Can I Work and Have Medicare?

Some individuals, maybe even you, will still be actively employed upon becoming eligible for Medicare. Can you enroll in Medicare while you’re still in the work force, and if not, will you get a penalty? If the employer has fewer than 20 employees, you’ll probably want to enroll in Parts A, B, and D upon becoming eligible for them. In this situation, Medicare usually becomes your primary coverage. If the employer has 20 employees or more, you may want to delay Parts A, B, and/or D if you have sufficient group coverage and know you won’t incur late enrollment penalties. Medicare usually pays second to group coverage from larger employers.… Read More

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The Mental Health Parity and Addiction Equity Act

The Mental Health Parity and Addiction Equity Act (MHPAEA) applies to employers with at least 51 employees offering a group health plan that includes any mental health and substance use disorder (MH/SUD) benefits. MHPAEA also applies to non-grandfathered insured plans in the small group market. Download the bulletin below for more information. As always please contact your Total Benefit Solutions account manager at (215)355-2121 if you have any questions or concerns. Download Mental Health Parity  

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CNN.com: Who gets hurt and who gets helped by the Senate health care bill

The Senate unveiled its legislation to dismantle the health reform law on Thursday. While it’s likely to change before lawmakers vote on it — possibly late next week — it’s already clear who will benefit and who will lose under the Senate plan. click here for the story on cnn.com

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Compare Medicare Plans in Your Area in real time!

  With Medicareful you can search and compare Medicare health plans at your own convenience, but with an expert nearby at Total Benefit Solutions Inc to help guide you along the way. Log in today and see for yourself! http://www.medicareful.com/totalbenefitsolutions

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Humana and Tenet have reached a new network agreement

Humana and Tenet have reached a new network agreement Humana is pleased to announce we have signed a new agreement, effective June 1, 2017, that allows Humana commercial, Medicare Advantage, Medicaid, and individual exchange health plan members to receive in-network care at Tenet hospitals, hospital-affiliated outpatient centers, and with Tenet physicians. We are currently in the process of loading Tenet providers to all applicable systems. There may be a delay in providers appearing in Physician Finder even though they are participating. For the best possible member experience, as always, we advise the member to check Physician Finder before seeking non-emergent care from a provider in order to help avoid any… Read More

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IBC: Acclaris to assume HSA custodial responsibilities from Bank of America

Acclaris to assume HSA custodial responsibilities from Bank of America in September 2017 Our spending account platform, Acclaris, received regulatory approval to become a non-bank health savings account (HSA) custodian and is ending its contract with Bank of America at the end of 2017. This includes custodial services Bank of America currently provides for the HSA.  click here for details

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Humana and Tenet have reached a new network agreement

Humana and Tenet have reached a new network agreement Humana is pleased to announce we have signed a new agreement, effective June 1, 2017, that allows Humana commercial, Medicare Advantage, Medicaid, and individual exchange health plan members to receive in-network care at Tenet hospitals, hospital-affiliated outpatient centers, and with Tenet physicians. We are currently in the process of loading Tenet providers to all applicable systems. There may be a delay in providers appearing in Physician Finder even though they are participating. For the best possible member experience, as always, we advise the member to check Physician Finder before seeking non-emergent care from a provider in order to help avoid any… Read More

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2018 Inflation Adjusted Amounts for HSAs

The IRS released the inflation adjustments for health savings accounts (HSAs) and their accompanying high deductible health plans (HDHPs) effective for calendar year 2018. All limits increased from 2017 amounts. Click to download the bulletin below and as always contact your Total Benefit Solutions account manager at (215)355-2121  if you have any questions or concerns regarding this notice.   Click Here to Download 2018 Inflation Adjusted Amounts for HSAs

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Recent Developments Regarding the Employer Mandate

Applicable large employers (ALEs) may be resting easy, having had no notification from the IRS of 2015 or 2016 assessments under the Employer Mandate of the Affordable Care Act (the ACA) and having reasonably expected that the Republican-led administration would limit or choose not to enforce this mandate. With the status of health care reform uncertain, the IRS has taken additional steps regarding the mandate, once again updating its website with FAQs on Employer Mandate penalties that build on information released in January (before the change in administration). Briefly, the guidance is included in the bulletin. Download the bulletin here

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PCOR Fee Filing Reminder for Self-Insured Plans and HRA’s

  The PCOR filing deadline is July 31, 2017 for all self-funded medical plans and HRAs for plan years ending in 2016. Click to download the bulletin for more information: Download the Bulletin here   As always contact your Total Benefit Solutions account manager at (215)355-2121 if you have any further questions or concerns.

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Independence speaks out on PA Premium Tax, Treat No Transport, and recently introduced bills

Independence speaks out on PA Premium Tax, Treat No Transport, and recently introduced bills Updates from IBX Government Affairs including the proposed PA premium tax changes, Treat No Transport reimbursement, scope of practice for nurse practitioners, and proposed bills on drug transparency and prior authorization… Download the Bulletin See IBC’s breakdown of the proposed budget impact here. As always please contact your Total Benefit Solutions account manager at (215)355-2121 if you have any questions or concerns.

