Consumer Driven Health Plans – Page 12 – Total Benefit Solutions Inc

ACA: Important Implementations & Delays in 2016

July 15, 2016July 17, 2016Ed MacConnell

As our third year of the ACA Open Enrollment Period arrived, it’s time to examine some of the new implementations in 2016. Some of the major components, especially those affecting businesses were delayed or deferred since the passage of the Affordable Care Act in 2010. This year is considered to be a big year due to the “full implementation” of the employer mandate as well as a number of changes, repeals, and moratoriums on other sections of ACA. Some of the key changes are listed below: CHANGES AND IMPLEMENTATIONS Full implementation of the Employer Mandate Currently it is not mandated that employers provide health care to their employees. Moving forward, however, if… Read More

FAQ Suggests Employers Include Marketplace Options with COBRA Notices

July 15, 2016Ed MacConnell

On June 21, 2016, the Departments of Labor, Health and Human Services, and the Treasury (collectively, the “Departments”) issued the 32nd Affordable Care Act (“ACA”) FAQ describing information that may be appropriate to include with COBRA notices. Many wondered if it were appropriate to provide information and if so, what kind of information could be provided about the Health Insurance Marketplaces/Exchanges (“Marketplaces”) so that COBRA-eligible individuals could consider health coverage alternatives available through the Marketplaces and possibly investigate whether they may be eligible for premium tax credits and cost-sharing reductions. Click the link to download the entire bulletin

Total Benefits & Healthiest You

July 13, 2016July 8, 2016Ed MacConnell

Healthiest You is more than a typical Teledoc benefit. Whenever members have questions or they are simply not feeling well, they can effortlessly connect to a 24×7 telehealth hotline for the diagnosis and treatment of illness, second opinions and consultations. They have board-certified, licensed physicians in every state waiting to provide exceptional care. They can even prescribe medication and save a trip to the doctor’s office, whether members are at home or on the road. Want more information? Click here to see the site.

Think HR Comply: Small Business Support from Total Benefit Solutions

July 11, 2016July 11, 2016Ed MacConnell

We are pleased to introduce to you a our sponsored client service—ThinkHR. If you are involved with employee issues, this will be a value-added benefit that will save you time and money. ThinkHR offers ThinkHR Live, a team of HR experts standing by to answer your questions or provide advice. This phone-based support service is available from 8:00 a.m. to 7:00 p.m. Central each business day. You also have access to ThinkHR Comply, an award-winning online resource center for all of your workforce issues. Download this brochure, it describes the scope of HR topics that are handled by the ThinkHR Live team. The service is provided to all Total Benefit… Read More

Critically Important: Insurance for Serious Illness

July 11, 2016July 8, 2016Ed MacConnell

Good news: You’ve got health insurance (at least, all Americans are required to or pay a penalty). Bad news: It doesn’t cover everything. Especially if something really bad happens, like a heart attack or stroke. Yes, a decent major medical plan will cover many of the health-related expenses related to a serious illness. But you’d likely still be left with significant out-of-pocket costs for deductibles and copayments. Medical insurance also doesn’t usually cover other related costs, such as travel to treatment centers, child care during absences or recovery, home modifications or rehabilitation charges. And if you lose income while you’re unable to work, you could have a tough time paying… Read More

Reminder: PCORI Fees Due August 1

July 9, 2016July 8, 2016Ed MacConnell

The annual Patient-Centered Outcomes Research Trust Fund (PCORI) fee is due to the IRS August 1, 2016. The fee, charged to certain health insurance policies, is used to support the activities of the Patient-Centered Outcomes Research Institute, a nonprofit, non-governmental organization (NGO) established by the Affordable Care Act (ACA). Fully- and self-insured group health plans ( Including HRA’s) are subject to PCORI fees. A health insurer will pay the fee on behalf of the employer if the plan is fully insured. Click here to read the bulletin from Primepay As always please contact your Total Benefit Solutions dedicated account manager at (215)355-2121 if you have any further questions or concerns.

Now Available from Total Benefit Solutions: Low Cost ERISA Wrap SPD Documents

July 8, 2016July 8, 2016Ed MacConnell

Wrap Summary Plan Description (SPD) If you offer group health insurance you’re now required by ERISA law, enforced by the Department of Labor and now the Affordable Care Act, to distribute a Wrap SPD within 120 days of the Plan’s effective date. The ERISA and ACA required Group Health Insurance Wrap SPD document is now available for a $99 one-time fee. You only update your Wrap SPD document as your benefit options change. The low cost Wrap SPD document is limited to fully insured group health insurance plans only. Here are the Wrap SPD document requirements by ERISA and the Affordable Care Act as succinctly as possible: If… Read More

Now Available: Health Advocate Member Advocacy

June 21, 2016June 21, 2016Ed MacConnell

Total Benefit Solutions clients can now take advantage of enrolling on Health Advocate as a group or as an individual/ family! It’s part of our Benefit Aid packages and it’s so easy you can enroll today by clicking here or ask your Total Benefit Solutions account manager at (215)355-2121 for more information. This video will tell you all about the benefits of Health Advocate!

