With open enrollment 2015 for individual health insurance coming up in November, employees and clients are worried about the cost of health insurance, the number of uninsured, and Marketplace glitches. This is according to a new survey by Bankrate.com. Click here to read the story on the Zane Benefits website.
Continue ReadingFMLA Proposed Rules To Recognize Same Sex Regardless of Residency
FMLA Proposed Rules To Recognize Same Sex Regardless of Residency The DOL is proposing to amend the regulatory definition of “spouse” under the Family and Medical Leave Act (“FMLA”) so that “spouse” for purposes of FMLA rights would include a same-sex spouse, regardless of where the employee and spouse live. This means the “place of celebration” will determine whether an individual is a spouse under FMLA, rather than the current rule which uses the “state of residence,” which recognizes a spouse under the law of the state in which the couple resides. Click the link to download the bulletin: 070714-P-ERC-FMLA_Proposed_Rules (1) Please contact you Total Benefit Solutions account manager at (215)355-2121 if… Read More
Continue ReadingIRS: Further Guidance on Employer Payment Plans
New Guidance on Employer Payment Plans The IRS issued an FAQ addressing the potential consequences of an arrangement where an employer reimburses employees for the purchase of individual health insurance premiums on a tax-favored basis (referred to as an “employer payment plan”). For this purpose, individual health insurance premiums includes individual coverage purchased either inside or outside of the Health Insurance Marketplace. The FAQ follows up on earlier guidance describing these types of arrangements (Notice 2013-54). Click the link for more information: 060214_P_ERC_Employer_Payment_Plans (1)
Continue ReadingTotal Benefit Solutions to partner with ThinkHR
In another effort to enhance our client experience and bring value to our small business clients, Total Benefit Solutions is proud to announce that we have entered into an agreement to provide Think HR. Soon our clients will get an introductory e-mail with instructions on how to access their complimentary ThinkHR account. We expect to have this resource available to our clients in September 2014, just in time for this year’s open enrollment period! Think HR will help our clients: Stay up to date with the latest news and resources Remain compliant with best practices from HR professionals Build tools like job… Read More
Continue ReadingHorizon: Changes to 2015 MOOP’s
Changes to Maximum Out-of-Pocket Limits Under the Affordable Care Act (ACA), all non-grandfathered group health plans regardless of size or funding arrangement, must comply with annual limits on out-of-pocket maximums for in-network covered services that are Essential Health Benefits (EHB)1. These out-of-pocket maximums are also known as a plan’s maximum out-of-pocket (MOOP). Click the link to download the full notice: Changes_to_MOOP_Limits Please contact your Total Benefit Solutions account manager at (215)355-2121 if you have any questions or concerns.
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Exchange Notification Reminder
Exchange Notification Reminder The very busy renewal date of December 1, 2014, is fast approaching. This notice is to remind you that each employer group must give their employees a Marketplace (Exchange) notification. The first link below is for employer groups that currently do offer coverage. The second link below is for an employer that does NOT offer coverage to employees. Please remember this notification is for the states of Pennsylvania and New Jersey. The form also works for any employer who is based in an FFM (Federal Facilitated Marketplace) State. It is NOT compliant in NY, MD or any other state that provides their own State… Read More
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U.S. Supreme Court Contraceptive Ruling
In a 5-4 decision that was described by one of the dissenting Justices as a “decision of startling breadth”, the Supreme Court has ruled in Burwell v. Hobby Lobby Stores, Inc. that closely held for-profit corporations are not compelled to provide contraceptive coverage under the Affordable Care Act’s preventive care mandate if they object to that coverage on religious grounds. The decision is a “win” for Hobby Lobby who had challenged the contraceptive mandate saying it forced them to either violate their faith or pay fines. Click here to download the bulletin
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What is Critical Illness Insurance?
Why Critical Illness as a “wrap” plan Because: They’re more affordable than you might think. They’re available for employer groups, individuals and seniors. They make selecting a health plan easier. They provide peace of mind against a catastrophic event and large out of pocket expenses. They’re person and portable, it doesn’t matter where you get your health insurance from, having your own critical illness plan makes it better. Many clients have asked how they can supplement their employees coverage when they get enrolled through the affordable care act healthcare.gov marketplace. Employers are permitted to offer wrap plans that consist of “excepted benefits”, meaning they are not regulated by the affordable… Read More
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Health Care Reform Updates: Updated Model COBRA Election Notice
Updated Model COBRA Election Notice Includes Information Regarding Health Insurance Exchanges Revised Notice Informs Individuals of New Coverage Alternatives A revised Model COBRA Election Notice is now available for group health plans to inform eligible employees and dependents of the right to continuation of coverage under federal law and how to make an election when a qualifying event occurs. The updated model notice includes information regarding coverage alternatives that will be available through the new Health Insurance Exchanges (also known as Marketplaces). COBRA Election Notice Requirement COBRA (the Consolidated Omnibus Budget Reconciliation Act) generally applies to group health plans sponsored by employers with 20 or employees (including both full-… Read More
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New Guidance on Cost Sharing Limits under Health Care Reform
The three agencies responsible for the implementation of health care reform (Treasury, Health and Human Services, and Labor) released a joint set of Frequently Asked Questions on cost sharing limits. Health care reform places a limit on the dollar amount of out-of-pocket expenses that a participant may be charged in a year. In 2014, that limit is $6,350 for self-only coverage and $12,700 for other coverage. In 2015, the limit increases to $6,600 for self-only coverage and $13,200 for other coverage. The guidance clarifies that if an out-of-network provider charges an amount greater than the amount allowed by the plan (i.e., balance bills the amount above the usual and customary… Read More
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What is Hospital Indemnity?
