New Jersey Small Employer Stop Loss Bill

A bill has been introduced in New Jersey in both the Senate and Assembly that, if passed, would prohibit insurance carriers or other insurers subject to the insurance laws of New Jersey or any other state from offering, issuing or renewing any stop loss insurance policy of any kind to small employers. Stop loss insurance provides reimbursement for catastrophic, excess or unexpected expenses and is used by small employers to self-insure part of the health insurance coverage they provide for employees. Under New Jersey law, in connection with a group health plan, a small employer means an employer with 2-50 eligible employees on business days during the preceding calendar year. If passed,… Read More

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What are PEO Solutions?

PEOs & the Philadelphia Area As you may be aware Independence Blue Cross recently introduced a PEO offering into the Pennsylvania market/Greater Philadelphia area through a partnership with Clear PEO. As a leading independent broker in the Northeast, Total Benefit Solutions, Inc.  has experience with PEOs and helping group clients find the best choices to put you in the strongest possible position to shop and compare PEO’s and traditional health benefits. In fact, Total Benefit Solutions, Inc. has already been partnering with established PEO’s for a number of years in the Pennsylvania market as well as the surrounding area. THE BASICS OF PEOs PEO is an acronym for Professional Employer… Read More

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Is your plan subject to the $110 Per Day ERISA Health Plan Documentation penalty?

Is your health plan group ERISA compliant? Health plans subject to the Employee Retirement Income Security Act (ERISA) must make available information about the plan to participants. The plan participants have a right to know about plan rules, financial data, plan operation and plan management. Many small employers fail to realize that they need to meet this requirement. The departments of labor have been coming to more employers and asking for this document more often, but typically the DOL audit is the direct result of an employee ( or former employee) grievance. When a member first becomes covered under an ERISA-covered health plan, the individual must receive an SPD (Summary Plan… Read More

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How Does Level Self Funded Health Insurance Work?

We have received a lot of questions regarding the new level funding health benefit programs so we prepared this video to make it a little easier to understand. Ask us today if Level Funding might be a good for for your health plan!

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Important News From Independence Blue Cross: Trinity Health termination

February 11th 2019: For the past several months, we have been negotiating the terms of our agreements with Trinity Health (Trinity), which includes the following entities, as well as their professional providers, subsidiaries, affiliates, and divisions: Mercy Health System of Southeastern Pennsylvania, including Mercy Fitzgerald, Mercy Philadelphia, and Nazareth hospitals St. Mary Medical Center, including St. Mary Rehabilitation Hospital, Saint Francis Healthcare, including Saint Francis Hospital, Wilmington, Delaware. We continue to engage in good‑faith negotiations, but we want to explain how customers and members could be affected if we are unable to reach a new agreement by March 31, 2019. How members would be affected If we are unable to reach a new agreement, Trinity will no longer be… Read More

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Total Benefit Solutions Partners with Aliera Healthcare

Aliera Healthcare is an innovative healthcare organization offering both traditional healthcare and health sharing plans, which are an alternative to traditional insurance. At the core of Aliera plans is a concentration on the patient using our “Core 4” Patient Centered Medical Home Model of Care. Employer Group plans range from ACA compliant ‘Minimum Essential Coverage” to Self-Funded Minimum Value Plans. Our Individual plans are supported by our Healthcare Sharing Ministry Partner, Trinity HealthShare. Click here to find our more about the benefits, rates and programs available and then call us at (215)355-2121!     

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IBC: PEO offering now available

Independence is pleased to partner with CLEAR Employer Services to provide a Professional Employer Organization (PEO) offering to companies looking to outsource many of their HR‑related functions, beginning with 1/1/2019 business. This solution supports primarily small and mid-size businesses by handling a variety of human resources and administrative functions, freeing company leaders to focus on growing their businesses through increased attention on strategy, innovation, and operations. Total Benefit Solutions inc., as one of the area’s leading brokers is excited to offer this  as a potential solution for our clients! Through the establishment of a PEO Master Health Plan, the PEO will be a single Large Group customer with membership consisting of… Read More

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Introducing Reference Based Pricing with ELAP Services

Total Benefit Solutions is proud to announce our partnership with ELAP services to provide our clients with the very best in reference based pricing benefit plans. Wondering if reference based pricing would be a good for your organization? Call us today to find out how it works at (215)355-2121!  

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How do you calculate the number of full time equivalent employees?

