6 Questions to ask your Benefits Broker

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Oxford/UHC: New Reward Program Encourages Pediatric Covid 19 Vaccinations

COVID-19 vaccines are an important step in helping to lessen the spread of the disease. While many adult New Yorkers have been vaccinated, vaccination rates among children remain relatively low. To encourage pediatric vaccination, we are offering New York-situs subscribers whose dependents are enrolled in a fully insured UnitedHealthcare or Oxford plan a $100 pre-paid Target Gift Card. The New York Pediatric COVID-19 Vaccination Reward program is in effect May 5, 2022 through October 1, 2022. Criteria for the New York UnitedHealthcare and Oxford Pediatric COVID-19 Vaccination Reward program Dependent child(ren) must be enrolled on an active subscriber’s New York UnitedHealthcare or Oxford fully insured plan. Dependent must be eligible for the… Read More

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2022 Patient-Centered Outcomes Research Trust Fund (“PCORTF”) Fees

  2022 Patient-Centered Outcomes Research Trust Fund (“PCORTF”) Fees May 23, 2022     This Allied Update serves as a reminder that the annual Patient-Centered Outcomes Research Trust Fund (“PCORTF”) fees are due by July 31, 2022. By way of background, at the end of 2019, the Federal Government reauthorized the annual payment of fees by health insurers and group health plans into the PCORTF until 2029. (Such payments were previously set to expire for plan years ending on or after October 1, 2018 and before October 1, 2019, and beyond.) The fee is due by July 31 of the calendar year immediately following the last day of the plan year in which… Read More

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Notice Requirements for Group Health Plans

ERISA requires plan administrators to give plan participants in writing the most important facts they need to know about their group health plans, including plan rules, financial information, and documents on the operation and management of the plan. Some of these facts must be provided to participants regularly and automatically by the plan administrator. Others must be made available upon request, free-of-charge or for copying fees.

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Fully Insured vs Level Funding: What’s the Difference?

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

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Support 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.

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Proposed Regulations to Fix ACA’s Affordability “Family Glitch”

individuals are not eligible for premium tax credits in the Marketplace

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What is a 5-Star Medicare Plan?

Did you know that Medicare plans come with a handy rating system and that the highest-rated of these plans have a Special Enrollment Period associated with them? Get ready to learn all about 5-star Medicare plans and what makes them special! Click here for more information! As always contact your Total Benefit Solutions Medicare health insurance specialists at (215)355-2121 with any additional questions or concerns!

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HealthCare.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

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Understanding Your OMNIA Health Plan: OMNIA Tier 1 and Tier 2

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When Can You Enroll on a Medicare Advantage or Drug Card?

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Independence is covering OTC COVID‑19 test kits through pharmacy benefits

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Medicare Part D Notification Requirements

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2021 MLR Rebate Checks Recently Issued to Fully Insured Plans

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How is COBRA health insurance affected if I am disabled?

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What Are Medicare Guaranteed Issue Rights?

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Medicare 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

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AmeriHealth New Jersey prepares to comply with new Transparency requirements

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MHPNJ : Important Plan Cancellation Status Information

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Amerihealth New Jersey: Using the E-Bill feature VIDEO

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Group Business: Independence Blue Cross and AmeriHealth NJ COBRA and Mini-COBRA Premium Assistance

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2021 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! 

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Independence: Using the e-bill feature

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Achieve Well-being Rewards

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Independence: Small Group Forms

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