Feds: Navigators don’t need E&O coverage

Enclosed in the 279 pages of proposed rules released Friday by the Department of Health and Human Services for the public health insurance exchanges is an answer, sort of, to a question brokers have raised for more than a year — who will be liable for navigators’ mistakes? n the section of the rules discussing navigators, the Obama administration’s document says “a state or an exchange must not require that all navigators be agents or brokers or carry errors and omissions coverage.” Further, the rule says that if navigators were to be required to carry E&O insurance, this would disqualify them from being considered a “community and consumer-focused nonprofit group.” Federal law… Read More

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IBC: Important Changes Regarding Medicare Part B Exclusion

From IBC November 2013: We are writing to let you know that we will be contacting your group customers to communicate the Medicare Exclusion and application of this exclusion to their benefit plan. What is the Medicare Exclusion? The Medicare Exclusion applies to members for whom Medicare would be the primary payer but they have not elected to enroll. These members will be responsible for paying their doctor, hospital, or other medical professional the amount Medicare would have paid and any applicable copayments, coinsurance, and deductibles. In turn, their group health benefit plan will only pay the remaining balance on claims submitted as if the member had enrolled in Medicare… Read More

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IBC: Small Group Metallic Plans Mapping

Upon renewal in 2014 small groups will be automatically “mapped” to a new ACA compliant metallic plan. Find your new recommended 2014 Blue Solutions plan using the chart below. To make your renewal even easier we’ve identified the plan that most closely matches your current plan. Or you can choose from among 36 other options to suit your needs. More comprehensive coverage Blue Solutions health plans now cover Essential Health Benefits like pediatric dental and vision. Your health plan also continues to cover doctor visits, hospital admissions, emergency room treatments, maternity care, lab tests, X-rays, prescriptions, and vision benefits for both children and adults. Click the link below to download the… Read More

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How Does a Group HRA Work?

A GroupHRA allows you to use your payroll to bring your employees better, more affordable employer health benefits. Your employees have a high deductible group health insurance policy and receive tax-free reimbursements through their payroll for medical expenses. In addition to payroll reimbursement, you can also make same-day reimbursements to employees by cash, check or direct deposit. Total Benefit Solutions Inc has partnered with Zane Benefit services to provide our clients an affordable, easy, electronic administration solution. What makes an HRA an attractive solution for your organization? The fact that you are in control! Download the report :How A Group HRA Works  Click here for more HRA information

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Health Reform: Regulations Issued on Waiting Periods

For plan years beginning on or after January 1, 2014, a group health plan and an insurance carrier offering group health insurance coverage may not apply any waiting period that exceeds 90 days. This rule applies to both grandfathered and non-grandfathered plans. It should be noted that nothing in the Affordable Care Act requires a group health plan or carrier to have a waiting period  Click here to download the bulletin

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IBC: July 1 rate increase for individual medically underwritten plans

IBC: We want to let you know that the monthly rates for our individual medically underwritten plans will increase in July 2014. We are notifying members muchearlier than is required to give them the opportunity to enroll in a plan that is compliant with the Affordable Care Act (ACA). The reason for the rate increase. We understand that it can be difficult to afford quality health insurance coverage. While we continue to work hard to keep costs down, the cost of health care continues to rise along with our member utilization. This is why it’s necessary for Independence Blue Cross (IBC) to implement an 11.5 percent rate increase. Click the link below to read… Read More

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Total Benefit Solutions Makes Enrolling Easier

In an effort to meet the enrollment challenges that many are facing under healthcare reform,  Total Benefit Solutions Inc has designed a custom form for our clients to use. Using this form and submitting it to Total Benefit Solutions Inc  will enable our Marketplace trained and certified licensed independent brokers to assist you in the enrollment process from the registration right through the enrollment! Remember as your independent broker we always work in your best interests,  not an insurance company. We represent you, our client and not an insurer or government agency. Click the link below to open the form and get started!  When completed, just click the link to… Read More

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Humana-When to Enroll: Important Deadlines under the Affordable Care Act

Have you enrolled? Open enrollment is ending soon! Do you know when? Watch this video from Humana and learn more, then call your Total Benefit Solutions Advisor at (215)355-2121 and get enrolled without any further delay!  

