Form 5500 Filing Reminder

For calendar year-end plans, the 2014 Form 5500 is due to be filed electronically no later than July 31, 2015. ERISA requires that Form 5500 be filed with the Department of Labor for most health and welfare plans (for example, medical, dental, and life insurance plans) by the last day of the seventh month following the end of plan year unless an extension (Form5558) is completed and mailed to the IRS.     Click here to read the Form 5500 Filing Reminder Click here to watch the Brainshark Video

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CMS has approved applications from DE and PA to create state-based Health Insurance Marketplaces.

HR News Alert from HR360.com Brought to you by Total Benefit Solutions Inc June 17, 2015 Approval Dependent on Certain ConditionsThe Centers for Medicare and Medicaid Services (CMS) has conditionally approved applications from Delaware and Pennsylvania to create state-based Health Insurance Marketplaces.Background Exchanges (also known as Health Insurance Marketplaces) provide an option for individuals to buy private health insurance. The Exchanges also operate the Small Business Health Options Program (SHOP) as an option for qualified small employers to purchase employee health coverage. The U.S. Department of Health and Human Services (HHS) has issued final rules relating to Exchanges which include standards for their establishment and operation (among other things). The… Read More

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Protections for LGBT Workers

    The EEOC has explained on its website that lesbian, gay, bisexual, and transgender (“LGBT”) individuals may bring valid sex discrimination claims against employers. A memorandum lists insurance issues involving benefits for same-sex couples as an issue of particular interest to the EEOC. Click Here to Download Protections for LGBT Workers – 060815R

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Health Reform Q&A: Can an S-Corporation offer health benefits to the shareholders and not the other employees?

At Total Benefit Solutions we often get e-mailed questions from our clients, friends and business partners. Some of them we like to post because they are asked so often. This question is one question that comes up a lot. Q- I represent an S Corp. There are 4 employees. 2 are the sole-shareholder and  his wife. Then there are 2 unrelated employees. All work 30 hours or more per week. The sole shareholder and wife are covered by an employer health insurance plan. The company pays 100% of the premiums. Health insurance  is not offered to the other 2 employees. Is this still permissible?   A-No. In the past, an… Read More

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Guidance Issued on Coverage for Preventive Items and Services

Frequently asked questions (FAQs), prepared jointly by the Departments of Labor (DOL), Health and Human Services (HHS), and the Treasury were issued on May 12, 2015 with respect to the Affordable Care Act (ACA) requirement for a non-grandfathered group health plan to provide coverage for in-network preventive items and services (including contraception)without any cost-sharing requirements, as summarized in the attached bulletin. Click here to download the FAQ bulletin

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Reminder: PCORI Fees Due by July 31 for Employers Sponsoring HRAs and Other Self-Insured Plans

Reminder: PCORI Fees Due by July 31 for Employers Sponsoring HRAs and Other Self-Insured Plans Fees to fund the Patient-Centered Outcomes Research Institute (PCORI) are due July 31 from employers that sponsor certain self-insured health plans, including health reimbursement arrangements (HRAs) that are not treated as excepted benefits. The fee, which is required under Health Care Reform, applies to plan years ending on or after October 1, 2012, and before October 1, 2019. Calculating the Fee For plan years ending on or after October 1, 2014 and before October 1, 2015, the fee for an employer sponsoring an applicable self-insured plan is $2.08 (two dollars for plan years ending on… Read More

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Instant Quotes for Individual Dental and Vision

  Total Benefit Solutions is proud to announce our new individual dental and vision plans with Delta Dental and VSP Vision and more! Click the link below to quote, compare and enroll instantly!   Click here now get instant dental and vision quotes   You don’t have to do it alone. Call us at  (215)355-2121 and one of our trained, licensed and certified account managers will answer your questions and help you through the process.

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OSHA Publishes Guide to Restroom Access for Transgender Workers

Federal Law Alerts – June 2015 On June 1, 2015, The Occupational Safety and Health Administration (OSHA) published A Guide to Restroom Access for Transgender Workers. The publication includes adescription of best practices and makes employers aware of federal, state, and local laws that reaffirm the core principle of providing employees with access to restroom facilities based on gender identification. Read A Guide to Restroom Access for Transgender Workers

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FAQ – What is Modified Adjusted Gross Income?

