Independence Blue Cross – Page 2 – Total Benefit Solutions Inc

Medicare Creditable Coverage Part D notification requirements

September 15, 2022September 15, 2022Ed MacConnell

FROM INDEPENDENCE: Each year, the Centers for Medicare & Medicaid Services (CMS) requires plans that offer prescription drug coverage to their Medicare‑eligible employees, retirees, and dependents to notify them by October 15 as to whether that coverage is “creditable” or “non‑creditable.” What customers must do Customers must take the following steps to comply with this requirement: Review the materials provided to determine whether their prescription drug coverage is creditable or non‑creditable. Disclose to their Medicare‑eligible members (employees and their dependents) whether their prescription drug coverage is creditable or non‑creditable prior to the Medicare Part D Annual Election period, running from October 15 through December 7 of this year and at other times during the future.… Read More

Medicare Advantage (MA) Quick Facts

August 30, 2022August 3, 2022Ed MacConnell

What is it? A Medicare Advantage Plan is a type of Medicare health plan offered by a private company, such as Independence Blue Cross, that contracts with Medicare to provide all Part A and Part B benefits. If enrolled in a Medicare Advantage Plan, Medicare services are covered through the plan and aren’t paid for under Original Medicare. Plan types offered: Medicare Advantage Plans include Health Maintenance Organizations (HMO) and Preferred Provider Organizations (PPO), for example. Independence offers Keystone 65 HMO as well as Personal Choice 65 PPO. Medical Coverage: If enrolled in a HMO, members must choose a PCP (which also will coordinate referrals) and must stay In-Network. PPO… Read More

Medigap Quick Facts

August 23, 2022August 3, 2022Ed MacConnell

What is it? A Medigap policy (also called “Medicare Supplement Insurance”) is private health insurance that’s designed to supplement Original Medicare. This means it helps pay some of the health care costs (“gaps”) that Original Medicare doesn’t cover, like copayments, coinsurance, and deductibles. Play types offered: Insurance companies can sell only a “standardized” policy identified in most states by letters. Independence Blue Cross offers Plans A, B, F, F-HD, G, G-HD, and N. Medical Coverage: No selection of a PCP is required; members are able to choose any doctor or hospital as long as they accept Original Medicare. This also allows for no referrals and no network. Prescription Drug Coverage:… Read More

Independence Blue Cross and Amerihealth: Behind on your health insurance payments?

August 15, 2022August 15, 2022Ed MacConnell

Please do not assume that your payment is on the way or has been made and that the insurance company will handle it. Our health insurance specialists can assist you with a conference call. Getting reinstated after a cancellation is a long and difficult process and is not always available! If your payments are behind we need to ask for termination suppression BEFORE you are cancelled. First, Please always contact the Billing Department at 215-567-3357 or 1-800-444-6301. When calling, please have your group name, billing account number and address for verification purposes. The Billing Department will not approve an account for termination suppression due to checks mailed, promise to pay… Read More

Independence Blue Cross: Care Cost Estimator

August 2, 2022July 19, 2022Ed MacConnell

Did you know that you can estimate your out-of-pocket costs before you schedule a doctor’s appointment or medical procedure? You can, with the new Care Cost Estimator tool. It also lets you compare providers by price, based on your specific health plan. The Care Cost Estimator tool will display: Provider details Quality information, such as reviews Your estimated out-of-pocket costs for a wide range of common procedures and office visits Click here to learn how to get started with the Care Cost Estimator. As always, please contact your Total Benefit Solutions, Inc health insurance specialists with any questions or concerns at (215)355-2121.

What is a Qualifying Life Event or QLE?

July 29, 2022July 14, 2022Ed MacConnell

There are 4 basic types of health insurance qualifying life events. (The following are examples, not a full list.) Loss of health coverage Losing existing health coverage, including job-based, individual, and student plans Losing eligibility for Medicare, Medicaid, or CHIP Turning 26 and losing coverage through a parent’s plan Changes in household Getting married or divorced Having a baby or adopting a child Death in the family Changes in residence Moving to a different ZIP code or county A student moving to or from the place they attend school A seasonal worker moving to or from the place they both live and work Moving to or from a shelter or… Read More

Case Study Library

July 22, 2022July 22, 2022Ed MacConnell

We present a few case studies to illustrate how we have helped our clients solve their complicated employee benefit challenges. Click here to learn more!

