House Passes Legislation to Change HSAs

The House of Representatives passed two pieces of legislation that, among other things, purport to improve and “modernize” health savings accounts (“HSAs”). While the bills call for significant changes to the current rules affecting HSAs, the specific details are very different. Both pieces of legislation have been sent to the Senate for consideration. Whether the Senate will take up these bills, let alone approve them “as is,” remains uncertain. There appears to be some bi-partisan agreement to loosen the current HSA rules, which means it is possible that we may see changes to these arrangements, which could be effective as early as January 1, 2019. When more information is available, we will… Read More

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Introducing Xpress Healthcare with Aetna Dental Access!

Total Benefit Solutions offers Xpress Healthcare with a great dental discount & more for Individuals, Families and Seniors! Click Here to shop, compare & enroll!

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The Four Stages of Medicare Part D (2018)

The Four Stages of Medicare Part D Coverage                          

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Trump Administration Expands Access To Short-Term Plans That Do Not Meet ACA Requirements

The New York Times  (8/4 Pear) reports that on Wednesday, the Trump Administration unveiled “a final rule…that clears the way for the sale of many more health insurance policies that do not comply with the Affordable Care Act and do not have to cover prescription drugs, maternity care or people with pre-existing conditions.” These new options “will help people struggling to afford coverage under the 2010 law, said James Parker, a senior adviser to” HHS Secretary Alex M. Azar II.         On its front page, the Washington Post  (7/31, A1, Goldstein) reports that these policies, which are intended “to fill brief gaps in coverage, will be available for 12 months at… Read More

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New Jersey Out-of-Network Bill

On June 1, 2018, New Jersey Gov. Murphy passed the Out-of-Network Consumer Protection, Transparency, Cost Containment and Accountability Act (the “OON Act”). In general, the OON Act applies to emergency services and other care provided by out-of-network physicians in in-network settings (i.e. hospital-based physicians). It  takes effect on September 1, 2018. Click the link below to download the full story: Click to Download For more information or if you have any questions, please feel free to contact your Total Benefit Solutions Account Manager at 215-355-2121    

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Medicare Part D Donut Hole Closing Sooner!

Did you know? The Bipartisan Budget Act of 2018 moved up the date for closing the so-called donut hole for brand name drugs to 2019. It was previously 2020. For 2019 and every year after, the beneficiary cost sharing for brand name drugs after the initial coverage limit is 25% — the same as after the deductible and before the initial coverage limit. In 2020, the beneficiary cost sharing for generic drugs will also be 25%. Ask your Total Benefit Solutions Account Manager for more information at (215)355-2121. Total Benefit Solutions Inc. is your Medicare health insurance specialist! We work for your benefit!

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CMS Expands the Extension of Needed Relief for Marketplace Enrollees Who Missed Medicare Enrollment

CMS is offering assistance to certain individuals enrolled in both Medicare Part A (and/or Part C) and the Exchange for individuals and families to drop their Exchange coverage and enroll in Part B without penalty. Further, CMS is offering assistance to certain individuals who dropped or lost their coverage from the Exchange and are paying a Part B late enrollment penalty from their subsequent enrollment into Part B. These eligible individuals can have their penalty reduced. Individuals can apply for the special enrollment and reduction in late enrollment penalties during a limited time – it is available now and ends September 30, 2018 Read Blog Post from MedicareRights.org CMS SHIP… Read More

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Total Benefit Solutions-now offering travel health insurance

Introducing GeoBlue Travel Health Insurance We are delighted to now  be able to offer our clients a unique set of international health insurance and trip protection plans through GeoBlue International Blue Cross . GeoBlue advantages include: Richer Benefits – rich coverage without the hidden surprises Better Service and Care – concierge-level access to an elite network of the most internationally-friendly medical providers around the world More Peace of Mind – you have the confidence associated with the most recognized health insurance brand in the U.S. GeoBlue plans offer unique benefits and services not available elsewhere. Each GeoBlue policy includes access to best-in-class doctors and hospitals in 190 countries. Members have the ability… Read More

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Aetna Funding Advantage (AFA) is a new self-funded option for small groups

