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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