Total Benefit Solutions – Page 6 – Total Benefit Solutions Inc

Allstate Benefits Level Funded Plan Member Kit

March 14, 2023March 10, 2023Ed MacConnell

Considering Level funding and/or reference based pricing for your group health insurance? Download the brochure below to learn more about it them contact your health insurance specialists at Total Benefit Solutions, Inc today to compare your current plan to level funded and reference based pricing options! The brochure includes information on reading an EOB, Vitality and the healthcare blue book as well. As always we can be reached at (215)355-2121. Employee-eKit-with-Healthcare-Bluebook-Member-FlyerDownload

What is an agent and broker?

March 13, 2023February 24, 2023Ed MacConnell

A trained insurance professional who can help you enroll in a health insurance plan. Agents may work or a single health insurance company; brokers may represent several companies. You won’t pay anything additional if you enroll with an agent or broker. As always, don’t hesitate to contact your Total Benefit Solutions health insurance specialists with any questions or concerns today at (215)355-2121.

What is State Mandated Disability or TDB?

March 9, 2023March 9, 2023Ed MacConnell

New Jersey Temporary Disability Benefits (TDB) and Family Leave Insurance (FLI). The New Jersey Temporary Disability Benefits (TDB) law, enacted in 1948 and later amended in 2008 to include Family Leave Insurance (FLI), allows for NJ covered workers to take paid time off for their own non-occupational related injury or illness (under TDB) or to care for a family member with a serious health condition or bond with a new child (under FLI). Which employers are subject to the law? Most New Jersey employers subject to the provisions of the Federal Unemployment Tax Act (FUTA) are also subject to NJ TDB law and are required to provide coverages for their employees working in… Read More

The End of COVID-19 Public Health Emergency: How will COVID treatments be affected?

March 8, 2023February 10, 2023Ed MacConnell

On Jan. 30, 2023, the Biden Administration announced it will end the public health emergency (and national emergency) declarations on May 11, 2023. COVID Treatment What’s changing: People with public coverage may start to face new cost-sharing for pharmaceutical COVID treatments (unless those doses were purchased by the federal government). Medicare beneficiaries may fact cost-sharing requirements for certain COVID pharmaceutical treatments after May 11. Medicaid and CHIP programs will continue to cover all pharmaceutical treatments with no-cost sharing through September 2024. After that date, these treatments will continue to be covered; however, states may impose utilization limits and nominal cost-sharing. What’s the same: Any pharmaceutical treatment doses (e.g., Paxlovid) purchased… Read More

What is a bronze health plan?

March 7, 2023February 27, 2023Ed MacConnell

One of 4 plan categories (also known as “metal levels”) in the Health Insurance Marketplace®. Bronze plans usually have the lowest monthly premiums but the highest costs when you get care. They can be a good choice if you usually use few medical services and mostly want protection from very high costs if you get seriously sick or injured. Note: Bronze plan deductibles can be very high. This means you could have to pay thousands of dollars of health care costs yourself before your plan starts to pay its share. All health plans in all categories provide free preventive services, and some plans offer other services at low or no… Read More

Notice: White House announces COVID-19 PHE and National Emergency will be allowed to expire

March 3, 2023February 16, 2023Ed MacConnell

On January 30, 2023, the White House announced its plan to allow the COVID-19 Public Health Emergency (PHE) and National Emergency periods to expire on May 11, 2023. We have provided example scenarios in the Compliance Alert that demonstrate the impact of the national emergency period expiration. We encourage you to review each example to determine the impact on your specific plan(s). Although we encourage you to review the entire Compliance Alert, we have provided a summary of the content for your review: Public Health Emergency During the PHE, group health plans are required to cover the cost of COVID-19 tests and testing-related services without cost-sharing or prior authorization or… Read More

What is the tax filing requirement?

March 2, 2023February 23, 2023Ed MacConnell

The minimum amount (or threshold) of income requiring you to file a federal tax return. 2022 filing requirements for most taxpayers: Gross income of at least $12,950 (individuals) or $25,900 (married filing jointly). Different thresholds apply for dependents, people 65 and older, and those who use other tax filing statuses (like married filing separately). Have any questions regarding this notice? Don’t hesitate to contact your Total Benefit Solutions health insurance specialists today at (215)355-2121.

The End of COVID-19 Public Health Emergency: How will PCR and rapid tests be affected?

March 1, 2023February 9, 2023Ed MacConnell

On Jan. 30, 2023, the Biden Administration announced it will end the public health emergency (and national emergency) declarations on May 11, 2023. PCR and rapid tests ordered or administered by a health professional What’s changing: Although most insured people will still have coverage of COVID tests ordered or administered by a health professional, these tests may no longer be free. What’s the same: Uninsured people in most states were not eligible for the temporary Medicaid pathway for COVID testing and therefore will continue to pay full price for tests unless they can get tested through a free clinic or community health center. Have any questions regarding this notice? Don’t… Read More

Do HSA’s, FSA’s, or HRA’s carryover or rollover?