If you’ve been shopping for personal health insurance, helping a client with taxes, or following the Affordable Care Act, you may have heard the term “Modified Adjusted Gross Income,” or MAGI. In this article I’ll answer the frequently asked question – “What is Modified Adjusted Gross Income?” I’ll also explain how to calculate MAGI and why MAGI matters. Click here for the story from Zane Benefits

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Philadelphia Mandatory Sick Pay Leave Updates & Poster

    Source: HR360 Effective May 13, 2015, most employers will be required to provide up to 40 hours of paid or unpaid sick time per calendar year to eligible employees (generally individuals who perform work within Philadelphia for at least 40 hours in a year), as follows: Employers with 10 or more employees must provide paid sick time. Note: All persons performing work for compensation on a full-time, part-time, or temporary basis must be counted. Chain establishments (an establishment doing business under the same trade name used by 15 or more establishments—whether such other establishments are located in Philadelphia or elsewhere—and regardless of the type of ownership of each… Read More

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CMS has uploaded a new video Medicare & You: Cervical cancer

Get information about how Medicare can help you detect cervical and vaginal cancer.  

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Lost your health coverage?

  Losing other health coverage, including losing a job-based plan, aging off a parent’s coverage at 26, losing coverage through divorce, losing eligibility for Medicaid or CHIP, and similar events. Coverage can take effect: The first day of the month after you enroll and after the loss of coverage Enrollment window: From 60 days before to 60 days after losing your other coverage Important: If you leave your job for any reason and lose your job-based health coverage, you qualify for a Special Enrollment Period. But you don’t get an SEP if you voluntarily drop: a job-based plan without leaving your job; an individual insurance plan; unexpired COBRA coverage; or… Read More

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Lost your health coverage?

  Losing other health coverage, including losing a job-based plan, aging off a parent’s coverage at 26, losing coverage through divorce, losing eligibility for Medicaid or CHIP, and similar events. Coverage can take effect: The first day of the month after you enroll and after the loss of coverage Enrollment window: From 60 days before to 60 days after losing your other coverage Important: If you leave your job for any reason and lose your job-based health coverage, you qualify for a Special Enrollment Period. But you don’t get an SEP if you voluntarily drop: a job-based plan without leaving your job; an individual insurance plan; unexpired COBRA coverage; or… Read More

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Gov. Wolf wants Pa. to operate Obamacare exchange

Gov. Wolf this week formally proposed setting up a state-based insurance marketplace, potentially protecting hundreds of thousands of Pennsylvania residents from the consequences of a Supreme Court decision that could gut Obamacare later this month. Read more at philly.com Remember that your Total Benefit Solutions professionals are trained, licensed, insured and available to help compare, shop and enroll all affordable care act plans on the healthcare Marketplace and off.  As always contact us today if you have any questions or concerns at (215)355-2121.

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PPACA dropouts cut enrollment by 1.5 million

(Bloomberg) — About 1.5 million people dropped off health insurance coverage rolls this year after failing to pay for policies they picked on the Obamacare marketplaces. That left 10.2 million covered by Affordable Care Act policies as of March 31, up from 6.3 million at the end of 2014, the Centers for Medicare & Medicaid Services said today. Eighty- five percent got subsidies to help them afford coverage. Click here to read the story.

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FAQs Further Clarify New Embedded Out-of-Pocket Requirement

As reported earlier, starting with the 2016 plan year, the self-only annual limitation on cost sharing for non-grandfathered plans ($6,850 for 2016) applies to each individual, even if the individual is enrolled in family coverage. On May 26, 2015, the Departments of Labor (DOL), Health and Human Services (HHS), and the Treasury (collectively, the Departments) issued new FAQs further clarifying this new rule, confirming that it applies to all non-grandfathered group health plans, including self-insured plans, large group health plans, and high deductible health plans. Click the link below to download the bulletin for further guidance. FAQs Further Clarify New Embedded Out-of-Pocket Requirement – 060115R  

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Employer Reporting Guide for Large Employers 6055 and 6056 Reporting for Large Employers

