Companies with fewer than 20 employees that offer group health coverage that pays secondary to Medicare (those not subject to the MSP rules) may be able to pay for the Medicare Part B, Part D, and Medicare Supplement Insurance premiums for their active employees. This is known as a Medicare Premium Reimbursement Arrangement. However, this is not an option for companies with 20 or more workers that are subject to the Medicare Secondary Payer provisions. All companies, regardless of size, can pay the health insurance or Medicare premiums for their retired employees, but no company can payfor individual health insurance coverage for their active employees . Our best practice: A… Read More
Continue ReadingOn March 28th, 2019, a Federal District Court in the District of Columbia struck down significant portions of the Department of Labor’s (DOL’s) Association Health Plan (AHP) Final Rule. Specifically, the Court found the DOL “failed to reasonably interpret” ERISA when issuing these rules: • expanding the definition of “employers” to include disparate groups of employers with no other commonality of interest other than geographic location; and • bringing working owners without employees within ERISA’s framework. This ruling effectively eliminates the expansion of AHPs to certain employers and working owners who do not meet the original parameters to be a part of an AHP. Click below to download the complete… Read More
Continue ReadingWe are pleased to share that Mercy Health System, St. Mary Medical Center, Saint Francis Healthcare and Independence Blue Cross (Blue Cross) anticipate coming to an agreement on a new, long-term contract this week, meaning there should be no interruption to your care or coverage at the following facilities: Mercy Fitzgerald Hospital Mercy Philadelphia Hospital Nazareth Hospital St. Mary Medical Center Saint Francis Healthcare in Delaware We thank you for your continued support and patience throughout this process, and apologize for any anxiety or inconvenience this negotiation may have caused you or your family – that was never our intention. We look forward to continuing to provide you the care… Read More
Continue ReadingEver wonder exactly which benefit notices your company was required to distribute to employees? Ever notice that some of them are only needed when your business is a specific type of business or organization or size? Wonder no more thanks to our partners at HR360! Download your complimentary copy of the 2-19 employee guide below that includes links and descriptions to all of your required notices for employers between 2-19 employees! Have more specific needs or a cheat sheet for a larger organization? Ask us today how partnering with total benefit solutions and HR360 can deliver this type of powerful information that you need, when you need it. Stay ahead… Read More
Continue ReadingFebruary 11th 2019: For the past several months, we have been negotiating the terms of our agreements with Trinity Health (Trinity), which includes the following entities, as well as their professional providers, subsidiaries, affiliates, and divisions: Mercy Health System of Southeastern Pennsylvania, including Mercy Fitzgerald, Mercy Philadelphia, and Nazareth hospitals St. Mary Medical Center, including St. Mary Rehabilitation Hospital, Saint Francis Healthcare, including Saint Francis Hospital, Wilmington, Delaware. We continue to engage in good‑faith negotiations, but we want to explain how customers and members could be affected if we are unable to reach a new agreement by March 31, 2019. How members would be affected If we are unable to reach a new agreement, Trinity will no longer be… Read More
Continue ReadingWalgreens Boots Alliance agreed to pay $269.2 million to settle U.S. claims that the drugstore chain defrauded a federally funded health care program over insulin drugs and a consumer-discount initiative. The two settlements, announced Tuesday, cover allegations over improper billing. In the first one, the company agreed to pay $209.2 million to resolve claims it billed Medicare, Medicaid and other programs for hundreds of thousands of insulin pens it distributed to people who didn’t need them. In the second, Walgreens said it would pay $60 million for overbilling Medicaid by not disclosing lower prices it offered in a discount program. To read more, click here.
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The Office of Civil Rights (“OCR”) of the Department of Health and Human Services (“HHS”) has posted an alert warning employers, and others, of a fake communication involving the OCR audit program under HIPAA. The email falsifies HHS departmental letterhead and the signature of the OCR Director and directs individuals to a non-governmental website marketing the cybersecurity services of a firm that is not associated with HHS or OCR. This phishing email originates from the email address OSOCRAudit@hhs-gov.us and directs individuals to a URL at http://www.hhs-gov.us. This is a subtle difference from the official email address for the real HIPAA audit program, OSOCRAudit@hhs.gov Phishing is a scam typically carried out… Read More
Continue ReadingCMS Change to LIS/Dual Special Enrollment Period
Continue ReadingIf companies could give employees tax free money to buy health insurance on their own, how many would do so?
We’re about to find out
Continue ReadingOne of the benefits of getting your Health Insurance through the Marketplace is the tax credit applied to your premium, which makes your costs much more affordable. However, when determining how much your tax credit will be, you use an estimate on your income for the following year. Life is always changing, so if your income changes, if your Family size changes or even being offered Healthcare in some other way it is IMPORTANT to alert the Marketplace of these changes or you may end up owing money back to the Government when you file your taxes at the end of the year. Here we will talk about which types… Read More
Continue ReadingHow to Find a Doctor You Trust Get a list of in-network providers: Call your insurance company or look at their plan materials for a list of doctors in their network. You’ll usually pay less to see a doctor in your network than a doctor who’s out-of-network. You can also call your Broker and they can help assist you in getting the names of Doctors near you that accept your plan. Do your research: Ask friends and family if they recommend their doctors. You may even be able to read online reviews for doctors in your area. Online reviews are a great way to gauge things such as bedside manner and wait… Read More
Continue ReadingYou hear it all the time: “I’m paying for Health Insurance I don’t even use!” But, Health insurance isn’t only for when you’re sick! You can use it to maintain your healthy status, you can use it for Preventative Care and you can also use this time to learn how your coverage works before you get sick. Also, many Health Insurance Plans offer things such as discounted gym memberships and rewards for healthy lifestyle choices (such as quitting smoking). Some plans even offer vision or dental benefits, so you can take advantage of an eye screening or 6 month dental check-up. Take advantage of free insurance benefits anytime Get preventive services,… Read More
Continue ReadingThe Departments of Treasury, Labor, and Health and Human Services (collectively, the “Departments”) issued proposed guidance that, if finalized, creates a mechanism for employers to offer Health Reimbursement Arrangements (HRAs) in connection with individual health insurance coverage. The proposed regulations add two new HRA options for employers to consider: • HRA integrated with individual health insurance coverage. Beginning with the first plan year on or after January 1, 2020, permit integration of an HRA with individual health insurance coverage provided certain conditions are met. • Excepted Benefit HRA. Beginning with the first plan year on or after January 1, 2020, employers that offer traditional group health plan coverage may consider offering… Read More
Continue ReadingPrescriptions costs are skyrocketing. We all know that. But did you know that there are several ways for people to save money on their monthly medications? As health insurance plans are becoming more catastrophic in nature, that means that people will need to become better health care consumers. Sometimes that means using the tools that the insurance company offers at no charge. Sometimes it means using discounts and other resources that are available outside the health plan. Here are a few ways, some already widely known and others not so much, to help drop down your costs at the Pharmacy. While this is not a comprehensive list of money-saving ideas, it is… Read More
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