Healthcare… the way it should be! Are you tired of waiting multiple weeks to go see your doctor, only to find yourself taking time off work so you can drive through traffic and sit in the waiting room for what seems like forever? Have you ever felt overwhelmed by the stress and anxiety of a difficult life situation and wished you had someone you could trust to hold your hand and walk you through to the other side? Then welcome to CADRPlus, an innovative new health care program that gives you unlimited, 24/7 access to doctors and other industry professionals from the comfort and convenience of your phone or computer,… Read More
Continue ReadingAmeriHealth New Jersey discontinues “Bill me Later” feature
AmeriHealth New Jersey has recently decided to remove the “Bill me Later” feature from AHNJ4U.com for Individual Coverage. “Bill me Later” gave members who enrolled 15 days prior to their desired effective date the option to be billed at a later time. This feature caused a delay in member billing and ID card production, leading to an exponential increase in call volumes. “Bill me Later” has been removed permanently from AHNJ4U.com, but members still have the option to pay by credit card for first time payments. Another alternative is to utilize an ACH payment option for reoccurring payments. If a member chooses to apply with paper checks, they must include… Read More
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Important Message from IBC’s Christopher Cashman
We received the following message this week from IBC’s EVP and President Commercial Markets Christopher Cashman and wanted to pass it on to our clients: As you know, over the past few weeks we have experienced unprecedented challenges as a result of the work required to enroll more than 170,000 members in our new Affordable Care Act (ACA)-compliant products. This has led to significant delays in several business areas, which we understand have been frustrating for you, your customers, and our members. While other health insurers across the country are facing similar challenges enrolling members with new ACA health plans, we are deeply concerned that we have not met your… Read More
Continue ReadingAmerihealth NJ: Individual Health Insurance payment deadline extension
From Amerihealth: IHC payment deadline extension ATTENTION: To offer a greater peace of mind for customers purchasing individual coverage through the Federally Facilitated Marketplace or our retail platform, AmeriHealth New Jersey is extending the payment deadline for new IHC members with January 2014 effective dates to February 5, 2014. We are also extending the payment deadline for new IHC members with February 2014 effective dates to March 5, 2014. This change is one more way that we are helping consumers navigate the health care reform environment. If you have any further questions, please contact Total Benefit Solutions (215)355-2121.
Continue ReadingIBC 2014 Renewals Important facts to know Q+A
There are many changes for small business groups for 2014. These changes affect sole proprietor plans, licensed professionals and small groups. Please take a moment to review this Q&A and let us know if you have any questions. Q. What is an Open Enrollment Period? A. An Open Enrollment is the time during which you are permitted to make changes to your benefit plan. Q. How will the 2014 Open Enrollment Process Work? A. IBC will be sending you, via regular mail, your, 2014 Renewal Package. Total Benefit Solutions will also follow up with another copy via fax or email. The package will include the 2013 rates for your current… Read More
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Horizon Blue Cross Important Update on Benefit Waiting Periods
Horizon BCBSNJ Group Administration – 90 Day Maximum Waiting Period Horizon BCBSNJ has issued This Letter to Group Administrators about the waiting period changes. We would like to provide you with additional clarification regarding this ACA change. • Groups with one to 99 employees who have a waiting period that exceeds 90 days per Horizon BCBSNJ’s system have been changed to a 90 day waiting period as of January 1, 2014. For example: A March 1 renewing group that has a six month waiting period will have a 90 day waiting period as of January 1, 2014. • Additionally, if a new employee is in the waiting period, as of January 1,… Read More
Continue ReadingAmerihealth Important Notice
From Amerihealth: We have recently identified an issue with member identification cards that were distributed to existing and new business members with a January 2014 effective date. Some member identification cards were printed with incorrect BIN and PCN numbers. We are working to resolve this issue as quickly as possible and will reissue new member identification cards to all affected members. In the interim, if you receive questions from affected customers, you may provide them with the correct BIN and PCN numbers below: BIN – 015814 PCN – 06440000 We apologize for any inconvenience this may cause. If you have any additional questions, please contact your AmeriHealth New Jersey broker… Read More