COVID-19 Vaccines Now Available for Young Children

July 15, 2022July 1, 2022Ed MacConnell

A recent CDC announcement recommends that children six months through five years of age should get an age-appropriate dose of the Pfizer‑BioNTech or Moderna COVID-19 vaccine. Independence covers the cost of administering vaccines and booster shots with no cost-share (such as co-pays, deductibles, coinsurance) for members regardless of where the vaccine is given. For Medicare Advantage members, the cost and administration of the vaccine and booster shots will be covered by Original Medicare so long as the health care provider administering the vaccine participates in the Medicare program. Please click here to learn more about the COVID-19 vaccines and boosters. As always, please contact your Total Benefit Solutions Inc health… Read More

Health Insurance Broker Change Leads to Better Results

July 7, 2022July 6, 2022Ed MacConnell

Watch Video The Issue A mid-sized group prospect was unhappy with their current broker and looking for a change. They thought more could be done to help control their employee benefit budget and were looking for guidance. They came to us with a 17% health insurance renewal. Our Solution Our team met with the business owner and Human Resource Director to review the following: The corporate goals and philosophy regarding employee benefits The benefit structure and costs of their present programs Options for cost containment strategies How to integrate wellness into their benefits portfolio Methods for better communication of the benefit programs to employees The Result The customer was pleased… Read More

6 Questions to ask your Benefits Broker

June 10, 2022June 10, 2022Ed MacConnell

Notice Requirements for Group Health Plans

May 16, 2022May 13, 2022Ed MacConnell

ERISA requires plan administrators to give plan participants in writing the most important facts they need to know about their group health plans, including plan rules, financial information, and documents on the operation and management of the plan. Some of these facts must be provided to participants regularly and automatically by the plan administrator. Others must be made available upon request, free-of-charge or for copying fees.

Support for your emotional health

May 12, 2022May 11, 2022Ed MacConnell

Virtual care visits from MDLIVE® IBC members pay $0 cost-share* You have access to care from therapists, psychologists, and psychiatrists who can help with concerns likeanxiety, depression, and panic disorders. With telebehavioral health from MDLIVE, you pay $0 costshare* for a confidential visit in the comfort of yourhome, or wherever you are. Choose to have your virtual care visit by video chat, using the MDLIVE website or mobile app, or by phone.

Independence is covering OTC COVID‑19 test kits through pharmacy benefits

January 31, 2022January 25, 2022Ed MacConnell

2021 MLR Rebate Checks Recently Issued to Fully Insured Plans

September 22, 2021September 21, 2021Ed MacConnell

What Are Medicare Guaranteed Issue Rights?

August 24, 2021August 23, 2021Ed MacConnell

AmeriHealth New Jersey prepares to comply with new Transparency requirements

August 19, 2021August 19, 2021Ed MacConnell

2021 Second Quarter Compliance Bulletins Compilation

July 7, 2021July 7, 2021Ed MacConnell

This document is a valuable resource, putting all of the latest health care reform news and updates in one location!

Independence: Using the e-bill feature

July 6, 2021June 30, 2021Ed MacConnell

Achieve Well-being Rewards

July 1, 2021June 30, 2021Ed MacConnell

Independence: Small Group Forms

June 30, 2021June 30, 2021Ed MacConnell

Tax Advantaged Benefit Documents

June 18, 2021June 18, 2021Ed MacConnell

This site is dedicated to providing employers with the tools they need to successfully establish these written plans with SPDs at the lowest cost possible.

Alternatives to Health Insurance Benefits

June 13, 2021June 18, 2021Ed MacConnell

What is Blue Card PPO?

June 11, 2021June 18, 2021Ed MacConnell

IRS Guidance Clarifies DCAP Relief

June 9, 2021June 10, 2021Ed MacConnell

The IRS released Notice 2021-26 to address taxation of Dependent Care Assistance Programs (“DCAPs”) as it relates to the relief afforded under Section 214 of the Consolidated Appropriations Act, 2021 (“CAA”) and the increased DCAP limit under the American Rescue Plan Act of 2021 (“ARPA”).

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