IRS Extends Employers’ and Insurers’ Reporting Deadlines Under the ACA On December 28, the U.S. Treasury and Internal Revenue Service announced a limited extension of the early 2016 due dates for the 2015 information reporting requirements for employers and insurers under the ACA. This is the first year that employers and insurers are required to report certain information about health coverage to employees, other individuals to the IRS. Specifically, employers will have two additional months beyond the February 1 due date to provide individuals forms for reporting on offers of health coverage and the coverage provided. The deadlines to report this information to the IRS are extended by three… Read More
Continue ReadingAetna and Coventry System Issues
January 4, 2016-From Aetna: We’re working to resolve system issues affecting member status for 2016. First payment deadline extended to 1/31/16 We are working to correct data issues that are causing some members to be incorrectly listed as inactive for 2016. While we work to correct the issues, we have extended the first payment deadline for members with a valid application, enrollment, or renewal with us until January 31, 2016.
Continue ReadingMedicare Premiums and Deductibles Updated for 2016!
As the Social Security Administration previously announced, there will no Social Security cost of living increase for 2016. As a result, by law, most people with Medicare Part B will be “held harmless” from any increase in premiums in 2016 and will pay the same monthly premium as last year, which is $104.90. Beneficiaries not subject to the “hold harmless” provision will pay $121.80, as calculated reflecting the provisions of the Bipartisan Budget Act signed into law by President Obama last week. Medicare Part B beneficiaries not subject to the “hold-harmless” provision are those not collecting Social Security benefits, those who will enroll in Part B for the first… Read More
Continue Reading2016 Health Insurance Open Enrollment Begins
2016 Individual and Family Plans Open Enrollment for 2016 Open enrollment opens on November 1st 2015 and ends on January 21st 2016. As the 2016 Open Enrollment Period gets ready to explode, we will be updating this page regularly with plan benefits, rates and information as they become available. Remember Total Benefit Solutions dedicated, licensed, certified and insured representatives can help anyone enroll on the healthcare Marketplace, or off! Full Service Client Intake Form: Click here to get started. This is not an application for insurance. This form will provide the information that is needed to determine Marketplace eligibility and must be entered on Healthcare.gov We understand that Health Care… Read More
Continue ReadingHealth Reform Video: What Counts as Income in the Marketplace?
What Counts as Income when applying for a Marketplace subsidy? This short video may help: As always contact your Total Benefit Solutions account manager at (215)355-2121 for help applying for a subsidy and health plan on or off the Marketplace.
Continue ReadingSmall Group Definition Changes Per the PACE Act
On Wednesday, October 7, 2015, President Obama signed into law H.R. 1624, the Protecting Affordable Coverage for Employees (PACE) Act, legislation that will give states the ability to define the size of a small group for health insurance purposes. The law repeals the mandated small group expansion of groups of up to 50 employees to groups of up to 100 employees that was to go into effect on January 1, 2016. This law gives states the flexibility to determine the size of their small group market instead of being forced into the national standard. No action is needed if states want to retain their respective definition. There is no announcement… Read More
Continue ReadingHealth Reform: Adjusted Amount for the PCORI fee for HRA Clients and Self Insured Groups
The Internal Revenue Service (IRS) recently released new guidance adjusting the Patient-Centered Outcomes Research Institute (PCORI) fee. Under the notice, the adjusted applicable dollar amount is $2.17 for plan years ending on or before October 1, 2015 and before October 1, 2016. For additional information, please see Notice 2016-60
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Health Reform: PACE Act halts small group expansion
In what only be called good news for employers with 50-99 employees, On October 7, 2015, the President signed into law bipartisan legislation, the Protecting Affordable Coverage for Employees (“PACE”) Act, which maintains the “50 or fewer” definition of a small employer. The PACE Act contains language that permits a state to use the expanded small group definition (employers with 100 or fewer employees). At this point, it is unclear whether states will retain the “50 or fewer” definition or opt to expand the small group market. Click here to view The PACE Act Halts Small Group Expansion Bulletin As always please contact your Total Benefit Solutions account manager at (215)355-2121… Read More
Continue ReadingEmployees on Leave May be Full Time for Penalty Purposes
Informal guidance has been released regarding calculating employees for penalty purposes as full time. Please click the link below to download the bulletin. Download Employees on Leave May be Full-time Employees for Employer Penalty Purposes – 100115R As always, if you have questions regarding this bulletin, please contact your Total Benefit Solutions, Inc. account manager at (215)355-2121.
Continue ReadingMedicare Part D Creditable Coverage Notice Due Soon
Medicare Part D Creditable Coverage Notice The Medicare Modernization Act (MMA) requires employers whose policies include prescription drug coverage to provide a written disclosure notice to all Medicare eligible policyholders of whether such coverage is creditable. Creditable coverage means that the coverage is expected to pay, on average, as much as the standard Medicare prescription drug coverage. This disclosure must be provided prior to October 15th, 2015 (and at various times as stated in the regulations) to: Medicare eligible active working individuals and their dependents (including a Medicare eligible individual when he or she joins the plan); Medicare eligible COBRA individuals and their dependents; Medicare eligible disabled individuals covered under… Read More
Continue ReadingTotal Benefit Solutions Introduces the All Check Compliance Tool!
