy, it’s important to compare offerings from multiple insurance companies, especially if you’ve already chosen a specific standardized plan. While policies with the same letter designation provide identical benefits, premium costs can differ between insurers. For example, Policy A from Company 1 offers the same coverage as Policy A from Company 2, but the two companies may set different pricing. At Total Benefit Solutions, Inc we look at many factors besides price including length of time in market, ease of use and client service availability. When choosing a Medigap, ask what factors the Medigap insurance company uses to set your premium. The following factors may affect… Read More
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UHC Medicare Ending Independent Broker Relationships and Compensation
Beginning June 1, UnitedHealthcare will no longer pay new or renewal commissions on Medicare Prescription Drug Plans. This effectively ends agent participation in the market through UnitedHealthcare products. UnitedHealthcare is also announcing the end of lifetime commissions on its UnitedHealthcare AARP Medicare Supplement products in Florida, Maine, Maryland, New Mexico, and Texas. The end of commissions impacts both new and internal replacements for applications with signature dates on or after June 4, 2025, and an effective date of July 1, 2025, or later. To our Total Benefit Solutions, Inc clients these changes effectively remove our ability to continue working with these plans. Please contact your Total Benefit Solutions, Inc health insurance specialists… Read More
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HRA Solutions : ICHRA vs. QSEHRA: Choosing an HRA that fits
What works? An ICHRA or a QSEHRA? It helps to understand the differences. An ICHRA allows businesses to reimburse employees for health insurance, while a QSEHRA is designed for small businesses with fewer than 50 employees and has annual contribution limits. Read on to determine which option best fits your company’s needs. When comparing an ICHRA vs. a QSEHRA, the key difference is eligibility: A Qualified Small Employer Health Reimbursement Arrangement (QSEHRA) is for small businesses with fewer than 50 employees. An Individual Coverage Health Reimbursement Arrangement (ICHRA) is available to businesses of any size, offering greater flexibility. With HRAs growing in popularity, choosing the right option depends on your company’s size, employee needs,… Read More
Continue ReadingNew Federal Rule Cuts Short-Term Health Plans to 4 Months, Affecting Coverage Options
HHS rule applies to short-term limited duration insurance (STLDI) plans sold or issued on or after September 1, 2024. A final rule announced by the Departments of Treasury, Health and Human Services, and Labor in March 2024, has imposed new nationwide duration limits on short-term limited duration insurance (STLDI) plans. The rule – which applies to plans sold or issued on or after September 1, 2024 – limits new STLDI plans to three-month terms, and caps total duration – including renewals – at no more than four months. A “renewal” includes a new policy issued by the same insurer (or another insurer in the same controlled group, meaning they’re treated… Read More
Continue ReadingCIGNA PDP: New customer onboarding program
Learn how our onboarding program supports our new customers. At Cigna HealthcareSM, we understand that nurturing strong relationships with your existing customers is not only vital for your business growth, but it is often easier than acquiring new clients.That’s why we’ve developed a comprehensive new customer onboarding program designed to support our customers and your retention goals. As you can see from the below activities, we are taking several steps to ensure our customers feel valued and well taken care of as they transition to one of our Medicare Advantage (MA) plans. New customer onboarding program Welcome calls Cigna Healthcare calls new customers to review benefits and ensure they have… Read More
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Small Employer Open Enrollment Period November 15 through December 15
While this has been in place for a number of years, we would like to remind you about the Small Employer Open Enrollment Period for fully insured health plans in all states. The Small Employer Open Enrollment Period is the period from November 15 through December 15 each year. During this period, employers that meet the definition of small employer but do not meet the carrier’s participation or contribution requirement will be accepted for a small employer plan with a January 1 effective date. Additionally, select carriers in New York may allow for a December effective date if applicable. Carriers require that employer groups enrolling under the Small Employer Open Enrollment Period submit completed applications… Read More
Continue ReadingMedicare Annual Pre-Enrollment Checklist
Before making an enrollment decision, it is important that you fully understand your benefits and rules. Download this handy form below when planning your Medicare enrollment. Please contact us at (215)355-2121 to schedule your annual Medicare review.
