Meet Pennie!

  Meet Pennie! Pennie is Pennsylvania’s own health insurance marketplace: We connect Pennsylvanians to coverage in an unexpectedly simple and approachable way.  Pennie was built with all Pennsylvanians in mind: For those who thought health insurance was out of reach or overwhelming, but also for those who understand the importance of insurance. All Pennsylvania health insurance consumers on the federal marketplace will need to transition to Pennie during this years open enrollment period beginning November 1st! Click to Meet PennieHave questions about Pennie and how it impacts your current coverage or this years upcoming open enrollment? Contact us at Total Benefit Solutions Inc, your Pennie trained and certified independent brokers … Read More

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From Independence: 2019 MLR rebates to be issued to group customers by September 30

  Independence is pleased to announce that we succeeded in achieving a federal Medical Loss Ratio (MLR) below the required minimums for individual, small, and large group fully‑insured QCC, as well as both large group fully insured Keystone Health Plan East and AmeriHealth PA businesses in Pennsylvania. As a result, Independence will issue affected customers a rebate of a portion of paid premiums during the 2019 reporting year. Check and notification mailing to begin week of September 14 Beginning the week of September 14, Independence will begin to mail impacted customers their rebate check, a required CMS prescribed notice, and an informative cover letter and FAQ. Their affected subscribers will receive the same required CMS prescribed… Read More

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Pennie is Pennsylvania’s new official destination for shopping for quality health insurance plans and accessing financial assistance, if eligible.

Pennie is Pennsylvania’s new official destination for shopping for quality health insurance plans and accessing financial assistance, if eligible. When is open enrollment? Open enrollment is November 1, 2020, to January 15, 2021. During this time period, anyone living legally in Pennsylvania can apply for health insurance through Pennie. Individuals with qualifying life events can enroll at any time of the year. Who can help you enroll? They have several options to assist you in enrolling in a health insurance plan. Don’t try completing the enrollment process by yourself, the experts at Total Benefit Solutions, Inc are Pennie-certified Brokers. Where can I learn more about financial assistance and if I… Read More

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FAQs Address School Reopening and FFCRA Leave

Photo by Deleece Cook on Unsplash Click Here to Download FAQs Address School Reopening and FFCRA Leave The Department of Labor’s Wage and Hour Division (“the Department”) added three new FAQs to clarify when benefits are available under the Families First Coronavirus Response Act (“FFCRA”) as the school year begins. The FFCRA provides eligible employees of covered employers (less than 500 employees) up to 12 weeks of expanded family and medical leave when they are unable to work (or telework) because they are caring for a son or daughter whose school or “place of care” has been closed or whose childcare provider is unavailable due to COVID-19-related reasons. During the… Read More

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Confused About Medicare & Your Options?

Medicare is a federal health insurance program for people who are 65 or more years old or have certain qualifyingdisabilities. However, the complexities of the Medicare marketplace often leave consumers wondering if they have made the right decisions after enrollment. Our approach is truly a multi-level evaluation of all your options! Reach out to us today and we will help ! (215)355-2121.Click here to download OUR APPROACH      

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Could an ICHRA be the answer to your group health insurance challenges?

The individual coverage health reimbursement arrangement (ICHRA) is a new way for small businesses and other organizations to offer employees group style health benefits. It has been said to offer the most flexibility for employers and employees alike, the “ best of both worlds” if you will. This allows the employer to help fund the cost of healthcare but not take on the administration of the benefits. It gives the employee more freedom to choose a plan that works with their provider of choice, but to ensure that the employee understands the plan and benefits, it is helpful to work with an independent broker. The broker will educate and assist your employee… Read More

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Medicare Supplements & Advantage Plans are Different!

Medicare Advantage Plans and Medicare Supplement Plans( also known as Medigap) are different! If you know someone is is on Medicare or turning 65 soon it’s important to know the difference! Here are some of the simple explanations of Medicare Advantage vs Supplement… Medicare Supplements work in tandem with Original Medicare, Part A, & Part B, and will help pay for various costs that Original Medicare will not cover, (gaps). These plans do not give stand-alone coverage; you need to be enrolled in Medicare Part A & Part B for your primary coverage. If you want prescription drug coverage, you have to purchase a separate Medicare Prescription Drug Plan (Part… Read More

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United Concordia providing premium refunds to small groups in August

United Concordia Dental has taken strong measures to support small and large groups during this difficult time. I’m pleased to share that United Concordia will also be issuing premium refunds to fully insured clients. United Concordia will refund 50% of an average monthly dental premium payment. Refunds will be in the form of a check and issued in August*. And as a valued partner, it is important to note that your commission won’t be impacted by this refund. United Concordia is required to notify recipients prior to issuing actual refunds. So, the week of July 27, they’ll mail postcards notifying small groups (under 100 enrolled) about the refunds they can… Read More

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Who is PENNIE?

