Elevate Your Productivity with Better BenAdmin

In a fast-paced world, time is of the essence. We’re all too familiar with the feeling of being buried under a mountain of administrative tasks, wishing for an extra set of hands or a few more hours in the day. Well, wish no more! Enter Better BenAdmin, the game-changer powered by EBM (Efficiency-Boosting Machine). Seamless Schedule Management Scheduling headaches? Not anymore. Better BenAdmin effortlessly handles your calendar, ensuring that appointments are well-organized and conflicts are a thing of the past. No more double-bookings or time wasted on manual scheduling. Effortless Email Handling Say goodbye to the endless email backlog. Better BenAdmin sorts, filters, and responds to emails with precision and… Read More

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Choosing the Right Health Insurance: HMO vs. PPO

When it comes to health insurance, understanding the differences between various plans is crucial for making an informed decision. Two common types of health insurance plans are Preferred Provider Organizations (PPOs) and Health Maintenance Organizations (HMOs). While both offer coverage for medical expenses, they have distinct features that can significantly impact your healthcare experience and costs. In this blog, we’ll explore three key differences between PPOs and HMOs to help you decide which one aligns better with your needs. 1. Network Flexibility: PPO: Preferred Provider Organizations are known for their expansive networks of healthcare providers. This includes a wide array of specialists and the option to seek care from out-of-network… Read More

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Annual Health Insurance Check-Up: Don’t Miss Out!

Health insurance is vital for your well-being, providing financial protection and access to essential healthcare. But it’s not a one-time decision. Did you know that reviewing your health insurance plan annually is crucial to ensure it still fits your needs and budget? In this blog, we’ll explore why this check-up is essential and provide key enrollment dates. Plus, we’re here to assist you every step of the way! Why an Annual Review Matters: Enrollment Dates: Let’s talk about the enrollment dates you need to remember: How We Can Help: Navigating health insurance can be complex, but you’re not alone. Our expert team is ready to assist you in reviewing your… Read More

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What’s New in the 2023 ACA Open Enrollment?

The 2023 Affordable Care Act (ACA) Open Enrollment period is upon us, marking a significant milestone as Health Insurance Marketplaces open their doors for the tenth year. From November 1, 2022, to January 15, 2023, individuals and families have the opportunity to secure comprehensive healthcare coverage. In this blog post, we’ll delve into the key changes and updates for this year’s open enrollment, focusing on insights gathered from the Kaiser Family Foundation’s informative article titled “Nine Changes to Watch in Open Enrollment 2023” [source: www.kff.org/policy-watch/nine-changes-to-watch-in-open-enrollment-2023/]. As the ACA Open Enrollment enters its tenth year, changes abound, ensuring improved access, affordability, and assistance for individuals and families seeking healthcare coverage. Staying… Read More

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HOW PEOS ARE HELPING SMBS MEET MARKET DISRUPTORS HEAD ON

The modern world is driven by convenience and customization, SMBs included. Digitization, remote-friendly roles, and a generational shift in the workforce all impact today’s employee experience. When this experience is lacking, it can be costly to companies in more ways than one.    click here to read the story from PEO insider Total Benefit Solutions Inc is dedicated to providing a comprehensive selection of solutions for the small business owner including the comparison of PEO’s to the typical employee benefits experience. Contact us today at (215)355-2121 to inquire about the possibility of using a PEO for your organization.

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Exploring PEOs: Efficiency and Compliance Solutions

In today’s business landscape, optimizing operations and compliance is an ongoing challenge. Enter PEOs – Professional Employer Organizations. PEOs offer outsourcing solutions that reshape how companies handle HR and administrative tasks. Let’s dive into the world of PEOs and unveil their potential advantages and drawbacks. A “PEO,” or Professional Employer Organization, forms a strategic partnership where businesses team up with experts to manage HR and admin functions. This collaboration lets companies offload tasks like payroll, benefits, and compliance, ideal for small to mid-sized businesses aiming to streamline while focusing on core activities. Pros of PEOs: Cons of PEOs: In conclusion, PEOs provide a promising avenue for businesses aiming to bolster… Read More

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IRS Addresses COVID-19 Testing and HDHP Treatment

As a result of the COVID-19 pandemic, high deductible health plans (“HDHPs”) can provide coverage for COVID-19 testing and treatment before the minimum deductible is satisfied without jeopardizing an individual’s ability to have tax-favored contributions made to their health savings account (“HSA”). This relief remains in effect pending future IRS guidance.On June 24, 2023, the IRS issued Notice 2023-37, announcing that this relief will sunset with respect to plan years ending on or before December 31, 2024. In addition, IRS Notice 2023-37 states that HDHPs may continue to provide first-dollar coverage for preventive care with an “A” or “B” rating by the United States Preventive Services Task Force (“USPSTF”), prior… Read More

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Unlock Your Best Health: 5 Must-Know Tips & Tools!