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Affordable Care Act Video: IBX Answers Five Common Questions

  Not Sure if you qualify? Ask your Total Benefit Solutions Advisor at  (215)355-2121

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Affordable Care Act Video: Subsidies and Tax Credits

Under the Affordable Care Act, individuals and families may qualify for financial assistants to help pay for health care coverage. Age, family size and total household income are the factors that will determine your eligibility for subsidies and tax credits. Answer a few simple questions to learn if you might qualify for financial support: click here or ask your Total Benefit Solutions Adviser to help you by calling us today at (215)355-2121. This short video from Independence Blue Cross makes it easy to understand how they work.

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Total Benefit Solutions Now Offering Online Enrollment with Consult-A-Doctor PLUS

Healthcare… the way it should be! Are you tired of waiting multiple weeks to go see your doctor, only to find yourself taking time off work so you can drive through traffic and sit in the waiting room for what seems like forever? Have you ever felt overwhelmed by the stress and anxiety of a difficult life situation and wished you had someone you could trust to hold your hand and walk you through to the other side?  Then welcome to CADRPlus, an innovative new health care program that gives you unlimited, 24/7 access to doctors and other industry professionals from the comfort and convenience of your phone or computer,… Read More

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Total Benefit Solutions Now Offering Online Enrollment with Consult-A-Doctor PLUS

Healthcare… the way it should be! Are you tired of waiting multiple weeks to go see your doctor, only to find yourself taking time off work so you can drive through traffic and sit in the waiting room for what seems like forever? Have you ever felt overwhelmed by the stress and anxiety of a difficult life situation and wished you had someone you could trust to hold your hand and walk you through to the other side?  Then welcome to CADRPlus, an innovative new health care program that gives you unlimited, 24/7 access to doctors and other industry professionals from the comfort and convenience of your phone or computer,… Read More

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Health Reform: Final Rule Issued Regarding Health Insurance Provider Fee

Beginning in 2014, a health insurance provider fee applies to covered entities engaged in the business of providing health insurance for United States health risks. United States health risks include the health risk of a U.S. citizen or a resident alien including those living abroad. Thus, insurers issuing expatriate policies covering a U.S. citizen or resident alien living abroad are subject to the fee. Medical, dental and vision carriers in the insured marketplace are subject to this fee. This fee does not apply to self-insured employer-sponsored plans. Click the link below to download the bulletin. Final Rule Issued Regarding Health Insurance Provider Fee  

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Healtcare Reform Law

Health Reform: Final Regulations Issued on Employer Penalty

On February 10, 2014, the IRS released final regulations implementing the Employer Shared Responsibility provision under the Affordable Care Act (ACA) for 2015 (the “employer penalty”). This guidance is lengthy and provides helpful clarification in many areas. We are in the process of reviewing the guidance, but you will find some key aspects of this rule below: The employer penalty will apply to employers with 100 or more full-time equivalent employees starting in 2015. For employers with 50-99 full-time equivalent employees, there is a one-year delay and the employer penalty provision will start in 2016. Click the link below to download the bulletin. Final Regulations Issued on Employer Penalty – 021114R

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AmeriHealth New Jersey discontinues “Bill me Later” feature

AmeriHealth New Jersey has recently decided to remove the “Bill me Later” feature from AHNJ4U.com for Individual Coverage. “Bill me Later” gave members who enrolled 15 days prior to their desired effective date the option to be billed at a later time. This feature caused a delay in member billing and ID card production, leading to an exponential increase in call volumes. “Bill me Later” has been removed permanently from AHNJ4U.com, but members still have the option to pay by credit card for first time payments. Another alternative is to utilize an ACH payment option for reoccurring payments. If a member chooses to apply with paper checks, they must include… Read More

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Healthcare Reform Update: ‘Pay or Play’ Delayed Until 2016 for Large Employers With Fewer Than 100 Full-Time Employees

‘Pay or Play’ Delayed Until 2016 for Large Employers With Fewer Than 100 Full-Time Employees Brought to you via HR360.com Newly issued final rules provide guidance for large employers who are subject to the shared responsibility (“pay or play”) requirements under Health Care Reform. These employers may be liable for a penalty if they do not offer affordable health insurance that provides a minimum level of coverage to full-time employees (and their dependents), and any full-time employee receives a premium tax credit for purchasing individual coverage on the Health Insurance Marketplace (Exchange). Click the link below to download the bulletin: Pay or Play Delayed to 2016

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Video: Who can help me enroll?

