Ed MacConnell

7 Mistakes You're Making with Group Health Insurance Costs (and How to Fix Them)

January 29, 2026Ed MacConnell

Let's be real: group health insurance for employers isn't cheap. And if you're running a small or mid-sized business, every dollar counts. The frustrating part? Many business owners are overspending on their group health benefits without even realizing it. The good news is that most of these costly mistakes are completely fixable. You just need to know what to look for. We've helped countless employers find affordable group health insurance that actually works for their teams and their budgets. Along the way, we've spotted the same mistakes popping up again and again. Here are the seven biggest ones: and exactly how to fix them. Mistake #1: Choosing a Plan Based… Read More

Medicare Secondary Payer Rules Explained: Your Quick-Start Guide to 2026 Compliance

January 26, 2026Ed MacConnell

If you're an employer offering group health benefits, or an employee trying to figure out how your coverage works alongside Medicare, the Medicare Secondary Payer (MSP) rules are something you absolutely need to understand. And with 2026 shaping up to be a major enforcement year, now's the time to get your compliance ducks in a row. Let's break down what the medicare secondary payer rules actually mean, when Medicare pays second, and what you need to do to stay on the right side of the regulations this year. What Are Medicare Secondary Payer Rules? Here's the deal: Medicare doesn't always pay first for your healthcare costs. In certain situations, another… Read More

Looking For Affordable Group Health Benefits? Here Are 10 Things Small Businesses Should Know

January 22, 2026Ed MacConnell

Running a small business means wearing a dozen hats, and figuring out affordable group health insurance shouldn't require a PhD in healthcare policy. Yet here you are, trying to attract top talent while keeping your budget intact. Good news: group health benefits for small business owners are more accessible than you might think. Whether you've got two employees or twenty, there are options that won't drain your bank account. Let's break down the ten essential things you need to know before making this critical decision. 1. You Don't Need a Big Team to Qualify Here's something that surprises a lot of small business owners: group health insurance typically requires just… Read More

Is "Junk" Insurance Worth It? Understanding Short-Term Health Plans

January 18, 2026January 18, 2026Ed MacConnell

Short-term health insurance plans have earned the nickname "junk insurance" from critics, but that doesn't tell the whole story. While these plans come with serious limitations, they can serve a purpose in very specific situations. The question isn't whether they're inherently good or bad: it's whether they're right for your particular circumstances. Let's cut through the noise and break down exactly what you're getting (and what you're not getting) with short-term health plans, so you can make an informed decision. What Are Short-Term Health Plans? Short-term medical insurance plans are temporary health coverage designed to bridge gaps between more comprehensive insurance policies. Think of them as a Band-Aid solution: they're… Read More

Does Group Health Plan Compliance Really Matter in 2026? Here's the Truth

January 16, 2026Ed MacConnell

Let's cut right to it: if you're an employer offering group health insurance, compliance isn't optional. It's not a "nice to have." It's the law. And in 2026, the requirements are more detailed: and the deadlines more numerous: than ever before. We get it. You're busy running a business. The last thing you want to think about is a mountain of IRS forms, federal attestations, and employee notices. But here's the truth: ignoring group health plans requirements can cost you big time. We're talking fines, penalties, and potential legal headaches that no business owner wants to deal with. So does group health plan compliance really matter in 2026? Absolutely. Let's… Read More

What Is Minimum Essential Coverage (MEC)? Understanding Your Health Plan Options

January 14, 2026Ed MacConnell

If you've ever shopped for health insurance, you've probably come across the term "Minimum Essential Coverage" or MEC. It sounds official. Maybe even a little intimidating. But here's the thing, it's actually a pretty straightforward concept once you break it down. Let's cut through the jargon and talk about what MEC actually is, why it matters in 2026, and how it affects you whether you're an individual looking for coverage or an employer trying to do right by your team. So, What Exactly Is Minimum Essential Coverage? Minimum Essential Coverage is any health insurance plan that meets the requirements set by the Affordable Care Act (ACA). Back when the ACA… Read More