How do I calculate the number of full time equivalent (FTE) employees?” Employers ask us all the time how the go about figuring how many FTE’s or Full Time Equivalents they have for ACA compliance purposes. Because the Affordable Care Act’s Employer Mandate (Employer Shared Responsibility Payments or the Play or Pay ) only applies to “applicable large employers,” defined as employing 50+ FTE employees. What if you don’t have 50 employees? So if you do not have 50 employees or anywhere close to it, you can rest assured, you don’t have to calculate.  The employers who typically have the biggest challenges are the employers who have a large number of part… Read More

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Total Benefit Solutions featured in the Southampton Spirit

Total Benefit Solutions: A Committed Team Focused On ‘Clients First’ For Health Insurance by Tianna Grosch Looking for affordable health insurance but not sure where to start? Seeking the correct health insurance with benefits fit to your needs can be a daunting task, one that you should leave in the hands of caring and compassionate professionals. Total Benefit Solutions, Inc. (TBS) is the right place to get the advice and assistance you need in order to make the best enrollment decision whether you’re a family, senior or company. Ed and Kathleen MacConnell began this agency inspired by their own difficulties in receiving insurance coverage for their daughter Katelin, who was… Read More

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IBC 2019 Member Renewal Notices

October 25th: Independence Blue Cross Member Renewal Letter details Due to the subsidy disruption in some counties, Independence will be sending renewal notices in 2 waves. On October 25th 2018: • Members who do not receive a subsidy will receive their renewal notices for 2019. The notice will include benefit and premium updates for 2019 and provide a personalized URL for a website that enables them to renew plans as-is (EZ Button), or make a change to their current plan. • Members who have a subsidy will receive a letter advising that Independence is waiting for more information from the federal government regarding their subsidy dollars. Upon receipt of this information, the renewal notices will be sent.… Read More

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Health Care Reform: How should employers disburse medical loss ratio (MLR) rebates from insurance carriers?

Recently a number of clients have received notices and/or checks for their organizations’s Medical Loss Ratio, or MLR rebates. Below is some helpful information from SHRM for understanding how these rebates can be used or distributed. According to the U.S. Department of Labor’s Technical Release No. 2011-04, the employer’s responsibility for distributing the rebate to participants is dependent on who paid for the insurance coverage. If the employer paid the entire cost of the insurance coverage, then no part of the rebate would be attributable to participant contributions. However, if participants paid the entire cost of the insurance coverage, then the entire amount of the rebate would be attributable to participant… Read More

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Introducing Xpress Healthcare with Aetna Dental Access!

Total Benefit Solutions offers Xpress Healthcare with a great dental discount & more for Individuals, Families and Seniors! Click Here to shop, compare & enroll!

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Association Health Plans: What Do New Guidelines Mean for Healthcare?

From our PEO partners at Extensis… Back in October, President Trump signed an executive order intended to help make healthcare more affordable to individuals and small employers.This executive order marked the administration’s continued efforts to undo aspects of the Affordable Care Act (ACA). It also encouraged the use of Association Health Plans (AHPs) on a much larger scale (county, state, region, or even nation-wide) to potentially lower the costs of healthcare for individuals and smaller businesses. At the time, the President directed the Labor Department to study how to make AHPs a feasible option. Click here to read the story  

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Medicare Part D Donut Hole Closing Sooner!

Did you know? The Bipartisan Budget Act of 2018 moved up the date for closing the so-called donut hole for brand name drugs to 2019. It was previously 2020. For 2019 and every year after, the beneficiary cost sharing for brand name drugs after the initial coverage limit is 25% — the same as after the deductible and before the initial coverage limit. In 2020, the beneficiary cost sharing for generic drugs will also be 25%. Ask your Total Benefit Solutions Account Manager for more information at (215)355-2121. Total Benefit Solutions Inc. is your Medicare health insurance specialist! We work for your benefit!

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CMS Expands the Extension of Needed Relief for Marketplace Enrollees Who Missed Medicare Enrollment

CMS is offering assistance to certain individuals enrolled in both Medicare Part A (and/or Part C) and the Exchange for individuals and families to drop their Exchange coverage and enroll in Part B without penalty. Further, CMS is offering assistance to certain individuals who dropped or lost their coverage from the Exchange and are paying a Part B late enrollment penalty from their subsequent enrollment into Part B. These eligible individuals can have their penalty reduced. Individuals can apply for the special enrollment and reduction in late enrollment penalties during a limited time – it is available now and ends September 30, 2018 Read Blog Post from MedicareRights.org CMS SHIP… Read More

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Four Stages of Medicare Part D

  It’s easy to see why Many people are confused by the Medicare part D plan coverage deductibles, limits and the donut hole. We have provided this graphic for you, our clients and friends to make it a little easier to see in a pie chart. Click the link below to download this graphic bulletin. 2018 Four Stages Of Medicare Part D   Want to compare part D plans in your area quickly? Click here   Have more questions? Call us today at (215)355-2121.

