This is an important announcement for customers in Arizona, California, Florida, Iowa, Kansas, Maryland, Minnesota, New Mexico, North Carolina, Oregon, Texas and West Virginia and for those with business in these states. The counties below are under a federal or state designated SEP due to an emergency. Applications for disaster SEP are only accepted as long as the SEP declaration is in place. For the most recent information, if a deadline is not specified below, please use Producers’ University’s Ongoing SEP tracker. Applications for SEPs submitted after the declaration date of that SEP will not be accepted. IMPORTANT : Please be aware The SEP begins on the date of the incident’s start, if that occurs earlier, or on… Read More
Continue ReadingYou can access your PCORI membership report on uhceservices.com
Under the Affordable Care Act (ACA), health insurers, and plan sponsors are responsible for paying the PCORI fee. The Patient-Centered Outcomes Research Institute (PCORI) fee also helps fund research that evaluates and compares health outcomes, clinical effectiveness, and the risks and benefits of medical treatments and services. Sponsors of self-funded (ASO) plans are required to submit Form 720 and pay the PCORI fee to the Internal Revenue Service (IRS) immediately. The payment must be made by July 31 of the year that follows the conclusion of the plan year. A PCORI Membership Report is given to UnitedHealthcare Level Funded groups whose plan year ends in 2023 to help with PCORI fee… Read More
Continue ReadingIRS Addresses Tax Treatment Of Work-Life Referral Services
The Internal Revenue Service (“IRS”) clarified the tax treatment of several work-life referral (“WLR”) services offered by employers in a new Fact Sheet FAQ. According to the FAQ, the value of the WLR services may be deducted from employees’ salary as a de minimis fringe benefit in cases when they are included in employee assistance programs (“EAPs”) or are otherwise bundled with other services. WLR Programs WLR services are offered to qualified employees through the employer-funded WLR program. WLR services are informative and referral consultations that help staff members locate, engage, and bargain with life-management providers to find answers to personal, professional, or family problems. Generally speaking, unless a part… Read More
Continue ReadingUnited Healthcare and Mount Sinai Renew Relationship
In accordance with a new multi-year agreement between UnitedHealthcare and Mount Sinai Health System, individuals participating in employer-sponsored and individual plans, such as the Oxford Health Plan, will once again have network access to the system’s hospitals. Additionally, the agreement guarantees continuous, uninterrupted access to the doctors at Mount Sinai. for more information click HERE We are dedicated to providing exceptional service, so please do not hesitate to contact our dedicated Total Benefit Solutions health insurance specialists at (215)-355-2121 or fill out the contact form below. We are available to answer any questions or address any concerns you may have.
Continue ReadingCleveland Clinic will remain in our MA network in Florida and Ohio
We are pleased to announce that Cleveland Clinic will stay part of our Medicare Advantage (MA) network in Florida and Ohio after successful negotiations! This covers all specialists, ancillary providers, hospitals, and primary care physicians (PCPs). Once a contractual agreement is achieved, Cleveland Clinic services will continue to be accessible without interruption. Customers will receive letters in the upcoming weeks letting them know that Cleveland Clinic is still in network and that they don’t need to take any action right now. The PCP assignments at Cleveland Clinic are all still the same. Have any questions? call us at (215) 355-2121 or click Cigna healthcare provider directory to view the most… Read More
Continue ReadingUnitedHealthcare – RxDC Information Required by Deadline
Please assist us in answering the required questions in the CAA Pharmacy Data Collection request information that is located in the employer/broker portal. It will make sure that UnitedHealthcare can successfully submit the data report. In order for us to prepare the data for submission to CMS by June 1, 2024, we must get the information by April 10, 2024, thus your prompt answer is extremely important. To read more click HERE We are dedicated to providing exceptional service, so please do not hesitate to contact our dedicated Total Benefit Solutions health insurance specialists at (215)-355-2121 or fill out the contact form below. We are available to answer any questions… Read More
Continue ReadingIRS News Release: Nutrition, Wellness, and General Health Expenses
The Internal Revenue Service (IRS) is informing taxpayers that costs associated with wellness, diet, and overall health are unlikely to be covered by Internal Revenue Code section 213 reimbursement for medical expenses. The IRS published a press statement and a list of commonly asked questions the IRS: The IRS is worried that individuals might not be aware of the situations in which spending related to diet or wellness can qualify as medical costs. The IRS reminded people in a news release on March 6, 2024, that personal expenses cannot be reimbursed through FSAs, HSAs, or HRAs in a way that is tax-favored. Employers should be wary of vendors who advertise… Read More
Continue ReadingCONSENT FOR HEALTH INSURANCE BROKER ASSISTANCE
CONSENT FOR BROKER ASSISTANCE FORM AS REQUIRED UNDER THE 2023 CMS-9899-F AMENDMENT OF 45 CFR § 155.220 Click here to complete the consent form This consent form outlines your rights. Please read it carefully. As a licensed Health Insurance Broker, Ed MacConnell of Total Benefit Solutions Inc has completed the annual Affordable Care Act certification by the Marketplace in your state. With this yearly training, and an individual or family’s formal consent, brokers are authorized to search for and assist households with their Marketplace account. The purpose of this form is to receive your informed written consent. Terms of Consent I give my permission to Total Benefit Solutions Inc, and/or their staff… Read More
Continue ReadingIRS Regulations Expand Requirement to File Electronically
Final regulations issued by the Internal Revenue Service (“IRS”) expand the requirement to electronically file certain returns and other documents with the IRS. This new requirement will impact employers who file Forms 1094-C, 1095-C, 1094-B and 1095-B. It will take effect for returns due to be filed on or after January 1, 2024. Please note that the information provided in the document is of a general nature and is not intended to interpret laws or regulations or address specific client situations. Employers are advised to seek advice from an attorney or tax professional before taking any action based on the information in the document. For more information and to read… Read More
Continue ReadingAre Health Insurance Premiums Tax Deductible?
