Breaking News: CMS Announces Open Enrollment Dates and More

Ed MacConnell

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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Video: New Premium Saver Gap Coverage

Ed MacConnell

  Want more information? Call your Total Benefit Solutions account manager today at (215)355-2121.

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GOP Pulls AHCA Before Vote

Ed MacConnell

On Friday, March 24, 2017, the U.S. House of Representatives pulled the American Health Care Act (“AHCA”) from consideration after not receiving enough Republican support to pass the bill. The AHCA was President Trump’s first attempt to repeal and replace the Affordable Care Act (the “ACA”). The AHCA, among other things, would have eradicated the penalties associated with the individual and employer mandates, and replaced the ACA subsidies with refundable tax credits. Download GOP Pulls AHCA Before Vote

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Small Businesses May Be Able to Keep Existing Health Coverage Through Calendar Year 2018

Ed MacConnell

Small Businesses May Be Able to Keep Existing Health Coverage Through Calendar Year 2018   A previously extended transitional policy which allows health insurance issuers, at their option, to continue group coverage that would otherwise be terminated or cancelled has been extended further—to policy years beginning on or before October 1, 2018, provided that all policies end by December 31, 2018. Health insurance issuers that renew coverage under the extended policy are required to provide standard notices to affected small businesses for each policy year. Extended Transitional Policy At the option of the states, issuers that have renewed policies under the transitional policy continually since 2014 may be permitted to… Read More

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Compliance Bulletin & Reform Center

Ed MacConnell

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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HSA / FSA / HRA Comparison of Key Features for 2017

Ed MacConnell

HR360: HSA / FSA / HRA  Comparison of Key Features for 2017 This guide brought to you by our partners at HR360. As us today how your organization can benefit from personalized HR services designed to fit your company’s legal compliance needs! Your Total Benefit Solutions Inc Account Manager is available at (215)355-2121. Click here to download the complimentary guide  

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Stand-Alone HRAs for Small Employers are Back!

Ed MacConnell

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

Ed MacConnell

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?

Ed MacConnell

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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Trump Issues Executive Order To Curb Some Parts Of ACA.

Ed MacConnell

Trump Issues Executive Order To Curb Some Parts Of ACA. The New York Times  (1/20, Davis, Pear, Subscription Publication) reported that on Friday, President Donald Trump issued an executive order  to government agencies directing them “to scale back as many aspects of the Affordable Care Act as possible, moving within hours of being sworn in to fulfill his pledge to eviscerate Barack Obama’s signature health care law.” According to the Times, the one-page order “has symbolic as well as substantive significance, allowing Mr. Trump to claim he acted immediately to do away with a health care law he has repeatedly called disastrous, even while it remains in place and he… Read More

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Update on the Status of the ACA

Ed MacConnell

Update on the Status of the ACA With the impending inauguration, recent actions by the Senate and some confusing media reports, we wanted to provide a short Q&A to help you understand current events and what to expect as we head down the health care reform road in 2017… What’s the latest news? Download the bulletin for an update: Download Update on the Status of the ACA   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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2016 Compliance Year In Review Digest

Ed MacConnell

2016 Compliance Year In Review Digest A complete digest of all our compliance bulletins for the entire year of 2016 from our business partners at Emerson Reid. A handy guide to all of the year’s updates and changes all in one place. Download your copy now and keep it for future reference.   Click to Download Compliance Digest 2016 Year in Review     As always please contact your Total Benefit Solutions Account Manager at (215)355-2121 if you have any questions or concerns.

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Relief for Small Employers with HRAs

Ed MacConnell

On December 13, 2016, President Obama signed into law the “21st Century Cures Act” which allows small employers without group medical plans to reimburse individual premiums and other medical expenses of employees under health reimbursement arrangements (“HRAs”), effective with the 2017 plan year, and provides relief from penalties to all small employers reimbursing individual premiums of employees for earlier plan years. In addition, the Cures Act provides a medical innovation package that funds medical research, accelerates cutting-edge treatments for rare diseases, and makes significant reforms to the mental health system. The Issue An employer cannot offer employees cash to reimburse the purchase of an individual policy, without regard to whether… Read More

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Health Reform: 4th Quarter 2016 Compliance Compilation

Ed MacConnell

Download a digest of our fourth quarter compliance bulletins. This digest includes the following bulletins:  Transitional Reinsurance Fee Form Now Available 10/14/2016 Final 2016 Forms 1094-C and 1095-C Available 10/25/2016 November 2017 Cost of Living Adjustments 11/01/2016 Relief Extended for Premium Reimbursement Programs for Student Employees 11/02/2016 Updates Regarding the NJ Small Employer Health Benefits Program 11/07/2016 Election Results and the ACA: Preliminary Thoughts 11/10/2016 16 Extension of Deadline for 2016 Forms 1095-C 11/21/2016 Adjusted PCOR Fee for Fifth Filing Year Released 11/22/2016 December Beware of Phishing Email Disguised as HIPAA Privacy Audit Letter 12/13/2016   Click here to download the 4th quarter compliance compilation

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New Law Exempts Certain Small Employer HRAs From ACA Market Reforms

Ed MacConnell

New Law Exempts Certain Small Employer HRAs From ACA Market Reforms Gaddiel Gonzalez-Brown & Brown Consulting President Obama has signed into law the 21st Century Cures Act, which, among other things, allows small employers to offer new “qualified small employer health reimbursement arrangements” to reimburse employees for qualified medical expenses, including individual health insurance premiums, for years after December 31, 2016. Small employers are defined as those with fewer than 50 full-time equivalent employees who do not offer a group health plan.   Background Under prior agency guidance, stand-alone HRAs (except for retiree-only HRAs and HRAs consisting solely of excepted benefits) and HRAs used to purchase coverage on the individual… Read More

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Health Reform: Cost of Living Adjustments, Individual Penalty, HSA limits & more for 2017

Ed MacConnell

    On October 25 and 27, 2016, the IRS released cost of living adjustments for 2017 under various provisions of the Internal Revenue Code (the Code). Some of these adjustments may affect your employee benefit plans. These adjustments include but are not limited to the following: Cafeteria Plans Qualified Transportation Fringe Benefits Requirement To Maintain Minimum Essential Coverage (Individual Penalty) Highly Compensated Non-Grandfathered Plan Cost-Sharing Limits H.S.A. Annual contribution limitation, catch up contribution and minimum deductibles Key Employee   Click here to download the bulletin   As always if you have any additional questions or concerns, please contact your dedicated Total Benefit Solutions, Inc. account manager at (215)355-2121.

