We have received a lot of questions regarding the new level funding health benefit programs so we prepared this video to make it a little easier to understand. Ask us today if Level Funding might be a good for for your health plan!
Continue ReadingWhat is an HRA and How It May See A Major Change Soon..
Before we get into how rules for HRAs may be changing, we should discuss what an HRA is and how it works. A Health Reimbursement Account (sometimes referred to a Health Reimbursement Arrangement) is an employer-funded group health plan that reimburses employees, tax-free, for qualified medical expenses up to a certain amount per year. This type of policy does not replace Medical Insurance and is usually coupled with a High-Deductible policy. Unlike an Health Savings Account (HSA), the Employee can not help to fund the account. Like HSAs though, there are maximum allowed contributions. In 2018, an Employer can fund an HRA up to $5,050 for a Single Employee and $10,250… Read More
Continue ReadingHow do you calculate the number of full time equivalent employees?
How do I calculate the number of full time equivalent (FTE) employees?” Employers ask us all the time how the go about figuring how many FTE’s or Full Time Equivalents they have for ACA compliance purposes. Because the Affordable Care Act’s Employer Mandate (Employer Shared Responsibility Payments or the Play or Pay ) only applies to “applicable large employers,” defined as employing 50+ FTE employees. What if you don’t have 50 employees? So if you do not have 50 employees or anywhere close to it, you can rest assured, you don’t have to calculate. The employers who typically have the biggest challenges are the employers who have a large number of part… Read More
Continue ReadingTotal Benefit Solutions featured in the Southampton Spirit
Total Benefit Solutions: A Committed Team Focused On ‘Clients First’ For Health Insurance by Tianna Grosch Looking for affordable health insurance but not sure where to start? Seeking the correct health insurance with benefits fit to your needs can be a daunting task, one that you should leave in the hands of caring and compassionate professionals. Total Benefit Solutions, Inc. (TBS) is the right place to get the advice and assistance you need in order to make the best enrollment decision whether you’re a family, senior or company. Ed and Kathleen MacConnell began this agency inspired by their own difficulties in receiving insurance coverage for their daughter Katelin, who was… Read More
Continue ReadingIBC 2019 Member Renewal Notices
October 25th: Independence Blue Cross Member Renewal Letter details Due to the subsidy disruption in some counties, Independence will be sending renewal notices in 2 waves. On October 25th 2018: • Members who do not receive a subsidy will receive their renewal notices for 2019. The notice will include benefit and premium updates for 2019 and provide a personalized URL for a website that enables them to renew plans as-is (EZ Button), or make a change to their current plan. • Members who have a subsidy will receive a letter advising that Independence is waiting for more information from the federal government regarding their subsidy dollars. Upon receipt of this information, the renewal notices will be sent.… Read More
Continue ReadingDo You Qualify For A Special Enrollment Period?
Have you lost your health insurance coverage due to a change in employment, a move, or another life event? Since the 2018 Open Enrollment Period is over, you can only enroll in or change a Health Insurance Marketplace plan if you have a life event that qualifies you for a Special Enrollment Period. Below are Life Events that can grant you a Special Enrollment Period. If you have any questions or would like to talk to someone here about a quote, give us a call at 215-355-2121 or click here. Life changes that can qualify you for a Special Enrollment Period -Changes in household- You may qualify for a Special Enrollment… Read More
Continue ReadingTrump 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
Continue ReadingNew 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
Continue ReadingCMS 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
Continue ReadingNew Association Health Plans
This is something that is happening right now, the rebirth of association health plans, but even better than before! I have been asked about being able to do this for years. We are super excited about this and this should be better than what we were able to do before with previous association health plans. Sole proprietors and small businesses will need to join an association in order to get these plans and they are going to be designed to be lower in cost than the current small group plans. Please review the bulletin by downloading below and call us at (215)355-2121 if you have any questions. Click to… Read More
Continue ReadingExtension of Deadline for 2017 Forms 1095-C
On December 22, 2017, the IRS issued Notice 2018-06, which provides a limited extension of time for employers to provide 2017 Forms 1095-C to individuals. It also extends good-faith transition relief from certain penalties for the 2017 reporting year. The deadlines to provide Forms 1094-C and 1095-C to the IRS was not extended. Should you have any questions, please contact your Total Benefit Solutions account manager at (215)355-2121. Click to Download Extension of Deadline for 2017 Forms 1095-C
Continue ReadingSearching for Keystone HMO Proactive Providers by Tier?
Please note you must select the proactive plans from the list. Go to this link: Choose a health plan: From the drop down select, Medical then Keystone Proactive: Now your search will return physicians with Tier listings showing:
Continue Reading2018 Individual Health Insurance Open Enrollment: PA Independence Individual Consumer Plans and Rates
Individual Health Insurance Open Enrollment 2018! Don’t do it yourself! Our dedicated professionals are here to help you take the fits out of the benefit planning process! One mistake and you could be stuck with a bad plan all year! We work with all available plans both on the healthcare.gov marketplace and off! Have your own expert help you! Our experts are trained to help you Choose between on and off exchange options Maximize any subsidy eligibility. Help you understand the cost sharing subsidies Help you choose the plan that is the best fit for you Explain the differences between the plan design and your out of pocket expectations Fill… Read More
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An Update on Short Term Medical Plans
President Trump recently signed an executive order asking the Secretaries of the Treasury, Labor and Health and Human Services to consider the expansion of availability of Short Term plans. These departments have 60 days to propose regulations or revise current guidance. We expect additional details to become available soon and will keep you updated as more information becomes available. While short term plans are not for everyone, they do meet an important need for consumers looking to avoid gaps in coverage. Of the short term plans available in the market, we encourage you to consider United Healthcare’s short term plans as they represent a name you know, and they are… Read More
Continue ReadingVideo: New Premium Saver Gap Coverage
Want more information? Call your Total Benefit Solutions account manager today at (215)355-2121.
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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.
Continue ReadingHSA / FSA / HRA Comparison of Key Features for 2017
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!
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
Continue ReadingTrump Issues Executive Order To Curb Some Parts Of ACA.
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
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
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
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: Cost of Living Adjustments, Individual Penalty, HSA limits & more for 2017
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.
Continue ReadingHealth Reform: IRS Extends Due Date for Furnishing Form 1095-B/C.
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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