Group Business: Independence Blue Cross and AmeriHealth NJ COBRA and Mini-COBRA Premium Assistance

  COBRA Premium Assistance Available to Eligible Group Members Through September 2021 Under the recently passed American Rescue Plan Act of 2021 (ARPA), eligible group members who elect COBRA (including state‑based “Mini‑COBRA”) continuation coverage due to an involuntary job loss or a reduction in hours within the past year may be eligible for 100 percent coverage of their monthly health insurance premiums. This temporary premium assistance will be provided at no cost to the employer or to the group member through September 30, 2021. Employers should consult the U.S. Department of Labor and IRS websites for more information. Obtaining Mini-COBRA Premium Assistance For groups subject to state continuation plans (referred to as Mini‑COBRA typically for those with 19 or fewer… Read More

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2021 Second Quarter Compliance Bulletins Compilation

This document is a valuable resource, putting all of the latest health care reform news and updates in one location! 

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Top 10 Questions to Ask Your Benefits Broker

Analyzing these ten critical questions in relation to your organization’s needs will help you make a more informed decision about your benefits broker

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IRS Guidance Clarifies DCAP Relief

The IRS released Notice 2021-26 to address taxation of Dependent Care Assistance Programs (“DCAPs”) as it relates  to the relief afforded under Section 214 of the Consolidated Appropriations Act, 2021 (“CAA”) and the increased DCAP limit under the American Rescue Plan Act of 2021 (“ARPA”).

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CMS Announces Medicare Plan Finder Improvements

Source: medicare.gov   This week, the Centers for Medicare & Medicaid Services (CMS) announced plans to improve and update the Medicare Plan Finder (MPF) and the Health Plan Management System (HPMS). HPMS is the system that Medicare Advantage and Part D plans use to provide data about their plan offerings to Medicare, and the MPF is the online tool that allows beneficiaries to evaluate, compare, and enroll in those plans. The changes will be in place for the start of the Medicare Open Enrollment Period starting on October 15 for 2022 plans. Many of the forthcoming MPF changes reflect suggestions that Medicare Rights and other advocates have made over the years to increase the tool’s… Read More

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Can Employers Ask for Proof of Vaccination?

From our partners at TOTAL HIPAA: As states reopen and companies invite employees back into the workplace, an employee’s vaccination status will become an important factor in minimizing workplace health risks and returning business to normal operations.  Can employers implement a mandatory vaccination program? What do laws like the Americans with Disabilities Act (ADA) and federal agencies like the Equal Employment Opportunity Commission (EEOC) have to say about this? Click the link below to read the rest at Total HIPAA… Can Employers Ask for Proof of Vaccination?

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Return to Work Checklist

Thankfully it seems things are coming to and end of the pandemic and your employees will be returning to the workplace!  Download our handy return to work checklist to make certain you have all your bases covered!  Compliments of our partners at Think HR! As always contact your Total Benefit Solutions, Inc health insurance specialist at (215)355-2121 for more information or to get your complimentary subscription to Think HR! Click here to download the return to work checklist  

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HHS Extends Public Health Emergency until July 20, 2021

The COVID-19 pandemic Public Health Emergency, scheduled to expire on April 21, 2021, was renewed. This will once again extend the period for an additional 90 days and as a result, numerous temporary benefit plan changes will remain in effect. Click to Download _HHS_Extends_Public_Health_Emergency_until_July_20_2021

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Update on COVID-19 Vaccine and Vaccine Administration Cost

Update on COVID-19 Vaccine and Vaccine Administration Cost Medicare has increased and simplified its payment rate for administration of the COVID-19 vaccine to $40 per dose. This change may impact group health plans with respect to their payment rate to providers. Non-grandfathered group health plans are required to cover, without cost sharing, the COVID-19 vaccine. This obligation extended to coverage associated with administering the vaccine. The federal government continues to pay for the vaccine itself through funding authorized by the CARES Act.For vaccines administered in-network, plans will pay the rate negotiated with in-network providers, and that continues to be true. For vaccines administered out-of-network, however, group health plans must reimburse… Read More

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COVID-19 PPE Now a Qualified Medical Expense

On March 26, 2021, the IRS issued IRS Announcement 2021-7, which clarifies that amounts paid for certain personal protective equipment (“COVID-19 PPE”) used to prevent the spread of COVID-19, including masks, hand sanitizer and sanitizing wipes can be treated as amounts paid for medical care under § 213(d) of the Internal Revenue Code. Accordingly, because these amounts are expenses for medical care under § 213(d) of the Internal Revenue Code, these amounts can also be eligible expenses under a health flexible spending account (health FSA), health savings accounts (HSAs), health reimbursement arrangements (HRAs) and Archer medical savings accounts (Archer MSAs). Note, that if the amount is paid or reimbursed under… Read More

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How Safe Is it to Return to Work Once You Are Vaccinated?

There are a lot of things we don’t know yet. Answer by Kara Govro, Senior HR Law Analyst With vaccines rolling out among select populations, can employers start to bring back vaccinated employees into the office? originally appeared on Quora, the place to gain and share knowledge, empowering people to learn from others and better understand the world. As long as employers are complying with state and local law, they can bring employees back whenever they think is prudent… Click here for the full storyhttps://apple.news/A3Zt-q6uTReW37kaI3Z4O8A

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PPE and Health FSA/HRA

The IRS announced that amounts paid for personal protective equipment such as masks, hand sanitizer and sanitizing wipes for the primary purpose of preventing the spread of COVID-19 are considered amounts paid for medical care under section 213 of the Internal Revenue Code. These items are now allowed to be reimbursed from a health FSA. The IRS notice recognizes all forms of PPE as expenses medical care and does not limit the PPE to just disposable or non-disposable items. Reimbursements are permitted for expenses incurred on or after 1/1/2020 and they must be properly documented for reimbursement. If plan terms do not allow the reimbursement of PPE but the plan… Read More

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Does Medicare Cover Oral Surgery?

From our partners at HealthLine: If you’re eligible for Medicare and considering oral surgery, you have options to help cover the costs. While original Medicare does not cover dental services that are required specifically for tooth or gum health, it may cover oral surgery for medical conditions. Some Medicare Part C (Medicare Advantage) plans also offer dental coverage. Let’s explore which types of oral surgery Medicare covers and why.   Click here for the full story. Questions about this story or Medicare coverages? Please contact your health insurance specialists at Total Benefit  Benefit Solutions, Inc (215)355-2121  

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Impact of Key Provisions of the American Rescue Plan Act of 2021 COVID-19 Relief on Marketplace Premiums

there are millions of uninsured people who could be getting subsidized coverage on the ACA Marketplaces, but have not taken advantage of this financial help. In many cases, it may be that the financial help available to them is not sufficient to make the premium or the deductible affordable

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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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Independence Blue Cross COVID-19 claim forms

Independence Blue Cross COVID-19 claim forms

Click on the proper link below to download the COVID-19 Claim form
you need !

As always please reach out to your Total Benefit Solutions, Inc
health insurance specialist at (215)355-2121 for any questions or concerns.

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