Who can help you enroll on a new affordable care act plan? Remember an independent broker like Total Benefit Solutions Inc can still help you enroll on a plan on the Federal Healtcare Exchange or off at no additional cost to you. Your independent broker is still truly your healthcare advocate! Another simple yet educational video from Humana:  

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Affordable Care Act: Coming Guidance Changes

The Department of Health and Human Services (“HHS”) recently issued proposed regulations addressing a number of provisions under the Affordable Care Act (“ACA”). Some of this guidance will impact employer-sponsored group health plans. Click the link below to download the entire bulletin.   Guidance Changes for 2015 ERC

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Video: How to Buy Health Insurance Under the Affordable Care Act

Another great an helpful video from Humana regarding enrolling on the new health insurance plans. Keep in mind an independent broker like Total Benefit Solutions Inc.  can still help you enroll at no additional cost.  

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Healtcare Reform Law

2014 Federal Poverty Levels Released

The Department of Health and Human Services has announced the Federal Poverty Line (“FPL”) amounts, as indexed for 2014. Why is this Important?  Beginning in 2015, large employers may be subject to the employer penalty under the Affordable Care Act if they do not offer affordable, minimum value coverage to all full-time employees and at least one full-time employee receives a subsidy in the Exchange. The FPL is relevant to the affordability of the coverage, as well as the eligibility for a subsidy. Click the link below to download this important bulletin 2014 FPL Announced – 020314R Remember: Your independent broker at Total Benefit Solutions, Inc. can help you compare, choose and enroll in a plan on the… Read More

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Can I keep my doctor?

“Can I keep my doctor?” is the most commonly asked question when switching healthcare plans. Know what questions to ask about health insurance plan networks before you buy. Take a moment to watch this concise new video from Humana.  

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Important Message from IBC’s Christopher Cashman

We received the following message this week from IBC’s EVP and President Commercial Markets Christopher Cashman and wanted to pass it on to our clients: As you know, over the past few weeks we have experienced unprecedented challenges as a result of the work required to enroll more than 170,000 members in our new Affordable Care Act (ACA)-compliant products. This has led to significant delays in several business areas, which we understand have been frustrating for you, your customers, and our members. While other health insurers across the country are facing similar challenges enrolling members with new ACA health plans, we are deeply concerned that we have not met your… Read More

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Amerihealth NJ: Individual Health Insurance payment deadline extension

From Amerihealth: IHC payment deadline extension ATTENTION: To offer a greater peace of mind for customers purchasing individual coverage through the Federally Facilitated Marketplace or our retail platform, AmeriHealth New Jersey is extending the payment deadline for new IHC members with January 2014 effective dates to February 5, 2014. We are also extending the payment deadline for new IHC members with February 2014 effective dates to March 5, 2014. This change is one more way that we are helping consumers navigate the health care reform environment. If you have any further questions, please contact Total Benefit Solutions (215)355-2121.

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Target to Drop Health Benefits for Part-Timers… Good News for Employees?

This week,  Fortune 500 retailer Target announced it would no longer provide health insurance for part-time employees as of April 1st. Instead, Target will provide $500 to those losing coverage and provide assistance in signing up for a new ObamaCare plan. For the majority of these part-time employees, this is really good news. Here’s why. According to Target’s news release, the decision came in light of new insurance options through the Health Insurance Marketplaces, and the fact that only 10% of part-time employees had enrolled in its part-time plan. “The launch of Health Insurance Marketplaces provides new options for health care coverage that we believe our part-time team members may… Read More

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IBC 2014 Renewals Important facts to know Q+A

There are many changes for small business groups for 2014. These changes affect sole proprietor plans, licensed professionals and small groups.  Please take a moment to review this Q&A and let us know if you have any questions. Q. What is an Open Enrollment Period? A. An Open Enrollment is the time during which you are permitted to make changes to your benefit plan. Q. How will the 2014 Open Enrollment Process Work? A. IBC will be sending you, via regular mail, your, 2014 Renewal Package.  Total Benefit Solutions will also follow up with another copy via fax or email. The package will include the 2013 rates for your current… Read More

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