Total Benefit Solutions is proud to announce that we have become a founding member of the Greater Philadelphia chapter of the Geriatric Advisory Council to better serve the needs of our senior clients. The Geriatric Advisory Council is a professional organization comprised of local businesses and non-profit organizations who are focused on eldercare and senior related issues.The council was formed with the mission of assisting seniors and their caregivers by providing FREE educational resources along with targeted referrals to help caregivers provide the quality of life care that their loved ones need and deserve. Click here to learn more about the GAC and the professional resources available.
Continue ReadingVideo: Are you eligible for a special enrollment period?
You might think that you have to wait for the annual open enrollment period to get enrolled. Think again! You may be eligible for a special enrollment period. Watch this short video to learn more, and then call us at (215)355-2121!
Continue ReadingVideo: Learn about the Premium Saver Plan
Group Supplemental Health Insurance – Gap Insurance What is the Premium Saver? The Premium Saver is an employer sponsored group supplemental insurance plan which is designed to help reduce the cost of group medical coverage. Combining the Premium Saver with certain major medical plans can deliver coverage groups want and can afford. How does the Premium Saver pay claims? It’s simple! The Premium Saver pays off of the underlying major medical plan EOB, and it pays benefits directly to the provider. When the insured goes in-network they always receive the carrier’s in-network discounts. What coverage does the Premium Saver provide? Supplemental Deductible and Co-Insurance Premium Saver plans have a supplemental… Read More
Continue ReadingWebinar: The Top 5 Reasons to Have (and use) an Employee Handbook
Webinar: The Top 5 Reasons to Have (and use) an Employee Handbook Now Available from our partners at Think HR Click here to watch the video of the webinar and download the slides.
Continue ReadingEBN: Small Employers look to Alternative Funding Solutions
In the wake of the health care reform, alternative funding solutions for health benefits continue to gain traction among small to mid-size groups. Pending changes to small group rules in January 2016 are driving demand for the funding solutions. Most prominently, groups with 50-100 employees will be subject to community rating legislation that governs how rates are developed and the type of coverage offered. Most states are also changing the definition of employee to the federal full-time employee definition, broadening the scope to include union employees that may have been excluded under previous small employer definitions. Here’s how the new rules will affect small to midsize groups, including potential financial impact, solutions available to mitigate… Read More
Continue ReadingHealthiest You – Wellness and Mobile App Overview
Healthiest You is now available through Total Benefit Solutions Inc. Ask us today how you and your employees can benefit from this type of wellness benefit! Below is the latest video on their mobile app.
Continue ReadingNew Law Protects New York City Workers
Stop Credit Discrimination in Employment Act Takes Effect Sept. 3 The Stop Credit Discrimination in Employment Act, signed into law by New York City’s mayor on May 6, 2015, amends the city’s Human Rights Law and prohibits discrimination based on consumer credit history. Effective September 3, 2015, this law bans employers, labor organizations and employment agencies from using an employee’s consumer credit history for any employment decision, including hiring, compensation, or the terms, conditions or privileges of employment. New York City is one of several jurisdictions that has enacted credit check bans.
Continue ReadingHealth Reform: Reduction in Hours First Lawsuit is Filed by Employees
The first complaint was filed challenging the permissibility of reducing hours below 30 per week in order to avoid the Employer Penalty. The complaint was filed in a New York district federal court on behalf of 10,000 workers at Dave and Buster’s. The plaintiffs allege that their hours were cut so that Dave and Buster’s could avoid health care costs associated with expanding eligibility in order to avoid the Employer Penalty. Click the link below to download this bulletin. Reduction in Hours Subject to Lawsuit in New York – 73115R
Continue ReadingVideo: Independence Blue Cross Medicare Plans
Enjoy the latest TV Commercial from Independence Blue Cross about their Medicare supplement plans. Remember, Independence Blue Cross is just one of the many insurers that Total Benefit Solutions works with, on the healthcare.gov marketplace, on the private market, in the senior market and also small groups. Call us at (215)355-2121 to see if IBC has a plan that’s a good fit for you.
Continue ReadingHealth Reform: Is Your Company Ready for the New Reporting Requirements?