Do you have individual health insurance and live in Pennsylvania or New Jersey? For this upcoming 2021 open enrollment period, Pennsylvania has officially transitioned to a state-based exchange – PENNIE! This full conversion to a SBE is slated to occur for the beginning of the 2021 open enrollment period. The open enrollment period that opens on November 1, 2020. That’s approaching fast! Our intent is to make this transition with our clients, with an aim to minimize disruption  as much as possible. We anticipate that there may be some speed bumps in this transition! Regardless of what you want, if you are currently enrolled on an individual health insurance plan through … Read More

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Independence to provide premium credits and other support to clients and members

From: Independence Blue Cross In our continued commitment to our clients and members throughout the COVID‑19 pandemic, Independence is offering medical and dental premium credits and other financial support to our fully insured clients. As a result of the COVID‑19 pandemic, Independence has experienced a lower volume of health care services being delivered to our members than was anticipated when current plan prices were set. Moreover, our members have been unable to access some types of routine health services — from preventive screenings to dental cleanings — and many elective procedures have been delayed or cancelled. We know many of our clients are having difficulties managing costs during this time when business has been interrupted, and… Read More

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How Does Short Term Medical work?

Total Benefit Solutions, Inc works with many clients who are in between jobs, in good health or people who just want to pay less for their health plan insurance plan. As your impartial health insurance broker we can quote multiple carriers to find the best fit for our clients! .Ask us today of a short term medical plan could be a good solution for you! Just give us a call at 215-355-2121.

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Can employees now make mid year changes to their FSA benefits?

Is it true that we can allow our employees to make changes to their health and FSA benefits based on changes in circumstances due to COVID-19 related reasons? A.- Yes. The IRS relaxed its cafeteria plan mid-year change rules for 2020. Now, plan sponsors may allow participants to change their pre-tax elections of health coverage and flexible spending account coverage. The IRS does not require the change to be limited to a COVID-19 related reason. However, for administrative purposes employers may want to place restrictions on the reason for changing elections and the number of times elections may be changed. Have more F.S.A. questions? Please contact your Total Benefit Solutions,… Read More

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National General: Telehealth Benefits Extended

Teladoc Updates & Telehealth Benefit Extended: As promised,  National General Benefits Solutions will continue to keep you updated on the latest plan adjustments for your clients during the COVID-19 pandemic. We know that the COVID-19 crisis has created a need for your clients and their plan members to eliminate person-to-person contact. Because of that, we implemented plan enhancements to help plan members get the care they need. Teladoc® Allied HSA Groups with TeladocWhen the COVID-19 crisis hit, we waived the $49 Teladoc consultation fee for your clients’ group health plan members. This is a reminder that the waiver of that fee will end on June 30, 2020. As of July 1, 2020,… Read More

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How do I add supplemental benefits with my Medicare coverage?

Question: I have Medicare, and I’m interested in getting services like dental, transportation, and home-delivered meals. Do I need a Medicare Advantage Plan to get these supplemental benefits? Is there a way to get these services if I have Original Medicare?  -Xavier   Dear Xavier,  A supplemental benefit is an item or service covered by a Medicare Advantage Plan that is not covered by Original Medicare. These items or services do not need to be provided by Medicare providers or at Medicare-certified facilities. To receive them, you just need to follow your plan’s rules. Some commonly offered supplemental benefits are dental care, vision care, hearing aids, and gym memberships. Supplemental benefits must be primarily health-related, with some… Read More

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COVID-19 Crisis Management Resource Center

We’re here for your benefit. Total Benefit Solutions, Inc. has partnered with Think HR to provide our clients with a COVID-19 crisis management resource center. This resource provides you with a number of benefits including letter templates, documents and even short, easy to understand videos. Right now employers feel isolated. But, they’re not alone. Your Total Benefit Solutions Inc, team, ThinkHR and Mammoth have been fielding thousands of coronavirus-related questions from business owners. And, we’re jointly making our essential COVID-19 crisis management resources available for free to all employers in need. Think HR is provided complimentary to all business clients of Total Benefit Solutions, Inc. If you don’t have your subscription access please… Read More

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The Case for Workplace Reporting with Think HR

