A bill has been introduced in New Jersey in both the Senate and Assembly that, if passed, would prohibit insurance carriers or other insurers subject to the insurance laws of New Jersey or any other state from offering, issuing or renewing any stop loss insurance policy of any kind to small employers. Stop loss insurance provides reimbursement for catastrophic, excess or unexpected expenses and is used by small employers to self-insure part of the health insurance coverage they provide for employees. Under New Jersey law, in connection with a group health plan, a small employer means an employer with 2-50 eligible employees on business days during the preceding calendar year. If passed,… Read More
Continue ReadingAetna Funding Advantage (AFA) is a new self-funded option for small groups
Aetna Funding Advantage (AFA) is a self-funded option that provides all of the financial and plan design flexibility of a traditional arrangement with special features designed to help companies with as few as 2 employees achieve even greater savings on their health insurance. Ask us today if self funding could be a good fit for your organization! Call your Total Benefit Solutions Inc. account manager at (215)355-2121 for more information! Learn more here: AFA-Customer-Flyer New! Minute Clinic Benefit! $0 Copay Minute Clinic Visits Flyer More Documents for downloading: Springboard Marketplace Your Online Administration and Enrollment Portal AFA AppleWatch Wellness Flyer AFA Sample Usage Reports Aetna & Teledoc for AFA AETNA… Read More
Continue Reading8 things to know about Medigap policies
Medicare Supplements or Medigap Plans A Medicare Supplement Insurance (Medigap) policy, sold by private companies, can help pay some of the health care costs that Original Medicare doesn’t cover, like copayments, coinsurance, and deductibles. Some Medigap policies also offer coverage for services that Original Medicare doesn’t cover, like medical care when you travel outside the U.S. If you have Original Medicare and you buy a Medigap policy, Medicare will pay its share of the Medicare-approved amount for covered health care costs. Then your Medigap policy pays its share. A Medigap policy is different from a Medicare Advantage Plan. Those plans are ways to get Medicare benefits, while a Medigap policy… Read More
Continue ReadingAetna Funding Advantage for Small Businesses
Aetna Funding Advantage (AFA) is a new self-funded option that provides all of the financial and plan design flexibility of a traditional arrangement with special features designed to help companies with as few as 2 employees achieve even greater savings on their health insurance. The benefits of self-funding have traditionally been considered by larger companies. But Aetna Funding Advantage has changed that. It is specifically designed to be attractive and affordable for small businesses like yours. Watch this short video and download the documents below for some information. As always please contact your Total Benefit Solutions dedicated account manager at (215)355-2121 if you have any questions, concerns or would like to learn… Read More
Continue ReadingCan 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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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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Individual and Family Open Enrollment-2017 Important Updates
As many people know by now there are many big changes with individual and family plans for open enrollment 2017. For anyone who is currently enrolled on one of the following your plan will NOT be renewed for 2017 and you will have to pick a new plan and/or a new insurer: Aetna: all plans cancelling in PA/NJ/NC/FL Aetna plans only remain in Delaware in our service area United Healthcare: All ACA plans cancelling. Short term plans are still available Oscar: All plans in NJ cancelling Health Republic: All plans in NJ cancelling Highmark and Capitol Blue Cross: No longer paying broker compensation Geisinger: No longer paying broker compensation Independence Blue… Read More
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ACA Individual 2017 Open Enrollment Important Update
2017 ACA ” Obamacare” plans open enrollment important update. The annual open enrollment period opens on November 1st 2016 and ends January 31st 2017. Independence Blue Cross will be the only insurer available in 2017 in the Philadelphia 5 County Area. With the passing of the Affordable Care Act changes come annually or even more often. Unfortunately not all of those changes are benefiting the consumer. This year here are some major changes that our clients on Individual Non Medicare plans need to be aware of… If you are a enrolled on an ACA compliant plan with Aetna or United Healthcare your plan is going away. Neither Aetna or United… Read More
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Aetna Small Group: New Small Group ACA termination policy effective October 1, 2016
New Small Group ACA termination policy effective October 1, 2016 RE: renewal policy changes from Aetna…. Starting October 1, we must receive written confirmation of customer renewal acceptance in advance of the customer renewal date for all Aetna small groups. This means that beginning with all October 1 renewal dates, we must receive written confirmation in advance of the policy renewal date. Written confirmation may include signed renewal acceptance from the customer delivered by mail, fax or email. Note: premium payment received in advance of the renewal date will also be considered renewal acceptance. If we haven’t received written acceptance of the renewal, or renewal alternates, from the customer in this… 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 ReadingHow do Tiered Network plans like the Keystone HMO Proactive and Horizon Omnia plans work?
Tiered or Narrow Network Plans: Under the Affordable Care Act, insurance carriers have introduced “tiered network”, or narrowed network plans. Keystone Proactive HMO Plans from Independence Blue Cross have a unique ” 3 tiered” network of providers. Although each carrier has different types of networks and benefit levels, the plans have the same general concept, steering the members by giving them a choice of providers that offer medical services at a lower out of pocket expense. Choosing a more expensive provider or facility may cost the member more out of pocket costs. United Healthcare offers 2 tiers in their “Navigate” plans, and Aetna uses “Savings Plus” designated providers to split… Read More
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