The Medicare Access and CHIP Reauthorization Act (MACRA) of 2015 requires that Social Security Number-based Health Insurance Claim Numbers (HICN) be removed from Medicare cards by April 2019; this is in an effort to lessen the current risk of beneficiary medical identity theft. A unique Medicare number, called the Medicare Beneficiary Identifier or MBI, will replace the current HICN. Beginning in April 2018, the Centers for Medicare and Medicaid Services (CMS) will begin the process of mailing new Medicare cards and will meet the statutory deadline for replacing all cards by April 2019. Educational Resources: CMS Transition to New Medicare Numbers and Cards – Fact Sheet CMS Website –… Read More
Continue ReadingAetna Funding Advantage (AFA) is a new self-funded option for small groups
Aetna Funding Advantage (AFA) is a self-funded option that provides all of the financial and plan design flexibility of a traditional arrangement with special features designed to help companies with as few as 2 employees achieve even greater savings on their health insurance. Ask us today if self funding could be a good fit for your organization! Call your Total Benefit Solutions Inc. account manager at (215)355-2121 for more information! Learn more here: AFA-Customer-Flyer New! Minute Clinic Benefit! $0 Copay Minute Clinic Visits Flyer More Documents for downloading: Springboard Marketplace Your Online Administration and Enrollment Portal AFA AppleWatch Wellness Flyer AFA Sample Usage Reports Aetna & Teledoc for AFA AETNA… Read More
Continue ReadingMedicare Part D CMS Notification Reminder
Employers sponsoring a group health plan need to report information on the creditable status of the plan’s prescription drug coverage to the Centers for Medicare and Medicaid Services (CMS). In order to provide this information, employers must access CMS’s online reporting system at: https://www.cms.gov/Medicare/Prescription-Drug-coverage/CreditableCoverage/CCDisclosureForm.html Click here to download the complete bulletin As always please contact you Total Benefit Solutions, Inc. account manager at (215)355-2121 if you have any additional questions or concerns.
Continue ReadingDOL Penalties Increase for 2018
In 2015, Congress passed the Federal Civil Penalties Inflation Adjustment Act of 2015 (the “Inflation Adjustment Act”) to direct federal agencies to adjust the civil monetary penalties for inflation every year. Civil penalties ensure compliance with federal regulation by incentivizing employers not to violate federal regulation and providing federal agencies the power to ensure compliance. However, when penalties are too low, or have failed to be increased for inflation, compliance with federal regulation remains stagnant. The Department of Labor (DOL) recently published the annual adjustments for 2018 that increase certain penalties applicable to employee benefit plans Click here to download the full bulletin As always please contact your Total Benefit… Read More
Continue ReadingIRS Releases 2018 Inflation Adjustments to Tax Provisions
The Internal Revenue Service released the annual inflation adjustments that will apply to certain benefit plan tax provisions in 2018. Revenue Procedure 2017-58, which can be accessed by clicking here, identifies inflation-adjusted items for different provisions of the tax code. From an employee benefits standpoint, the following limits may be of interest to employers: The dollar limit on voluntary employee salary reduction contributions to health flexible spending accounts is increased to $2,650 for plan years beginning in 2018. The monthly exclusion amount for transportation and transit passes is increased to $260. The monthly limit for the qualified parking exclusion is increased to $260. The dollar amount used to determine the penalty… Read More
Continue ReadingCongress Passes Tax Reform Bill
On December 20, 2017, the House and Senate sent President Trump the Tax Cuts and Jobs Act for signature. The House of Representatives passed their version of the bill on November 16, 2017 while the Senate passed their version on December 2, 2017. Because the versions were not identical, a Tax-Bill Conference Committee was formed from members of the Senate and the House of Representatives to negotiate the text of the combined bill. After the finalized text was approved and released by the committee, the House and Senate each passed the combined bill (which happened on December 20th in the House and December 19th in the Senate) before… Read More
Continue ReadingExtension of Deadline for 2017 Forms 1095-C
On December 22, 2017, the IRS issued Notice 2018-06, which provides a limited extension of time for employers to provide 2017 Forms 1095-C to individuals. It also extends good-faith transition relief from certain penalties for the 2017 reporting year. The deadlines to provide Forms 1094-C and 1095-C to the IRS was not extended. Should you have any questions, please contact your Total Benefit Solutions account manager at (215)355-2121. Click to Download Extension of Deadline for 2017 Forms 1095-C
Continue Reading2017 Employer Reporting Requirements
2017 Employer Reporting Requirements The below document outlines sections 6055 & 6066, the “B” and “C” forms, and the employer reporting obligations to both employees and the IRS. Download 2017_Employer_Reporting_Requirements Click here to watch a brainshark video that explains the forms and reporting requirements.
