What are Commuter or Transit Benefits (Section 132)?

Commuter or Transit Benefits (Section 132) Parking & mass transit expenses may be paid for with pre-tax dollars through a commuter plan. This plan is a straightforward way for participants to reduce their commuting costs and for employers to gain additional payroll tax reductions. Some states, like NY and NJ have mandated the inclusion of commuter benefit plans over the last few years. A commuter benefit plan is typically offered as one component of a Flexible Spending Account (Section 125) What expenses qualify as commuter/transit benefits? Commuter highway vehicle: A commuter vehicle is any highway vehicle that seats at least 6 adults (not including the driver). In addition, you must reasonably… Read More

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How Does Level Self Funded Health Insurance Work?

We have received a lot of questions regarding the new level funding health benefit programs so we prepared this video to make it a little easier to understand. Ask us today if Level Funding your group’s health insurance might be a good for for your health plan! Contact your Total Benefit Solutions Account manager at (215)355-2121.

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Does Medicare Cover Oral Surgery?

From our partners at HealthLine: If you’re eligible for Medicare and considering oral surgery, you have options to help cover the costs. While original Medicare does not cover dental services that are required specifically for tooth or gum health, it may cover oral surgery for medical conditions. Some Medicare Part C (Medicare Advantage) plans also offer dental coverage. Let’s explore which types of oral surgery Medicare covers and why.   Click here for the full story. Questions about this story or Medicare coverages? Please contact your health insurance specialists at Total Benefit  Benefit Solutions, Inc (215)355-2121  

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Impact of Key Provisions of the American Rescue Plan Act of 2021 COVID-19 Relief on Marketplace Premiums

there are millions of uninsured people who could be getting subsidized coverage on the ACA Marketplaces, but have not taken advantage of this financial help. In many cases, it may be that the financial help available to them is not sufficient to make the premium or the deductible affordable

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ARPA Extends Open Enrollment for Individual Coverage in PA

Pennie (PA Individual Exchange) has communicated that they will be extending the open enrollment period from May 15 until August 15, 2021. This extension is to help consumers be able to take advantage of the benefits of the American Rescue Plan. Some of the key benefits of this plan are below: There is no longer a cap on who is eligible for Pennie’s income-based tax credits, which help reduce monthly premium costs. Previously only people whose household income was under 400% of federal poverty level (about $51,000 for an individual), could qualify for a tax credit. Now, anyone may be eligible for a tax credit. The size of the tax… Read More

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What is Minimum Essential Coverage or MEC health insurance?

The Affordable Care Act states that all individuals must have health benefits and all employers with 50 or more full-time employees must provide coverage to all eligible employees or they are subject to fines/penalties. This can be known as “pay or play” or employer shared responsibility. We offer Minimum Essential Coverage plans which both penalties are satisfied for the employee and the employer. MEC plans are substantially less expensive than traditional medical insurance and serve as a low-cost solution for most companies. To contain healthcare costs, many employers and other plan sponsors are considering Minimum Essential Coverage, or MEC, health insurance. MEC plans can keep your workforce healthier. Preventable diseases, gone… Read More

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Departments Issue Guidance Re: FFCRA and CARES Act

On February 26, 2021, the Departments of Labor, Health and Human Services, and the Treasury (together, the “Departments”) issued FAQ 44 addressing health coverage issues related to COVID-19. Briefly, the new FAQs focus on diagnostic testing and coverage for testing and clarify previous guidance in FAQs.Background Section 6001 of the FFCRA requires group health plans (including grandfathered health plans) and health insurance issuers to provide coverage for certain items and services related to testing or the diagnosis of COVID-19 without any cost-sharing requirements, prior authorization or othermedical requirements. Section 3201 of the CARES Act amended Section 6001 of the FFCRA to include a broader range of diagnostic items and services… Read More

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New COBRA Subsidy Begins April 1st under COVID Relief