Continue ReadingBig Changes to Medicare Part D for Medicare beneficiaries still working
Annually. employers must inform the Centers for Medicare and Medicaid Services (“CMS”) and participants and beneficiaries who qualify for Medicare Part D of the creditable or non-creditable status of the group health plan prescription drug plan(s). When prescription medication coverage meets or exceeds Medicare Part D, it is considered creditable. Any coverage that falls short of Medicare Part D’s quality standards is deemed non-creditable As previously reported, the Inflation Reduction Act of 2022 (“IRA”) changed aspects of the Medicare Part D program to enhance and improve Medicare Part D coverage. The changes include: A newly defined standard Part D benefit design consisting of three phases: annual deductible, initial coverage, and… Read More
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Ready for another year of helping clients who get their health insurance through Pennie!
Ready for another year of helping clients who get their health insurance through Pennie! Open enrollment starts November 1st 2024 and ends January 15th 2025! (215)355-2121 https://lnkd.in/bhhqqAJ
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Individual Health Insurance help is available for employer groups!
Why do group clients need help with an Individual health insurance expert? Here are some scenarios when groups need individual solutions:
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IBC Medicare Members Save money with your IBX Care Card
Your IBX Care Card comes preloaded with a quarterly balance. Your card will be automatically reloaded every quarter (every three months). Be sure to spend your allowance each quarter, as any unused balance will not roll over to the next quarter. Please keep your card in a safe location, as you may use the same card for as long as you remain a member of a participating plan. Click here for more information about the IBX Care card for Medicare members or contact us today at (215)355-2121
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What is a level funded health insurance plan?
A level-funded plan is a type of self-funded plan in which the employer contributes a steady monthly payment to cover costs for administration, claims payments, and stop-loss insurance. Level funding has its advantages when compared to fully insured plans and programs. Level-funded plans often cost less, making it easier for small- and mid-sized employers to offer their employees high-quality health care benefits at a more affordable price. Total Benefit Solutions, Inc offers small- to mid-sized employers an opportunity to have a level-funded plan for their business through a Self-Funded Program. We work with many different carriers who offer level funded programs. These carriers change by State. How does the plan… Read More
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Wellcare PDP Plans: Contract Termination: Important Change!!
Total Benefit Solutions, Inc has been notified by Wellcare PDP plans that our contract is being terminated without cause beginning immediately. Due to the changes in coverage mandated by the Inflation Reduction Act, Wellcare is terminating our agreement for the purposes of not paying bew or renewal business commissions. What does that mean for our clients?Beginning immediately, we will no longer be able to enroll new customers onto Wellcare PDP plans. Further moving forward, we will be unable to provide service to our existing clients already on Wellcare or who choose to renew with a Wellcare PDP plan for 2025. Our experts are standing by to answer your questions or… Read More
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Important Changes to Medicare Drug Coverage for 2025
The Inflation Reduction Act (IRA) has resulted in significant changes to Part D including: Elimination of the Coverage Gap or “donut hole”A new $2,000 out-of-pocket spending capA shift in cost sharing responsibility in the catastrophic coverage phaseA new cost sharing smoothing option called the Medicare Prescription Payment Plan These changes have an enormous impact on your Medicare coverage in 2025 for nearly all those on Medicare including Medicare beneficiaries who are still choosing their employer plans. Please review your ANOC carefully for your 2025 coverage and contact your Total Benefit Solutions Inc health insurance experts if you have any questions or concerns about how these changes impact you and your… Read More
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CMS Releases 2025 Medicare Part D Bid Information and Announces Premium Stabilization Demonstration
The Centers for Medicare & Medicaid Services (CMS) is releasing preliminary technical Medicare Part D bid information for contract year 2025 to help Part D plan sponsors finalize their Part D and Medicare Advantage (MA) offerings and prepare for Medicare Open Enrollment. Additionally, CMS is announcing a voluntary demonstration to support implementation of the redesigned Part D benefit and improve stability for people with Medicare in 2025. The preliminary average Part D premiums will be released later this summer. CMS will release the 2025 landscape in mid-to-late September, as in past years, once all offerings are finalized. Final average MA premiums and deductibles, along with other key information, are released annually in September with the… Read More
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New Medicare plans could wind up forcing seniors to switch or buy new plans or face a significant penalty
Many seniors who remain working past 65 are still on their employer’s health plan instead of government-run Medicare. However, a new update to Medicare coverage under the Inflation Reduction Act means seniors who delay joining Medicare could face additional hurdles when it comes to drug coverage. Who Does It Affect?Currently, seniors are able to avoid late penalties for Medicare Part D as long as their company’s plan pays on average just as much as the traditional Medicare prescription drug plan. These numbers are scheduled to change drastically in 2025. Starting January 1, most employer plans will no longer be accepted as a way out of the late penalties because they… Read More
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Medicare: Did You Know Part A?