Five major tips and resources for maintaining overall health and wellness: Remember, it’s important to personalize these tips to your individual needs and consult with healthcare professionals before making significant changes to your lifestyle. We’re committed to providing exceptional support, so please don’t hesitate to reach out to our dedicated Total Benefit Solutions health insurance specialists at (215)-355-2121. We’re here to answer any questions or address any concerns you may have.

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Top 10 Ways to Make Your Health Benefits Work for You

Unleash the Full Potential of Your Health Coverage!  Are you making the most of your health benefits? The Employee Benefits Security Administration (EBSA) administers crucial health benefit laws that cover employer-based health plans. These laws safeguard your rights to essential information about your health plan, guide you on qualifying for benefits and making claims, ensure continued health benefits during job transitions, and offer protections for special medical conditions. Start by exploring your health coverage options, delving into different plans, and matching them with your needs. Not sure if your plan covers mental health or substance use disorder services? We’ve got you covered with essential information on these benefits too! Your… Read More

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Why Short Term Heath Insurance is not “ JUNK” insurance.

Short-term health insurance, also known as temporary health insurance, is a type of health coverage designed to provide temporary medical insurance for a limited duration, typically ranging from a few months to a year. While short-term health insurance may not be suitable for everyone, it does offer certain benefits for specific situations. When people label Short Term health as “ JUNK” it is clear they do not understand that many people still need short term health insurance coverage. The ACA solved many problems when it comes to access to coverage, but first problem is the COBRA prohibition which specifically disallows ACA tax credits for people who can get on COBRA.… Read More

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Making HSAs Work Smarter

In the dynamic world of employee benefits, leaders have come to grasp the immense potential benefits hold in achieving their key goals. One approach that has gained significant traction is the combination of High Deductible Health Plans (HDHPs) with Health Savings Accounts (HSAs), a powerful duo that not only reduces benefits costs but also empowers employees with greater control over their healthcare expenses. However, despite the evident advantages, the journey to unlocking the full potential of HDHPs + HSAs is far from over. There lies an untapped opportunity to optimize plan design and elevate employee education, enabling companies to enhance their workforce’s well-being while achieving cost-effectiveness. If you are eager… Read More

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What is a Medicare MSA?

Medicare MSA (Medical Savings Account) is a specific type of Medicare Advantage plan available in the United States. However, please note that policies and plan names may change over time, so it’s important to consult official sources for the most up-to-date information. A Medicare MSA is a high-deductible health plan (HDHP) that works in conjunction with a medical savings account. It combines a high-deductible insurance policy with a savings account where funds are deposited and can be used to pay for eligible medical expenses. Here are some key features of a Medicare MSA: High-Deductible Health Plan: Medicare MSA plans have a higher deductible than traditional Medicare plans. This means you’ll… Read More

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Navigating Health Insurance for “gig” Economy Entrepreneurs

For self-employed individuals or today’s gig workers, obtaining health insurance can be a bit different compared to traditional employer-sponsored plans. Empower yourself with a range of valuable choices to explore! Take a moment to peruse the document below, where you’ll find a comprehensive list of options available to you. We’re committed to providing exceptional support, so please don’t hesitate to reach out to our dedicated Total Benefit Solutions health insurance specialists at (215)-355-2121. We’re here to answer any questions or address any concerns you may have.

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What are the preferred plans for insured employees?

Preferred Provider Organization plans remain the most common plan type. Nearly half (49%) of insured employees enrolled in a PPO in 2022. That compares to 29% enrolled in an HDHP, 12% enrolled in an HMO, nine percent in a Point-of-Service (POS) plan, and one percent in a conventional (indemnity) plan. If you have any questions or concerns about this bulletin, please contact your Total Benefit Solutions Inc health insurance account manager at (215) 355-2121

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How much do employees contribute towards their insurance expenses?

Average Contributions Most employees do make a contribution toward their insurance costs. Covered workers, on average, contribute 17% of the premium for single coverage and 28% of the premium for family coverage. These numbers are similar to those reported by KFF in its EHBS in 2021. The average contribution for workers at small firms is $7,556, which is more than a third higher than the average for those at large firms ($5,580). Workers at private, for-profit firms contribute a higher percentage of the premium versus those at public firms, regardless of coverage type. A fortunate one-third of employees (33%) at small firms are enrolled in coverage where the employer pays… Read More

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What Additional Changes Are Being Made to Part D?

