2024 Medicare Parts A & B Premiums and Deductibles

On October 12, 2023, the Centers for Medicare & Medicaid Services (CMS) released the 2024 premiums, deductibles, and coinsurance amounts for the Medicare Part A and Part B programs, and the 2024 Medicare Part D income-related monthly adjustment amounts. The Medicare Savings Programs (MSPs) help more than 10 million people with coverage of Medicare premiums and, in most cases, other cost sharing. In their continued efforts to improve access to health care and lower costs for millions of Americans, the Department of Health and Human Services (HHS), through CMS, recently finalized a rule to streamline enrollment in MSPs, making coverage more affordable for an estimated 860,000 people. In addition, the… Read More

Continue Reading

Medicare Supplement Insights: Protecting Your Wallet

In a world where healthcare costs are a growing concern for many, Medicare Supplement coverage has emerged as a reliable solution to bridge the gaps in original Medicare. As we delve into the latest data from 2021, including insights from the National Association of Insurance Commissioners (NAIC), the California Department of Managed Health Care, and the Medicare Current Beneficiary Survey (MCBS) from 2020, a compelling narrative about the significance of Medicare Supplement plans unfolds. Key Takeaways: 1. A Majority Embrace Medicare Supplement: In 2020, a staggering 54% of original Medicare enrollees without additional insurance coverage, such as Medicaid or employer-provided insurance, turned to Medicare Supplement policies for added peace of… Read More

Continue Reading

Medicaid & CHIP Enrollment Extension!

In a recent development, the Centers for Medicare & Medicaid Services (CMS) and the Departments of Labor (DOL) and the Treasury have issued a letter urging employers, plan sponsors, and carriers to consider extending the enrollment period for employer-sponsored health plans. This extension is aimed at helping individuals who have lost their Medicaid and Children’s Health Insurance Program (CHIP) coverage due to the resumption of normal eligibility and enrollment procedures. Traditionally, Medicaid coverage requires annual renewal of eligibility. However, during the COVID-19 Public Health Emergency, these renewal requirements were temporarily halted to prevent members from losing their coverage. Unfortunately, this pause in eligibility rules came to an end on March… Read More

Continue Reading

2024 ACA Affordability Shake-Up: Are You Ready?

Are you ready for some important news regarding the Affordable Care Act (ACA)? The IRS has just released an update that could impact your organization’s healthcare offerings. In this blog post, we’ll break down the latest announcement and what it means for employers and employees alike. If you’re interested in diving deeper, be sure to download our PDF for more information. IRS Announces 2024 ACA Affordability Indexed Amount The IRS recently made an important announcement in Revenue Procedure 2023-29 regarding the Affordable Care Act’s (ACA) affordability indexed amount under the Employer Shared Responsibility Payment (ESRP) requirements. This announcement is significant for employers as it affects the calculation of penalties related… Read More

Continue Reading

MLR Rebate Checks Unveiled: A Must-Read for Employers

Every year, insurance carriers are required to meet specific Medical Loss Ratio (MLR) thresholds, ensuring that a significant portion of collected premiums goes toward medical care and improving healthcare quality. For the large group market, this threshold stands at 85 cents for every premium dollar collected, while in the small group market, it’s 80 cents. If these thresholds are not met, employers are in for a timely financial boost, in the form of premium credits or checks. MLR Rebate Deadline: September 30, 2023 The clock is ticking. If your insurance carrier falls short of the MLR threshold, they are obligated to distribute MLR checks to employers by September 30, 2023.… Read More

Continue Reading

Voluntary Benefits: Customized Coverage for Your Team

Unlocking the Power of Voluntary Benefits In today’s competitive job market, employers aim to attract and retain top talent by offering comprehensive benefits beyond the basics. Enter voluntary benefits – a customizable solution that benefits both employers and employees. What Are Voluntary Benefits? Voluntary benefits are offerings that employers provide for purchase by employees. They empower employees to tailor their benefits to their needs, offering flexibility and convenience. Here are their key characteristics: A Variety of Benefits Voluntary benefits offer a wide array of options, including: Advantages for Employers and Employees Employers benefit from: Employees enjoy: While voluntary benefits may not suit everyone, employers should assess their package and consult… Read More

Continue Reading

Employer’s Guide to Medicare Compliance

Medicare is a critical healthcare program in the US, covering seniors and certain disabled individuals. Employers offering group health insurance to Medicare-eligible individuals must meet specific requirements. In this blog, we’ll discuss three key Medicare requirements for employers: Employers must ensure compliance with these Medicare regulations to provide necessary healthcare information and process claims correctly. This ensures employees receive the coverage they’re entitled to. For comprehensive information and resources, refer to our PDF document below. Meeting these obligations supports employee well-being and eases healthcare coverage complexities. As always, if you have any questions or concerns about this bulletin, please contact your Medicare health insurance experts at Total Benefit Solutions, Inc.… Read More