February 28, 2023February 22, 2023Ed MacConnell

Health Savings Account (HSA): All funds belong to the employee. Unused balances roll over into the next year. Funds do not expire from year-to-year. Rollover funds do not count towards the contribution limit. Health Flexible Spending Account (FSA): Amounts must be incurred by the end of the plan year and do not usually carry over unless an employer allows up to $610 to carry over into the next year. Amounts that roll do not affect the maximum election that can be made for the plan year. Otherwise, employers may adopt a 2 and half month grace period that allows participants to access unused amounts remaining in their accounts. Health Reimbursement… Read More

Small Group – Form 1095-B: Who receives it and why

February 27, 2023February 21, 2023Ed MacConnell

Form 1095-B is a health insurance tax form used to report certain information to the IRS and taxpayers about individuals who are covered by Minimum Essential Coverage (MEC). What are the IRS reporting requirements? The ACA requires individuals to obtain and report that they had MEC or otherwise qualify for an exemption from the requirement. However, there is no longer an individual tax penalty following the 2017 Tax Cuts and Jobs Act. Individuals may need Form 1095-B to demonstrate MEC for nontax-related purposes. The ACA also requires certain employers to offer all full-time employees and their dependents MEC to meet affordability and minimum value standards. This is known as the… Read More

The End of the COVID-19 Public Health Emergency: How will at-home COVID tests be affected?

February 24, 2023February 9, 2023Ed MacConnell

On Jan. 30, 2023, the Biden Administration announced it will end the public health emergency (and national emergency) declarations on May 11, 2023. At-home COVID tests What’s changing: At-home (or over-the counter) tests may become more costly for people with insurance. After May 11, 2023, people with traditional Medicare will no longer receive free, at-home tests. Those with private insurance and Medicare Advantage (private Medicare plans) no longer will be guaranteed free at-home tests, but some insurers may continue to voluntarily cover them. For those on Medicaid, at-home tests will be covered at no-cost through September 2024. After that date, home test coverage will vary by state. A temporary Medicaid… Read More

UHC: Short Term Medical no longer offered in DE & SD, starting February 17, 2023

February 23, 2023February 16, 2023Ed MacConnell

Effective February 17, 2023, the United Healthcare-branded Short Term Medical product, underwritten by Golden Rule Insurance Company will no longer be available for new sales in Delaware and South Dakota. View the updated product availability grid. This change does not affect existing business of this product in these states. Current customers can keep their coverage until the plan’s term date if they continue plan payments and meet the eligibility requirements of their plan. As always, don’t hesitate to contact your Total Benefit Solutions health insurance specialists with any questions or concerns today at (215)355-2121.

Medicaid Redetermination

February 22, 2023February 16, 2023Ed MacConnell

Pennsylvania resumed their redetermination process for current Medicaid members February 1, 2023. The Families First Coronavirus Response Act (FFCRA) provided states with additional Medicaid funding. To receive additional funding, a state was required to pause all Medicaid disenrollment. The pause on Medicaid disenrollment is now ending and states will resume Medicaid redeterminations of eligibility and disenrollment of those determined to be ineligible for Medicaid coverage. Loss of eligibility for Medicaid is a Qualifying Event for Special Enrollment on the Marketplace. Many of these individuals could be eligible for financial assistance on the Marketplace and will need enrollment assistance from a broker. Visit the Medicaid Redetermination Resource Center for important updates… Read More

Notification Reminder for Forms 1095-C and 1095-B

February 21, 2023February 14, 2023Ed MacConnell

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

Thinking about a PEO?

February 18, 2023February 9, 2023Ed MacConnell

We Can Help You Navigate the World of Professional Employer Organizations (PEOs). PEOs have become a growing solution for small- and mid-sized employers looking to streamline their administrative processes. However, the number of PEOs has risen dramatically, leaving employers with many options and confusion about where to start. What is a PEO?If you are unfamiliar with the term PEO, it is a business entity that helps service other businesses in the areas of payroll administration, human resources, risk management, and employee benefits. Total Benefit Solutions, Inc. can help you find the right PEO in a complex market and select the best fit for your company. We can quote PEO services… Read More

Stay Up to Date on the Affordability of Employer Coverage and the Family Glitch with These Resources

February 16, 2023February 8, 2023Ed MacConnell

beginning on January 1, 2023, the new rule on affordability of employer coverage for the family members of employees went into place and changed how affordability is calculated for employees’ family members. To assist employers in understanding this rule change, the Centers for Medicare & Medicaid Services (CMS) created a resource outlining the most important takeaways for employers. Employers can use this resource to understand the family glitch and how it affects them and their employees. You can view this resource here. Have any questions regarding this notice? Don’t hesitate to contact your Total Benefit Solutions health insurance specialists today at (215)355-2121.