Continue ReadingReceived Letter 226J – Now What?
The IRS issued Letter 226J to certain Applicable Large Employers (“ALEs”). This letter describes the proposed Employer Shared Responsibility Payment (“ESRP”) owed for calendar year 2015. Download this bulletin
Continue ReadingSearching for Keystone HMO Proactive Providers by Tier?
Please note you must select the proactive plans from the list. Go to this link: Choose a health plan: From the drop down select, Medical then Keystone Proactive: Now your search will return physicians with Tier listings showing:
Continue ReadingFind Your Keystone Proactive HMO Providers by Tier
Searching for providers by tier? Please note you must select the proactive plans from the list. Go to this link: Choose a health plan: From the drop down select, Medical then Keystone Proactive: Now your search will return physicians with Tier listings: Simple hospital listing by tier: Click here Download “Talk to your doctor about the Keystone Proactive plans” Keystone HMO Proactive provider Quality Standards Questions? Contact your Total Benefit Solutions account manager at(215)355-2121.
Continue Reading8 things to know about Medigap policies
Medicare Supplements or Medigap Plans A Medicare Supplement Insurance (Medigap) policy, sold by private companies, can help pay some of the health care costs that Original Medicare doesn’t cover, like copayments, coinsurance, and deductibles. Some Medigap policies also offer coverage for services that Original Medicare doesn’t cover, like medical care when you travel outside the U.S. If you have Original Medicare and you buy a Medigap policy, Medicare will pay its share of the Medicare-approved amount for covered health care costs. Then your Medigap policy pays its share. A Medigap policy is different from a Medicare Advantage Plan. Those plans are ways to get Medicare benefits, while a Medigap policy… Read More
Continue ReadingCHIP RENEWAL SIGNED INTO LAW
On December 15, Governor Wolf signed House Bill 1388 (Irvin-R-Mifflin/Centre/Huntington) into law. CHIP was re-authorized through December 31, 2019 or 90 days after Federal funding for CHIP ceases. The amendment allows for an extension if the Federal Government authorizes funding beyond December 31, 2019.
Continue ReadingWhat is Benefits CheckUp?
There are benefits you may be missing! BenefitsCheckUp helps you find and enroll in public and private benefits programs. You can also find information on Medicare Prescription Drug Coverage including an online application for the Extra Help. It’s simple and free and always includes the most up-to-date information. Click here to visit Benefits Checkup
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CMS publishes updated 2018 Medicare cost-sharing amounts
The Centers for Medicare & Medicaid Services (CMS) recently published updated cost-sharing amounts for 2018 which are outlined below. 2018 Medicare Costs at a Glance Standard Part B Premium Most people pay $134 each month Medicare Part B deductible (Medical deductible) $183 per year Medicare Part A deductible (Hospital deductible) $1,340 for each benefit period Beneficiaries will pay $134 (or higher depending on income) if they: • Enroll in Part B for the first time in 2018, or • Are directly billed for their Part B premium, or • Are dually eligible for Medicaid and have their premium paid by state Medicaid agencies pay an income-related premium Some beneficiaries who were held… Read More
Continue ReadingAetna Funding Advantage for Small Businesses
Aetna Funding Advantage (AFA) is a new self-funded option that provides all of the financial and plan design flexibility of a traditional arrangement with special features designed to help companies with as few as 2 employees achieve even greater savings on their health insurance. The benefits of self-funding have traditionally been considered by larger companies. But Aetna Funding Advantage has changed that. It is specifically designed to be attractive and affordable for small businesses like yours. Watch this short video and download the documents below for some information. As always please contact your Total Benefit Solutions dedicated account manager at (215)355-2121 if you have any questions, concerns or would like to learn… Read More
Continue ReadingGuidance Issued on QSEHRAs
Under the Affordable Care Act, a health reimbursement arrangement (HRA) must be integrated with a group health plan (as it could not meet the market reform provisions on its own) and was not able to reimburse employees for individual premiums. However, on December 13, 2016, President Obama signed into law the “21st Century Cures Act” which established QSEHRAs (a special standalone HRA). Click to Download Guidance Issued on QSEHRAs This guidance is big news for small groups who would prefer to provide a reimbursement as opposed to a group health plan. Please contact your Total Benefit Solutions account manager at (215)355-2121 if you have any questions or concerns.