Continue Reading

COBRA and Medicare: Complementary Health Insurance Explained

In today’s rapidly changing job landscape, it’s not uncommon for individuals to find themselves eligible for both Medicare and COBRA simultaneously. This dual eligibility can be a bit bewildering, but understanding how these two crucial insurance options interact is vital to making informed decisions that could impact your finances and peace of mind. Let’s delve into the intricacies of how COBRA works with Medicare and explore the options available to you. COBRA Unveiled First, let’s demystify COBRA. The Consolidated Omnibus Budget Reconciliation Act (COBRA) is a federal program designed to provide a safety net for workers and their families. It allows you to maintain the health coverage provided by your… Read More

Continue Reading

Unlocking Change: Pennie’s First Health Equity Report

Are you interested in delving into the intricate landscape of health coverage equity in the Keystone State? Look no further! Pennie is proud to present its inaugural Health Equity report, and it’s available for you to download right now. This comprehensive report goes beyond the surface, delving deep into the heart of healthcare disparities across Pennsylvania. Here’s what you can expect to find within its pages: Addressing Health Coverage Inequities Together: The report lays out a roadmap for collective action to combat the existing health coverage inequities. Discover how Pennie is dedicated to working with communities to bridge these gaps. Setting the Baseline for Change: To measure progress effectively, it’s… Read More

Continue Reading

Unlocking Medicare’s Potential: Top 3 Broker Benefits

It’s that time of year again – the Annual Open Enrollment period for Medicare is almost here, and it’s a crucial opportunity you won’t want to miss. If you’re eligible for Medicare, this is your chance to make important decisions about your healthcare coverage. Here are some compelling reasons why you should take advantage of this opportunity: Expert Guidance: Navigating the world of Medicare can be a complex and overwhelming task. Fortunately, during the Annual Open Enrollment period, you can access personalized advice and guidance from experienced brokers who understand the ins and outs of Medicare. These professionals can help you make informed decisions tailored to your unique healthcare needs.… Read More

Continue Reading

Who Needs Extra Protection During Flu Season?

The flu season is upon us once again, and it’s time to make sure you and your loved ones are protected. The flu is more than just a pesky inconvenience; it can be a serious illness that leads to hospital visits and even death. By getting vaccinated, not only are you protecting yourself from getting sick, but you’re also playing a significant role in preventing the flu from spreading to others. Where to Get Your Flu Shot Getting a flu shot is convenient and accessible. You can receive one at your doctor’s office, your local pharmacy, or various clinics in your area. Plus, if you’re covered by Medicare, you’re in… Read More

Continue Reading

How income affects your Medicare drug coverage premiums

You could pay a higher monthly premium for Medicare drug coverage (Part D) depending on your income. This includes Part D coverage you get from a Medicare drug plan, a Medicare Advantage Plan with drug coverage, or a Medicare Cost Plan that includes drug coverage. This is true even if your drug coverage is through your employer. Download this bulletin to learn more about extra Medicare drug coverage premiums As always if you have any questions or concerns about this bulleting please contact your Medicare health insurance experts at Total Benefit Solutions, Inc (215)355-2121

Continue Reading

Medicare Diabetes Prevention Program: PDF Download

Medicare covers a health behavior change program to help you prevent or delay type 2 diabetes. The program includes 22 group sessions with a behavior coach who works with you to make lasting diet and exercise changes. You’ll also get support to keep you motivated. For a comprehensive understanding of Medicare prevention programs, download this informative PDF today! As always if you have any questions or concerns about this bulleting please contact your Medicare health insurance experts at Total Benefit Solutions, Inc (215)-355-2121

Continue Reading

A Voluntary Benefits Strategy

The Issue One of our clients approached us during a pre-renewal meeting to ask how they can further control costs without drastically impacting the well-being of their employees…click here to continue

Continue Reading

Medicare Diabetes Prevention Program

If you have been diagnosed with prediabetes, it’s essential to take proactive steps to manage your condition and reduce the risk of developing type 2 diabetes. The good news is that there are programs available designed specifically to assist individuals like you in preventing or delaying the onset of type 2 diabetes. These programs often encompass a comprehensive approach that includes education, lifestyle modifications, and support systems tailored to your specific needs. Let us help, don’t miss this opportunity to take control of your health and potentially prevent the development of type 2 diabetes. Download this PDF for more information! As always if you have any questions or concerns about… Read More

Continue Reading

What’s New in the 2023 ACA Open Enrollment?