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BREAKING: Aetna to withdraw from New Jersey Small Employer ACA market in 2018

Aetna to withdraw from New Jersey Small Employer ACA market in 2018  Due to mounting financial losses and an uncertain marketplace outlook, Aetna has made the decision to leave the Individual market in New Jersey. Regrettably, this decision also impacts our New Jersey small employer ACA insured medical products. New Jersey law requires a carrier to withdraw from the insured small employer market if it is withdrawing from the individual market.  As such, Aetna will withdraw all of its commercial (fully insured) medical plans offered in the small employer health insurance market. What this means Health insurance coverage for New Jersey small employer clients will end at midnight on the… Read More

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House Passes Bill to Repeal ACA

Just six weeks after the House leaders failed to muster the votes to pass an earlier version of the American Health Care Act (AHCA), the House Republicans narrowly passed their health care bill to repeal and replace Obamacare with a 217 to 213 vote on Thursday… Click the link below to download the bulletin with important points: Download House Passes Bill to Repeal Obamacare

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Video: Our New Online Enrollment System

Watch this short video to get a quick overview of our new employee enrollment system with Ease Central!   As always please contact your Total Benefit Solutions account manager at (215)355-2121 if you have any questions about our new enrollment system with Ease Central!

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Breaking News: CMS Announces Open Enrollment Dates and More

CMS issued final rule to increase choices and encourage stability in health insurance markets for 2018 The Centers for Medicare & Medicaid Services (CMS) issued the final Market Stabilization rule to help lower premiums and stabilize individual and small group markets, and to increase choices for Americans. Individuals obtaining coverage in the Marketplace created by the Affordable Care Act have faced double-digit premium increases, fewer plans to choose from, and a market that continues to be threatened by insurance issuer exits.*  The CMS rule is designed to provide some relief for patients and issuers now. “CMS is committed to ensuring access to high quality affordable healthcare for all Americans and… Read More

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Video: New Premium Saver Gap Coverage

  Want more information? Call your Total Benefit Solutions account manager today at (215)355-2121.

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Video: New Individual Dental & Vision Choices

Click here to shop, compare and enroll!

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DeNovo HR Consulting: Pet Friendly Workplaces

Companion dogs have been found to lower stress in the workplace. So sometimes, if we’re very lucky, we’ll arrive at work in the morning to discover that someone has brought their pups into the office for the day.  In fact, the International Journal of Workplace Health Management published its findings on “the effect of the presence at work of employees’ dogs on stress and organizational perceptions.” They found that “over the course of the day, stress declined for the DOG group with their dogs present and increased for the NO-DOG and NO-PET groups… On dog absent days, owners’ stress increased through the day, mirroring the pattern of the NO-DOG group.”…… Read More

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GOP Pulls AHCA Before Vote

On Friday, March 24, 2017, the U.S. House of Representatives pulled the American Health Care Act (“AHCA”) from consideration after not receiving enough Republican support to pass the bill. The AHCA was President Trump’s first attempt to repeal and replace the Affordable Care Act (the “ACA”). The AHCA, among other things, would have eradicated the penalties associated with the individual and employer mandates, and replaced the ACA subsidies with refundable tax credits. Download GOP Pulls AHCA Before Vote

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Small Businesses May Be Able to Keep Existing Health Coverage Through Calendar Year 2018

Small Businesses May Be Able to Keep Existing Health Coverage Through Calendar Year 2018   A previously extended transitional policy which allows health insurance issuers, at their option, to continue group coverage that would otherwise be terminated or cancelled has been extended further—to policy years beginning on or before October 1, 2018, provided that all policies end by December 31, 2018. Health insurance issuers that renew coverage under the extended policy are required to provide standard notices to affected small businesses for each policy year. Extended Transitional Policy At the option of the states, issuers that have renewed policies under the transitional policy continually since 2014 may be permitted to… Read More

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Compliance Bulletin & Reform Center

Health Care Compliance and Reform Education Center A fundamental change in the way the United States handles health care has arrived. Benefit rules and coverage change faster today than they used to in ten years! Our Compliance and Health Reform Education Center is where we will keep a copy of our health care reform bulletins throughout the year, in an easy  to view format where you can download a brief summary or watch a short informative video. Click here to visit totalbenefitscomply.com Please contact your Total Benefit Solutions account manager at (215)355-2121 if you have any further questions.  

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MEDICARE 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). Watch a video overview   Download a bulletin

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Human Resources: Tours of Duty

Human Resources: Tours of Duty From our friends at DeNovo HR Consulting:   In September of 2016, the Bureau of Labor Statistics released updated employee tenure stats.  I think we all predicted what they would reveal:  the median number of years that the average employee stays with a company is 4.2, which is down from 4.6 years when last published in 2014. Employees in professional occupations and management roles have the highest median tenure of 5.1 years.  On the other side of the coin, workers in service occupations have the lowest median tenure of 2.9 years, with those specifically in the food service industry coming in at only 1.9 years.… Read More

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Examining The House Republican ACA Repeal And Replace Legislation

On March 6, 2017, the House Republican leadership introduced Affordable Care Act repeal and replacement budget reconciliation bills in the Ways and Means (W&M) (summary) and Energy and Commerce (E&C) (summary) committees. The bills, collectively titled the American Health Care Act, are the committees’ responses to the instructions they received in the Budget Resolution passed by both houses of Congress in mid-January to prepare budget reconciliation legislation to repeal the ACA. What The Two Bills Do, And What They Don’t Like the leaked bill analyzed here earlier, the two proposed bills do not repeal the ACA. They leave in place the ACA’s titles affecting Medicare, quality of care, program integrity,… Read More

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HSA / FSA / HRA Comparison of Key Features for 2017

HR360: HSA / FSA / HRA  Comparison of Key Features for 2017 This guide brought to you by our partners at HR360. As us today how your organization can benefit from personalized HR services designed to fit your company’s legal compliance needs! Your Total Benefit Solutions Inc Account Manager is available at (215)355-2121. Click here to download the complimentary guide  

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