Maximum Out of Pocket Limits Announced for 2021

On May 8, 2020, the Department of Health and Human Services (“HHS”) published its Annual Notice of Benefit and Payment Parameters for 2021. This guidance is a final rule that addresses certain provisions of the Affordable Care Act (“ACA”). The final rule follows a proposed rule issued in January. Generally, these changes apply to plan years beginning on or after January 1, 2021.   Click to download this notice If you have any questions or concerns about this notice please contact your Total Benefit Solutions, Inc. Benefit Specialist at (215)355-2121.

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VSP Vision Extends current rates

So much has changed in our business environment due to the COVID-19 pandemic. VSP® Vision Care is committed to doing all we can to help our clients navigate through the uncertainty, as we move toward recovery. Effective immediately, VSP is automatically extending policies for all clients* with fewer than 1,000 enrolled that are scheduled to renew between August 1, 2020 and March 1, 2021. The extension will allow the client to keep their current rate for an additional 24 months, which helps to provide them with fiscal certainty and stability. It’s our way of helping ease the burden of the current business climate.  August 1, 2020 – September 1, 2020… Read More

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In Memoriam: Avraham S. MacConnell

  We are extremely sad to announce the sudden passing of our founder, Avraham Shlomo MacConnell Born Edward Andrew MacConnell on January 10th 1948, he passed away suddenly on Monday May 11 2020, Due to complications caused by Coronavirus. Founder: Avraham S MacConnell   Born at St Joseph’s Hospital in Philadelphia. Parents were Robert T MacConnell & Beatrice ( Patterson) MacConnell. Avraham had a diverse and enriched life. He was drafted and served in Vietnam for the US Army from 1967-1969. His first child, Edward was born while he was there. When he returned he joined the Philadelphia Police Department in 1970 and served the citizens of Philadelphia until 1987… Read More

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IRS Issues Relief for Cafeteria Plans in Response to COVID-19

On May 12, 2020, in response to the COVID-19 pandemic, the Internal Revenue Service (“IRS”) issued two notices,Notice 2020-29 and Notice 2020-33, providing welcome relief and guidance to employers sponsoring Section125 cafeteria plans (“Section 125 plans”), health flexible spending accounts (“health FSAs”), dependent careassistance programs (“DCAPs”), and qualified high deductible health plans (“HDHPs”).Click Here to Read IRS Issues Relief for Cafeteria Plans in Response to COVID-19 – 051520R

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SEP for individuals affected by a FEMA-Declared Weather Related Emergency or Major Disaster — Applicable for COVID-19

The Centers for Medicare & Medicaid Services (CMS) clarified yesterday that the Special Enrollment Period (SEP) for Individuals Affected by a FEMA-Declared Weather Related Emergency or Major Disaster is applicable and is available for beneficiaries who were eligible for — but unable to make — an election due to the COVID-19 pandemic and meet the terms of the SEP listed below. Who’s eligible for this SEP?  What you need to know This SEP is available nationwide to residents of all states, tribes, territories, and the District of Columbia effective March 1, 2020. This declaration does not mean that all Medicare beneficiaries get an SEP. To be eligible, beneficiaries must meet… Read More

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New Guidance Offers Relief and Extends Deadlines for Benefit Plans

  New Guidance Offers Relief and Extends Deadlines for Benefit Plans The Department of Labor’s Employee Benefit Security Administration (EBSA), along with the TreasuryDepartment (collectively, “the Departments”), issued several pieces of guidance over the last week affectingemployer-sponsored benefit programs. Click Here for New Guidance Offers Relief and Extends Deadlines for Benefit Plans – 050520R As always contact your Total Benefit Solutions benefit specialist at (215)355-2121 if you have any questons or concerns about this bulletin

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COVID-19 Returning to Work and Benefit Eligibility Considerations

Employers with employees returning to work after a leave of absence, reduction in hours (e.g., furlough) or termination of employment (e.g., layoff) may have questions about the implications for medical benefit eligibility and the effect on the ACA’s employer shared responsibility rules. The answer to the benefit eligibility question will depend heavily on whether the employee was terminated fromemployment (a termination and rehire) or kept active as an employee (e.g., while on furlough) with continued benefit eligibility. Click here to download COVID_19_Returning_to_Work_and_Benefit_Eligibility_Considerations As always please contact your Total Benefit Solutions benefit specialist at (215)355-2121 if you have any questions or concerns about this bulletin. 

