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

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IBC 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

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IBC 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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United 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!

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IBC: 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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EMA 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

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IBC 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

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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.

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Coventry 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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