Ed MacConnell

The PEO Puzzle: Is Co-Employment a Dream or a Trap for Your Business?

May 20, 2026May 20, 2026Ed MacConnell

For many small to mid-sized business owners, managing employee benefits feels like a second full-time job. You want to offer affordable group health insurance, but the sheer weight of payroll, compliance, and administration can be suffocating. Enter the PEO, or Professional Employer Organization. A PEO promises to take the burden off your shoulders, offering "big company" benefits and high-tech HR systems. It sounds like a dream, but for some, it quickly turns into a "black box" of hidden costs and lost control. So, is co-employment the right move for your company in 2026? At Total Benefit Solutions Inc, we believe in looking under the hood before you sign on the… Read More

Medicare Secondary Payer Rules: 15 Things You Need to Know to Avoid Penalties

May 20, 2026May 20, 2026Ed MacConnell

Let’s be honest: most small business owners would rather read the fine print on a shampoo bottle than dive into the federal register. But when it comes to Medicare Secondary Payer (MSP) rules, “ignorance is bliss” is a high-speed ticket to a financial car crash. At Total Benefit Solutions Inc, we spend our days navigating the labyrinth of health insurance regulations so you don’t have to. We’ve seen it all, from small shops accidentally triggering massive fines to large corporations tripping over the “Section 111” paperwork monster. If you are providing group health insurance for employers, you are already in the crosshairs of these rules. To help you stay on… Read More

May 19, 2026Ed MacConnell

Category: Medicare Things change if you are on Medicare due to a disability rather than age. The government gives larger employers more responsibility here. Large Group Health Plan (100+ Employees): If the employer has 100 or more employees, the employer plan pays Primary. Smaller Groups (Under 100 Employees): Medicare pays Primary. This is a common "gotcha" for businesses with 50 or 75 employees. They are used to being "Primary" for their 65+ workers, but for a disabled employee on Medicare, the roles flip! (It’s enough to give anyone a headache, which is why we’re here to help.) 4. How Do You Count "Employees" Anyway? You’d think counting to 20 or… Read More

Beyond Health: Why Group Life and Disability Are the Secret Sauce for Retention

May 18, 2026May 18, 2026Ed MacConnell

Category: Medicare In the competitive landscape of 2026, health insurance is no longer a "perk", it is a baseline expectation. For small and medium-sized businesses looking to attract and keep top-tier talent, offering a medical plan is simply the price of entry. To truly stand out and create a culture of loyalty, savvy employers are looking beyond the doctor's office. They are looking at Group Life and Disability insurance. Often called the "ancillary" benefits, these two coverages are the secret sauce for employee retention. While health insurance helps employees pay for getting well, life and disability insurance ensure their families stay financially well if the unthinkable happens. At Total Benefit… Read More

Dr Ben E Fitz Total Benefit Solutions, Inc

Laughter is the Best (Secondary) Policy: A Collection of Insurance Broker Humor

May 17, 2026May 18, 2026Ed MacConnell

Let’s be honest: navigating the world of health insurance can often feel like trying to solve a Rubik’s Cube while blindfolded, and the cube is on fire. At Total Benefit Solutions Inc, we spend our days knee-deep in policy manuals and government regulations (the "un-fun" stuff), so we know exactly how stressful this industry can be. Sometimes, the only way to handle a denied claim or a rising premium is to take a deep breath and find the humor in the situation. After all, if we didn't laugh, we might just start eating our own deductible (the amount you pay out-of-pocket before your insurance kicks in). To lighten your day,… Read More

A Little Health Insurance Humor: The Deductible Dilemma

May 16, 2026May 18, 2026Ed MacConnell

We’ve all been there. You’ve spent the entire year tracking every co-pay, every prescription, and every specialist visit like a detective on a high-stakes case. You finally hit that magic number, the annual deductible, and you’re ready to let the insurance company take the wheel for a bit. Then you look at the calendar. It’s December 31st. In about six hours, that beautiful, $0-out-of-pocket horizon is going to reset faster than a New Year’s resolution. It’s the ultimate "so close, yet so far" moment in adulting. Why the Deductible Dance is So Hard Navigating health insurance can feel like trying to solve a Rubik's Cube while wearing oven mitts. Between… Read More

Level Funding: The Small Business “Cheat Code” for Better Health Benefits

May 14, 2026May 14, 2026Ed MacConnell

Category: Medicare If you own a small or medium-sized business, you know the annual "renewal dance" all too well. Every year, your health insurance carrier sends a letter that looks like a ransom note, demanding a 10%, 15%, or even 20% premium increase. You’re told it’s because of "market trends" or "rising healthcare costs," even if your employees didn’t even use their insurance much last year. It feels like you're throwing money into a black hole. In a traditional "fully insured" plan (the kind most small businesses have), the insurance company keeps every penny of your premium, whether your team is healthy or not. If you pay $100,000 in premiums… Read More

Urgent Medicare Alert: Clear Spring Health Exiting 3 States– Don’t Lose Your Benefits!