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Deferred Payment Plans For Groups Facing Hardship During COVId-19 Crisis

From IBC: We have been closely monitoring the situation with COVID‑19 (Coronavirus) and we understand the financial impact our customers and members may be experiencing. We are committed to working with our customers to help them get through the crisis and will be offering payment flexibility for the customers who are most in need. Instructions for Deferred Payment Plan for Customers with Fewer than 500 Employees As announced in a previous Edge article, while we encourage all customers who are able to pay their premiums on time to continue to do so, we understand the toll the COVID‑19 crisis is taking on many businesses. We want to help our mutual… Read More

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HIPAA compliance when employees are working from home

COVID-19 has more Americans working from home than ever, and this changes the way we do business. You are still required to be HIPAA compliant, even while working from home. Our HIPAA partners at Total HIPAA Compliance have created a checklist that all employers who work with HIPAA compliance should  review and share with their employees. Click here for the checklists. As always please contact your Total Benefit Solutions Benefit specialist at (215)355-2121 if you have any questions or concerns about this bulletin.  

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CARES Act Relaxes Requirements for OTC Drugs & Makes other Benefit Changes

Exciting news in the benefits world! The CARES Act, that was signed into law on March 27th, makes access to over-the-counter (OTC) drugs easier for FSA, HRA and HSA participants. Here’s what you need to know: Prescriptions are no longer required for OTC drugs to be considered an eligible expense. FSAs, HSAs and some HRAs can now reimburse OTC drugs without a prescription. Participants will no longer need to provide prescription for OTC drug reimbursements effective immediately. Menstrual care products such as a tampon, pad, liner, cup, sponge, or similar product are now eligible expenses. These changes are permanent and apply to OTC drugs and menstrual care products purchased on… Read More

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Special Enrollment Considerations During the COVID-19 Pandemic

Several insurance carriers are communicating their intent to open a “special enrollment period” in connection with the COVID-19 pandemic. This special enrollment period would allow employees, who had previously failed to enroll in coverage for themselves, their spouses, and/or their children, to enroll in employer sponsored coverage. Carriers will permit employers to opt-in or opt-out of special enrollment periods. Download Special Enrollment Considerations During the COVID-19 Pandemic – 033020R   As always please contact your Total Benefit Solutions, Inc benefit specialist with questions or concerns regarding this notice at (215)355-2121.

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CDC launches Coronavirus Self Checker

The CDC launched an online bot called Clara to help people who think they may have COVID-19, the disease caused by the novel coronavirus, decide whether to seek medical care. The Coronavirus Self-Checker asks questions to establish the user’s level of illness and their location, and recommendations for users may include calling 911 or staying at home and contacting their health care provider within 24 hours. Click here to open the Self Checker

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Refundable Tax Credits Would Finance Paid Leave

There are still many questions for small business owners about the economic help coming from Washington. The attached gives some guidance about the tax credits for paid leaves.  Download Refundable Tax Credits Would Finance Paid Leave As always contact your Total Benefit Solutions benefit specialist at (215)355-2121 if you have any questions or concerns regarding this bulletin.

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Small Business Loans under the CARES act

We have received a lot of questions about these loans from our clients so we went ahead and asked our accounting firm to explain what is coming in plain language we can all understand.  We hope this can help some of our clients get a better understanding of at least one component of the new act. Here is his response: The following are going to be the two kinds of loans available to small business under the act.  It is one of the loans or the other, not both  We have very little information on the first one, as far as applying, but we now know the exact calculation of… Read More

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Employer Compliance Notice! The “Emergency Family and Medical Leave Expansion Act,” & “Emergency Paid Sick Leave Act.” will affect your business!

In response to the coronavirus (COVID-19) pandemic, Congress enacted a bill providing various forms of relief, including two separate laws mandating that employers give employees paid leave for specified purposes related to COVID-19. The two leave laws are the “Emergency Family and Medical Leave Expansion Act,” and the “Emergency Paid Sick Leave Act.” The leave mandates take effect no later than 15 days after passage (April 2, 2020) and sunset on Dec. 31, 2020.The Emergency Family and Medical Leave Expansion Act. In general, the Emergency Family and Medical Leave Expansion Act amends the federal Family and Medical Leave Act (FMLA) to allow employees to take leave for certain child care… Read More

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Aetna adds benefits during COVID Outbreak