Continue ReadingThe IRS Code has numerous provisions designed to help employers
Employer Strategies and Solutions to Substantially Reduce: the high cost of Health Insurance; the cost for Out-of-Pocket Medical Expenses; the cost for Dependent Day Care Expenses; the cost for Parking and Transit Expenses; cost of Self-Employed Healthcare Expenses; Employer Matching Payroll Taxes by 8%; Employee Income Taxes by 30%. The IRS Code has numerous provisions designed to help employers provide essential benefits to their employees tax-free. This saves the employee approximately 30% in income taxes on expenses they’re already paying for, and because the employees have reduced their taxable income, the employer realizes a reduced matching payroll tax liability of approximately 8%. Everybody saves money. To take advantage of… Read More
Continue ReadingNew Indexed PCORI Fees Issued
Under the Affordable Care Act, (ACA) a fund for a new nonprofit corporation to assist in clinical effectiveness research was created. To aid in the financial support for this endeavor, certain health insurance carriers and health plan sponsors are required to pay fees based on the average number of lives covered by welfare benefits plans. These fees are referred to as either Patient-Centered Outcome Research Institute (PCORI) or Clinical Effectiveness Research (CER) fees. The applicable fee was $2.26 for plan years ending on or after October 1, 2016 and before October 1, 2017. For plan years ending on or after October 1, 2017 and before October 1, 2018, the fee… Read More
Continue Reading2018 Individual Health Insurance Open Enrollment: PA Independence Individual Consumer Plans and Rates
Individual Health Insurance Open Enrollment 2018! Don’t do it yourself! Our dedicated professionals are here to help you take the fits out of the benefit planning process! One mistake and you could be stuck with a bad plan all year! We work with all available plans both on the healthcare.gov marketplace and off! Have your own expert help you! Our experts are trained to help you Choose between on and off exchange options Maximize any subsidy eligibility. Help you understand the cost sharing subsidies Help you choose the plan that is the best fit for you Explain the differences between the plan design and your out of pocket expectations Fill… Read More
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An Update on Short Term Medical Plans
President Trump recently signed an executive order asking the Secretaries of the Treasury, Labor and Health and Human Services to consider the expansion of availability of Short Term plans. These departments have 60 days to propose regulations or revise current guidance. We expect additional details to become available soon and will keep you updated as more information becomes available. While short term plans are not for everyone, they do meet an important need for consumers looking to avoid gaps in coverage. Of the short term plans available in the market, we encourage you to consider United Healthcare’s short term plans as they represent a name you know, and they are… Read More
Continue ReadingTotal Benefit Solutions Partners with Clover Health
New to Bucks County this year, Total Benefit Solutions is proud to announce that we have added Clover Healthg to our list of outstanding Medicare partners. Ask us during your briefing if Clover Health is a good fit for you!
Continue ReadingTrump Halts Cost-Sharing Reductions
On Thursday, October 12, 2017, the White House indicated that President Trump will end ACA cost-sharing reduction (“CSR”) payments to insurance companies effective immediately. Click Here to Download Trump Halts Cost-Sharing Reductions
Continue ReadingNew Executive Order and Insight on the Employer Mandate
New Executive Order and Insight on the Employer Mandate President Trump signed an Executive Order (“EO”) on October 12, 2017, directing various federal agencies to take regulatory action that will “increase health care choices for millions of Americans.” Along with the EO, the Administration issued a press release and some internal talking points that provide helpful insight into what the agencies are directed to review. Click to download this bulletin
Continue ReadingTotal Benefit Solutions Recertifies with Humana Medicare
Once again Total Benefit Solutions will be offering Humana Medicare Advantage Plans, Medicare Supplements and Medicare Part D PDP Drug plans as we have recertified with Humana. Ask us today if a Medicare plan from Humana might be a good fit for you. Watch this short video to learn more about Humana PDP plans.
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