ICHRA – Total Benefit Solutions Inc

New PCOR fee Announced

December 20, 2024December 20, 2024Loramei Romeo

The IRS released Notice 2024-83 on December 3, 2024, which states that the PCOR fee which is determined by the adjusted applicable dollar amount used for plan years that starts on or after October 1, 2024, and before October 1, 2025, is $3.47. For self-funded medical plans which includes level funding and some HRAs including ICHRAs for plan years ending in 2024 the PCOR filing deadline is July 31, 2025. For insured policies the carriers are responsible for paying. Employer Action: There are no further required actions for employes with self-funded health plans (or an HRA) as of the moment. Reminders will be sent in mid-2025 for the fee and… Read More

Final 2024 ACA Reporting Instructions and Forms Issued

October 14, 2024October 14, 2024Mirasol Bandong

Forms 1094-C, 1095-C, 1094-B, and 1095-B are among the final instructions and forms that the IRS has made available for calendar year 2024 ACA reporting. As a reminder, since good faith relief from penalties is no longer available, it is crucial to make sure the forms are accurate, timely, and submitted to the IRS. There are no significant changes to the 2024 forms Forms 1094-C/1095-C Applicable large employers (ALEs) must provide Form 1095 to full time employees and Form 1094-C and 1095-Cs will be filed with the IRS. Covered employees or other primary insured individuals in the self-funded health plan must also receive Forms 1095-C from ALEs that offer a… Read More

What is a level funded health insurance plan?

September 1, 2024September 1, 2024Ed MacConnell

A level-funded plan is a type of self-funded plan in which the employer contributes a steady monthly payment to cover costs for administration, claims payments, and stop-loss insurance. Level funding has its advantages when compared to fully insured plans and programs. Level-funded plans often cost less, making it easier for small- and mid-sized employers to offer their employees high-quality health care benefits at a more affordable price. Total Benefit Solutions, Inc offers small- to mid-sized employers an opportunity to have a level-funded plan for their business through a Self-Funded Program. We work with many different carriers who offer level funded programs. These carriers change by State. How does the plan… Read More

Pros and Cons of PEO’s

August 13, 2023August 13, 2023Ed MacConnell

A Professional Employer Organization (P.E.O.) is a company that provides comprehensive HR outsourcing services to small and medium-sized businesses. As your independent broker, Total Benefit Solutions, Inc can shop and compare various PEO’s to help determine which one might be the best fit for your organization, if any. Just like we can do with insurance carriers ad TPA’s! We have had a lot of questions about PEO’s so we created these pro and com quick tips to give you a quick overview of the top points about PEO’s that are asked the most often. The professionals at Total Benefit Solutions are independent and can evaluate the PEO offerings of multiple… Read More

Why Short Term Heath Insurance is not “ JUNK” insurance.

July 29, 2023July 29, 2023Ed MacConnell

Short-term health insurance, also known as temporary health insurance, is a type of health coverage designed to provide temporary medical insurance for a limited duration, typically ranging from a few months to a year. While short-term health insurance may not be suitable for everyone, it does offer certain benefits for specific situations. When people label Short Term health as “ JUNK” it is clear they do not understand that many people still need short term health insurance coverage. The ACA solved many problems when it comes to access to coverage, but first problem is the COBRA prohibition which specifically disallows ACA tax credits for people who can get on COBRA.… Read More

Guidance Issued on Emergency Period Expiration

April 24, 2023April 24, 2023Ed MacConnell

** This Compliance Bulletin contains guidance released in FAQ 58; however, President Joe Biden subsequently signed a House Bill on April 10, 2023 immediately ending the National Emergency, which may change certain dates referenced below. It is possible that FAQ 58 will be updated to reflect new dates. The signed Bill did not change the end of the Public Health Emergency, which remains May 11, 2023.** On March 29, 2023, the Departments of Labor, the Treasury, and Health and Human Services (collectively, “the Departments”) released FAQ 58, answering certain frequently asked questions regarding the announced end of the National Emergency and the Public Health Emergency (“PHE”) on May 11, 2023.… Read More

Individual Coverage HRA: Choice and affordability in employee health benefits

March 6, 2023March 3, 2023Ed MacConnell

How HRAs work Health Reimbursement Arrangements are employer-funded accounts that reimburse employees for eligible medical expenses. No employee contributions are allowed. Since an HRA is funded only by the employer, the employer sets the rules of the plan. The ICHRA works much the same as other HRAs, with the following important differences: ICHRA rules Traditional group health plans An employer may not offer an ICHRA and a traditional group health plan (GHP) to employees within the same class. However, an employer may offer an ICHRA to one class of employees and a traditional GHP to another class. Also, a traditional GHP may be grandfathered for current employees while all new… Read More

1095-B Tax Form Available Electronically for Employees of Cigna Fully-Insured Clients

February 12, 2023February 9, 2023Ed MacConnell

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.

ACA: Special Election Cheat Sheet

February 9, 2023February 9, 2023Ed MacConnell

Download our SEP Cheat Sheet. Know your health insurance SEP to get enrolled outside of the annual open enrollment period. As always contact your Total Benefit Solutions health insurance experts for more specific information about your situation at (215)355-2121 http://www.totalbenefits.net

What is Limited Medical Insurance?

January 29, 2023January 29, 2023Ed MacConnell

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

Turning 26: Your Guide to Health Insurance

September 23, 2022Ed MacConnell

Turning 26: Your Guide to Getting Your New Health Insurance:https://totalbenefits.net/turning-26-your-guide-to-health-insurance/

Understanding the Coding of Health Plans from MEC to Metallic

August 15, 2022July 22, 2022Ed MacConnell

Choosing the right insurance plan for you (and your family) is not an easy task. The Affordable Care Act (ACA) has introduced major changes to the way carriers traditionally marketed their health plans to the public and introduced a volume of new terms, requirements and complexities, many of which may sound confusing to the general public. From terms like “minimum essential coverage” to the various metallic plan categories of Bronze, Silver, Gold and Platinum, a solid foundation of knowledge is essential in order to find the coverage required at an affordable price. The health insurance experts at Total Benefit Solutions Inc are well versed on these terms so when you… Read More

Case Study Library

July 22, 2022July 22, 2022Ed MacConnell

We present a few case studies to illustrate how we have helped our clients solve their complicated employee benefit challenges. Click here to learn more!

2022 PCOR Fee Filing Reminder for Self-Insured Plans

June 16, 2022Ed MacConnell

The Patient-Centered Outcomes Research (PCOR) fee filing deadline is August 1, 2022, for all self-funded medical plansand HRAs for plan years ending in 2021. The IRS issued Notice 2022-04 announcing the adjusted fee amount for this year. please download the bulleting below for more details and contact your Total Benefit Solutions, Inc. health insurance specialist at (215)355-2121.

6 Questions to ask your Benefits Broker

June 10, 2022June 10, 2022Ed MacConnell

Notice Requirements for Group Health Plans

May 16, 2022May 13, 2022Ed MacConnell

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.

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

May 10, 2022May 9, 2022Ed MacConnell

individuals are not eligible for premium tax credits in the Marketplace

HealthCare.gov Notices New Class of Individual Employer Policies

May 2, 2022Ed MacConnell

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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