The 2023 Affordable Care Act (ACA) Open Enrollment period is upon us, marking a significant milestone as Health Insurance Marketplaces open their doors for the tenth year. From November 1, 2022, to January 15, 2023, individuals and families have the opportunity to secure comprehensive healthcare coverage. In this blog post, we’ll delve into the key changes and updates for this year’s open enrollment, focusing on insights gathered from the Kaiser Family Foundation’s informative article titled “Nine Changes to Watch in Open Enrollment 2023” [source: www.kff.org/policy-watch/nine-changes-to-watch-in-open-enrollment-2023/]. As the ACA Open Enrollment enters its tenth year, changes abound, ensuring improved access, affordability, and assistance for individuals and families seeking healthcare coverage. Staying… Read More

Continue Reading

HOW PEOS ARE HELPING SMBS MEET MARKET DISRUPTORS HEAD ON

The modern world is driven by convenience and customization, SMBs included. Digitization, remote-friendly roles, and a generational shift in the workforce all impact today’s employee experience. When this experience is lacking, it can be costly to companies in more ways than one.    click here to read the story from PEO insider Total Benefit Solutions Inc is dedicated to providing a comprehensive selection of solutions for the small business owner including the comparison of PEO’s to the typical employee benefits experience. Contact us today at (215)355-2121 to inquire about the possibility of using a PEO for your organization.

Continue Reading

Decoding Medicare Supplement Charts

So, you’re on the quest to unravel the complexities of Medicare supplement plans, and in your journey, you’ve stumbled upon the elusive “Medicare Supplement Comparison Chart.” It’s like a mosaic of options, donning a variety of colors and fonts, yet each one is strangely reminiscent of the other. But what exactly are these charts? What secrets do they hold? Well, that’s what we’re here to uncover today. Cracking Open the Chart Imagine this: you’re face-to-face with a Medicare Supplement Comparison Chart. But what’s beneath the surface? Every column you see represents one of the ten available Medigap plans up for grabs – think Plans A, B, C, D, F, G,… Read More

Continue Reading

Are 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 Reading

What are the preferred plans for insured employees?

Preferred Provider Organization plans remain the most common plan type. Nearly half (49%) of insured employees enrolled in a PPO in 2022. That compares to 29% enrolled in an HDHP, 12% enrolled in an HMO, nine percent in a Point-of-Service (POS) plan, and one percent in a conventional (indemnity) plan. If you have any questions or concerns about this bulletin, please contact your Total Benefit Solutions Inc health insurance account manager at (215) 355-2121

Continue Reading

What Additional Changes Are Being Made to Part D?

As of 2023, the out-of-pocket cost of insulin products is limited to no more than $35 per month in all Part D plans. In addition, adult vaccines covered under Part D, such as the shingles vaccine, are covered with no cost sharing. Starting in 2024, people with Medicare who have incomes up to 150% of poverty and resources at or below the limits for partial low-income subsidy benefits will be eligible for full benefits under the Part D Low-Income Subsidy (LIS) Program. The law eliminates the partial LIS benefit currently in place for individuals with incomes between 135% and 150% of poverty. Also starting in 2024, the calculation of the… Read More

Continue Reading

How Is the Medicare Part D Benefit Changing in 2025?

Changes in 2025 include a new $2,000 out-of-pocket spending cap, elimination of the coverage gap phase, a higher share of drug costs paid by Part D plans in the catastrophic phase, along with a new manufacturer price discount and reduced liability for Medicare in this phase, and changes to plan costs and the manufacturer price discount in the initial coverage phase. Out-of-pocket drug spending will be capped at $2,000 Beginning in 2025, Part D enrollees’ out-of-pocket drug costs will be capped at $2,000. This amount will be indexed to rise each year after 2025 at the rate of growth in per capita Part D costs. (This cap does not apply… Read More

Continue Reading

How Is the Medicare Part D Benefit Changing in 2024?

In 2024, costs in the catastrophic phase will change: the 5% coinsurance requirement for Part D enrollees will be eliminated and Part D plans will pay 20% of total drug costs in this phase instead of 15%. The 5% coinsurance requirement for Part D enrollees in the catastrophic phase will be eliminated In 2024, once Part D enrollees without low-income subsidies (LIS) have drug spending high enough to qualify for catastrophic coverage, they will no longer be required to pay 5% of their drug costs, which in effect means that out-of-pocket spending for Part D enrollees will be capped. In 2024, the catastrophic threshold will be set at $8,000. This… Read More

Continue Reading

The Benefits of Short-Term Health Insurance

Short-term health insurance is a type of health insurance that provides coverage for a limited period of time, typically anywhere from 30 days to 12 months. These plans are designed to provide temporary coverage for individuals who are in between jobs, waiting for employer-sponsored coverage to begin, or who are not eligible for other types of health insurance. Affordable Premiums Short-term health insurance plans typically have lower premiums than traditional health insurance plans. This is because short-term plans are designed to provide coverage for a limited period of time and do not have to meet the same requirements as other types of health insurance. This makes them a more affordable… Read More

Continue Reading

ACA special enrollment period opens soon for people losing Medicaid coverage

The Centers for Medicare and Medicaid Services (CMS) will open an ACA special enrollment period (SEP) for people losing Medicaid coverage due to the end of the COVID-19 public health emergency (PHE). The PHE ends May 11. The ACA SEP aims to maintain continuity of coverage as people transition from Medicaid into a Marketplace-qualified health plan. It runs March 31 to July 31, 2023. Have any questions regarding this notice? Don’t hesitate to contact your Total Benefit Solutions health insurance specialists today at (215)355-2121.

Continue Reading