Ed MacConnell

What is the total cost estimate for health coverage?

November 15, 2022September 29, 2022Ed MacConnell

The total amount you may have to pay for health plan coverage, which is estimated before you actually have the coverage and have health expenses under the coverage. Generally, your total cost is your premium + deductible + out-of-pocket costs + any copayments/coinsurance. When you preview plans at Healthcare.gov, you’ll see an estimate of your total costs, but your actual expenses will likely vary. Have any questions regarding this notice? Please contact your Total Benefit Solutions health insurance specialists at (215)355-2121.

Key Facts About Medicare Part D Enrollment and Costs in 2022

November 14, 2022October 19, 2022Ed MacConnell

The Medicare Part D program provides an outpatient prescription drug benefit to older adults and people with long-term disabilities in Medicare who enroll in private plans, including stand-along prescription drug plans (PDPs) to supplement traditional Medicare and Medicare Advantage prescription drug plans (MA-PDs) that include drug coverage and other Medicare-covered benefits. This analysis provides the latest data about Medicare Part D enrollment and costs in 2022 and trends over time, based on data from the Centers for Medicare & Medicaid Services (CMS). To read the entire article, click here. As always, please contact your Total Benefit Solutions health insurance specialists today at (215)355-2121.

Prescription Drug Reporting Reminder

November 12, 2022November 3, 2022Ed MacConnell

As previously reported, plan sponsors of group health plans must submit information annually about prescription drugs and health care spending to the Centers for Medicare and Medicaid Services (“CMS”). The first deadline is December 27, 2022, for reporting on calendar years 2020 and 2021. Additionally: To learn more, click here to download the document. Have any questions regarding this notice? Please call your Total Benefit Solutions health insurance experts today at (215)355-2121.

10 Steps to Use a Medicare MSA Plan

November 11, 2022October 19, 2022Ed MacConnell

Choose and join a high-deductible Medicare MSA Plan. You set up an MSA with a bank the plan selects. Medicare gives the plan an amount of money each year for your health care. The plan deposits some money into your account. You can use the money in your account to pay your health care costs, including health care costs that aren’t covered by Medicare. When you use account money for Medicare-covered Part A and Part B services, it counts towards your plan’s deductible. If you use all of the money in your account and you have additional health care costs, you’ll have to pay for your Medicare-covered services out0of-pocket until… Read More

What is a Qualified Health Plan?

November 10, 2022September 23, 2022Ed MacConnell

An insurance plan that’s certified by the Health Insurance Marketplace®, provides essential health benefits, follows established limits on cost-sharing (like deductibles, copayments, and out-of-pocket maximum amounts), and meets other requirements under the Affordable Care Act. All qualified health plans meet the Affordable Care Act requirement for having health coverage, known as “minimum essential coverage.” As always, please contact your Total Benefit Solutions health insurance specialists today at (215)355-2121.

What is cost sharing?

November 9, 2022September 28, 2022Ed MacConnell

The share of costs covered by your insurance that you out of your own pocket. This term generally includes deductibles, coinsurance, and copayments, or similar charges, but it doesn’t include premiums, balance billing amounts for non-network providers, or the cost of non-covered services. Cost sharing in Medicaid and CHIP also includes premiums. As always, please contact your Total Benefit Solutions health insurance specialists today at (215)355-2121.

What is a Special Enrollment Period (SEP) and what qualifies a consumer for an SEP?

November 8, 2022September 23, 2022Ed MacConnell

A Special Enrollment Period (SEP) is a time outside the annual Open Enrollment period when individuals may enroll in or change qualified health plans (QHPs). Individuals qualify for SEPs based on certain life events. Note that consumers can also qualify for an SEP during Open Enrollment; in certain situations, such as an SEP due to the birth of a child, an SEP during Open Enrollment can allow qualifying consumers’ coverage to start sooner than it would have if they had enrolled during Open Enrollment without the SEP. Events that permit an SEP include: Loss of qualifying health coverage (Note: This SEP does not include loss of coverage due to nonpayment… Read More

Beam Teams with Angle Health to Deliver Dynamic Employee Benefits

November 7, 2022October 14, 2022Ed MacConnell

Beam Dental is partnered with Angle Health, a digital-first healthcare benefits providers for the modern employee. Through the partnership with Beam, Angle can now attach best-in-class dental benefits to their innovative healthcare products, creating a more comprehensive and robust benefits package for employers. “There is tremendous activity and innovation in the small group health space right now. Angle is an exciting addition to this space,” said Andy Hutter, Beam’s Director of Digital Distribution. “Angle’s vision for modernizing healthcare aligns well with Beam’s own vision, and we are very excited to deliver a powerful combination of innovative coverage to the market.” Beam is changing and modernizing the dental insurance industry by… Read More