As of 2023, the out-of-pocket cost of insulin products is limited to no more than $35 per month in all Part D plans. In addition, adult vaccines covered under Part D, such as the shingles vaccine, are covered with no cost sharing. Starting in 2024, people with Medicare who have incomes up to 150% of poverty and resources at or below the limits for partial low-income subsidy benefits will be eligible for full benefits under the Part D Low-Income Subsidy (LIS) Program. The law eliminates the partial LIS benefit currently in place for individuals with incomes between 135% and 150% of poverty. Also starting in 2024, the calculation of the… Read More

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How Is the Medicare Part D Benefit Changing in 2024?

In 2024, costs in the catastrophic phase will change: the 5% coinsurance requirement for Part D enrollees will be eliminated and Part D plans will pay 20% of total drug costs in this phase instead of 15%. The 5% coinsurance requirement for Part D enrollees in the catastrophic phase will be eliminated In 2024, once Part D enrollees without low-income subsidies (LIS) have drug spending high enough to qualify for catastrophic coverage, they will no longer be required to pay 5% of their drug costs, which in effect means that out-of-pocket spending for Part D enrollees will be capped. In 2024, the catastrophic threshold will be set at $8,000. This… Read More

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What Does the Medicare Part D Benefit Look Like in 2023?

The standard design of the Medicare Part D benefit currently has four distinct phases, where the share of drug costs paid by Part D enrollees, Part D plans, drug manufacturers, and Medicare varies (Figure 1). (The Part D enrollee shares reflect costs paid by enrollees who are not receiving low-income subsidies.) If you have any questions or concerns please contact your Total Benefit Solutions, Inc Medicare health insurance specialist at (215)355-2121.

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Delta Dental Plans Association: Survey shows patients rate their experiences with dentists a 9.5

OAK BROOK, Ill., June 22, 2023 /PRNewswire/ — Delta Dental announced key findings from the Consumer Assessment of Healthcare Providers and Systems (CAHPS®) Dental Plan Survey, which provides feedback from Delta Dental patients about their oral health care experiences. Delta Dental is the only carrier utilizing the survey nationwide to continuously enhance patient experiences with its outstanding network of dentists. This trusted anonymous survey tool is used in the health care industry to evaluate a patient’s experience throughout their dental care journey and includes questions related to care from dentists and staff, access to dental care, and dental plan information and services. Recent CAHPS Dental Plan Survey findingsMore than 20,000 Delta Dental adult… Read More

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Independence Blue Cross Announcing Value and Select formulary changes effective July 1

We want to remind you that we are making changes to the Value and Select Drug Program (Select) formularies for July 1. Updates are made to these formularies on a quarterly basis. A flyer summarizing the changes to each formulary is available by clicking on Value formulary or Select Drug Program. The complete, updated lists for July 1 are available on our website. To view, choose the link to either the Value or Select formulary. The updated list is available under “Formulary drug documents.” Members, as well as their providers, who are impacted by the changes were sent letters in April (60 days in advance). Members are encouraged to talk with their provider about switching… Read More

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The Benefits of Short-Term Health Insurance

Short-term health insurance is a type of health insurance that provides coverage for a limited period of time, typically anywhere from 30 days to 12 months. These plans are designed to provide temporary coverage for individuals who are in between jobs, waiting for employer-sponsored coverage to begin, or who are not eligible for other types of health insurance. Affordable Premiums Short-term health insurance plans typically have lower premiums than traditional health insurance plans. This is because short-term plans are designed to provide coverage for a limited period of time and do not have to meet the same requirements as other types of health insurance. This makes them a more affordable… Read More

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12 Tips for Maximizing Your High Deductible

Nearly 40% of people have a health care plan with a high deductible. An even higher percentage of people wish they had a lower deductible (who wouldn’t?!). And with medical bills being the leading cause of bankruptcies, it is important to understand how to maximize your high deductible so that you can stay afloat in case something unexpected were to happen. 1. Find Out What’s Free Many routine services are free. Instead of staying home to save money, you could get a free screening for preventative care. Common services covered are colonoscopies, mammograms, and vaccinations. About 90% of people with high deductible plans don’t know that such services are free.… Read More

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How to activate your OSCAR account

We want you to get the most of your plan. Setting up your Oscar account will help you do that by putting care right at your fingertips .

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