Employers can’t fix what they don’t know. Instances of sexual harassment, discrimination, fraud, and health and safety violations can go unnoticed if employees don’t have an effective way to report issues they witness or experience. Join us for our upcoming webinar on Thursday, June 25 as Don Phin, attorney and workplace consultant, discusses what safe workplace reporting is, how it mitigates risk, and why it bolsters a positive work culture. Click Here to Register. In this 60-minute webinar, we will also cover how brokers can support employers by offering an effective workplace reporting solution like ThinkHR’s newest release, Tell Us. Can’t make the live webinar? Register here, and we’ll send you a… Read More

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New to Medicare? There are several steps you’ll want to take…

Question: I will be eligible for Medicare soon and may need to enroll. What steps should I take to make sure that I have coverage that works for me?   -Thelma (Atlanta, GA)  Dear Thelma,  There are several steps you’ll want to take when you’re new to Medicare:  First, know when to enroll in Medicare Part A (hospital insurance) and Part B (medical insurance).  If you are already receiving retirement benefits from the Social Security Administration or Railroad Retirement Board at the time you become eligible for Medicare, you will be automatically enrolled in Medicare Parts A and B. There are three times you can enroll in Medicare Parts A and B… Read More

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2020 PCOR Fee Filing Reminder for Self-Insured Plans

The Patient-Centered Outcomes Research (PCOR) fee filing deadline is July 31, 2020 for all self-funded medical plansand HRAs for plan years ending in 2019. Year-end federal legislation reinstated the PCOR fee through September 30,2029. The IRS issued Notice 2020-44 announcing the adjusted fee amount for this year as well as limited transition relief. Click the link below for the full notice including fees and dates: 2020 PCOR Fee Filing Reminder for Self-Insured Plans – 061220R

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RE-ENGAGE EMPLOYEES THROUGH LEARNING

Employees are disengaged COVID-19 has disrupted the workforce, forcing employers to consider remote work, layoffs, furloughs, and return-to-work scenarios quicker than expected. Unfortunately, these actions can have unintended, far-reaching consequences to employee engagement. Click the link below to read the story from our partners at Think HR: https://www.thinkhr.com/blog/re-engage-employees-through-learning/ Total Benefit Solutions, Inc. clients receive a complimentary subscription to Think HR. Ask us how to get yours today by calling your Total Benefit Solutions, Inc., Benefit Specialist at (215)355-2121.  

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The IRS offers three new tax credits for COVID-19 related issues.

The IRS offers three new tax credits for COVID-19 related issues. Employee Retention Credit The Employee Retention Credit is intended to help businesses keep employees on payroll. The tax credit is 50% of up to $10,000 in wages paid by an eligible employer with a business financially impacted by COVID-19. The tax credit is refundable. Employers of any size may be eligible, excluding state and local governments and small businesses with SBA loans. Employers must meet one of the following requirements: (a) have a business fully or partially suspended by government order due to COVID-19 during the calendar quarter or (b) have gross receipts below 50% of the comparable quarter… Read More

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HSA limits for 2021 released

The IRS released the inflation adjustments for health savings accounts (HSAs) and their accompanying high deductible health plans (HDHPs) effective for calendar year 2021. Most limits increased from 2020 amounts. Annual Contribution Limits For calendar year 2021, the limitation on deductions for an individual with self-only coverageunder a high deductible health plan is $3,600. For calendar year 2021, the limitation on deductionsfor an individual with family coverage under a high deductible health plan is $7,200.High Deductible Health Plans For calendar year 2021, a “high deductible health plan” is defined as a health plan with an annualdeductible that is not less than $1,400 for self-only coverage or $2,800 for family coverage(unchanged… Read More

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Proper Use of Premium Credits

Proper Use of Premium Credits In light of the current pandemic, some carriers are offering premium credits attributable to a portion of the premiums paid in months where COVID-19 limited the benefit available to participants. While this is good news, the availability of such premium credits creates fiduciary  issues with respect to plan assets under ERISA. This summary is intended to highlight possible issues and mitigate potential ERISA fiduciary exposure. Click the link below to download this important notice Proper Use of Premium Credits – 051820R      

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Maximum Out of Pocket Limits Announced for 2021

On May 8, 2020, the Department of Health and Human Services (“HHS”) published its Annual Notice of Benefit and Payment Parameters for 2021. This guidance is a final rule that addresses certain provisions of the Affordable Care Act (“ACA”). The final rule follows a proposed rule issued in January. Generally, these changes apply to plan years beginning on or after January 1, 2021.   Click to download this notice If you have any questions or concerns about this notice please contact your Total Benefit Solutions, Inc. Benefit Specialist at (215)355-2121.

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