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ACA 90 Day Maximum Waiting Period – Small and Large Group Markets Update
Published: Thursday, December 26, 2013 ACA 90 Day Waiting Period Limitation Effective January 1, 2014, a group health plan or health insurance issuer offering group health insurance coverage shall not apply any waiting period that exceeds 90 days. Please note the following administrative guidelines per carrier: Aetna Groups in the Small Group Market (applicable in all states – NY, NJ, PA, DE, CT): The carrier will change to a maximum of 60 days at the first renewal on or after January 1, 2014 unless the employer advises the carrier differently. Groups in the Large Group (51+ Employees) Market: The benefit waiting period will change at the first renewal in 2014.… Read More
Continue ReadingIBC Group Medicare Security 65 Billing Issues
Security 65 Invoices Security 65 groups that are transitioning to our new operating platform effective January 1, 2014 are receiving premium invoices that reflect a zero-dollar balance. These invoices were sent in error and new invoices reflecting the appropriate premium due and membership information are being generated. Please be assured that this was an invoice issue only and did not affect membership. All members are currently active and there is no impact to access of care.
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IBC Communications to new and renewing HSA customers
Communications to new and renewing HSA customers Customers preparing to migrate to the new platform recently received information about IBC’s new integrated Bank of America HSA. For January 1, 2014, effective dates, new IBC customers and customers who have renewed their QHDHP or newly selected one, will receive a packet by December 31 to help them easily manage the transition to the new Bank of America HSA. It includes: a cover letter about account setup and employer contributions an HSA Employer Portal User Access Request Form for small group and mid-market and larger groups to request access to make HSA contributions via ibxpress.com an FAQ with details about transitioning to… Read More
Continue ReadingIBC January 1 2014 Enrollments-UPDATE
We know that we have an extraordinary number of clients who are waiting for approvals from Independence Blue Cross for their new health insurance plans that are effective on January 1st 2014. Please rest assured that we have been following up on your enrollments each and every day. The following was provided to us this week from IBC: Broker Care Center and Individual Coverage – Primary and Producing Agents The Broker Care Center is currently experiencing high call volume due to peak season and inquiries regarding individual coverage. Please be assured that we are leveraging all resources to reduce your wait time and provide prompt service. Producers are encouraged to… Read More
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IBC teams up with Guardian to offer ancillary products
Independence Blue Cross has teamed up with Guardian to provide their clients with a selection of quality specialty ancillary products to supplement their medical plans. Specialty products include life, disability critical illness and cancer. Click here to read the rest
Continue ReadingUnited Concordia Introduces Online Individual Dental Plans
United Concordia has rolled out the iDental platform! With iDental individuals and families can enroll on a dental plan who do not have coverage through their employer. There are five plan options to choose from and annual maximum benefits as high as $1500 per family. Best of all, you can quote and enroll the coverage instantly online. Click here to get a free dental plan quote!
Continue ReadingIBC: Important change to claims processing for PPO plans
Independence Blue Cross (IBC) will begin notifying customers later this week regarding a change in how claims for certain out-of-network providers will be processed under their IBC Personal Choice® PPO health plan. This change impacts fully insured, self-funded, and Individual commercial Personal Choice® PPO plans only. There is no impact to Medicare plans. Effective November 1, 2013, members who have claims submitted by providers who participate in the Highmark Blue Shield (Highmark) professional provider network inside IBC’s five-county service area will be subject to higher out-of-pocket costs and may also be subject to balance billing. Currently, claims submitted by a participating Highmark professional provider are processed as out of network and applied… Read More
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Health Reform: Aetna to distribute MLR rebates
By August 1st, Aetna is scheduled to mail rebate notices and checks to policyholders and subscribers whose plans are due a rebate under the Minimum Medical Loss Ratio provision of the Affordable Care Act. For group plans, rebate checks will be sent to the policyholder, with few exceptions. Please click the link below to download the bulletin. Click to download
Continue ReadingNew Employee Assistance Plan PLUS!
