How Does Level Self Funded Health Insurance Work?

We have received a lot of questions regarding the new level funding health benefit programs so we prepared this video to make it a little easier to understand. Ask us today if Level Funding your group’s health insurance might be a good for for your health plan! Contact your Total Benefit Solutions Account manager at (215)355-2121.

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ARPA Extends Open Enrollment for Individual Coverage in PA

Pennie (PA Individual Exchange) has communicated that they will be extending the open enrollment period from May 15 until August 15, 2021. This extension is to help consumers be able to take advantage of the benefits of the American Rescue Plan. Some of the key benefits of this plan are below: There is no longer a cap on who is eligible for Pennie’s income-based tax credits, which help reduce monthly premium costs. Previously only people whose household income was under 400% of federal poverty level (about $51,000 for an individual), could qualify for a tax credit. Now, anyone may be eligible for a tax credit. The size of the tax… Read More

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Enrollment Period at Get Covered New Jersey Extended

More information on the American Rescue Plan Act changes may be found on the Get Covered New Jersey website. Contact your Total Benefit Solutions, Inc health insurance specialist to get enrolled or if you have any questions or concerns at (215)355-2121

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What is Minimum Essential Coverage or MEC health insurance?

The Affordable Care Act states that all individuals must have health benefits and all employers with 50 or more full-time employees must provide coverage to all eligible employees or they are subject to fines/penalties. This can be known as “pay or play” or employer shared responsibility. We offer Minimum Essential Coverage plans which both penalties are satisfied for the employee and the employer. MEC plans are substantially less expensive than traditional medical insurance and serve as a low-cost solution for most companies. To contain healthcare costs, many employers and other plan sponsors are considering Minimum Essential Coverage, or MEC, health insurance. MEC plans can keep your workforce healthier. Preventable diseases, gone… Read More

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Copays vs Coinsurance: What is the employer impact?

In a recent study, the Employee Benefits Research Institute examined the differential effect of copayments and coinsurance on health care services. They found that coinsurance reduces inpatient care and specialist physician office visits, but copayments do not. Specifically: For inpatient health care, each 1 percent increase in coinsurance led to a 0.18 percent decrease in utilization. For specialty physician office visits, each 1 percent increase in coinsurance led to a 0.19 percent decrease in utilization. Those who were more likely to want a telehealth visit but did not receive one were more likely to have an unmet need for care because of the pandemic. There was no evidence that demand… Read More

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Departments Issue Guidance Re: FFCRA and CARES Act

On February 26, 2021, the Departments of Labor, Health and Human Services, and the Treasury (together, the “Departments”) issued FAQ 44 addressing health coverage issues related to COVID-19. Briefly, the new FAQs focus on diagnostic testing and coverage for testing and clarify previous guidance in FAQs.Background Section 6001 of the FFCRA requires group health plans (including grandfathered health plans) and health insurance issuers to provide coverage for certain items and services related to testing or the diagnosis of COVID-19 without any cost-sharing requirements, prior authorization or othermedical requirements. Section 3201 of the CARES Act amended Section 6001 of the FFCRA to include a broader range of diagnostic items and services… Read More

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New COBRA Subsidy Begins April 1st under COVID Relief

Congress passed the American Rescue Plan Act of 2021 (“the Act”) on March 10, 2021 and it was signed into law on March 11, 2021. The Act includes a 100% COBRA subsidy available to certain COBRA qualified beneficiaries who lose group health plan coverage as the result of an involuntary termination or reduction in hours. This is different from the original House legislation, which included an 85% subsidy (with the COBRA beneficiary responsible for 15% of the COBRA premiums). Employers will be able to claim a credit against payroll taxes to reimburse the cost of the subsidy. The COBRA subsidy begins April 1, 2021 (the first day of the month… Read More

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COBRA Subsidy in the works

          Photo by AllGo – An App For Plus Size People on Unsplash A COBRA subsidy is included in early drafts of the proposed fiscal year 2021 budget reconciliation package. If finalized, the COBRA subsidy would apply to workers who have lost group coverage during the COVID-19 pandemic due to involuntary termination or reduction in hours of employment. Download this bulletin below for more information and as always contact your Total Benefit Solutions, Inc health insurance specialist with any questions at (215)355-2121. Download COBRA Subsidy in the Works

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Are you an applicable large employer, or not? That’s the question!

Calculating Your FTE Count Are you an applicable large employer, or not? That’s the question! To answer this question you’ll need to add up your full-time employees plus the full-time equivalent of part-time employees. For some businesses, this may have been simple, but not for all. This is how you determine your FTE count. Full-Time Employees: Any employee who works an average of at least 30 hours per week in a given month. Or at least 130 hours of service in a given month. Full-Time Equivalent: The full-time equivalent of part-time employees is the number of hours worked by all your part-time employees in a given month divided by 120. For example: two employees… Read More

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What is a minimum essential coverage (MEC) plan?