May 13, 2026May 13, 2026Ed MacConnell

If you are a Medicare beneficiary in Illinois, Georgia, or Colorado, you need to check your mail, and your insurance card, immediately. Clear Spring Health has officially announced its complete exit from the Medicare Advantage market in these three states. This isn’t a “next year” problem; it is happening right now. Coverage for every single enrolled member will officially end at midnight on May 31, 2026. At Total Benefit Solutions Inc, we know how stressful it is to hear that your health coverage is vanishing mid-year. As your health insurance advocates, we are here to ensure you don’t fall through the cracks of this transition. You have less than three… Read More

The May 2026 Medicare Updates Everything You Need to Know Now

May 13, 2026May 13, 2026Ed MacConnell

Welcome to your essential update for May 2026. If you’ve been feeling like the world of health insurance is moving faster than you can keep up with, you aren’t alone. Between shifting pharmaceutical programs and complex federal regulations, staying informed is a full-time job. Luckily, it’s our full-time job. At Total Benefit Solutions Inc, we don’t just watch the changes; we navigate them for you. This month, we have three major updates that will impact how you access care, how much you pay for prescriptions, and how your business stays compliant with Medicare rules. The July 2026 Ozempic/GLP-1 “Bridge Program” One of the most frequent questions we’ve received lately is:… Read More

Medicare Secondary Payer Rules: 15 Things You Need to Know to Avoid Penalties.

May 13, 2026May 13, 2026Ed MacConnell

So, your business is growing, your team is aging like a fine wine, and suddenly, you’ve got employees hitting that magical number: 65. Congratulations! You’ve reached the level of the “Medicare Secondary Payer” (MSP) boss fight. If that sounds intimidating, it’s because it can be. Medicare Secondary Payer rules are essentially the government’s way of saying, “We aren’t paying for this if someone else can.” At Total Benefit Solutions Inc, we spend our days navigating these regulatory minefields so you don’t have to step on a $1,000-per-claim landmine. Whether you’re offering group health insurance for employers or looking into affordable group health insurance options, understanding MSP is non-negotiable. Here are… Read More

The Ozempic Odyssey: Navigating Medicare Coverage Without the Headache

May 12, 2026May 13, 2026Ed MacConnell

If you’ve turned on a television or scrolled through social media lately, you’ve heard the names: Ozempic, Wegovy, Zepbound. These GLP-1 medications have completely transformed the conversation around weight management and chronic disease. But for those of us on Medicare, the conversation has often been a short one: "No, Medicare doesn't cover weight loss drugs." For years, that 2003 federal law (the Medicare Modernization Act) has acted like a brick wall, explicitly banning coverage for medications used solely for weight loss. At Total Benefit Solutions Inc, we don't like the word "no." Neither does our resident expert, Dr. Ben E. Fitz. Today, we’re breaking down the complex odyssey of Medicare… Read More

Why Everyone Is Talking About Blue Card PPO (And Why Your Remote Team Needs It)

May 11, 2026May 13, 2026Ed MacConnell

If you’re a small business owner or an HR manager in 2026, you’ve likely noticed that the traditional office is a thing of the past. Your lead developer might be coding from a cabin in Colorado, while your head of marketing is based in a suburban home in Pennsylvania. While this geographic flexibility is a huge win for talent retention, it often creates a massive headache when it comes to group health insurance for employers. How do you provide a health plan that works just as well for someone in rural Montana as it does for someone in downtown Philadelphia? The answer that more and more savvy businesses are turning… Read More

Big News: We’ve Joined the American Association for Medicare Supplement Insurance (AAMSI)!

