New Jersey Out-of-Network Bill

On June 1, 2018, New Jersey Gov. Murphy passed the Out-of-Network Consumer Protection, Transparency, Cost Containment and Accountability Act (the “OON Act”). In general, the OON Act applies to emergency services and other care provided by out-of-network physicians in in-network settings (i.e. hospital-based physicians). It  takes effect on September 1, 2018. Click the link below to download the full story: Click to Download For more information or if you have any questions, please feel free to contact your Total Benefit Solutions Account Manager at 215-355-2121    

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CMS Expands the Extension of Needed Relief for Marketplace Enrollees Who Missed Medicare Enrollment

CMS is offering assistance to certain individuals enrolled in both Medicare Part A (and/or Part C) and the Exchange for individuals and families to drop their Exchange coverage and enroll in Part B without penalty. Further, CMS is offering assistance to certain individuals who dropped or lost their coverage from the Exchange and are paying a Part B late enrollment penalty from their subsequent enrollment into Part B. These eligible individuals can have their penalty reduced. Individuals can apply for the special enrollment and reduction in late enrollment penalties during a limited time – it is available now and ends September 30, 2018 Read Blog Post from MedicareRights.org CMS SHIP… Read More

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Video: New Premium Saver Gap Coverage

  Want more information? Call your Total Benefit Solutions account manager today at (215)355-2121.

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Medicare 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

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What is Critical Illness Insurance?

Why Critical Illness as a “wrap” plan Because: They’re more affordable than you might think. They’re available for employer  groups, individuals and seniors. They make selecting a health plan easier. They provide peace of mind against a catastrophic event and large out of pocket expenses. They’re person and portable, it doesn’t matter where you get your health insurance from, having your own critical illness plan makes it better. Many clients have asked how they can supplement their employees coverage when they get enrolled through the affordable care act healthcare.gov marketplace. Employers are permitted to offer wrap plans that consist of “excepted benefits”, meaning they are not regulated by the affordable… Read More

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Crozer-Keystone Health System No Longer In Network with Cigna-Healthspring MAPD Plans

Please be advised of a change in the Cigna-HealthSpring provider network which may impact some of your customers. Starting May 1, 2014, Crozer-Keystone Health System will no longer be available to Cigna-HealthSpring members for hospital, home health or ancillary (surgery and other similar treat­ments) services. In a few days, we will mail the attached letter to the affected membership to advise them of this change. Please note that Crozer-Keystone health system primary care and specialty group doctors are still part of the Cigna-HealthSpring network. Only hospital, home health and ancillary services are leaving the network beginning May 1, 2014. Cigna-HealthSpring members currently under an active treatment plan may continue to… Read More

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