Aetna Funding Advantage (AFA) is a self-funded option that provides all of the financial and plan design flexibility of a traditional arrangement with special features designed to help companies with as few as 2 employees achieve even greater savings on their health insurance. Ask us today if self funding could be a good fit for your organization! Call your Total Benefit Solutions Inc. account manager at (215)355-2121 for more information! Learn more here: AFA-Customer-Flyer New! Minute Clinic Benefit! $0 Copay Minute Clinic Visits Flyer More Documents for downloading: Springboard Marketplace Your Online Administration and Enrollment Portal AFA AppleWatch Wellness Flyer AFA Sample Usage Reports Aetna & Teledoc for AFA AETNA… Read More

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IRS Releases 2018 Inflation Adjustments to Tax Provisions

The Internal Revenue Service released the annual inflation adjustments that will apply to certain benefit plan tax provisions in 2018. Revenue Procedure 2017-58, which can be accessed by clicking here, identifies inflation-adjusted items for different provisions of the tax code. From an employee benefits standpoint, the following limits may be of interest to employers: The dollar limit on voluntary employee salary reduction contributions to health flexible spending accounts is increased to $2,650 for plan years beginning in 2018. The monthly exclusion amount for transportation and transit passes is increased to $260. The monthly limit for the qualified parking exclusion is increased to $260. The dollar amount used to determine the penalty… Read More

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Congress Passes Tax Reform Bill

    On December 20, 2017, the House and Senate sent President Trump the Tax Cuts and Jobs Act for signature. The House of Representatives passed their version of the bill on November 16, 2017 while the Senate passed their version on December 2, 2017. Because the versions were not identical, a Tax-Bill Conference Committee was formed from members of the Senate and the House of Representatives to negotiate the text of the combined bill. After the finalized text was approved and released by the committee, the House and Senate each passed the combined bill (which happened on December 20th in the House and December 19th in the Senate) before… Read More

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CMS publishes updated 2018 Medicare cost-sharing amounts

The Centers for Medicare & Medicaid Services (CMS) recently published updated cost-sharing amounts for 2018 which are outlined below. 2018 Medicare Costs at a Glance Standard Part B Premium Most people pay $134 each month Medicare Part B deductible (Medical deductible) $183 per year Medicare Part A deductible (Hospital deductible) $1,340 for each benefit period Beneficiaries will pay $134 (or higher depending on income) if they: • Enroll in Part B for the first time in 2018, or • Are directly billed for their Part B premium, or • Are dually eligible for Medicaid and have their premium paid by state Medicaid agencies pay an income-related premium Some beneficiaries who were held… Read More

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Guidance Issued on QSEHRAs

  Under the Affordable Care Act, a health reimbursement arrangement (HRA) must be integrated with a group health plan (as it could not meet the market reform provisions on its own) and was not able to reimburse employees for individual premiums. However, on December 13, 2016, President Obama signed into law the “21st Century Cures Act” which established QSEHRAs (a special standalone HRA). Click to Download Guidance Issued on QSEHRAs This guidance is big news for small groups who would prefer to provide a reimbursement as opposed to a group health plan. Please contact your Total Benefit Solutions account manager at (215)355-2121 if you have any questions or concerns.  

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The IRS Code has numerous provisions designed to help employers

Employer Strategies and Solutions to Substantially Reduce:   the high cost of Health Insurance; the cost for Out-of-Pocket Medical Expenses; the cost for Dependent Day Care Expenses; the cost for Parking and Transit Expenses; cost of Self-Employed Healthcare Expenses; Employer Matching Payroll Taxes by 8%; Employee Income Taxes by 30%. The IRS Code has numerous provisions designed to help employers provide essential benefits to their employees tax-free. This saves the employee approximately 30% in income taxes on expenses they’re already paying for, and because the employees have reduced their taxable income, the employer realizes a reduced matching payroll tax liability of approximately 8%. Everybody saves money. To take advantage of… Read More

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Compare Medicare Plans in Your Area in real time!

  With Medicareful you can search and compare Medicare health plans at your own convenience, but with an expert nearby at Total Benefit Solutions Inc to help guide you along the way. Log in today and see for yourself! http://www.medicareful.com/totalbenefitsolutions

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Humana and Tenet have reached a new network agreement

Humana and Tenet have reached a new network agreement Humana is pleased to announce we have signed a new agreement, effective June 1, 2017, that allows Humana commercial, Medicare Advantage, Medicaid, and individual exchange health plan members to receive in-network care at Tenet hospitals, hospital-affiliated outpatient centers, and with Tenet physicians. We are currently in the process of loading Tenet providers to all applicable systems. There may be a delay in providers appearing in Physician Finder even though they are participating. For the best possible member experience, as always, we advise the member to check Physician Finder before seeking non-emergent care from a provider in order to help avoid any… Read More