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Health Reform: IRS Extends Due Date for Furnishing Form 1095-B/C.

Ed MacConnell

IRS Extends Due Date for Furnishing Form 1095-B/C. As applicable large employers and employers with self-funded health plans are working on their Affordable Care Act compliance preparations, the IRS announced an extension of a key ACA deadline. Notice 2016-70 extends the due date for furnishing Form 1095-B and Form 1095-C from January 31, 2017 to March 2, 2017.  The Notice also extends transition relief from penalties if an employer makes a “good faith effort” to comply with reporting requirements. This relief is welcome news for employers who are still working on their compliance approach. A copy of the notice can be downloaded here.

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Election Results and the ACA

Ed MacConnell

With the outcome of the 2016 elections now official, the Republicans will hold the majority in both chambers of Congress and control of the White House beginning in 2017. Since President-elect Trump ran on a platform of “Replace and Repeal” of the Affordable Care Act (ACA), we anticipate that acting on this campaign promise will be one of the top priorities of the new Trump administration. We anticipate there will be significant disruption for individuals, employers, brokers and carriers across the country. Click here to read the latest bulletin

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HHS Penalties Increase

Ed MacConnell

  On September 6, 2016, the Department of Health and Human Services (“HHS”) issued an interim final regulation that adjusts civil penalties for inflation. The interim final regulation does not follow the usual procedures that offer a notice and comment period. As such, a Notice of Proposed Rulemaking has not been issued and a comment period is not provided due to potential delay in the applicability of the regulation. Click to download this bulletin For more information please contact your Total Benefit Solutions account manager at (215)355-2121

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Large Employer Mandate – Measurement Periods Defined

Ed MacConnell

In order to determine “full-time” status for ongoing employees – those who have been employed by their employer for at least one complete Standard Measurement Period (SMP) – employers must establish and identify the measurement and stability period they will use to determine their employees’ “full-time” status. This is a critical component of determining the impact of Variable Hour Employees on a group’s Large Employer status under PPACA’s Pay or Play mandate. Download the bulletin below from our partners at PrimePay. Click to download measurement periods defined

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HR 360:Most Common Summary Plan Description (SPD) Mistakes

Ed MacConnell

One of the most important documents participants must receive automatically when becoming covered under a health benefit plan that is subject to ERISA (the federal Employee Retirement Income Security Act) is a summary of the plan, called the Summary Plan Description or SPD. The fact is, many employers are confused about this very important ERISA-required disclosure, which can put them at risk. Click this link to download the publication

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Notice of Subsidies in the Federal Marketplace

Ed MacConnell

The Affordable Care Act (“ACA”) requires each Health Insurance Marketplace (“Marketplace”) to notify any employer whose employee was determined to be eligible for Advance Premium Tax Credits (“APTC”) and Cost Sharing Reductions (“CSR”) because the employee attested that he or she was not: • enrolled in employer sponsored coverage, or • eligible for employer coverage that is affordable and meets minimum value requirements. In 2016, the Federally-Facilitated Marketplace (“FFM”) will begin issuing these notices to employers. State-based Marketplaces began this notification process in 2015. Click here to download the bulletin

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Healtcare Reform Law

ACA: Important Implementations & Delays in 2016

Ed MacConnell

As our third year of the ACA Open Enrollment Period arrived, it’s time to examine some of the new implementations in 2016. Some of the major components, especially those affecting businesses were delayed or deferred since the passage of the Affordable Care Act in 2010. This year is considered to be a big year due to the “full implementation” of the employer mandate as well as a number of changes, repeals, and moratoriums on other sections of ACA. Some of the key changes are listed below: CHANGES AND IMPLEMENTATIONS Full implementation of the Employer Mandate Currently it is not mandated that employers provide health care to their employees. Moving forward, however, if… Read More

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FAQ Suggests Employers Include Marketplace Options with COBRA Notices

Ed MacConnell

On June 21, 2016, the Departments of Labor, Health and Human Services, and the Treasury (collectively, the “Departments”) issued the 32nd Affordable Care Act (“ACA”) FAQ describing information that may be appropriate to include with COBRA notices. Many wondered if it were appropriate to provide information and if so, what kind of information could be provided about the Health Insurance Marketplaces/Exchanges (“Marketplaces”) so that COBRA-eligible individuals could consider health coverage alternatives available through the Marketplaces and possibly investigate whether they may be eligible for premium tax credits and cost-sharing reductions. Click the link to download the entire bulletin

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Total Benefits & Healthiest You

Ed MacConnell

Healthiest You is more than a typical Teledoc benefit. Whenever members have questions or they are simply not feeling well, they can effortlessly connect to a 24×7 telehealth hotline for the diagnosis and treatment of illness, second opinions and consultations. They have board-certified, licensed physicians in every state waiting to provide exceptional care. They can even prescribe medication and save a trip to the doctor’s office, whether members are at home or on the road. Want more information? Click here to see the site.  

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