Introducing Xpress Healthcare with Aetna Dental Access!

Total Benefit Solutions offers Xpress Healthcare with a great dental discount & more for Individuals, Families and Seniors! Click Here to shop, compare & enroll!

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The Four Stages of Medicare Part D (2018)

The Four Stages of Medicare Part D Coverage                          

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Watch Out For Medicare Scams!

Your new Medicare card is on the way, so if someone calls and says you need to give them your personal information or money to get the new card, hang up! It’s a scam. Medicare will never call uninvited and ask for personal information or money for you to get your new Medicare Number and card.Learn what to do if you get a suspicious call like this. If you haven’t gotten your new Medicare card yet, don’t worry. Mailing cards to each group of states takes at least a month, so you might get your card at a different time than friends or neighbors in your area. In the meantime, keep… Read More

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Your New Medicare Card is on the way! Watch out for scams!

Watch out for scams Your new Medicare card is on the way, so if someone calls and says you need to give them your personal information or money to get the new card, hang up! It’s a scam. Medicare will never call uninvited and ask for personal information or money for you to get your new Medicare Number and card. Learn what to do if you get a suspicious call like this. If you haven’t gotten your new Medicare card yet, don’t worry. Mailing cards to each group of states takes at least a month, so you might get your card at a different time than friends or neighbors in your area.… Read More

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Medicare Part D Donut Hole Closing Sooner!

Did you know? The Bipartisan Budget Act of 2018 moved up the date for closing the so-called donut hole for brand name drugs to 2019. It was previously 2020. For 2019 and every year after, the beneficiary cost sharing for brand name drugs after the initial coverage limit is 25% — the same as after the deductible and before the initial coverage limit. In 2020, the beneficiary cost sharing for generic drugs will also be 25%. Ask your Total Benefit Solutions Account Manager for more information at (215)355-2121. Total Benefit Solutions Inc. is your Medicare health insurance specialist! We work for your benefit!

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CMS Expands the Extension of Needed Relief for Marketplace Enrollees Who Missed Medicare Enrollment

CMS is offering assistance to certain individuals enrolled in both Medicare Part A (and/or Part C) and the Exchange for individuals and families to drop their Exchange coverage and enroll in Part B without penalty. Further, CMS is offering assistance to certain individuals who dropped or lost their coverage from the Exchange and are paying a Part B late enrollment penalty from their subsequent enrollment into Part B. These eligible individuals can have their penalty reduced. Individuals can apply for the special enrollment and reduction in late enrollment penalties during a limited time – it is available now and ends September 30, 2018 Read Blog Post from MedicareRights.org CMS SHIP… Read More

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Four Stages of Medicare Part D

  It’s easy to see why Many people are confused by the Medicare part D plan coverage deductibles, limits and the donut hole. We have provided this graphic for you, our clients and friends to make it a little easier to see in a pie chart. Click the link below to download this graphic bulletin. 2018 Four Stages Of Medicare Part D   Want to compare part D plans in your area quickly? Click here   Have more questions? Call us today at (215)355-2121.

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Your Medicare Card Is Changing!

  The Medicare Access and CHIP Reauthorization Act (MACRA) of 2015 requires that Social Security Number-based Health Insurance Claim Numbers (HICN) be removed from Medicare cards by April 2019; this is in an effort to lessen the current risk of beneficiary medical identity theft. A unique Medicare number, called the Medicare Beneficiary Identifier or MBI, will replace the current HICN. Beginning in April 2018, the Centers for Medicare and Medicaid Services (CMS) will begin the process of mailing new Medicare cards and will meet the statutory deadline for replacing all cards by April 2019. Educational Resources:  CMS Transition to New Medicare Numbers and Cards – Fact Sheet CMS Website –… Read More

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Medicare Part D CMS Notification Reminder

  Employers sponsoring a group health plan need to report information on the creditable status of the plan’s prescription drug coverage to the Centers for Medicare and Medicaid Services (CMS). In order to provide this information, employers must access CMS’s online reporting system at: https://www.cms.gov/Medicare/Prescription-Drug-coverage/CreditableCoverage/CCDisclosureForm.html   Click here to download the complete bulletin As always please contact you Total Benefit Solutions, Inc. account manager at (215)355-2121 if you have any additional questions or concerns.          