Health Reform: Is Your Company Ready for the New Reporting Requirements? In 2016, employers with at least 50 full-time employees (FTEs) must provide Forms 1095-C to their employees and to the IRS. This new requirement applies to both insured and self-insured medical plans. The forms require, in part, tracking per each month in 2015 per each FTE: the tier of health plan coverage offered (e.g., employee-only, employee+spouse, or no coverage offered); the self-only premium an employee must pay for the lowest-cost plan that provides minimum value; and the reason why an employer would not be subject to a penalty for a particular month (e.g., employee is in a waiting period or the affordability… Read More
Continue ReadingIBC: 2015 SHOP Updates
For 2015, the Small business Health Options Program (SHOP) platform manages more processes and information. As a result, the involvement of insurance carriers has been reduced. Understanding how it will work this year will help you work with employers to decide if they should purchase coverage through SHOP or directly from Independence Blue Cross (Independence). Like last year, groups may still only offer one plan option to all employees. However, the application and setup processes are now managed entirely through SHOP instead of by insurance carriers. This means certain Independence benefits are no longer available. Independence will continue to provide member identification cards, process member claims, and provide member services to answer questions. Click the link below to download… Read More
Continue ReadingTake Advantage of Medicare’s Free Preventive Services
Many seniors are unaware that preventive tests, screenings and counseling sessions are now available for free, with no copays or deductibles, thanks to the Affordable Care Act. More than 60 million people took advantage of these services, at no cost to themselves, during the first three years after the services became free in 2011, according to government reports. Click the link below to download a list from Medicare for Dummies of Medicare preventative services. Medicares-preventive-services-chart13 Questions about Medicare eligibility, open enrollment, supplements, health plans or PDP drug cards? Total Benefit Solutions, Inc. has a dedicated team of Medicare health plan professionals who are trained, annually re-certified, licensed and… Read More
Continue ReadingVideo: Turning 26? Here’s when to apply for health insurance
Video: Turning 26? Here’s when to apply for health insurance If you are turning 26 and still on your parent’s health insurance plan, first of all, happy birthday! And secondly, congratulations! You can now purchase your very own health insurance. In fact, once you turn 26, your parent’s can no longer cover you under their health plan. Remember, Independence Blue Cross is just one of the many insurers that Total Benefit Solutions works with, on the healthcare.gov marketplace, on the private market, in the senior market and also small groups. Call us at (215)355-2121 to see if IBC has a plan that’s a good fit for you, or click here for… Read More
Continue ReadingHealth Care Reform: Taxes and Fees-PCORI Fee, Transitional Reinsurance Fee, Insurer Fee and Excise Tax
Health Care Reform: Taxes and Fees-PCORI Fee, Transitional Reinsurance Fee, Insurer Fee and Excise Tax From United Healthcare: Taxes and fees under the health reform law impact both fully insured and self-funded plans. But, they impact funding types differently. Employers with self-funded health plans submit applicable health reform fees directly to the government, and those with fully insured health plans will see fees prorated into their premiums. The fees are prorated over 12 months. Here is what you need to know about these fees and how they will impact your business. Please note that this document, provided by United Healthcare, has carrier specific language, however please contact your Total Benefit… Read More
Continue ReadingFraud, Waste & Abuse-Did You Know?
Fraud, Waste & Abuse: did you know? As a nation, we spend over $2.7 trillion on healthcare every year, and it is estimated that tens of billions are lost each year to FWA. One recent study estimated that fraud and abuse added as much as $98 billion to annual spending on Medicare and Medicaid. It affects not only the cost but quality of care received. Combating healthcare fraud in Medicare and Medicaid is an important priority for the Federal Government. The Centers for Medicare & Medicaid Services (CMS), the Federal agency responsible for administering these programs, takes its role in leading anti-fraud efforts very seriously and has issued strict requirements… Read More
Continue ReadingHealth reform: CMS releases SHOP HOW-TO video for employees
CMS releases SHOP video for employees The SHOP enrollment for employees video has been posted by CMS. Please keep in mind that the employer group needs to be set up on the SHOP first. Please contact your Total Benefit Solutions, Inc account manager if you have any questions about setting your organization up as a SHOP employer. Total Benefit Solutions, Inc is a certified SHOP independent broker. Click the video below to watch the video.