Congress passed the American Rescue Plan Act of 2021 (“the Act”) on March 10, 2021 and it was signed into law on March 11, 2021. The Act includes a 100% COBRA subsidy available to certain COBRA qualified beneficiaries who lose group health plan coverage as the result of an involuntary termination or reduction in hours. This is different from the original House legislation, which included an 85% subsidy (with the COBRA beneficiary responsible for 15% of the COBRA premiums). Employers will be able to claim a credit against payroll taxes to reimburse the cost of the subsidy. The COBRA subsidy begins April 1, 2021 (the first day of the month… Read More

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HSA/HDHP Limits Increase for 2020

On May 28, 2019, the IRS released Revenue Procedure 2019-25 to announce the inflation-adjusted limits for health savings accounts (HSAs) and high deductible health plans (HDHPs) for 2020. These limits include: The maximum HSA contribution limit; The minimum deductible amount for HDHPs; and The maximum out-of-pocket expense limit for HDHPs. These limits vary based on whether an individual has self-only or family coverage under an HDHP.  The IRS limits for HSA contributions increase for 2020. Eligible individuals with self-only HDHP coverage will be able to contribute up to $3,550 for 2020, while eligible individuals with family HDHP coverage will be able to contribute up to $7,100 for 2020. The HDHP… Read More

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Court Strikes Down Association Health Plan Rules

On March 28th, 2019, a Federal District Court in the District of Columbia struck down significant portions of the Department of Labor’s (DOL’s) Association Health Plan (AHP) Final Rule. Specifically, the Court found the DOL “failed to reasonably interpret” ERISA when issuing these rules: • expanding the definition of “employers” to include disparate groups of employers with no other commonality of interest other than geographic location; and • bringing working owners without employees within ERISA’s framework. This ruling effectively eliminates the expansion of AHPs to certain employers and working owners who do not meet the original parameters to be a part of an AHP. Click below to download the complete… Read More

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New Jersey Small Employer Stop Loss Bill

A bill has been introduced in New Jersey in both the Senate and Assembly that, if passed, would prohibit insurance carriers or other insurers subject to the insurance laws of New Jersey or any other state from offering, issuing or renewing any stop loss insurance policy of any kind to small employers. Stop loss insurance provides reimbursement for catastrophic, excess or unexpected expenses and is used by small employers to self-insure part of the health insurance coverage they provide for employees. Under New Jersey law, in connection with a group health plan, a small employer means an employer with 2-50 eligible employees on business days during the preceding calendar year. If passed,… Read More

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Change of Income? When and How to Notify the Marketplace.

One of the benefits of getting your Health Insurance through the Marketplace is the tax credit applied to your premium, which makes your costs much more affordable. However, when determining how much your tax credit will be, you use an estimate on your income for the following year. Life is always changing, so if your income changes, if your Family size changes or even being offered Healthcare in some other way it is IMPORTANT to alert the Marketplace of these changes or you may end up owing money back to the Government when you file your taxes at the end of the year. Here we will talk about which types… Read More

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“I’m paying for Health Insurance I don’t even use!”

You hear it all the time: “I’m paying for Health Insurance I don’t even use!” But, Health insurance isn’t only for when you’re sick!  You can use it to maintain your healthy status, you can use it for Preventative Care and you can also use this time to learn how your coverage works before you get sick. Also, many Health Insurance Plans offer things such as discounted gym memberships and rewards for healthy lifestyle choices (such as quitting smoking). Some plans even offer vision or dental benefits, so you can take advantage of an eye screening or 6 month dental check-up. Take advantage of free insurance benefits anytime Get preventive services,… Read More

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Ways to Save Money on Your Prescription Drugs

Prescriptions costs are skyrocketing. We all know that. But did you know that there are several ways for people to save money on their monthly medications? As health insurance plans are becoming more catastrophic in nature, that means that people will need to become better health care consumers. Sometimes that means using the tools that the insurance company offers at no charge. Sometimes it means using discounts and other resources that are available outside the health plan. Here are a few ways, some already widely known and others not so much, to help drop down your costs at the Pharmacy. While this is not a comprehensive list of money-saving ideas, it is… Read More

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Important Info! HSA Limits for 2019

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“Can I use my HSA for…….?”

Health Savings Accounts and You Health Savings Accounts (HSAs) aren’t new. They’ve been around since late 2003. Initially they were created along with the Medicare Prescription Drug, Improvement, and Modernization Act  to replace the Medical Saving Account System. Initially these plans were designed to help with Drug Costs under Medicare policies; However, as Insurance Premiums increased, more and more Employer and Individual Policies offered High-Deductible Plans to help curb costs. Due to that, HSAs were thrown into the spotlight as a way to use Pre-Tax Dollars to cover out-of-pocket Medical costs. In 2017, a reported 22million Americans have an HSA. Each year, that number continues to climb. Many people still have a… Read More

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Common Questions: Rules For Your HSA After Becoming Medicare Eligible

Medicare and Your HSA In 2017, over 22 million Americans have a Health Savings Account. Each year that number goes higher and higher as High Deductible Plans become more popular with Individuals and Employers. Once you turn 65 and enroll in Medicare, you can no longer open an HSA or deposit money into it, but what if you already had one with a balance? You don’t have to worry about a “Use It Or Lose It” clause. That money can still be used towards out-of-pocket costs! Here are some very common questions about how you can continue to benefit from your HSA and why keeping funds in it for your… Read More

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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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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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IRS Releases 2018 Inflation Adjustments to Tax Provisions

The Internal Revenue Service released the annual inflation adjustments that will apply to certain benefit plan tax provisions in 2018. Revenue Procedure 2017-58, which can be accessed by clicking here, identifies inflation-adjusted items for different provisions of the tax code. From an employee benefits standpoint, the following limits may be of interest to employers: The dollar limit on voluntary employee salary reduction contributions to health flexible spending accounts is increased to $2,650 for plan years beginning in 2018. The monthly exclusion amount for transportation and transit passes is increased to $260. The monthly limit for the qualified parking exclusion is increased to $260. The dollar amount used to determine the penalty… Read More

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Extension of Deadline for 2017 Forms 1095-C

On December 22, 2017, the IRS issued Notice 2018-06, which provides a limited extension of time for employers to provide 2017 Forms 1095-C to individuals. It also extends good-faith transition relief from certain penalties for the 2017 reporting year. The deadlines to provide Forms 1094-C and 1095-C to the IRS was not extended. Should you have any questions, please contact your Total Benefit Solutions account manager at (215)355-2121.   Click to Download Extension of Deadline for 2017 Forms 1095-C

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2018 Inflation Adjusted Amounts for HSAs

The IRS released the inflation adjustments for health savings accounts (HSAs) and their accompanying high deductible health plans (HDHPs) effective for calendar year 2018. All limits increased from 2017 amounts. Click to download the bulletin below and as always contact your Total Benefit Solutions account manager at (215)355-2121  if you have any questions or concerns regarding this notice.   Click Here to Download 2018 Inflation Adjusted Amounts for HSAs

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Independence speaks out on PA Premium Tax, Treat No Transport, and recently introduced bills

Independence speaks out on PA Premium Tax, Treat No Transport, and recently introduced bills Updates from IBX Government Affairs including the proposed PA premium tax changes, Treat No Transport reimbursement, scope of practice for nurse practitioners, and proposed bills on drug transparency and prior authorization… Download the Bulletin See IBC’s breakdown of the proposed budget impact here. 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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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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HSA / FSA / HRA Comparison of Key Features for 2017

HR360: HSA / FSA / HRA  Comparison of Key Features for 2017 This guide brought to you by our partners at HR360. As us today how your organization can benefit from personalized HR services designed to fit your company’s legal compliance needs! Your Total Benefit Solutions Inc Account Manager is available at (215)355-2121. Click here to download the complimentary guide  

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