Total Benefit Solutions, Inc. in partnership with Benefit Mall introduces All Check! Want to know how to easily calculate your FTE’s ( Full Time Equivilents)? Not sure if you need to provide the Notice of Exchange? Unsure about your Health Care Tax Credit Eligibilty? Want to get an idea what your overall ACA compliance obligations might be? Let Total Benefit Solutions and All Check do the work. How? It;s simple. Download the input sheet, complete and return to your Total Benefit Solutions, Inc account manager and we will crunch the numbers and send you a customized report just like the sample! Click Here to Download The Input Sheet Sample_ComplianceReport.2147.21136.20150903 … Read More
Continue ReadingHealth Reform: ACA Compliance Partnership
Total Benefit Solutions has partnered with industry leaders such as PrimePay to provide ACA Compliance tools to our valued clients. To learn more about this new ACA Compliance tool, please download the bulletin below and contact your Total Benefit Solutions dedicated account manager at (215)355-2121 today! Click to Download
Continue ReadingKey Facts You Need to Know About: Cost-Sharing Reductions
A recent analysis shows that more than 2 million marketplace enrollees who are eligible for cost-sharing reductions (CSRs) are foregoing this extra level of financial assistance by enrolling in plans that do not qualify. Consumers can receive CSRs only if they enroll in a silver level plan through their marketplace. Many of those who chose not to receive CSRs are likely enrolling in bronze plans with lower premiums but higher out-of-pocket costs. It’s important to communicate the benefits and trade-offs of receiving CSRs to the consumers you are assisting, especially those with significant health care needs. To learn more about cost-sharing reductions, check out this helpful resource from the Center on Budget… Read More
Continue ReadingHealth Reform: Draft 2015 Form 1095-C and Instructions, Increased Penalties, and Electronic Filing Steps Issued
On August 7, 2015, the IRS issued revised draft 2015 Form 1095-C with instructions. The forms and instructions are substantially the same as those applicable to the 2014 year, but the penalties have been revised. Click here to download this important update for all applicable large employers. As always if you have any questions or concerns about your organization’s health care reform compliance, please contact your Total Benefit Solutions, Inc account manager at (215)355-2121
Continue ReadingNew Law Clarifies Employer Mandate and HSA Eligibility for Veterans
On July 31, 2015, President Obama signed into law H.S. 3236, Surface Transportation and Veterans Health Care Choice Improvement Act of 2015. Notably, the law makes changes affecting the employer mandate and HSA eligibility as to individuals who are (or were formerly) service members. Click here to download the bulletin
Continue ReadingTotal Benefit Solutions Joins Geriatric Advisory Council
Total Benefit Solutions is proud to announce that we have become a founding member of the Greater Philadelphia chapter of the Geriatric Advisory Council to better serve the needs of our senior clients. The Geriatric Advisory Council is a professional organization comprised of local businesses and non-profit organizations who are focused on eldercare and senior related issues.The council was formed with the mission of assisting seniors and their caregivers by providing FREE educational resources along with targeted referrals to help caregivers provide the quality of life care that their loved ones need and deserve. Click here to learn more about the GAC and the professional resources available.
Continue ReadingVideo: Are you eligible for a special enrollment period?
You might think that you have to wait for the annual open enrollment period to get enrolled. Think again! You may be eligible for a special enrollment period. Watch this short video to learn more, and then call us at (215)355-2121!
Continue ReadingVideo: Learn about the Premium Saver Plan
Group Supplemental Health Insurance – Gap Insurance What is the Premium Saver? The Premium Saver is an employer sponsored group supplemental insurance plan which is designed to help reduce the cost of group medical coverage. Combining the Premium Saver with certain major medical plans can deliver coverage groups want and can afford. How does the Premium Saver pay claims? It’s simple! The Premium Saver pays off of the underlying major medical plan EOB, and it pays benefits directly to the provider. When the insured goes in-network they always receive the carrier’s in-network discounts. What coverage does the Premium Saver provide? Supplemental Deductible and Co-Insurance Premium Saver plans have a supplemental… Read More
Continue ReadingWebinar: The Top 5 Reasons to Have (and use) an Employee Handbook
Webinar: The Top 5 Reasons to Have (and use) an Employee Handbook Now Available from our partners at Think HR Click here to watch the video of the webinar and download the slides.
Continue ReadingCIGNA Webinar: 2 Distinct forms of ACA Reporting
From CIGNA-Informed on Reform Series. You’ll want to use the “maximize” or full screen feature to view the video in the bottom right hand corner of the menu bar.
Continue ReadingInfographic: Great Employee Handbook by Think HR
Click here to watch the Think HR Webinar Video Top 5 Reasons to Have (and use) an employee handbook
Continue ReadingEBN: Small Employers look to Alternative Funding Solutions
In the wake of the health care reform, alternative funding solutions for health benefits continue to gain traction among small to mid-size groups. Pending changes to small group rules in January 2016 are driving demand for the funding solutions. Most prominently, groups with 50-100 employees will be subject to community rating legislation that governs how rates are developed and the type of coverage offered. Most states are also changing the definition of employee to the federal full-time employee definition, broadening the scope to include union employees that may have been excluded under previous small employer definitions. Here’s how the new rules will affect small to midsize groups, including potential financial impact, solutions available to mitigate… Read More
Continue ReadingIndependence Blue Cross: Custom IBX WireTM mobile messaging available
Independence Blue Cross: Custom IBX WireTM mobile messaging is available for large groups IBC is offering direct messaging to some larger group customers beginning January 2016. Click here for more information.
Continue ReadingDelta Dental of PA Small Business Program Changes: No more ID cards
Please be advised that Delta Dental of PA is now instructing Allied Administrators (TPA) to cease issuing ID cards for Small Business Program (SBP) groups. To obtain dental care, the employee just has to let the dentist know that they have a Delta Dental of PA PPO plan & simply provide the dentist with name, DOB & enrollee ID or SSN. He or she will be able to easily locate the employee in the system, or can give Delta a quick call (toll free: 800-932-0783) to determine their eligibility & benefits. Delta has created a flyer format that will be included in new group welcome kits & provides the employees that want an ID card direction… Read More
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