Our Employer & Employee Assistance Program is more than an EAP, it’s like having 5 specialized consultants in 1 – and on call 24/7, AND it’s available for groups down to only 2 employees! Click the link below for the details. EAP BROCHURE 2013
Continue ReadingEMA Group to become Total Benefit Solutions Inc!
The health insurance industry is on its way to a major overhaul by the end of this year. With the implementation of the Patient Protection and Affordable Care Act (PPACA), nearly every American will be affected by the new law and many already have. With this in mind, we have decided to refocus our efforts to better serve our clients in alignment with the new world of health benefits. We are proud to announce that beginning August 1, 2013; EMA Group Inc. will be known as Total Benefit Solutions Inc. Although our name is changing; our commitment to provide top notch guidance and support to our clients will never change.… Read More
Continue ReadingIBC Requesting tobacco data
Under the Affordable Care Act (ACA) and effective January 1, 2014, insurers are permitted to use the following four categories to determine premiums: Age Family Size Geography Tobacco To comply with this provision, IBC will be implementing a new process to collect tobacco usage as part of their rating methodology for groups with 2-50 employees and sole proprietors. Over the next several days, IBC will send letters to employers with January 1, 2014 renewal dates to gather this information. In the mailing, there will be a letter and a Tobacco Use Form, that must be completed for each of their employees and dependents age 21 and over… Read More
Continue ReadingAetna Completes Acquisition of Coventry Health Care, Inc.
HARTFORD, Conn.–(BUSINESS WIRE)–Aetna (NYSE: AET) announced it has completed its acquisition of Coventry Health Care, Inc., a diversified managed health care company based in Bethesda, Md. See press release
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IBC-Important update-changes to group plan selection requirements
We would like to share some important updates and reminders about the Summary of Benefits and Coverage (SBC), under the Affordable Care Act (ACA), including information about off-anniversary benefit changes, obtaining SBCs through our brochure and giveaway system (BAGS), and SBC postcards that are sent to members. Under the ACA both group health plans (customers) and health insurance issuers (health insurers) are required to provide the SBC to participants under certain circumstances. ACA 60-day notification requirement for off-anniversary benefit changes For customers who make off-anniversary material modifications (e.g., benefit changes) that affect the content of the SBC, participants in the customer’s group health plan must receive notification of the change… Read More
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Aetna introduces the Premium Savings Plan for Healthcare Reform
The Premium Savings program allows you to keep the plan you have, as allowed under the ACA. Doing so will help you to limit disruption in a changing health care environment. Plus,it gives you the time you need to assess your business needs in the future. Aetna clients have the option to: Canceltheir current policy and add a new 12 month policy with a new renewal date of Sept., Oct., Nov. or Dec. 2013. In some states, customers may be able to retain current benefits and rate levels through September-December 2014. Maintain their existing policy and renewal cycle ending in 2014 and move to plans and rates that comply with 2014 ACA regulations at… Read More
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United Healthcare offering early renewal option
Due to the expected rate increases, and uncertainty caused by the PPACA implementation date of January 1st 2014, United Healthcare is allowing groups who renew in the first quarter of the year to roll their renewal back to December 2013. This is an opportunity for United Healthcare clients to renew early and also lock in their plan and rates for most of the year 2014. More details will be following soon. Please contact us if you have any questions or concerns at 215/355-2121. Want more information from United Healthcare on reform? Click here for a guide for employers.
Continue ReadingCoventry is offering an early renewal option for small groups
Coventry/Health America is offering an early renewal option for small groups rated in BenefitExpress. These clients have the option to renew off-cycle for another 12 months. Selecting a December 1 renewal option can provide consistency, stability and predictability in rates and benefits, especially for employers concerned with ACA changes taking effect in January 2014. Contact your Total Benefit Solutions representative for more details.
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