Continue ReadingDownload our Mid-Year Compliance Bulletin Compilation
Our Mid-year Compliance Bulletin Compilation is now available, featuring all of our released compliance bulletins for January through June. This document acts a resource for you to have all of the latest health reform information and updates in one place. You can click on a bulletin title in the table of contents and it will bring directly to the corresponding page. Click the link below to download the document. 2015_Compliance_Compilation_mid_year
Continue ReadingIRS Releases Draft 2015 Forms 1094-C and 1095-C
Last week, the IRS issued draft 2015 Forms 1094-C and 1095-C. The forms are substantially the same as the 2014 forms,except for a couple of changes. Please click the link below to read the bulletin. IRS Releases Draft 2015 Forms 1094-C and 1095-C – 062615R Not sure what forms you need? Fee free to contact your Total Benefit Solutions account manager at (215)355-2121 or check our health care reform compliance center.
Continue ReadingUpcoming client webinar: Top Five Reasons to Have (and Use) an Employee Handbook
Upcoming Webinars: Top Five Reasons to Have (and Use) an Employee Handbook Thursday, July 9 from 8:30 a.m. – 9:30 a.m. Pacific Join Laura Kerekes, ThinkHR’s Chief Knowledge Officer, and John Dickinson, partner at Constangy, Brooks, Smith & Prophete, to discover five compelling reasons you should have (and use) an employee handbook. Approved for 1 HRCI credit and 1 SHRM PDC. Click the link to register for the webinar. Please note the time is Pacific time.
Continue ReadingReminder: PCORI Fees Due by July 31 for Employers Sponsoring HRAs and Other Self-Insured Plans
Reminder: PCORI Fees Due by July 31 for Employers Sponsoring HRAs and Other Self-Insured Plans Fees to fund the Patient-Centered Outcomes Research Institute (PCORI) are due July 31 from employers that sponsor certain self-insured health plans, including health reimbursement arrangements (HRAs) that are not treated as excepted benefits. The fee, which is required under Health Care Reform, applies to plan years ending on or after October 1, 2012, and before October 1, 2019. Calculating the Fee For plan years ending on or after October 1, 2014 and before October 1, 2015, the fee for an employer sponsoring an applicable self-insured plan is $2.08 (two dollars for plan years ending on… Read More
Continue ReadingInstant Quotes for Individual Dental and Vision
Total Benefit Solutions is proud to announce our new individual dental and vision plans with Delta Dental and VSP Vision and more! Click the link below to quote, compare and enroll instantly! Click here now get instant dental and vision quotes You don’t have to do it alone. Call us at (215)355-2121 and one of our trained, licensed and certified account managers will answer your questions and help you through the process.
Continue ReadingOSHA Publishes Guide to Restroom Access for Transgender Workers
Federal Law Alerts – June 2015 On June 1, 2015, The Occupational Safety and Health Administration (OSHA) published A Guide to Restroom Access for Transgender Workers. The publication includes adescription of best practices and makes employers aware of federal, state, and local laws that reaffirm the core principle of providing employees with access to restroom facilities based on gender identification. Read A Guide to Restroom Access for Transgender Workers
Continue ReadingFAQ – What is Modified Adjusted Gross Income?
If you’ve been shopping for personal health insurance, helping a client with taxes, or following the Affordable Care Act, you may have heard the term “Modified Adjusted Gross Income,” or MAGI. In this article I’ll answer the frequently asked question – “What is Modified Adjusted Gross Income?” I’ll also explain how to calculate MAGI and why MAGI matters. Click here for the story from Zane Benefits
Continue ReadingPhiladelphia Mandatory Sick Pay Leave Updates & Poster
Source: HR360 Effective May 13, 2015, most employers will be required to provide up to 40 hours of paid or unpaid sick time per calendar year to eligible employees (generally individuals who perform work within Philadelphia for at least 40 hours in a year), as follows: Employers with 10 or more employees must provide paid sick time. Note: All persons performing work for compensation on a full-time, part-time, or temporary basis must be counted. Chain establishments (an establishment doing business under the same trade name used by 15 or more establishments—whether such other establishments are located in Philadelphia or elsewhere—and regardless of the type of ownership of each… Read More
Continue ReadingLost your health coverage?
Losing other health coverage, including losing a job-based plan, aging off a parent’s coverage at 26, losing coverage through divorce, losing eligibility for Medicaid or CHIP, and similar events. Coverage can take effect: The first day of the month after you enroll and after the loss of coverage Enrollment window: From 60 days before to 60 days after losing your other coverage Important: If you leave your job for any reason and lose your job-based health coverage, you qualify for a Special Enrollment Period. But you don’t get an SEP if you voluntarily drop: a job-based plan without leaving your job; an individual insurance plan; unexpired COBRA coverage; or… Read More
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