With fully insured plans, premiums are paid directly to the insurer. Claims accountA claims account is exactly what it sounds like. A portion of the monthly payment is used to pay for claims submitted by plan members. Stop-loss InsuranceStop-loss is an employer’s safety net. This protects the employer against higher-than-expected claims. With level-funding, employers will never have to pay more than the amount they are responsible for funding the claims account each year. After that, stop-loss insurance kicks in. Administrative costsAdministrative services are provided to the employer so they can spend their time focusing on their business while a third-party administrator handles plan management such as paying claims, customer service,… Read More
Continue ReadingSupport for your emotional health
Virtual care visits from MDLIVE® IBC members pay $0 cost-share* You have access to care from therapists, psychologists, and psychiatrists who can help with concerns likeanxiety, depression, and panic disorders. With telebehavioral health from MDLIVE, you pay $0 costshare* for a confidential visit in the comfort of yourhome, or wherever you are. Choose to have your virtual care visit by video chat, using the MDLIVE website or mobile app, or by phone.
Continue ReadingProposed Regulations to Fix ACA’s Affordability “Family Glitch”
individuals are not eligible for premium tax credits in the Marketplace
Continue ReadingHealthCare.gov Notices New Class of Individual Employer Policies
hCare.gov managers are signaling that they think individual coverage health reimbursement arrangements matter. The regulators in charge of the federal Affordable Care Act public exchange system today gave ICHRAs official attention, by adding an ICHRA use reporting requirements for the insurers that sell coverage through HealthCare.gov. Click here for the full story on Think Advisor.com
Continue ReadingMedicare Supplement Plan F or G?
Many of our clients ask what is the “best” Medicare supplement that they can buy. While there is no overall “best”, the Medicare Supplement Plan F is generally considered the most comprehensive coverage among Medicare supplements due to the fact that most services are covered without any member co-pay or cost sharing at all. Keep in mind that Medicare supplements, like Plan F do not cover prescriptions and that a beneficiary with Medicare supplement will need to have other coverage for prescription drug coverage. A little known fact about Medicare supplements is that they do not have an annual “open enrollment” period so a beneficiary with a supplement can… Read More
Continue Reading2021 Second Quarter Compliance Bulletins Compilation
This document is a valuable resource, putting all of the latest health care reform news and updates in one location!
Continue ReadingTax Advantaged Benefit Documents
This site is dedicated to providing employers with the tools they need to successfully establish these written plans with SPDs at the lowest cost possible.
Continue ReadingTop 10 Questions to Ask Your Benefits Broker
Analyzing these ten critical questions in relation to your organization’s needs will help you make a more informed decision about your benefits broker
Continue ReadingWhat is Balance Billing?
When a provider bills you for the difference between the provider’s charge and the allowed amount. For example, if the provider’s charge is $100 and the allowed amount is $70, the provider may bill you for the remaining $30. A preferred provider may not balance bill you for covered services. Ask your health insurance experts at Total Benefit Solutions today how to avoid balance billing charges!
Continue ReadingIRS Announces New Inflation Adjusted HSA and HRA numbers for 2022
These new rates will take effect for the calendar year 2022. Please reach out to your Total Benefit Solutions, Inc health insurance specialists at (215)355-2121 if you have any questions or concerns about this notice.
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