Alternatives to ACA plans

December 29, 2025December 29, 2025Ed MacConnell

Here’s a clear, well‑organized breakdown of the main alternatives to ACA (Affordable Care Act) health insurance plans, grounded in the search results you triggered. — 🌟 Alternatives to ACA Health Insurance Plans People often look for non‑ACA options when they don’t qualify for subsidies or want lower premiums, more flexibility, or year‑round enrollment. The search results highlight several categories of alternatives. — 🧭 Main Categories of ACA Alternatives 1. Short‑Term Health Insurance – Designed for temporary gaps (between jobs, waiting for coverage, etc.) – Lower premiums, fast enrollment – Not ACA‑compliant → can exclude pre‑existing conditions, limit benefits, cap payouts – Available year‑round Sources: — 2. Health Care Sharing Ministries… Read More

Lost Your Job? Here’s Your Complete Guide to Health Insurance Options (COBRA vs ACA vs Medicaid Compared)

December 6, 2025December 23, 2025Ed MacConnell

Losing your job hits hard enough without worrying about losing your health insurance too. The good news? You’ve got options, and we’re going to walk through every single one so you can make the smartest choice for your situation. Here’s the reality: You have 60 days from your last day of coverage to make a decision. That might seem like plenty of time, but trust me: these 60 days fly by when you’re dealing with job searches, unemployment paperwork, and everything else that comes with a career transition. The three main paths forward are COBRA (continuing your old employer’s plan), ACA Marketplace plans (buying individual coverage), and Medicaid (government assistance… Read More

2026 Medicare Parts A & B Premiums and Deductibles

November 15, 2025November 15, 2025Ed MacConnell

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

Highmark – Important Update Regarding Plan Availability on External Enrollment Platforms

August 29, 2025August 29, 2025Ed MacConnell

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

Medigap Plans: Comparing Costs

May 27, 2025May 22, 2025Ed MacConnell

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

UHC Medicare Ending Independent Broker Relationships and Compensation

May 25, 2025May 25, 2025Ed MacConnell

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

HRA Solutions : ICHRA vs. QSEHRA: Choosing an HRA that fits

May 22, 2025May 22, 2025Ed MacConnell

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

New Federal Rule Cuts Short-Term Health Plans to 4 Months, Affecting Coverage Options

May 17, 2025May 17, 2025Ed MacConnell

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

CIGNA PDP: New customer onboarding program

December 20, 2024December 20, 2024Ed MacConnell

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

Small Employer Open Enrollment Period November 15 through December 15

October 24, 2024October 24, 2024Ed MacConnell

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

Medicare Annual Pre-Enrollment Checklist

September 30, 2024Ed MacConnell

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.

Big Changes to Medicare Part D for Medicare beneficiaries still working

September 28, 2024Ed MacConnell

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

Ready for another year of helping clients who get their health insurance through Pennie!

September 8, 2024September 8, 2024Ed MacConnell

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

Individual Health Insurance help is available for employer groups!

September 6, 2024September 6, 2024Ed MacConnell

Why do group clients need help with an Individual health insurance expert? Here are some scenarios when groups need individual solutions:

IBC Medicare Members Save money with your IBX Care Card

September 3, 2024September 3, 2024Ed MacConnell

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

What is a level funded health insurance plan?

September 1, 2024September 1, 2024Ed MacConnell

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

Wellcare PDP Plans: Contract Termination: Important Change!!

August 25, 2024August 24, 2024Ed MacConnell

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

Important Changes to Medicare Drug Coverage for 2025

August 24, 2024August 31, 2024Ed MacConnell

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

CMS Releases 2025 Medicare Part D Bid Information and Announces Premium Stabilization Demonstration

August 2, 2024August 2, 2024Ed MacConnell

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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