Health insurance premiums can be tax-deductible under certain conditions in the United States. However, please note that tax laws and regulations can change, so it’s essential to consult a tax professional or the latest IRS guideline for the most up-to-date information. Typically, if you are self-employed or have health insurance coverage through your employer and pay your premiums with after-tax dollars, you may be eligible to deduct the premiums on your federal income tax return. This deduction is generally reported on Schedule 1 of Form 1040, which is used to calculate your Adjusted Gross Income (AGI). Keep in mind that there are specific requirements and limitations for deducting health insurance… Read More
Continue ReadingWhat is the tax filing requirement?
The minimum amount (or threshold) of income requiring you to file a federal tax return. 2022 filing requirements for most taxpayers: Gross income of at least $12,950 (individuals) or $25,900 (married filing jointly). Different thresholds apply for dependents, people 65 and older, and those who use other tax filing statuses (like married filing separately). Have any questions regarding this notice? Don’t hesitate to contact your Total Benefit Solutions health insurance specialists today at (215)355-2121.
Continue Reading1095-B Tax Form Available Electronically for Employees of Cigna Fully-Insured Clients
Effectively 1/1/23, Cigna transitioned from physically mailing 1095-B tax forms to on-demand electronic availability for customers on fully-insured client medical plans. Just one way Cigna is making healthcare simpler for customers, enrollees can access their 1095-B tax forms anytime, anywhere via myCigna.com® . Click here to read more. As always contact your Total Benefit Solutions group health insurance specialist at (215)355-2121 if you have any further questions or concerns.
Continue ReadingNotification Reminder for Forms 1095-C and 1095-B
Under the Affordable Care Act (“ACA”), the deadline for applicable large employers (“ALEs”) to furnish Form 1095-C and 1095-B to certain individuals (such as full-time employees in the case of Form 1095-C) is January 31 with respect to the preceding calendar year. The Internal Revenue Service (“IRS”) released final regulations on December 12, 2022 with respect to ACA reporting requirements. These final regulations provided an automatic extension of 30 days to furnish these statements to individuals. This means that Wednesday, March 2, 2023 is the deadline to furnish individuals with 2022 Forms 1095-C and 1095-B. This extension is automatic; employers or other reporting entities are not required to file a… Read More
Continue ReadingWhat is Limited Medical Insurance?
A limited medical plan is a form of supplemental health insurance that can be used with or without a major medical plan. Limited medical plans have a set amount of money for treatment that they give to you to pay for common medical expenses. They recognize that common services like wellness visits can sometimes turn into a financial strain for people. Since this type of insurance does not cover everything due to a predetermined limit on what you receive, you will want to look closely at the benefits before choosing a plan. It can be helpful to pair a limited medical plan with a major medical plan. Doctors visits and… Read More
Continue Reading2022 MLR Rebate Checks to Be Issued Soon to Fully Insured Plans
As a reminder, insurance carriers are required to satisfy certain medical loss ratio (“MLR”) thresholds. This generally means that for every dollar of premium a carrier collects with respect to a major medical plan; it should spend 85 cents in the large group market (80 cents in the small group market) on medical care and activities to improve health care quality. If these thresholds are not satisfied, rebates are available to employers in the form of a premium credit or check. If a rebate is available, carriers are required to distribute MLR checks to employers by September 30, 2022. Click the link below to download the full bulletin.
Continue Reading2022 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
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 ReadingIRS Guidance Clarifies DCAP Relief
The IRS released Notice 2021-26 to address taxation of Dependent Care Assistance Programs (“DCAPs”) as it relates to the relief afforded under Section 214 of the Consolidated Appropriations Act, 2021 (“CAA”) and the increased DCAP limit under the American Rescue Plan Act of 2021 (“ARPA”).
Continue ReadingUpdate on COVID-19 Vaccine and Vaccine Administration Cost
Update on COVID-19 Vaccine and Vaccine Administration Cost
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