We understand the many challenges you and your clients are facing due to the COVID-19 pandemic.  We continue to monitor this evolving situation and are committed to responding quickly to the COVID-19 pandemic, while also prioritizing the needs of you, your clients and our members. We are pleased to announce that Aetna is waiving cost-sharing and co-pays for inpatient hospital admissions related to COVID-19 for Aetna’s commercially insured members, part of several additional steps to help members access the care that they need during the COVID-19 pandemic.   You can read the complete CVS Health press release here. We will continue to publish updates and information as well as additional questions and… Read More

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Telemedicine and the Coronavirus

As the number of confirmed coronavirus disease 2019 (COVID-19) cases rises daily, hospitals and medical care providers are overwhelmed with phone calls and in-person visits. Telemedicine and telehealth services. Feel free to download this handy guide for you and your employees. While most medical plans include a telemedicine benefit, Total Benefit Solutions does offer a separate Teledoc benefit package for those without health coverage to would like to take advantages of the other services included.  Teledoc is available form under $20 per month. Click here to see the available packages Click to Download Telemedicine and COVID As always contact your Total Benefit Solutions, Inc benefit specialist at (215)355-2121 if you… Read More

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Independence Blue Cross: Employee Eligibility Exception for laid off employees

Employee Eligibility Exception for furloughed or temporarily laid off employees. As a result of the COVID‑19 outbreak, Independence will honor employer requests to continue coverage for employees furloughed or temporarily laid off as a result of impacts of  COVID‑19. This exception applies to fully insured and self-funded business, and is contingent upon the following: Full premium payments continue to be made by the employer.Self‑funded employers must continue to remit invoiced amounts in full. The employer is responsible for collecting employee contributions, if applicable. No reductions to employer contributions will be allowed. Only actively at‑work employees can be added to the plan as new enrollees. Our preferred Stop Loss partner, HM Insurance Group (HMIG) HMIG will honor… Read More

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H.S.A. Bank COVID-19 UPDATES

The safety and well-being of our employees, customers, and partners is HSA Bank’s top priority. We’re actively monitoring the coronavirus disease 2019 (COVID-19) pandemic, and following advice from the Centers for Disease Control and Prevention (CDC) and local health officials. We’re diligently working to ensure continued access to your account information and our services. We have remote work capabilities that will keep our operations running should this pandemic become more widespread. Our Client Assistance Center is currently available 24 hours a day, 7 days a week at 1-800-357-6246. Additionally, we offer click-to-chat during our standard business hours of 8:30 a.m. to 5 p.m. CT, Monday through Friday. And whether you’re at the… Read More

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An Update from us on COVID-19

At Total Benefit Solutions, Inc we’re learning as we go. First and foremost, we wish you and your employees safety and good health.   We wanted you to know that we are up and functional with all of our benefit specialists working remotely for their safety and yours. We are NOT permitted to do face to face meetings at this time due to the governor’s mandated shutdown.   We understand businesses may be forced to make difficult decisions in these uncertain times.   Most employers with 20 or more employees must follow COBRA continuation of coverage notice rules, if they make certain changes to an employee’s health coverage. Smaller employers may… Read More

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DOL Penalties Increase for 2020

The Department of Labor (DOL) published the annual adjustments for 2020 that increase certain penalties applicable to employee benefit plans.  Employer ActionPrivate employers, including non-profits, should ensure employees receive required notices timely (SBC, CHIP, SPD, etc.) to prevent civil penalty assessments. In addition, employers should ensure Form 5500s are properly and timely filed, if applicable. Finally, employers facing document requests from EBSA should ensure documents are provided timely, as requested. Click Here to Download Penalties_Increase_for_2020

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A message from Medicare-Coronavirus

Coronavirus test Medicare Part B (Medical Insurance) covers a test to see if you have coronavirus (officially called 2019-novel coronavirus or COVID-19). This test is covered when your doctor or other health care provider orders it, if you got the test on or after February 4, 2020. Your costs in Original Medicare You usually pay nothing for Medicare-covered clinical diagnostic laboratory tests.  Click here to see the full message.

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Notice for Aetna Funding Advantage and Fully-insured clients

In response to the rapidly evolving COVID-19 outbreak, CVS Health announced a series of steps designed to support the health and well-being of your clients Aetna members, ensure patient access to medication, and remove barriers to care.   Effective immediately, your clients small group members will have access to the following resources: • Co-pays for members will be waived for all diagnostic testing related to COVID-19. This policy will cover the test kit for patients who meet CDC guidelines for testing, which can be done in any approved laboratory location. Aetna will waive the member costs associated with diagnostic testing at any authorized location for all small group business. • For the next… Read More

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