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New Association Health Plans

This is something that is happening right now, the rebirth of association health plans, but even better than before!  I have been asked about being able to do this for years. We are super excited about this and this should be better than what we were able to do before with previous association health plans.  Sole proprietors and small businesses will need to join an association in order to get these plans and they are going to be designed to be lower in cost than the current small group plans. Please review the bulletin by downloading below and call us at (215)355-2121 if you have any questions.   Click to… Read More

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Total Benefit Solutions-now offering travel health insurance

Introducing GeoBlue Travel Health Insurance We are delighted to now  be able to offer our clients a unique set of international health insurance and trip protection plans through GeoBlue International Blue Cross . GeoBlue advantages include: Richer Benefits – rich coverage without the hidden surprises Better Service and Care – concierge-level access to an elite network of the most internationally-friendly medical providers around the world More Peace of Mind – you have the confidence associated with the most recognized health insurance brand in the U.S. GeoBlue plans offer unique benefits and services not available elsewhere. Each GeoBlue policy includes access to best-in-class doctors and hospitals in 190 countries. Members have the ability… Read More

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You’re getting a new Medicare card!

    You’re getting a new Medicare card! Between April 2018 and April 2019, we’ll be removing Social Security numbers from Medicare cards and mailing each person a new card. This will help keep your information more secure and help protect your identity. You’ll get a new Medicare Number that’s unique to you, and it will only be used for your Medicare coverage. The new card won’t change your coverage or benefits. You’ll get more information from Medicare when your new card is mailed.   Click here to download more information

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Total Benefit Solutions announces affiliation with Medi-Share

Total Benefit Solutions is proud to announce our selection as a select broker with Medi-Share.  Medi–Share is a faith based healthcare sharing program where Christians share their financial resources to pay each other’s medical expenses.  Medi-Share can be offered to employees of small groups as well as individual families in need of an alternative health care solution. Click here to learn more about Medi-Share      Medi–Share isn’t insurance. Christian Care Ministry and the Medi–Share program are not registered or licensed by any insurance entity, nor is it required to be.  

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Expanding Access to Quality, Affordable Health Coverage for Millions of Americans Employed by Small Businesses

On June 19, 2018, the U.S. Department of Labor expanded access to affordable health coverage options for America’s small businesses and their employees through Association Health Plans. Association Health Plans work by allowing small businesses, including self-employed workers, to band together by geography or industry to obtain healthcare coverage as if they were a single large employer. Association Health Plans will also be able to strengthen negotiating power with providers from larger risk pools and greater economies of scale. The Department of Labor expanded access to Association Health Plans as a result of President Donald J. Trump’s Executive Order “Promoting Healthcare Choice and Competition Across the United States.”   As always… Read More

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IRS reverses decision on 2018 HSA limits

The IRS reversed its March 5 decision to decrease the 2018 contribution limit for family coverage only. The new contribution limit is back to $6,900 (previously adjusted to $6,850). To review the official IRS announcement, visit the Internal Revenue Service press release (published April 26, 2018). This means individuals who have already contributed $6,900 are fine and do not need to return any money. And those individuals who have automatic contributions that would have exceeded the earlier $6,850 limit in 2018 are fine. No changes need to be made as long as they do not exceed the $6,900 family contribution maximum. If you have questions, please contact your Total Benefit Solutions, Inc.… Read More

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ThinkHR Webinar: How to Easily Build a Compliant Multistate Handbook

  May 22 and 24, 8:30 a.m. Pacific Daylight Time ThinkHR Webinar: How to Easily Build a Compliant Multistate Handbook Handbooks, not rule books: A new approach to an old requirement   Register Now Join Dan Riordan, President and COO at ThinkHR and Shannon Flanagan, Director of People Operations at ThinkHR, as they discuss some of 2018’s hot topics when it comes to employee handbooks. Dan and Shannon will share their insights on how employers can update their marijuana/drug testing and social media policies to reflect today’s environment while staying compliant with changing laws and providing a safe and supportive workplace. Then, stick around to get a preview demo of… Read More

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