May 11, 2026May 13, 2026Ed MacConnell

If you’ve been hanging around Total Benefit Solutions Inc for more than five minutes, you know we don’t do things halfway. Whether we’re fighting a denied claim until the insurance company basically begs us to stop calling (we won’t) or navigating the labyrinth of federal regulations, we’re all in. That’s why I’m beyond excited to share some major news. I’ve officially joined the American Association for Medicare Supplement Insurance (AAMSI). You can even check out my shiny new profile right here. Now, I know what you’re thinking: "Ed, another acronym? Really?" But hang with me for a second, because this isn’t just a badge for my email signature. It’s a… Read More

The 2026 ACA Affordability Rule Explained in Under 3 Minutes

May 8, 2026May 10, 2026Ed MacConnell

— If you’re a business owner or an HR manager, you know that health insurance rules change faster than the weather in Philadelphia. One minute you’re settled into your 2025 plan design, and the next, the IRS drops a new percentage that changes how much you can charge your team for coverage. The 2026 ACA Affordability threshold has officially been announced, and it’s a big one. For the first time in a while, we’re seeing a significant jump in the percentage. We know you’re busy. That’s why we’ve broken down everything you need to know about affordable group health insurance requirements for 2026 in a post that takes less time… Read More

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Why Everyone Is Talking About the New Medicare GLP-1 Bridge (And You Should Too)

May 7, 2026May 8, 2026Ed MacConnell

If you’ve turned on a television, scrolled through social media, or even just sat in a doctor’s waiting room lately, you’ve heard the names. Ozempic. Wegovy. Zepbound. These GLP-1 medications (Glucagon-like peptide-1 receptor agonists) have basically become the “iPhone” of the medical world, everybody wants one, but the price tag can make your eyes water. For years, if you were on Medicare, the conversation usually ended with a polite but firm “No.” Federal law literally forbade Medicare from covering drugs specifically for weight loss. It was a frustrating “Catch-22” (a situation where you can’t win because of contradictory rules): you were encouraged to get healthy, but the most effective tools… Read More

Why Your Hospital Bills Are Total Fiction (And How Reference-Based Pricing Fixes It)

May 7, 2026May 7, 2026Ed MacConnell

If you’ve ever opened a hospital bill and felt your heart stop for a second, and not because of the medical condition you were there for, you aren’t alone. We’ve all seen it: a $50 charge for a single Tylenol pill or a $3,000 bill for a fifteen-minute "consultation" that felt more like a quick "hello." Here’s the dirty little secret the healthcare industry doesn't want you to know: those numbers are almost entirely made up. In the world of health insurance and hospital billing, the prices you see on your statement are part of a document called the Chargemaster. Think of the Chargemaster as the "MSRP" (Manufacturer’s Suggested Retail… Read More

The ‘Blue Card’ Hack: How to Get National PPO Access on a Local Budget

May 6, 2026May 7, 2026Ed MacConnell

If you’re a small business owner in Pennsylvania or New Jersey, you’ve likely felt the "geographic squeeze." You want to offer your team top-tier health insurance, but as soon as you look at national PPO plans, the premiums start looking like a mortgage payment for a small island. Most employers think they have two choices: pay a fortune for a "name brand" national plan or stick to a local HMO that leaves their remote workers or frequent travelers stranded without coverage. But there’s a third option, a "hack," if you will, that many brokers don’t explain clearly. It’s called the Blue Card PPO program. It’s the secret to getting a… Read More

Medicare Secondary Payer Rules: 15 Things You Need to Know to Avoid Penalties

May 6, 2026May 7, 2026Ed MacConnell

Let’s be honest: talking about Medicare Secondary Payer (MSP) rules is about as exciting as watching paint dry in a room full of accountants. But here’s the kicker, if you’re a small business owner, ignoring these rules is a great way to watch your hard-earned profits vanish into a black hole of federal fines. At Total Benefit Solutions Inc, we spend our days navigating the labyrinth of group health insurance for employers, and we’ve seen it all. We know that you’re just trying to provide affordable group health insurance without getting slapped by Uncle Sam. CMS (the Centers for Medicare & Medicaid Services) has a very specific sense of humor,… Read More

How to Choose the Best Group Health Benefits for Small Business (Compared)

May 5, 2026May 7, 2026Ed MacConnell

Choosing the right group health insurance for employers can feel like trying to navigate a maze without a map. If you are a small business owner, you already know the stakes. Providing group health benefits for small business is one of your biggest expenses, yet it’s also your most powerful tool for attracting and keeping great employees. In 2026, the landscape of healthcare is shifting faster than ever. With median premium increases hitting double digits (often around 11% or higher), the "standard" way of doing things might not be the best way for your bottom line. We see many business owners stuck in a cycle of "renewal shock," where they… Read More

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Level Funded vs. Fully Insured: Which Is Better For Your Trucking Company?