The Affordable Care Act states that all individuals must have health benefits and all employers with 50 or more full-time employees must provide coverage to all eligible employees or they are subject to fines/penalties. This can be known as “pay or play” or employer shared responsibility. We offer Minimum Essential Coverage plans which both penalties are satisfied for the employee and the employer. MEC plans are substantially less expensive than traditional medical insurance and serve as a low-cost solution for most companies. To contain healthcare costs, many employers and other plan sponsors are considering Minimum Essential Coverage, or MEC, health insurance. MEC plans can keep your workforce healthier. Preventable diseases, gone… Read More

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DOL Penalties Increase for 2021

The Department of Labor (DOL) published the annual adjustments for 2021 that increase certain penalties applicable toemployee benefit plans. Private employers, including non-profits, should ensure employees receive required notices timely (SBC, CHIP, SPD, etc.)to prevent civil penalty assessments. In addition, employers should ensure Form 5500s are properly and timely filed, ifapplicable. Finally, employers facing document requests from EBSA should ensure documents are provided timely, asrequested. Download DOL Penalties Increase for 2021

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Review us on Google

 At Total Benefit Solutions we strive to provide our clients with the best service and support when shopping, enrolling and servicing their health insurance all year long. We appreciate having the opportunity and as always “We Work for Your Benefit”.  If you have worked with us, please help us get some feedback by  reviewing us on Google.  You’ll need to be logged in to your Google account to do so. Click here to rate us!

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What is my Max Out of Pocket?

In health insurance, you may have heard of the “maximum out-of-pocket  or MOOP.” Here’s a quick overview of how it works, including which costs count towards it, and what happens after your maximum out-of-pocket (MOOP)  is met. Max Out of Pocket Presentation

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How Does Short Term Medical work?

Total Benefit Solutions, Inc works with many clients who are in between jobs, in good health or people who just want to pay less for their health plan insurance plan. As your impartial health insurance broker we can quote multiple carriers to find the best fit for our clients! .Ask us today of a short term medical plan could be a good solution for you! Just give us a call at 215-355-2121.

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Four Stages of Medicare Part D

  It’s easy to see why Many people are confused by the Medicare part D plan coverage deductibles, limits and the donut hole. We have provided this graphic for you, our clients and friends to make it a little easier to see in a pie chart. Click the link below to download this graphic bulletin. 2018 Four Stages Of Medicare Part D   Want to compare part D plans in your area quickly? Click here   Have more questions? Call us today at (215)355-2121.

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An Update on Short Term Medical Plans

President Trump recently signed an executive order asking the Secretaries of the Treasury, Labor and Health and Human Services to consider the expansion of availability of Short Term plans. These departments have 60 days to propose regulations or revise current guidance. We expect additional details to become available soon and will keep you updated as more information becomes available. While short term plans are not for everyone, they do meet an important need for consumers looking to avoid gaps in coverage. Of the short term plans available in the market, we encourage you to consider United Healthcare’s  short term plans as they represent a name you know, and they are… 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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Health4Me Mobile Application

UnitedHealthcare’s Health4Me provides instant access to you and your family’s critical health information — anytime/anywhere. Whether you want to find physicians near you, check the status of a claim or speak directly with a nurse, Health4Me is your go-to resource for everything related to your health. Learn more by watching the video below. As always if you have any questions please contact your Total Benefit Solutions Inc account manager at (215)355-2121.

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Individual and Family Open Enrollment-2017 Important Updates

As many people know by now there are many big changes with individual and family plans for open enrollment 2017. For anyone who is currently enrolled on one of the following your plan will NOT be renewed for 2017 and you will have to pick a new plan and/or a new insurer: Aetna: all plans cancelling  in PA/NJ/NC/FL  Aetna plans only remain in Delaware in our service area United Healthcare: All ACA plans cancelling. Short term plans are still available Oscar: All plans in NJ cancelling Health Republic: All plans in NJ cancelling Highmark and Capitol Blue Cross: No longer paying broker compensation Geisinger: No longer paying broker compensation Independence Blue… Read More

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ACA Individual 2017 Open Enrollment Important Update

2017 ACA ” Obamacare” plans open enrollment important update. The annual open enrollment period opens on November 1st 2016 and ends January 31st 2017. Independence Blue Cross will be the only insurer available in 2017 in the Philadelphia 5 County Area. With the passing of the Affordable Care Act changes come annually or even more often. Unfortunately not all of those changes are benefiting the consumer. This year here are some major changes that our clients on Individual Non Medicare plans need to be aware of… If you are a enrolled on an ACA compliant plan with Aetna or United Healthcare your plan is going away. Neither Aetna or United… Read More

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UnitedHealthcare and Optum take action to support Orlando shooting tragedy

Those Grieving Over Orlando Can Get Free Mental Health Services Thanks To This Insurance Company: UnitedHealthcare and Optum, two health benefits companies of UnitedHealth Group, are offering free mental health services for anyone affected by the shooting in Orlando that killed 49 people over the weekend. The resources are available to anyone in the country, whether they are insured by the group or not. Optum will operate a 24/7 helpline, and users can speak to a trained mental health professional for as long as they need. click here for more information

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Health Care Reform: Taxes and Fees-PCORI Fee, Transitional Reinsurance Fee, Insurer Fee and Excise Tax

Health Care Reform: Taxes and Fees-PCORI Fee, Transitional Reinsurance Fee, Insurer Fee and Excise Tax   From United Healthcare: Taxes and fees under the health reform law impact both fully insured and self-funded plans. But, they impact funding types differently. Employers with self-funded health plans submit applicable health reform fees directly to the government, and those with fully insured health plans will see fees prorated into their premiums. The fees are prorated over 12 months. Here is what you need to know about these fees and how they will impact your business. Please note that this document, provided by United Healthcare, has carrier specific language, however please contact your Total Benefit… Read More

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