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Breaking News: CMS Announces Open Enrollment Dates and More

CMS issued final rule to increase choices and encourage stability in health insurance markets for 2018 The Centers for Medicare & Medicaid Services (CMS) issued the final Market Stabilization rule to help lower premiums and stabilize individual and small group markets, and to increase choices for Americans. Individuals obtaining coverage in the Marketplace created by the Affordable Care Act have faced double-digit premium increases, fewer plans to choose from, and a market that continues to be threatened by insurance issuer exits.*  The CMS rule is designed to provide some relief for patients and issuers now. “CMS is committed to ensuring access to high quality affordable healthcare for all Americans and… Read More

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Compliance Bulletin & Reform Center

Health Care Compliance and Reform Education Center A fundamental change in the way the United States handles health care has arrived. Benefit rules and coverage change faster today than they used to in ten years! Our Compliance and Health Reform Education Center is where we will keep a copy of our health care reform bulletins throughout the year, in an easy  to view format where you can download a brief summary or watch a short informative video. Click here to visit totalbenefitscomply.com Please contact your Total Benefit Solutions account manager at (215)355-2121 if you have any further questions.  

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MEDICARE PART D: CMS NOTIFICATION REMINDER

Employers sponsoring a group health plan need to report information on the creditable status of the plan’s prescription drug coverage to the Centers for Medicare and Medicaid Services (CMS). Watch a video overview   Download a bulletin

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Stand-Alone HRAs for Small Employers are Back!

Stand-Alone HRAs for Small Employers are Back! The 21st Century Cures Act, signed by President Obama on December 13, 2016, gave small employers a means of providing employees help with their individual insurance premiums and other out-of-pocket qualified medical expenses without violating the provisions of the Affordable Care Act (ACA). Small employers can now provide a specific kind of Health Reimbursement Arrangement (HRA) to help employees with the costs of individual health coverage. According to the statutory language under “Title XVIII – Other Provisions” of the Act, qualified small employer health reimbursement arrangements (QSEHRAs) are not considered “group health plans” and do not have to adhere to ACA market reforms,… Read More

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Think HR’s Employee Handbook Builder

Employee Handbooks. Each employer group should have one. The question is, if so, how current is it? With ThinkHR’s 50-State Handbook Builder, building handbooks and keeping them updated becomes a simple process. Use the Handbook Builder to: Minimize your clients’ risk of employment liability with clear, regulatory-compliant policies. Help clients ease the burden of compliance with pre-developed content, step-by-step instructions, expert commentary and online support. Reinforce your value as a partner and provider of essential HR resources. Differentiate your agency and deliver cost savings to your clients with a robust handbook builder at no additional cost. Employee Handbook Builder Features: Compiled in collaboration with one of the country’s leading employment… Read More

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What is Healthcare Blue Book?

Starmark plans adding HealthcareBlueBook! Healthcare Bluebook* is an online tool that lets members: Shop for care by seeing price ranges in the area Compare facilities based on quality data Access on any device (mobile, desktop, tablet) Click here to learn more   *Healthcare Bluebook is included with Starmark major medical plan designs with an effective date of 12/1/2016, or later. Healthcare Bluebook is not an affiliate of Starmark® or Trustmark® Life Insurance Company. Before receiving treatment, call the provider network at the toll-free number on your medical ID card to verify that the hospital and/or healthcare provider participates in the network.   For more information about StarMark health plans with Healthcare Blue… Read More

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Talking with your doctor about Keystone HMO Proactive

  A Keystone HMO Proactive plan with a tiered network gives you the opportunity to look for the best value when you receive care. Tell your primary care physician (PCP) you have a tiered network plan so you can discuss your health care decisions and work together to make the best choices for you. Download this document for more information. As always please contact your Total Benefit Solutions, Inc, account manager at (215)355-2121 if you have any questions or concerns.

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Health4Me Mobile Application

UnitedHealthcare’s Health4Me provides instant access to you and your family’s critical health information — anytime/anywhere. Whether you want to find physicians near you, check the status of a claim or speak directly with a nurse, Health4Me is your go-to resource for everything related to your health. Learn more by watching the video below. As always if you have any questions please contact your Total Benefit Solutions Inc account manager at (215)355-2121.

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