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CMS publishes updated 2018 Medicare cost-sharing amounts

The Centers for Medicare & Medicaid Services (CMS) recently published updated cost-sharing amounts for 2018 which are outlined below. 2018 Medicare Costs at a Glance Standard Part B Premium Most people pay $134 each month Medicare Part B deductible (Medical deductible) $183 per year Medicare Part A deductible (Hospital deductible) $1,340 for each benefit period Beneficiaries will pay $134 (or higher depending on income) if they: • Enroll in Part B for the first time in 2018, or • Are directly billed for their Part B premium, or • Are dually eligible for Medicaid and have their premium paid by state Medicaid agencies pay an income-related premium Some beneficiaries who were held… Read More

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Total Benefit Solutions Partners with Clover Health

New to Bucks County this year, Total Benefit Solutions is proud to announce that we have added Clover Healthg to our list of outstanding Medicare partners. Ask us during your briefing if Clover Health is a good fit for you!

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Total Benefit Solutions Recertifies with Humana Medicare

Once again Total Benefit Solutions will be offering Humana Medicare Advantage Plans, Medicare Supplements and Medicare Part D PDP Drug plans as we have recertified with Humana. Ask us today if a Medicare plan from Humana might be a good fit for you. Watch this short video to learn more about Humana PDP plans.  

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Can I Work and Have Medicare?

Some individuals, maybe even you, will still be actively employed upon becoming eligible for Medicare. Can you enroll in Medicare while you’re still in the work force, and if not, will you get a penalty? If the employer has fewer than 20 employees, you’ll probably want to enroll in Parts A, B, and D upon becoming eligible for them. In this situation, Medicare usually becomes your primary coverage. If the employer has 20 employees or more, you may want to delay Parts A, B, and/or D if you have sufficient group coverage and know you won’t incur late enrollment penalties. Medicare usually pays second to group coverage from larger employers.… Read More

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Compare Medicare Plans in Your Area in real time!

  With Medicareful you can search and compare Medicare health plans at your own convenience, but with an expert nearby at Total Benefit Solutions Inc to help guide you along the way. Log in today and see for yourself! http://www.medicareful.com/totalbenefitsolutions

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Humana and Tenet have reached a new network agreement

Humana and Tenet have reached a new network agreement Humana is pleased to announce we have signed a new agreement, effective June 1, 2017, that allows Humana commercial, Medicare Advantage, Medicaid, and individual exchange health plan members to receive in-network care at Tenet hospitals, hospital-affiliated outpatient centers, and with Tenet physicians. We are currently in the process of loading Tenet providers to all applicable systems. There may be a delay in providers appearing in Physician Finder even though they are participating. For the best possible member experience, as always, we advise the member to check Physician Finder before seeking non-emergent care from a provider in order to help avoid any… Read More

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Video: New Individual Dental & Vision Choices

Click here to shop, compare and enroll!

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GOP Pulls AHCA Before Vote

On Friday, March 24, 2017, the U.S. House of Representatives pulled the American Health Care Act (“AHCA”) from consideration after not receiving enough Republican support to pass the bill. The AHCA was President Trump’s first attempt to repeal and replace the Affordable Care Act (the “ACA”). The AHCA, among other things, would have eradicated the penalties associated with the individual and employer mandates, and replaced the ACA subsidies with refundable tax credits. Download GOP Pulls AHCA Before Vote

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Compliance Bulletin & Reform Center

Health Care Compliance and Reform Education Center A fundamental change in the way the United States handles health care has arrived. Benefit rules and coverage change faster today than they used to in ten years! Our Compliance and Health Reform Education Center is where we will keep a copy of our health care reform bulletins throughout the year, in an easy  to view format where you can download a brief summary or watch a short informative video. Click here to visit totalbenefitscomply.com Please contact your Total Benefit Solutions account manager at (215)355-2121 if you have any further questions.  