May 4, 2026May 4, 2026Ed MacConnell

If you’re running a trucking company in 2026, you already know that the road isn’t just getting longer: it’s getting more expensive. Between fluctuating fuel costs, maintenance, and the constant battle to keep good drivers behind the wheel, your margins are constantly under pressure. One of the biggest line items on your balance sheet is likely health insurance. For years, the "safe" choice was a traditional fully insured plan. You pay the premium, the insurance company takes the risk, and everyone moves on. But as premiums continue to climb by double digits year after year, many fleet owners are asking: Is there a better way? At Total Benefit Solutions Inc,… Read More

The MAGI Hack: How Early Retirees Can Save $15,000 on Health Insurance Before 65

May 1, 2026May 1, 2026Ed MacConnell

You’ve finally done it. You’ve put in your thirty-plus years, the house is mostly paid off, and you’re ready to trade the morning commute for morning coffee on the porch. But there’s one giant, expensive hurdle standing between you and the finish line: The Medicare Gap. If you’re 60, 61, or 62 years old, you’re in the "health insurance danger zone." You are too young for Medicare (which starts at 65), and if you aren't careful, you could be staring at health insurance premiums that look like a second mortgage, sometimes $1,500 to $2,000 a month for a couple. At Total Benefit Solutions Inc, we see early retirees panic when… Read More

HSA, HMO, PPO, Oh My! The Ultimate Health Insurance Acronym Cheat Sheet

April 30, 2026May 1, 2026Ed MacConnell

Does reading your health insurance policy feel like trying to decode a secret government transmission? You aren’t alone. Between the HMOs, the HSAs, and the alphabet soup of other acronyms, it’s easy to feel like you need a law degree just to choose a doctor. At Total Benefit Solutions Inc (www.totalbenefits.net), we see this frustration every day. We’re not just brokers; we’re advocates who believe that you shouldn’t have to learn a second language just to get the medical care you’ve already paid for. Whether you are an individual looking for an ACA (Affordable Care Act) plan or a small business owner trying to provide for your team, this cheat… Read More

The 3-Tier Strategy: How Keystone Proactive Plans Save Your Team Money

April 27, 2026May 1, 2026Ed MacConnell

Let’s be honest: most people look at their health insurance plan once a year during open enrollment, get a headache from the jargon, and then tuck the ID card into their wallet hoping they never have to use it. But as a business owner or HR manager, you don’t have that luxury. You’re watching premiums climb every single year, and you’re looking for a way to give your employees great coverage without draining the company's bank account. At Total Benefit Solutions, we’ve seen every plan under the sun. Right now, one of the most effective tools in our arsenal for small and mid-sized businesses in the Philadelphia area is the… Read More

A man turning age 26 who needs health insurance

The Birthday Scaries: Turning 26 and Losing Your Parents’ Health Insurance

April 27, 2026May 1, 2026Ed MacConnell

Happy birthday! You’ve finally hit the big 2-6. You’re officially a “real” adult in the eyes of the healthcare world. While that usually means a nice dinner or a weekend getaway, for many, it also brings a sudden, cold realization. The “Birthday Scaries” are real, and they usually hit right when you realize you are officially off your parents’ health insurance plan. One day you’re covered, and the next, you’re staring at a world of deductibles (the amount you pay out of pocket before insurance kicks in) and premiums (your monthly bill) all on your own. Don’t panic. At Total Benefit Solutions Inc, we’ve helped thousands of young professionals navigate… Read More

The Ultimate Guide to Ozempic Coverage: How to Fight Denials and Win Your Appeal

April 26, 2026May 1, 2026Ed MacConnell

If you feel like you’re in a constant wrestling match with your insurance company over Ozempic, you’re not alone. It’s April 2026, and while GLP-1 medications like Ozempic, Wegovy, and Mounjaro have revolutionized healthcare, they’ve also created a massive administrative headache for patients and employers alike. At Total Benefit Solutions Inc., we see these "denial letters" every single day. Most people open them, feel defeated, and assume the fight is over. But here’s the truth: a "no" from an insurance company is often just the beginning of a negotiation. As independent advocates, we’ve learned that the secret to winning isn't just asking nicely, it’s about knowing the rules of the… Read More

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