On February 21, 2024, MVP stopped doing business with Change Healthcare and its subsidiaries, as well as all digital interactions. This was due to a cyber security breach. In compliance with national and state regulations, MVP is implementing innovative business solutions and restoring affected service functionality as needed. Processing Delays for Provider Claims : New York State Department of Financial Services encourage issuers and pharmaceutical benefit managers (PBMs) to take into account granting provider requests to halt or reverse specific administrative processes. MVP is assessing each provider’s request for suspension and tolling individually and determining whether a certification is necessary. To read more click HERE We are dedicated to providing… Read More
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Health Care Cyberattack
Although it does not yet know when the recovery from the Change Healthcare hack last month will be completed, UnitedHealth is testing the system to restore it. This week, the care giant said that it is testing technology for processing medical claims. It already has mostly restored systems for handling drug claims and processing payments. The technology utilized to file and handle insurance claims is provided by Change Healthcare. It works with claims from many insurers and processes around 14 billion transactions annually. Some patients might be directed to different pharmacies where billing issues are less of a concern. Industry executives have stated that delays in patient bills are possible. Progress:… Read More
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UnitedHealthcare – RxDC Information Required by Deadline
Please assist us in answering the required questions in the CAA Pharmacy Data Collection request information that is located in the employer/broker portal. It will make sure that UnitedHealthcare can successfully submit the data report. In order for us to prepare the data for submission to CMS by June 1, 2024, we must get the information by April 10, 2024, thus your prompt answer is extremely important. To read more click HERE We are dedicated to providing exceptional service, so please do not hesitate to contact our dedicated Total Benefit Solutions health insurance specialists at (215)-355-2121 or fill out the contact form below. We are available to answer any questions… Read More
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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.
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Exploring PEOs: Efficiency and Compliance Solutions
In today’s business landscape, optimizing operations and compliance is an ongoing challenge. Enter PEOs – Professional Employer Organizations. PEOs offer outsourcing solutions that reshape how companies handle HR and administrative tasks. Let’s dive into the world of PEOs and unveil their potential advantages and drawbacks. A “PEO,” or Professional Employer Organization, forms a strategic partnership where businesses team up with experts to manage HR and admin functions. This collaboration lets companies offload tasks like payroll, benefits, and compliance, ideal for small to mid-sized businesses aiming to streamline while focusing on core activities. Pros of PEOs: Cons of PEOs: In conclusion, PEOs provide a promising avenue for businesses aiming to bolster… Read More
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Cracking the Code: Navigating Health Cost Surge in 2023
Managing Health Costs in 2023 Multiple industry and benefits sources are predicting health insurance premium increases in the range of five to eight percent for 2023. An analysis by Aon is forecasting a 6.5% increase. The Society for Human Resource Management (SHRM) is expecting a bump of 5.6%, based on a prediction by Mercer. The International Foundation of Employee Benefit Plans says employers are anticipating a 7.5% increase. The country’s oldest actuarial consulting firm, Buck, has forecast an increase in the range 5.8% to 6.9%. If you have any questions or concerns about this news please contact your Total Benefit Solutions, Inc health insurance specialists at (215)-355-2121
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How much do employees contribute towards their insurance expenses?
Average Contributions Most employees do make a contribution toward their insurance costs. Covered workers, on average, contribute 17% of the premium for single coverage and 28% of the premium for family coverage. These numbers are similar to those reported by KFF in its EHBS in 2021. The average contribution for workers at small firms is $7,556, which is more than a third higher than the average for those at large firms ($5,580). Workers at private, for-profit firms contribute a higher percentage of the premium versus those at public firms, regardless of coverage type. A fortunate one-third of employees (33%) at small firms are enrolled in coverage where the employer pays… Read More
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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
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Notification Reminder for Forms 1095-C and 1095-B
Under the Affordable Care Act (“ACA”), the deadline for applicable large employers (“ALEs”) to furnish Form 1095-C and 1095-B to certain individuals (such as full-time employees in the case of Form 1095-C) is January 31 with respect to the preceding calendar year. The Internal Revenue Service (“IRS”) released final regulations on December 12, 2022 with respect to ACA reporting requirements. These final regulations provided an automatic extension of 30 days to furnish these statements to individuals. This means that Wednesday, March 2, 2023 is the deadline to furnish individuals with 2022 Forms 1095-C and 1095-B. This extension is automatic; employers or other reporting entities are not required to file a… Read More
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What is Limited Medical Insurance?
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
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Medicare Creditable Coverage Part D notification requirements
FROM INDEPENDENCE: Each year, the Centers for Medicare & Medicaid Services (CMS) requires plans that offer prescription drug coverage to their Medicare‑eligible employees, retirees, and dependents to notify them by October 15 as to whether that coverage is “creditable” or “non‑creditable.” What customers must do Customers must take the following steps to comply with this requirement: Review the materials provided to determine whether their prescription drug coverage is creditable or non‑creditable. Disclose to their Medicare‑eligible members (employees and their dependents) whether their prescription drug coverage is creditable or non‑creditable prior to the Medicare Part D Annual Election period, running from October 15 through December 7 of this year and at other times during the future.… Read More
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Case Study Library
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!
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Health Insurance Broker Change Leads to Better Results
Watch Video The Issue A mid-sized group prospect was unhappy with their current broker and looking for a change. They thought more could be done to help control their employee benefit budget and were looking for guidance. They came to us with a 17% health insurance renewal. Our Solution Our team met with the business owner and Human Resource Director to review the following: The corporate goals and philosophy regarding employee benefits The benefit structure and costs of their present programs Options for cost containment strategies How to integrate wellness into their benefits portfolio Methods for better communication of the benefit programs to employees The Result The customer was pleased… Read More
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2022 PCOR Fee Filing Reminder for Self-Insured Plans
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.
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2022 Patient-Centered Outcomes Research Trust Fund (“PCORTF”) Fees
2022 Patient-Centered Outcomes Research Trust Fund (“PCORTF”) Fees May 23, 2022 This Allied Update serves as a reminder that the annual Patient-Centered Outcomes Research Trust Fund (“PCORTF”) fees are due by July 31, 2022. By way of background, at the end of 2019, the Federal Government reauthorized the annual payment of fees by health insurers and group health plans into the PCORTF until 2029. (Such payments were previously set to expire for plan years ending on or after October 1, 2018 and before October 1, 2019, and beyond.) The fee is due by July 31 of the calendar year immediately following the last day of the plan year in which… Read More
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2021 Second Quarter Compliance Bulletins Compilation
This document is a valuable resource, putting all of the latest health care reform news and updates in one location!
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Tax Advantaged Benefit Documents
This site is dedicated to providing employers with the tools they need to successfully establish these written plans with SPDs at the lowest cost possible.
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Top 10 Questions to Ask Your Benefits Broker
Analyzing these ten critical questions in relation to your organization’s needs will help you make a more informed decision about your benefits broker
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Update on COVID-19 Vaccine and Vaccine Administration Cost
Update on COVID-19 Vaccine and Vaccine Administration Cost
Continue ReadingHow 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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