  Beginning with calendar year (CY) 2015, an applicable large employer (ALE or “large employer,” as referenced in this summary) must use Forms 1094-C and 1095-C to report the information required under Internal Revenue Code (Code) sections 6055 and 6056 about offers of health coverage to full-time employees’ (FTEs) and individuals’ enrollment in health coverage.   This guide, brought to you by  our partners at Emerson Reid will help you  as an employer determine the following: Do I need to report? If so, report what? If so, report when? And on what forms? Please click the link below to download our employer reporting guide. As always, if you have any… Read More

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Total Benefit Solutions New Individual Dental & Vision Choices

As always at Total Benefit Solutions Inc, we are looking for ways to help our clients get the coverages they need. With our new dental and vision enrollment portal we can now offer individual dental and vision plans from top notch insurers like Delta Dental and Davis Vision. Easy to quote and easy to enroll! Try it today  and see for yourself by clicking here  

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Aetna & Coventry Formulary Changes

  Changes to your drug lists – starting July 1, 2015 Regularly, Aetna Pharmacy and Coventry Prescription Management Services, Inc. update drug lists based on the latest medical findings, information from the Food and Drug Administration (FDA), drug makers and cost arrangements, which include manufacturer rebates. Members are being notified They sending letters to clients about drug list changes for 2015. Click to read the 2015 Aetna Drug Changes Letter or 2015 Coventry Drug List Changes Letter. Impacted members with Aetna or Coventry pharmacy benefits will also receive a notification. Understanding the preferred drugs benefit They call drugs “preferred” because the members’ copay may be lower than the copay for non-preferred drugs. Members typically pay lower… Read More

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Do I Need Disability Insurance?

 The answer is simple: If you have a job, you need disability insurance. Check out this cool info-graphic, then call us at (215)355-2121 to find out how easy it is to get disability coverage to protect your income! Click this link to download DI Infographic      

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Cadillac Tax Preliminary Guidance: Part II

The IRS issued Notice 2015-16 to begin the process of developing regulatory guidance regarding the excise tax on high cost employer-sponsored health coverage, commonly known as the “Cadillac Tax.” Beginning January 1, 2018, a 40% excise tax will apply on the cost of applicable coverage that exceeds prescribed thresholds (described later in this article). Click the link below to download the bulletin: Cadillac Tax Part II  

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What is Tele-Doc?

Total Benefit Solutions now offers benefit and consulting packages that include the Tel-Doc benefit. Watch these videos for more information and ask us how you can add Tele-Doc benefit for an affordable monthly fee!        

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HSA Contribution Limits and Minimum Deductibles Adjusted for Inflation

                          HSA Contribution Limits and Minimum Deductibles Adjusted for Inflation    HR News Alert Brought to you by Total Benefit Solutions Inc May 6th 2015   HSA Contribution Limits and Minimum Deductibles Adjusted for InflationThe IRS has released the 2016 inflation adjusted amounts for health savings accounts (HSAs). To be eligible to contribute to an HSA, an individual must be covered under a high deductible health plan (HDHP) and meet certain other eligibility requirements. Annual Contribution Limitation  For calendar year 2016, the annual limitation on HSA deductions for an individual with self-only coverage under an HDHP is $3,350. The annual… Read More

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Assurant To Leave Health Insurance Market

We want to share a recent announcement made by Assurant Health’s parent company, Assurant, Inc. Following a strategic review of its portfolio of businesses, Assurant has decided to focus on housing and lifestyle specialty protection products and services. See the links below for further information:   assurant memo AIZ-NewsRelease-FINAL   As alwas contact your Total Benefit Solutions Inc account manager at (215)355-2121 if you have any questions or concerns

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UHC: Introducing Plans with Rate Caps and Wellness Rewards

United Healthcare: Introducing All Savers Plans. Would your small group be interested in a medical plan with a rate increase cap in year two? Does a plan with a free “fitbit” type device sound like a great way to integrate wellness into your health benefits? What if I told you that your employees could earn money back towards their deductibles by meeting small, simple daily wellness goals? Finally, an insurance carrier has introduced a plan for your health conscious group that gives you a direct advantage in the rates because you are working towards better overall health! United Healthcare has introduced the All Savers level funding plans with Motion Credit.… Read More

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