Health Partners Medicare has added all Dedicated Senior Medical Center locations

November 4, 2022November 4, 2022Ed MacConnell

Health Partners Medicare has added all Dedicated Senior Medical Center locations to its provider network. Dedicated Senior Medical Center is a family-owned primary and specialty care practice committed to delivering superior healthcare to Medicare-eligible seniors. The agreement allows our members to visit any of the five Dedicated locations in Philadelphia. Health Partners Medicare is committed to strengthening our provider network throughout Pennsylvania and New Jersey. As always contact your Total Benefit Solutions Inc health insurance specialists at (215)355-2121 if you have any further questions or concerns.

How does the Marketplace verify immigration status?

November 4, 2022September 26, 2022Ed MacConnell

The Marketplace verifies the citizenship and immigration statuses of consumers applying for Marketplace coverage using several electronic systems. Citizenship and immigration information submitted in the Marketplace eligibility application will be checked against the Marketplace’s trusted data sources, including the Social Security Administration, the Department of Homeland Security, and the Internal Revenue Service. If a consumer’s citizenship or immigration status cannot be verified, the Marketplace will notify the consumer of an inconsistency or data matching issue on their initial eligibility notice and ask them to submit additional information to resolve the inconsistency. As always, please contact your Total Benefit Solutions health insurance specialists with any questions or concerns at (215)355-2121.

What is medical underwriting?

November 3, 2022September 22, 2022Ed MacConnell

A process used by insurance companies to try to figure out your health status when you’re applying for health insurance coverage to determine whether to offer you coverage, at what price, and with what exclusions or limits. As always, please contact your Total Benefit Solutions health insurance specialists today at (215)355-2121.

Can consumers who qualify for COBRA continuation coverage opt out of it and get coverage through the Marketplace instead?

November 2, 2022September 23, 2022Ed MacConnell

Consumers who qualify for COBRA coverage can opt out of it and enroll in Marketplace coverage. However, voluntarily terminating COBRA continuation coverage does not make a consumer eligible for a Special Enrollment Period (SEP) based on loss of the COBRA continuation coverage. Note that all qualified enrollees eligible for COBRA continuation coverage can get the Marketplace subsidy, not just the employee who qualifies for the COBRA benefit, as long as they are not actually enrolled in the COBRA continuation coverage. As always, please contact your Total Benefit Solutions health insurance specialists with any questions or concerns at (215)355-2121.

Get connected with the IBX Smartphone App

November 2, 2022November 2, 2022Ed MacConnell

Download the free IBX app for your iPhone or Android to help you make the most of your Independence Blue Cross health plan. With new and improved features, the IBX app gives you easy access to your health care coverage 24/7, wherever you are. As always contact your Total Benefit Solutions, Inc health insurance professionals if you have any questions about this bulletin. Click here to read more.

Open Enrollment Tips from Total Benefit Solutions!

November 1, 2022October 26, 2022Ed MacConnell

As always, please contact your Total Benefit Solutions health insurance specialists today at (215)355-2121.

Get assistance with your PENNIE health insurance account

October 31, 2022August 16, 2022Ed MacConnell

Already on the health insurance Marketplace and need some help? Assigning Total Benefit Solutions, Inc is easy! Download the document and follow the steps. We will get notified and start helping you right away! Need more direction? Give us a call (215)355-2121

Inflation Reduction Act: Eliminates Cost Sharing for Adult Vaccines in Medicare Part D and Improves Access to Adult Vaccines in Medicaid & CHIP

October 28, 2022September 14, 2022Ed MacConnell

Medicare Part D: Eliminates cost sharing for adult vaccines covered under Medicare Part D that are recommended by the Advisory Committee on Immunization Practices (ACIP), such as for shingles Medicaid and CHIP: Requires state Medicaid and CHIP programs to cover all approved vaccines recommended by ACIP and vaccine administration, without cost sharing Have any questions regarding this notice? Don’t hesitate to contact your Total Benefit Solutions health insurance specialists today at (215)355-2121.