If an individual does not qualify for premium free Part A what they pay for Part A will vary depending on how long they or their spouse worked and paid Medicare (FICA) taxes. Have more questions? Ask the Medicare health insurance specialists at Total Benefit Solutions, Inc for more information (215)355-2121.
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Is The Covid 19 vaccine covered by Medicare in 2024?
I s The Covid 19 vaccine covered by Medicare? Medicare does cover the updated (2023–2024 formula) Moderna or Pfizer-BioNTech COVID-19 vaccine for people 5 and older. If you’re immunocompromised (like people who have had an organ transplant and are at risk for infections and other diseases), you can get a 3-dose series of updated (2023–2024 formula. Have more Medicare questions? For more information contact your Total Benefit Solutions, Inc health insurance professionals at (215)355-2121
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2024 Medicare Parts A & B Premiums and Deductibles
On October 12, 2023, the Centers for Medicare & Medicaid Services (CMS) released the 2024 premiums, deductibles, and coinsurance amounts for the Medicare Part A and Part B programs, and the 2024 Medicare Part D income-related monthly adjustment amounts. The Medicare Savings Programs (MSPs) help more than 10 million people with coverage of Medicare premiums and, in most cases, other cost sharing. In their continued efforts to improve access to health care and lower costs for millions of Americans, the Department of Health and Human Services (HHS), through CMS, recently finalized a rule to streamline enrollment in MSPs, making coverage more affordable for an estimated 860,000 people. In addition, the… Read More
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CONSENT FOR HEALTH INSURANCE BROKER ASSISTANCE
CONSENT FOR BROKER ASSISTANCE FORM AS REQUIRED UNDER THE 2023 CMS-9899-F AMENDMENT OF 45 CFR § 155.220 Click here to complete the consent form This consent form outlines your rights. Please read it carefully. As a licensed Health Insurance Broker, Ed MacConnell of Total Benefit Solutions Inc has completed the annual Affordable Care Act certification by the Marketplace in your state. With this yearly training, and an individual or family’s formal consent, brokers are authorized to search for and assist households with their Marketplace account. The purpose of this form is to receive your informed written consent. Terms of Consent I give my permission to Total Benefit Solutions Inc, and/or their staff… Read More
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Employer 2024 Penalties Associated with the ACA (Affordable Care Act)
Add New Post Employers with a large number of part time employees have unique challenges when it comes to ACA compliance. Those with 50 or more full-time or full-time equivalent employees must meet two important requirements of the Affordable Care Act (ACA), or be subject to penalties A and B, A PENALTY: Employers who fail to offer a Minimum Essential Coverage (MEC) plan that provides certain wellness and preventive care to full-time employees may face a penalty of $2,970 per fulltime employee (minus the first 30). B PENALTY: A penalty of $4,460 per full-time employee who enrolls in a subsidized plan throughout a government exchange if the employer fails to… Read More
Continue ReadingShop for Affordable Short Term Health Care Coverage
Lower Cost Health Insurance is available if you qualify!
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Cheapest Health Insurance in Pennsylvania (2024 Plans)
Premium costs on Pennsylvania’s health insurance marketplace, Pennie vary by Catastrophic, Bronze, Silver or Gold tier. In Pennsylvania, Highmark Blue Cross Blue Shield offers the most affordable Bronze and Catastrophic plans, while UPMC Health Plan and Jefferson Health Plans provide the lowest-priced Gold and Silver plans in 2024, respectively. Of course, just because one plan costs less to buy does not make it the best plan to meet your needs. The health insurance experts at Total Benefit Solutions, Inc can shop the entire market for you, taking into account the healthcare needs of your family and guide you to the best plan for you. Contact us today at (215)355-2121.
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