Employers supporting a group health plan, whether through insurance or self-insurance, are required to communicate the creditable or non-creditable status of the plan’s prescription drug coverage to the Centers for Medicare and Medicaid Services (CMS). This reporting is facilitated through access to CMS’s online reporting system here. To comply with regulations and maintain transparency, follow these key points: Access CMS Online Reporting: Employers (insured or self-insured) should use CMS’s online system to report prescription drug coverage details. Key Deadlines: 1.Within 60 days after the plan year starts. 2.Within 30 days after prescription drug plan termination. 3.Within 30 days after any creditable coverage status change. Example Deadline: For a calendar year… Read More
Continue ReadingPros and Cons of PEO’s
A Professional Employer Organization (P.E.O.) is a company that provides comprehensive HR outsourcing services to small and medium-sized businesses. As your independent broker, Total Benefit Solutions, Inc can shop and compare various PEO’s to help determine which one might be the best fit for your organization, if any. Just like we can do with insurance carriers ad TPA’s! We have had a lot of questions about PEO’s so we created these pro and com quick tips to give you a quick overview of the top points about PEO’s that are asked the most often. The professionals at Total Benefit Solutions are independent and can evaluate the PEO offerings of multiple… Read More
Continue ReadingCracking the Code: Navigating Health Cost Surge in 2023
Managing Health Costs in 2023 Multiple industry and benefits sources are predicting health insurance premium increases in the range of five to eight percent for 2023. An analysis by Aon is forecasting a 6.5% increase. The Society for Human Resource Management (SHRM) is expecting a bump of 5.6%, based on a prediction by Mercer. The International Foundation of Employee Benefit Plans says employers are anticipating a 7.5% increase. The country’s oldest actuarial consulting firm, Buck, has forecast an increase in the range 5.8% to 6.9%. If you have any questions or concerns about this news please contact your Total Benefit Solutions, Inc health insurance specialists at (215)-355-2121
Continue ReadingRevised Form 720
The IRS has released a revised Form 720, Quarterly Federal Excise Tax Return, the proper method to file and report PCORI fees. If you owe a PCORI fee, it must be paid using IRS Form 720 by July 31, following the last day of the policy year or plan year. Form 720 and the fee must be submitted on the same date. If your business does not owe a PCORI fee, IRS Form 720 does not need to be completed. Issuers and plan sponsors will only be required to file Form 720 once a year. Per the IRS, “Issuers and plan sponsors who are required to pay the PCORI fee… Read More
Continue ReadingGet Your FSA, HRA, HSA Health Accounts Comparison Chart
What’s the difference which spending account you use at your company? Download our comparison chart for a quick, simple side by side comparison. Contact your health insurance experts at Total Benefit Solutions, Inc to find out which account might be the best fit for your organization!
Continue ReadingDo FSA’s and HRA’s have Reimbursable Expenses?
Health Flexible Spending Account (FSA) Health Reimbursement Arrangement (HRA) As always, don’t hesitate to contact your Total Benefit Solutions health insurance specialists today at (215)355-2121.
Continue ReadingNotification Reminder for Forms 1095-C and 1095-B
Under the Affordable Care Act (“ACA”), the deadline for applicable large employers (“ALEs”) to furnish Form 1095-C and 1095-B to certain individuals (such as full-time employees in the case of Form 1095-C) is January 31 with respect to the preceding calendar year. The Internal Revenue Service (“IRS”) released final regulations on December 12, 2022 with respect to ACA reporting requirements. These final regulations provided an automatic extension of 30 days to furnish these statements to individuals. This means that Wednesday, March 2, 2023 is the deadline to furnish individuals with 2022 Forms 1095-C and 1095-B. This extension is automatic; employers or other reporting entities are not required to file a… Read More
Continue ReadingWhat is Limited Medical Insurance?
A limited medical plan is a form of supplemental health insurance that can be used with or without a major medical plan. Limited medical plans have a set amount of money for treatment that they give to you to pay for common medical expenses. They recognize that common services like wellness visits can sometimes turn into a financial strain for people. Since this type of insurance does not cover everything due to a predetermined limit on what you receive, you will want to look closely at the benefits before choosing a plan. It can be helpful to pair a limited medical plan with a major medical plan. Doctors visits and… Read More
Continue ReadingWhat is Stop Loss Coverage?
Stop-loss insurance, in combination with a self-funded group health plan, is a type of coverage that protects companies from catastrophic or unexpected medical claims. Why choose a plan with stop-loss coverage? Protecting a company financially is critical and stop-loss is an employer’s safety net. With the Self-Funded Program, , stop-loss insurance is always included in employers’ monthly payments. This protects the employer against higher-than-expected claims. With level-funding, employers will never have to pay more than the amount, agreed upon up front, that they are responsible for funding the claims account each year. By choosing a self-funded plan with stop-loss coverage, employers limit their risk, protect themselves against high claims, and have… Read More
Continue ReadingWhat is a drug formulary?
The drug formulary is a list of medications that have been selected by an insurance company for their medical effectiveness, positive results, and value. The formulary includes generic medications and a defined list of brand medications. Sometimes it includes specialty mediations. Most formularies will have exclusions, or drugs not covered by your plan. You maximize your benefits when you purchase formulary medications. Your health insurance specialists at Total Benefit Solutions, In. can help you understand your plan’s formulary and how to find or search that list. Contact us today at (215)355-2121 if you have questions about your health insurance plan’s drug coverage.
Continue ReadingHealth Insurance Shopping Is Confusing!
The professionals at Total Benefit Solutions, Inc are here to help you find the right coverage for you or your small business! our health insurance experts Are certified, licensed and experienced to help you deal with ACA plans (Obamacare), Medicare supplements, short term medical and small group health plans too! Call us today at (215)355-2121.
Continue ReadingMedicare Creditable Coverage Part D notification requirements
FROM INDEPENDENCE: Each year, the Centers for Medicare & Medicaid Services (CMS) requires plans that offer prescription drug coverage to their Medicare‑eligible employees, retirees, and dependents to notify them by October 15 as to whether that coverage is “creditable” or “non‑creditable.” What customers must do Customers must take the following steps to comply with this requirement: Review the materials provided to determine whether their prescription drug coverage is creditable or non‑creditable. Disclose to their Medicare‑eligible members (employees and their dependents) whether their prescription drug coverage is creditable or non‑creditable prior to the Medicare Part D Annual Election period, running from October 15 through December 7 of this year and at other times during the future.… Read More
Continue ReadingHow does a Flex Spending Account Work?
A Flexible Spending Account Plan (“FSA”) offers an easy and convenient way for you to save money on taxes and make your benefit dollars go further. If you participate in a Health Care and/or Dependent (Day) Care FSA, your employer puts money aside from your paycheck (before taxes are taken out) and you use that money to pay for eligible health care and/or dependent (day) care expenses. Questions about an F.S.A. account? please contact your Total Benefit Solutions group health insurance specialists at (215)355-2121 www.totalbenefits.net
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