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MEDICARE PART D: CMS NOTIFICATION REMINDER

Employers sponsoring a group health plan need to report information on the creditable status of the plan’s prescription drug coverage to the Centers for Medicare and Medicaid Services (CMS). Watch a video overview   Download a bulletin

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2016 Compliance Year In Review Digest

2016 Compliance Year In Review Digest A complete digest of all our compliance bulletins for the entire year of 2016 from our business partners at Emerson Reid. A handy guide to all of the year’s updates and changes all in one place. Download your copy now and keep it for future reference.   Click to Download Compliance Digest 2016 Year in Review     As always please contact your Total Benefit Solutions Account Manager at (215)355-2121 if you have any questions or concerns.

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Health Reform: Cost of Living Adjustments, Individual Penalty, HSA limits & more for 2017

    On October 25 and 27, 2016, the IRS released cost of living adjustments for 2017 under various provisions of the Internal Revenue Code (the Code). Some of these adjustments may affect your employee benefit plans. These adjustments include but are not limited to the following: Cafeteria Plans Qualified Transportation Fringe Benefits Requirement To Maintain Minimum Essential Coverage (Individual Penalty) Highly Compensated Non-Grandfathered Plan Cost-Sharing Limits H.S.A. Annual contribution limitation, catch up contribution and minimum deductibles Key Employee   Click here to download the bulletin   As always if you have any additional questions or concerns, please contact your dedicated Total Benefit Solutions, Inc. account manager at (215)355-2121.

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Total Benefit Solutions participating in CVS Retail Locations During Medicare Open Enrollment

Total Benefit Solutions is pleased to announce that we are participating in the Independence Blue Cross Medicare/ CVS Pharmacy retail program for the upcoming open enrollment period. What this means to our clients is that we will be on site at our local CVS Pharmacy during the AEP. Starting on Saturday October 15th and continuing through open enrollment we will be on site nearly each  Monday, Wednesday and Friday at the CVS Pharmacy in Feasterville from Noon to 2 PM each day. Please feel free to stop in without an appointment to get your questions answered and pick up your 2017 plan information from Independence Blue Cross.   We will… Read More

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Reminder to Distribute Creditable Coverage Notice

  Employers who sponsor a group health plan with prescription drug benefits are required to notify their Medicare-eligible participants and beneficiaries as to whether the drug coverage provided under the plan is “creditable” or “non-creditable.” This notification must be provided prior to October 15th each year. Download medicare-part-d-reminder-to-distribute-creditable-coverage-notice-

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Original Medicare: Did You Know?

Many Medicare beneficiaries are unaware that original Medicare coverage has significant deductibles and co-pays. Part A helps cover medically necessary inpatient care in hospitals. In 2016, for each benefit period (typically 60 days as defined by Medicare) in a year, beneficiaries pay: $1,288 deductible and no coinsurance for a stay of up to 60 days $322 coinsurance per day for days 61-90 of a hospital stay $644 coinsurance per “lifetime reserve day” after day 90 each benefit period (up to 60 days over your lifetime) All costs for each inpatient day beyond 150 days   At Total Benefit Solutions, Inc we specialize in Medigap programs that are affordable and cover most or… Read More

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Healtcare Reform Law

ACA: Important Implementations & Delays in 2016

As our third year of the ACA Open Enrollment Period arrived, it’s time to examine some of the new implementations in 2016. Some of the major components, especially those affecting businesses were delayed or deferred since the passage of the Affordable Care Act in 2010. This year is considered to be a big year due to the “full implementation” of the employer mandate as well as a number of changes, repeals, and moratoriums on other sections of ACA. Some of the key changes are listed below: CHANGES AND IMPLEMENTATIONS Full implementation of the Employer Mandate Currently it is not mandated that employers provide health care to their employees. Moving forward, however, if… Read More

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