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In an age when more and more positions require duties to be carried out almost exclusively on
computers, and where the internet can instantly connect anyone anywhere, many employers, including ,
are offering the option of telecommuting. Telecommuting allows employees to work from home or
another alternate location and communicate with their employers electronically.
Employee Eligibility Exception for furloughed or temporarily laid off employees. As a result of the COVID‑19 outbreak, Independence will honor employer requests to continue coverage for employees furloughed or temporarily laid off as a result of impacts of COVID‑19. This exception applies to fully insured and self-funded business, and is contingent upon the following: Full premium payments continue to be made by the employer.Self‑funded employers must continue to remit invoiced amounts in full. The employer is responsible for collecting employee contributions, if applicable. No reductions to employer contributions will be allowed. Only actively at‑work employees can be added to the plan as new enrollees. Our preferred Stop Loss partner, HM Insurance Group (HMIG) HMIG will honor… Read More
On December 2, 2019, the IRS issued Notice 2019-63, which provides: • An extension of time, until March 2, 2020, for employers to provide Forms 1095-C to their full-time employees and other individuals; and • An extension of relief from penalties for the 2019 reporting year for employers and other entities that make good-faith efforts to comply with the reporting requirements.
Annual Medicare Part D reporting is required for all employers who provide health benefits with prescription drug coverage. The reporting is an online filing to the Centers for Medicare & Medicaid Services (CMS), and it lets CMS know if the prescription drug coverage available on the employer’s health plan is “creditable.” The Medicare Part D reporting helps CMS determine if a person enrolling in a stand-alone Part D plan is subject to a late enrollment penalty. Late enrollment penalties apply for individuals who delay enrollment in a Part D plan upon first becoming eligible unless they have prescription drug coverage elsewhere that is at least as good as the standard… Read More
UnitedHealthcare’s policy will limit outpatient surgery payments to hospitals Kelly Gooch UnitedHealthcare has expanded prior authorization requirements and site of service medical necessity reviews for certain surgeries in an effort to shift surgical procedures to less expensive locations, according to Modern Healthcare. The outpatient surgery policy will limit the circumstances under which UnitedHealthcare will pay for certain surgeries in a hospital outpatient setting. Taking effect in November for fully insured groups in most states, UnitedHealthcare will only pay for a surgical procedure performed in an outpatient hospital setting if the insurer determines the site of service for the procedure is medically necessary, UnitedHealthcare told Becker’s Hospital Review. “Medical necessity reviews for… Read More
It’s Your Last Chance.. The Medicare Access and CHIP Reauthorization Act of 2015 eliminates all Medigap Plans that cover the Medicare Part B deductible. A deductible is an amount of money you must pay out of pocket before your plan will begin covering services. The Part B deductible in 2019 was $185 and is projected to be $197. Medicare Part B covers most of your outpatient services. Things such as Doctor visits, labs and tests, durable medical equipment, and some medications. That means, unless a preventative care visit, you would have to pay out of pocket $197 before your plan would cover you. Why would Congress decide to pass a… Read More
Medicare in 2020 Everyone has heard of Medicare and over the years, here at Total Benefit Solutions have posted numerous articles explaining how Medicare works. We even wrote out a post about the history of Medicare a little over a year ago (That post can be found here ). However, nothing in the Insurance World stays still and every so often we like to revisit this sector of the Insurance Market and explain how Medicare works with some updates. This way, whether you’re new to Medicare, or you’ve been on it for a while, you are up-to-date on how your Insurance Plan works! Original Medicare (Part A and Part… Read More