Hospital Indemnity Plans as a “wrap” Many clients have asked how they can supplement their employees coverage when they get enrolled through the affordable care act healthcare.gov marketplace. Employers are permitted to offer wrap plans that consist of “excepted benefits”. A group Hospital Indemnity plan can fit the bill and provide a comprehensive financial support plan for a family dealing with a medical crisis. It also allows the employee to make a more prudent health plan selection by giving them coverage for any large deductibles, co-pays or cost sharing scenarios. Hospital Indemnity plans are available to individuals too. Download more information on Shelterpoint’s Hospital Indemnity plan Below is a… Read More
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SAME SEX MARRIAGE PA COURT DECISION
Prepared by Vince Phillips, PAHU Lobbyist May 22, 2014 On May 20, 2014, Federal Judge John Jones III issued a landmark ruling in Whitewood et al vs. Michael Wolf (Commonwealth of PA) that struck down Pennsylvania’s 1996 Marriage Law specifying that a marriage is defined as being between a man and a woman. The ruling also forced PA to recognize same-sex marriages conducted in other states. On May 21, Governor Corbett said that although as a Catholic, he disagreed with the ruling, he would not appeal it. The ruling is effective immediately but an unanswered question is effective date for employer-offered health plans. Is it now? Is it a month… Read More
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Comparative Effectiveness Fee Reminder
The Comparative Effectiveness Research Fee is now known as the Patient-Centered Outcomes Research Institute (PCORI) Fee. The Patient Protection and Affordable Care Act (the Act) imposes a new Patient-Centered Outcomes Research Institute (PCORI) fee, formerly the comparative effectiveness research fee, on plan sponsors and issuers of individual and group policies. The first year of the fee is $1 per covered life per year, the second year the fee adjusts to $2 per covered life and then it’s indexed to national health expenditures thereafter until it ends in 2019. Click here to download this bulleting regarding the timely payment of the fees. Purpose of the Fee The assessed fees are to… Read More
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19th Set of FAQ’s Released on Affordable Care Act
Frequently asked questions (“FAQs”), prepared jointly by the Departments of Labor (“DOL”), Health and Human Services (“HHS”), and the Treasury (collectively, the “Departments”),were issued with respect to various Affordable Care Act (“ACA”) requirements, including their effect on COBRA and CHIPRA notices…Topics Include: Updated COBRA And CHIPRA Notices Out-Of-Pocket Maximum Requirements Generic Drugs Balance Billing Reference-Based Pricing Coverage Of Preventive Services Health FSA Carryover And Excepted Benefits Effect of Carryover on Excepted Benefits Determination Summary Of Benefits And Coverage Click here to download the bulletin from our partners at Emerson Reid.
Continue ReadingNuts and Bolts of the Small Employer Tax Credit
This presentation is intended to convey general information about the employer health care tax credit under the affordable care act and is not an exhaustive analysis. Information contained in this presentation may change as guidance develops. Total Benefit Solutions inc and Emerson Reid do not provide legal or tax advice. For advice specific to your situation, please consult an attorney or other professional. Click here to download “nuts and bolts” Download Small Business Health Care Tax Credit FAQ’sFAQs
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Calculator May Help Small Businesses Determine SHOP Eligibility
Calculator May Help Small Businesses Determine SHOP Eligibility The U.S. Department of Health & Human Services has developed a Full-Time Equivalent (FTE) Employee Calculator to help small employers determine whether they qualify for the Small Business Health Options Program (SHOP). Background SHOP is available as an option for qualified small employers to purchase employee health coverage. The federal government is running the program in states that chose not to operate their own SHOP Marketplace (Exchange). For 2014, employers are generally eligible to purchase health coverage through the federally-facilitated SHOP Marketplace if they have 50 or fewer full-time equivalent employees (FTEs), including part-time employees. (For example, 2 part-time employees… Read More
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Aetna: Important updates to our Pennsylvania Small Group eligibility guidelines
This briefing is applicable to all brokers writing Pennsylvania based employers We have updated our eligibility guidelines as it relates to sole proprietors, owners, partners, W-2 employees and husband / wife groups for 2014. These updates have been made to maintain compliance with state and federal requirements. Please review the updates we have outlined below. We thank you for your continued collaboration. The following applies to Small Group Pennsylvania new business and renewals: The definition of an employer is now one W-2 common law employee. This accommodates an owner with at least one “enrolling” W-2 common law employee who is not a spouse and not an owner. Sole proprietors, owners… Read More
Continue ReadingHealthcare.gov Users Prompted To Change Passwords Because Of Heartbleed Risk.