Broker Change Leads to Better Results

February 15, 2023February 15, 2023Ed MacConnell

Broker Change Leads to Better Results Sometimes a benefits consultant may become a bit complacent and fail to aggressively pursue available cost containment strategies for a client. When that happens, it may be time to consider a change. Read for a case study on how we handled a situation like this for one of our clients. 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… Read More

Do FSA’s and HRA’s have Reimbursable Expenses?

February 15, 2023February 2, 2023Ed MacConnell

Health Flexible Spending Account (FSA) Health Reimbursement Arrangement (HRA) As always, don’t hesitate to contact your Total Benefit Solutions health insurance specialists today at (215)355-2121.

Independence: Advanced Network for Gene‑Based Therapeutics

February 14, 2023February 8, 2023Ed MacConnell

As part of our comprehensive strategy for managing specialty drugs, Independence is proud to announce the establishment of our Advanced Network for Gene‑Based Therapeutics. This network ensures that our members have access to multi-million-dollar gene‑based therapies, like Luxturna®, Zolgensma®, and Skysona®, delivered in facilities that share our commitment to driving clinical outcomes and value. Click here for the full story.

CIGNA transitioning to digital ID cards

February 13, 2023February 7, 2023Ed MacConnell

By July 2024, Cigna is planning to fully transition from physical ID cards to digital ID cards. Eligible medical, dental and vision clients with an April 1, 2023, May 1, 2023, and June 1, 2023 new and renewal effective date will be notified of this change on Feb. 7, 2023. We’re excited to announce that we’re transitioning to digital ID cards, so you will no longer automatically receive a physical ID card in the mail. With a digital ID card you never have to worry about losing or misplacing your card(s) again. It’s always right there on myCigna, whenever you need it.* Log in to myCigna.com® or the myCigna® App to get… Read More

Independence: Dental rates modified from the original 2023 prices

February 9, 2023February 6, 2023Ed MacConnell

The 2023 Independence Blue Cross dental rates for individual and family plans have been modified from the original rates. Your health insurance broker at Total Benefit Solutions Inc can provide your updated rates and also help guide you to choose an alternative dental plan in light of these changes. Please contact us today at (215)355-2121 if you have any questions or concerns regarding these changes.

ACA: Special Election Cheat Sheet

February 9, 2023February 9, 2023Ed MacConnell

Download our SEP Cheat Sheet. Know your health insurance SEP to get enrolled outside of the annual open enrollment period. As always contact your Total Benefit Solutions health insurance experts for more specific information about your situation at (215)355-2121 http://www.totalbenefits.net

Notification Reminder for Forms 1095-C and 1095-B

February 9, 2023February 9, 2023Ed MacConnell

Bright Health Announces Departure from ACA Marketplace

February 8, 2023February 6, 2023Ed MacConnell

Publish Date: 2/1/2023 Bright Health announced October 11 that it was pulling out of the ACA Marketplace in 15 counties throughout Florida. As a result, 250,000 individuals with Bright Health coverage will be impacted. Some of the impacted individuals will be auto-migrated to Florida Blue as part of this transition. If you are impacted or have any questions or concerns about this please contact your Total Benefit Solutions, Inc health insurance experts at (800)924-6718

Independence: Additional MLR rebates for 2020 to be issued to some policyholders

February 7, 2023February 6, 2023Ed MacConnell

Starting this week, Independence Blue Cross (Independence) will be issuing an additional medical loss ratio (MLR) rebate to affected customers and subscribers for a portion of their 2020 health insurance premiums. The check mailing will continue until the end of February. The additional rebate is being issued following a clarification on MLR calculation provided by the Centers for Medicare & Medicaid Services (CMS). As a result of the clarification, we looked at prior year calculations and determined an additional amount was due for 2020. Any applicable interest has been included in the amount of each check. Click here for the full story As always please contact your Total Benefit Solutions,… Read More

Share this:

Like this:

Share this:

Like this:

Share this:

Like this:

Share this:

Like this:

Share this:

Like this:

Share this:

Like this:

Share this:

Like this:

Share this:

Like this:

Share this:

Like this:

Share this:

Like this:

Share this:

Like this:

Share this:

Like this:

Share this:

Like this:

Share this:

Like this:

Share this:

Like this:

Share this:

Like this:

Share this:

Like this:

Share this:

Like this:

Share this:

Like this:

Share this:

Like this:

Share this:

Like this:

Share this:

Like this:

Share this:

Like this:

Share this:

Like this:

Share this:

Like this: