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.
Continue ReadingPPE and Health FSA/HRA
The IRS announced that amounts paid for personal protective equipment such as masks, hand sanitizer and sanitizing wipes for the primary purpose of preventing the spread of COVID-19 are considered amounts paid for medical care under section 213 of the Internal Revenue Code. These items are now allowed to be reimbursed from a health FSA. The IRS notice recognizes all forms of PPE as expenses medical care and does not limit the PPE to just disposable or non-disposable items. Reimbursements are permitted for expenses incurred on or after 1/1/2020 and they must be properly documented for reimbursement. If plan terms do not allow the reimbursement of PPE but the plan… Read More
Continue Reading
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
Continue ReadingARPA 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
Continue ReadingDepartments 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
Continue ReadingNew 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
Continue ReadingPandemic Aid Package Includes Relief From High Premiums
From KHN: As President Joe Biden’s pandemic relief package steams through Congress, Democrats have hitched a ride for a top health care priority: strengthening the Affordable Care Act with some of the most significant changes to insurance affordability in more than a decade. The bill would spend $34 billion to help Americans who buy insurance on the marketplaces created by the ACA through 2022, when the benefits would expire. The Senate sent its relief package, one of the largest in congressional history, back to the House where it could come up as early as Tuesday. It is expected to pass and then go to Biden for his signature. Highlights… Read More
Continue Reading
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.
Continue Reading
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.
Continue ReadingHealth Reform: 4th Quarter 2016 Compliance Compilation
Download a digest of our fourth quarter compliance bulletins. This digest includes the following bulletins: Transitional Reinsurance Fee Form Now Available 10/14/2016 Final 2016 Forms 1094-C and 1095-C Available 10/25/2016 November 2017 Cost of Living Adjustments 11/01/2016 Relief Extended for Premium Reimbursement Programs for Student Employees 11/02/2016 Updates Regarding the NJ Small Employer Health Benefits Program 11/07/2016 Election Results and the ACA: Preliminary Thoughts 11/10/2016 16 Extension of Deadline for 2016 Forms 1095-C 11/21/2016 Adjusted PCOR Fee for Fifth Filing Year Released 11/22/2016 December Beware of Phishing Email Disguised as HIPAA Privacy Audit Letter 12/13/2016 Click here to download the 4th quarter compliance compilation
Continue Reading
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
Continue ReadingFAQ Suggests Employers Include Marketplace Options with COBRA Notices
On June 21, 2016, the Departments of Labor, Health and Human Services, and the Treasury (collectively, the “Departments”) issued the 32nd Affordable Care Act (“ACA”) FAQ describing information that may be appropriate to include with COBRA notices. Many wondered if it were appropriate to provide information and if so, what kind of information could be provided about the Health Insurance Marketplaces/Exchanges (“Marketplaces”) so that COBRA-eligible individuals could consider health coverage alternatives available through the Marketplaces and possibly investigate whether they may be eligible for premium tax credits and cost-sharing reductions. Click the link to download the entire bulletin
Continue ReadingThink HR Comply: Small Business Support from Total Benefit Solutions
We are pleased to introduce to you a our sponsored client service—ThinkHR. If you are involved with employee issues, this will be a value-added benefit that will save you time and money. ThinkHR offers ThinkHR Live, a team of HR experts standing by to answer your questions or provide advice. This phone-based support service is available from 8:00 a.m. to 7:00 p.m. Central each business day. You also have access to ThinkHR Comply, an award-winning online resource center for all of your workforce issues. Download this brochure, it describes the scope of HR topics that are handled by the ThinkHR Live team. The service is provided to all Total Benefit… Read More
Continue ReadingAmerihealth NJ: No Longer Providing COBRA Administration
AmeriHealth New Jersey has announced that they will no longer provide administrative services for the continuation of coverage under the Consolidated Omnibus Reconciliation Act (COBRA) and Retiree Billing services. AmeriHealth NJ will discontinue COBRA administration and Retiree Billing services in 2016 for customers on the following schedule: For customers renewing January 1 through July 31, COBRA administration services will end on December 31, 2016. For customers renewing August 1 through December 31, services will end on their 2016 renewal date. Approximately 30 days before COBRA administration services end, COBRA members will be notified that their COBRA plan is being transferred to another service provider, and their COBRA eligibility will continue uninterrupted. … Read More
Continue ReadingLimited Benefit Medical Plans
Why Consider a Limited Benefit Medical Plan? When it comes to medical benefits, employers used to face two choices — comprehensive employer-paid medical plans or no insurance at all. However, with the inception of the Patient Protection and Affordable Care Act (PPACA), the option not to offer medical insurance no longer exists for some employers. Limited benefit medical plans can be powerful tools for recruiting and retaining employees in situations where traditional medical benefits are not offered or affordable. These plans can also be useful in increasing productivity through reduced absenteeism due to illness, improving employee morale and as a means to provide the level of coverage required by law.… Read More
Continue ReadingNow Available: Health Advocate Member Advocacy
Total Benefit Solutions clients can now take advantage of enrolling on Health Advocate as a group or as an individual/ family! It’s part of our Benefit Aid packages and it’s so easy you can enroll today by clicking here or ask your Total Benefit Solutions account manager at (215)355-2121 for more information. This video will tell you all about the benefits of Health Advocate!
Continue ReadingHealth Care Reform: 8 things the IRS wants small employers to know about the health care tax credit
The Affordable Care Act’s small business health care tax credit is designed to encourage small employers to offer health insurance coverage to their employees. Click the link below to download the whitepaper 8 things the IRS wants small employers to know about this credit: 8 Things to Know About the Small Business Health Care Tax Credit For more information about the Small Business Health Care Tax Credit contact your Total Benefit Solutions, Inc account manager at (215)355-2121 or visit your ThinkHR library at www.thinkhr.com and log in. Watch a video below about the Small Business Healthcare Tax Credit
Continue Reading
Now Available: Empower Me Benefits Private Exchange
Total Benefit Solutions has partnered with Empower Me Benefits to provide our clients with best in industry benefits technology that‘s customizable for even the smallest employer. The EmpowerMe Benefits Exchange allows you to remain complaint with the Affordable Care Act (ACA), easily manage benefits, and control health care costs with a single solution. The EmpowerMeBenefits Exchange is an online benefit marketplace and benefits administration platform designed specifically to meet the needs of small and mid-sized companies. The Exchange provides employers with an enrollment and administration platform that aids employers in ACA compliance. This web-based solution allows you to offer any medical coverage next to pre-selected ancillary, voluntary, and TPA products.… Read More
Continue ReadingGroup Health Plan Notices 2015 CALENDAR
Group Health Plan Notices 2015 CALENDAR From our partners at HR360: This calendar/checklist is designed to help companies review the key reporting and notice requirements that may apply to their employer-sponsored group health plans under ERISA , the Affordable cxare Act, Medicare and more. Please note that this list is for general reference purposes only and is not all-inclusive. Note: ERISA and benefit requirements are complex, and your plan’s responsibilities may vary depending on the individual circumstances surrounding your company’s plan. Employers who have questions are encouraged to consult with their plan administrators, the U.S. Department of Labor’s Employee Benefits Security Administration, the Internal Revenue Service, or a knowledgeable employment law attorney… Read More
Continue ReadingHow do Tiered Network plans like the Keystone HMO Proactive and Horizon Omnia plans work?
Tiered or Narrow Network Plans: Under the Affordable Care Act, insurance carriers have introduced “tiered network”, or narrowed network plans. Keystone Proactive HMO Plans from Independence Blue Cross have a unique ” 3 tiered” network of providers. Although each carrier has different types of networks and benefit levels, the plans have the same general concept, steering the members by giving them a choice of providers that offer medical services at a lower out of pocket expense. Choosing a more expensive provider or facility may cost the member more out of pocket costs. United Healthcare offers 2 tiers in their “Navigate” plans, and Aetna uses “Savings Plus” designated providers to split… Read More
Continue Reading
2014 Compliance Bulletin Compilation
Download our 2014 Compliance Bulletin Compilation, featuring all of our released compliance bulletins for the entire year! Topics include, Health Savings Accounts, The Individual Mandate, Employer “pay or play” mandate, exemptions, FSA carryovers and much, much more. All of the bulletins are in an easy to search format for your convenience. 2014 Compliance Compilation – Download As always please contact your Total Benefit Solutions account manager at (215)355-02121 if you have any further questions or concerns.
Continue Reading
Health Reform: Healthcare.Gov Sneak Preview
Healthcare.Gov Sneak Preview Announced Yesterday, Affordable Care Act customers can peek at 2015 prices for the program’s health plans today after the government released a “window-shopping” feature overnight Here is a direct link to the 2015 “sneak preview”: https://www.healthcare.gov/see-plans/ If you have any questions or concerns about your 2015 enrollment, please contact Total Benefit Solutions at (215)355-2121
Continue Reading
Total Benefit Solutions is your Marketplace Navigator
What do you get with Total Benefit Solutions as your Marketplace Navigator? A broker who is Unbiased and objective Trained Local Certified Licensed Insured Up to date Representing you Part of a team of dedicated professionals Click here for more information and to see our “Marketplace Navigator” brochure: Individual Enrollment Navigator Brochure
Continue Reading
2015 Health Reform: Prepare for Health Insurance Open Enrollment
Preparing for 2015 Open Enrollment Getting prepared for open enrollment 2015 has been a major challenge. Total Benefit Solutions is dedicated to serving all of our clients throughout this second annual open enrollment period. With that in mind our offices will be open on the weekend of November 15th 2014 to help you get enrolled. Open enrollment for individual plans begins November 15th, 2014 and ends February 15th 2015. Anyone who enrolls prior to the 15th of the month will be effective the 1st of the next month. This is important because you must enroll by December 15th in order for your plan to be effective on January 1st, 2015… Read More
Continue Reading
Health Reform: SHOP Marketplace Changes for 2015
Health Reform: SHOP Marketplace Changes for 2015 In 2014, small businesses that offer coverage through an FF-SHOP Marketplace are able to offer their employees a single qualified health plan (QHP). In 2015, small businesses that offer coverage through an FF-SHOP Marketplace may be able to offer their employees a choice of QHPs and qualified dental plans (QDPs). To qualify for an FF-SHOP, a business must: Be located in an FF-SHOP’s service area (generally a state) Have at least one eligible common-law employee on payroll Have 50 or fewer full-time equivalent (FTE) employees on payroll This methodology includes part-time employees, but not seasonal employees (those working fewer than 120 days per… Read More
Continue Reading