Departments issue new ACA FAQ’s

June 7, 2016June 6, 2016Ed MacConnell

The Departments of Labor, the Treasury, and Health and Human Services (collectively, the “Departments”) have issued the 31st set of Affordable Care Act (“ACA”) frequently asked questions (“FAQs”). This time, the Departments address a wide range of topics including preventive services, disclosure obligations, coverage in connection with approved clinical trials, reference-based pricing, the Mental Health Parity and Addiction Equity Act, and the Women’s Health and Cancer Rights Act. Below is a brief summary of the guidance issued on these topics. Click the link below to download the bulletin. Download Departments Issue 31st set of FAQs

2017 Inflation Adjusted Amounts for HSAs

May 6, 2016May 5, 2016Ed MacConnell

The IRS released the inflation adjustments for health savings accounts (HSAs) and their accompanying high deductible health plans (HDHPs) effective for calendar year 2017. Most limits remained the same as 2016 amounts. Click the link below to download the bulletin. 2017 Inflation Adjusted Amounts for HSAs

Form 1095-C Notification Reminder and Frequently Asked Questions

March 19, 2016March 20, 2016Ed MacConnell

Form 1095-C Notification Reminder and Frequently Asked Questions 2015 Forms 1095-C must be furnished to individuals by March 31, 2016. Generally, if Forms 1094-C and/or 1095-C are incorrect and incomplete, a penalty may apply if not corrected by the due date and the employer cannot show reasonable cause. Briefly, the amount of penalties can range from $50/form with a $500,000 maximum penalty/year to $250/form with a maximum penalty of $3M/year. Click here to download Form 1095-C Notification Reminder and Frequently Asked Questions – 031516R As always please contact your Total Benefit Solutions, Inc. account manager at (215)355-2121 if you have any questions or concerns about this bulletin, or any other… Read More

Now Available: Empower Me Benefits Private Exchange

February 13, 2016February 13, 2016Ed MacConnell

Total Benefit Solutions has partnered with Empower Me Benefits to provide our clients with best in industry benefits technology that‘s customizable for even the smallest employer. The EmpowerMe Benefits Exchange allows you to remain complaint with the Affordable Care Act (ACA), easily manage benefits, and control health care costs with a single solution. The EmpowerMeBenefits Exchange is an online benefit marketplace and benefits administration platform designed specifically to meet the needs of small and mid-sized companies. The Exchange provides employers with an enrollment and administration platform that aids employers in ACA compliance. This web-based solution allows you to offer any medical coverage next to pre-selected ancillary, voluntary, and TPA products.… Read More

New Guidance Tackles Employer Mandate Issues

February 6, 2016February 6, 2016Ed MacConnell

A number of Employer Mandate updates are included in this bulletin. Please click on the link to download this important update. As always please contact your Total Benefit Solutions, Inc account manager if you have any questions or concerns regarding this release at (215)355-2121. Download Update:Employer Mandate Issues 2016

Health Reform: Draft 2015 Form 1095-C and Instructions, Increased Penalties, and Electronic Filing Steps Issued

August 27, 2015August 27, 2015Ed MacConnell

On August 7, 2015, the IRS issued revised draft 2015 Form 1095-C with instructions. The forms and instructions are substantially the same as those applicable to the 2014 year, but the penalties have been revised. Click here to download this important update for all applicable large employers. As always if you have any questions or concerns about your organization’s health care reform compliance, please contact your Total Benefit Solutions, Inc account manager at (215)355-2121

New Law Clarifies Employer Mandate and HSA Eligibility for Veterans

August 27, 2015Ed MacConnell

On July 31, 2015, President Obama signed into law H.S. 3236, Surface Transportation and Veterans Health Care Choice Improvement Act of 2015. Notably, the law makes changes affecting the employer mandate and HSA eligibility as to individuals who are (or were formerly) service members. Click here to download the bulletin

Health Reform: Is Your Company Ready for the New Reporting Requirements?

July 23, 2015July 23, 2015Ed MacConnell

Health Reform: Is Your Company Ready for the New Reporting Requirements? In 2016, employers with at least 50 full-time employees (FTEs) must provide Forms 1095-C to their employees and to the IRS. This new requirement applies to both insured and self-insured medical plans. The forms require, in part, tracking per each month in 2015 per each FTE: the tier of health plan coverage offered (e.g., employee-only, employee+spouse, or no coverage offered); the self-only premium an employee must pay for the lowest-cost plan that provides minimum value; and the reason why an employer would not be subject to a penalty for a particular month (e.g., employee is in a waiting period or the affordability… Read More

Lost your health coverage?