The CBS Evening News (4/20, story 8, 1:55, Glor) reported Sunday night that “visitors to the to Affordable Care website are being advised to take steps to protect themselves” from Heartbleed, the online security flaw. Mark Albert reported over the weekend, healthcare.gov made the move to “reset everyone’s account password.” Saturday evening, the NBC Nightly News (4/19, story 7, 0:25, Holt) reported that people “with accounts on healthcare.gov are being told to change their passwords after review found that the website was vulnerable to the security breach bug.” The Hill (4/19, Wilson) “Hillicon Valley” blog reported that the call to change log in information for the site were “out of… Read More
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COMPLIANCE NOTICE: Individual Health Plans as Employee Benefits Under the Affordable Care Act (ACA)
COMPLIANCE NOTICE: Individual Health Plans as Employee Benefits Under the Affordable Care Act (ACA) Released on September 13, 2013, IRS Notice 2013-54 addresses the viability of individual health insurance plans as a tax-advantaged employee benefit under the Affordable Care Act (ACA). Unfortunately, the news was not good for employers wanting to offer such plans to their employees: the IRS determined that such plans are prohibited under the ACA. PLEASE CLICK BELOW TO DOWNLOAD THE RELEASE FROM AMERIFLEX… COMPLIANCE_ Individual Health Plans as Employee Benefits Under the Affordable Care Act
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SHOP for Small Group Customers Buying a plan through SHOP versus direct
SHOP for Small Group Customers Buying a plan through SHOP versus direct Buying plans through the Small Business Health Options Program, or SHOP, provides an advantage only for employers with fewer than 25 employees that are eligible for a tax credit provided by the Affordable Care Act (ACA). If customers are not eligible for this tax credit, there is no advantage to purchasing a plan through SHOP. This is because… Click here to download the SHOP bulletin
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Health Reform: New Guidance Clarifies Rules on Health FSA Carryovers
Near the end of 2013, the IRS issued Notice 2013-47 that permits a cafeteria plan to provide for the use of up to $500 of any unused amount remaining in the health FSA in the immediately following plan year (the “carryover” provision). This provision is optional, requires a plan amendment, and cannot be offered if the cafeteria plan allows a grace period. Click here to download the bulletin
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Health Reform: Law Repeals Deductible Limits for Small Group Plans
The Protecting Access to Medicare Act of 2014, legislation extending the “doc fix” for Medicare payments, also includes a provision that repeals the maximum deductible limits applicable to many small group health plans. As you recall, deductible limits for non-grandfathered small group plans are capped under the ACA at $2,000 for single coverage and $4,000 for family coverage effective for the first plan year on or after January 1, 2014. This legislation repeals the deductible limits as of the date health care reform was enacted (March 23, 2010). Click here to download the bulletin
Continue ReadingEd MacConnell earns Voluntary Benefits Certification
We are pleased to announce that Edward T MacConnell, President of Total Benefit Solutions has earned the certification of Certified Voluntary Worksite Professional from the National Association of Health Underwriters. Voluntary/Worksite products are not new to the employee benefit industry. However, the surge of interest in these products has accelerated as employers seek ways to help attract and retain talent. The industry has responded swiftly with new products, new features, new enrollment technologies and many changes to the underwriting rules of these products. This has created new responsibilities for agents, brokers and consultants as advising clients in this area will differentiate their value to the consumers they serve. Certified Voluntary Worksite… Read More
Continue ReadingHR4302 Bill Passes: Repeals limitation on deductibles for employer-sponsored health plans
On March 31, 2014 President Obama signed into law Bill HR4302 – Protecting Access to Medicare Act of 2014, sometimes called the “Doc Fix” bill. While the primary purpose of this bill was to prevent the automatic cuts to physician Medicare payments, this bill also included a significant modification to the Affordable Care Act (ACA). This bill included a section that ends the limitations on deductibles that were set at $2,000/individual and $4,000/family within the ACA on small group employer sponsored health plans, and made the effective date retroactive to the original enactment of the ACA. The act states: SEC. 213. ELIMINATION OF LIMITATION ON DEDUCTIBLES FOR EMPLOYER-SPONSORED HEALTH PLANS.… Read More
Continue ReadingMy Experience with Obamacare: A Freelancer Applies for Health Insurance
Our friends at Zane Benefits recently shared this comic and I enjoyed it so much I thought you might like it too: Click here to see the rest of the comic on zanebenefits.com Click here to see the rest of the comic on zanebenefits.com
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