New Jersey State Temporary Disability Rates Released

October 27, 2022October 27, 2022Ed MacConnell

2023 Contribution Rates Released The Maximum Employee Contribution Rate, Employee and Employer Taxable Wage Base Officially announced on October 21th, 2022, by the NJ Department of Labor and Workforce Development. The 2023 DisabilityEmployEE Contribution Rate has been withdrawn and will be set at 0%; The 2023 Disability EmployEE Taxable Wage Base for will be $156.800 The 2023 Disability EmployEE Maximum Contribution will be $0.00 or Zero for this year. The 2023 Disability EmployER Maximum Taxable Wage Base Is $41,100. The 2023 Family Leave Insurance EmployEE Contribution rate will be .06% of the taxable wage base Contributions and Wages – January 1st, 2023 Taxable Wage & Rates EmployER EmployEE Annualized Wage… Read More

What is a Health Maintenance Organization (HMO)?

October 27, 2022September 21, 2022Ed MacConnell

A type of health insurance plan that usually limits coverage to care from doctors who work for or contract with the HMO. It generally won’t cover out-of-network care except in an emergency. An HMO may require you to live or work in its service area to be eligible for coverage. HMOs often provide integrated care and focus on prevention and wellness. As always, please contact your Total Benefit Solutions health insurance specialists today at (215)355-2121.

Pennie’s Open Enrollment Period for 2023 Coverage is Around the Corner

October 26, 2022Ed MacConnell

Pennie’s Open Enrollment Period for 2023 Coverage is Around the Corner: Pennie’s Open Enrollment Period will run from November 1, 2022, to January 15, 2023. As a reminder, existing Pennie customers will be receiving auto-renewal notices this week with information on their 2023 plans. Great news! Thanks to the Inflation Reduction Act, enhanced savings continue to be available for Pennie customers and those enrolling in coverage through Pennie! As always if you have any questions or concerns please contact your Pennie health insurance experts at Total Benefit Solutions Inc (215)355-2121

What Are Medicare Guaranteed Issue Rights?

October 26, 2022July 25, 2022Ed MacConnell

Please contact your Total Benefit Solutions Inc Medicare health insurance specialists today at (215)355-2121 with any questions.

CIGNA Supplemental Benefits Now Available Online

October 26, 2022October 25, 2022Ed MacConnell

CIGNA’s Medicare supplements and dental/vision plans are available to quote and enroll online for your convenience! Just click the link below to get your quotes and as always contact your Total Benefit Solutions, Inc health insurance specialists at (215)355-2121 if you have any questions or concerns! Click here

Inflation Reduction Act: Expands Eligibility for Full Benefits Under the Medicare Part D Low-Income Subsidy Program

October 25, 2022September 9, 2022Ed MacConnell

The Part D Low-Income Subsidy (LIS) Program helps beneficiaries with their Part D premiums, deductibles, and cost sharing. Beneficiaries qualify for full or partial benefits depending on their income and resources. Current law: Beneficiaries qualify for full LIS benefits if they have income up to 135% of poverty and lower resources (up to $9,900 individual, $15,600 couple in 2022) Beneficiaries qualify for partial LIS benefits if they have income between 135-150% of poverty and higher resources (up to $15,510 individual, $30,950 couple in 2022) Inflation Reduction Act: Expands eligibility for full LIS benefits to individuals with incomes between 135% and 150% of poverty and higher resources (at or below the… Read More

When can I buy a Medigap plan?

October 24, 2022July 25, 2022Ed MacConnell

Why Use Medicareful to Find Your Plan?

October 22, 2022October 20, 2022Ed MacConnell

Medicare insurance can seem complex on your own. We’re here to help! Medicareful is an easy-to-use Medicare plan finder that compares some of the available plans in your area and connects you with a licensed sales agent who will guide you through enrollment. Whether it’s a Medicare Supplement, Medicare Advantage Part C Plan, or a Medicare Part D drug plan, we’ve got you covered. https://medicareful.com/totalbenefitsolutions

Blue KC: Employer/Group Open Enrollment Dates – Mark Your Calendar

October 21, 2022September 28, 2022Ed MacConnell

Blue KC is pleased to offer two open enrollment deadlines – one for physical ID cards and one for digital ID cards – to provide flexibility to new and renewing groups. Benefit information and open enrollment files/eligibility updates must be submitted to Blue KC based on the following schedule to ensure new ID cards are available to members by January 1, 2023: November 1, 2022 – Paperwork Deadline November 21, 2022 – Eligibility File – Physical ID Card December 16, 2022 – Eligibility File – Digital ID Card Please note: Small groups that make plan changes after this timeframe will receive updated ID cards once their plan changes have been… Read More

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