June 4, 2015June 5, 2015Ed MacConnell

Losing other health coverage, including losing a job-based plan, aging off a parent’s coverage at 26, losing coverage through divorce, losing eligibility for Medicaid or CHIP, and similar events. Coverage can take effect: The first day of the month after you enroll and after the loss of coverage Enrollment window: From 60 days before to 60 days after losing your other coverage Important: If you leave your job for any reason and lose your job-based health coverage, you qualify for a Special Enrollment Period. But you don’t get an SEP if you voluntarily drop: a job-based plan without leaving your job; an individual insurance plan; unexpired COBRA coverage; or… Read More

Lost your health coverage?

June 4, 2015June 4, 2015Ed MacConnell

FAQs Further Clarify New Embedded Out-of-Pocket Requirement

June 2, 2015Ed MacConnell

As reported earlier, starting with the 2016 plan year, the self-only annual limitation on cost sharing for non-grandfathered plans ($6,850 for 2016) applies to each individual, even if the individual is enrolled in family coverage. On May 26, 2015, the Departments of Labor (DOL), Health and Human Services (HHS), and the Treasury (collectively, the Departments) issued new FAQs further clarifying this new rule, confirming that it applies to all non-grandfathered group health plans, including self-insured plans, large group health plans, and high deductible health plans. Click the link below to download the bulletin for further guidance. FAQs Further Clarify New Embedded Out-of-Pocket Requirement – 060115R

UHC: Introducing Plans with Rate Caps and Wellness Rewards

April 28, 2015April 28, 2015Ed MacConnell

United Healthcare: Introducing All Savers Plans. Would your small group be interested in a medical plan with a rate increase cap in year two? Does a plan with a free “fitbit” type device sound like a great way to integrate wellness into your health benefits? What if I told you that your employees could earn money back towards their deductibles by meeting small, simple daily wellness goals? Finally, an insurance carrier has introduced a plan for your health conscious group that gives you a direct advantage in the rates because you are working towards better overall health! United Healthcare has introduced the All Savers level funding plans with Motion Credit.… Read More

Health Reform: Q+A: Are we able to give a bonus to employees to sign up for health insurance?

April 17, 2015April 12, 2015Ed MacConnell

The following question came to us recently from a small group client. Send us your question and we may use yours in the future! Question: Are we able to give a signing up bonus to encourage employees to sign up for health insurance or will that be an issue with health care reform? Answer: An employer may provide bonuses at its discretion as long as the amount is reported as taxable compensation. Federal law prohibits employers from providing incentives to certain employees (such as Medicare-eligible persons) to discourage them from enrolling for group health coverage, but there is no prohibition against incentives to encourage enrollment. The bonus would be taxable compensation… Read More

Health Care Reform: 2016 Cost-Sharing Limits, Reinsurance Fee,and Other Changes Related to the Exchange

April 11, 2015April 10, 2015Ed MacConnell

On February 27, 2015, the Department of Health and Human Services (“HHS”) changed cost-sharing and transitional reinsurance program fee limits and released standards for health insurers and the Exchange (a.k.a. the Health Insurance Marketplace). This article identifies a few items of note for employers. 2016 Cost-Sharing Limits, Reinsurance Fee, and Other Changes Related to the Exchange – 040915R

Group Health Plan Notices 2015 CALENDAR

April 10, 2015Ed MacConnell

Group Health Plan Notices 2015 CALENDAR From our partners at HR360: This calendar/checklist is designed to help companies review the key reporting and notice requirements that may apply to their employer-sponsored group health plans under ERISA , the Affordable cxare Act, Medicare and more. Please note that this list is for general reference purposes only and is not all-inclusive. Note: ERISA and benefit requirements are complex, and your plan’s responsibilities may vary depending on the individual circumstances surrounding your company’s plan. Employers who have questions are encouraged to consult with their plan administrators, the U.S. Department of Labor’s Employee Benefits Security Administration, the Internal Revenue Service, or a knowledgeable employment law attorney… Read More

How do Tiered Network plans like the Keystone HMO Proactive and Horizon Omnia plans work?

February 9, 2015January 13, 2021Ed MacConnell

Tiered or Narrow Network Plans: Under the Affordable Care Act, insurance carriers have introduced “tiered network”, or narrowed network plans. Keystone Proactive HMO Plans from Independence Blue Cross have a unique ” 3 tiered” network of providers. Although each carrier has different types of networks and benefit levels, the plans have the same general concept, steering the members by giving them a choice of providers that offer medical services at a lower out of pocket expense. Choosing a more expensive provider or facility may cost the member more out of pocket costs. United Healthcare offers 2 tiers in their “Navigate” plans, and Aetna uses “Savings Plus” designated providers to split… Read More

2014 Compliance Bulletin Compilation

January 19, 2015Ed MacConnell

Download our 2014 Compliance Bulletin Compilation, featuring all of our released compliance bulletins for the entire year! Topics include, Health Savings Accounts, The Individual Mandate, Employer “pay or play” mandate, exemptions, FSA carryovers and much, much more. All of the bulletins are in an easy to search format for your convenience. 2014 Compliance Compilation – Download As always please contact your Total Benefit Solutions account manager at (215)355-02121 if you have any further questions or concerns.

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