Health Insurance 101: The Moop

What is your health insurance MOOP and what’s included?? This is the maximum amount  that you will have to pay under your plan for health care services, hence called the Maximum out of Pocket (MOOP). Any care for covered services you get after you meet your out-of-pocket maximum will be covered 100 percent. The out-of-pocket maximum varies by plan and can be found in your benefit brochure. The out-of-pocket maximum does not include premiums or charges for covered services that are not Essential Health Benefits (EHBs).  It will include in network deductibles, coinsurance and copays. Have more health insurance questions? Contact you Total Benefit Solutions, Inc health insurance experts today… Read More

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What is a minimum essential coverage (MEC) plan?

The Affordable Care Act states that all individuals must have health benefits and all employers with 50 or more full-time employees must provide coverage to all eligible employees or they are subject to fines/penalties. This can be known as “pay or play” or employer shared responsibility. We offer Minimum Essential Coverage plans which both penalties are satisfied for the employee and the employer. MEC plans are substantially less expensive than traditional medical insurance and serve as a low-cost solution for most companies. To contain healthcare costs, many employers and other plan sponsors are considering Minimum Essential Coverage, or MEC, health insurance. MEC plans can keep your workforce healthier. Preventable diseases, gone… Read More

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Attaching Total Benefit Solutions In Pennie or Get Covered New Jersey

Already on the health insurance Marketplace and need some help? Assigning Total Benefit Solutions, Inc is easy! Download the document and follow the steps. We will get notified and start helping you right away! Need more direction? Give us a call (215)355-2121  Download How to designate Total Benefit Solutions

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Video: Health Insurance Basics Choosing The Right Plan

Take a few minutes to watch this video from Independence Blue Cross  then call the experts at Total Benefit Solutions, Inc to shop the entire marketplace with the guidance of a health insurance expert (215)355-2121

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What Are Trial Rights for Medicare Advantage?

What Are Trial Rights for Medicare Advantage? Medicare Advantage trial rights work similarly to Medicare Supplement free look period rights, but they have different qualifying criteria and a longer time frame associated with them. Essentially, your clients have a 12-month period to test out a Medicare Advantage plan. (With a Medicare Supplement free look period, your client has 30 days to make a decision of whether they’d like to keep their new policy or not.) If they like it, great, they can keep it! If they have buyer’s remorse, they can switch back to Original Medicare and either return to their former Medicare Supplement (if they had one) or pick up a… Read More

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Coverage for Covid 19

    If you are uninsured and are seeking coverage to protect you and your family from the costs of COVID-19, we can still enroll in health insurance! You only have until May 15. Contact us today at (215)355-2121

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Onboarding Employees with Total Benefit Solutions

This quick and simple video shows you how easy it is to enroll your employees onto your group health insurance and benefits when you are working with Total Benefit Solutions, Inc! Make it easier for you call us today at (215)355-2121  

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Reminders for Medicare CMS Notice and 1094-1095 filing

Medicare Part D – CMS Notification ReminderEmployers sponsoring a group health plan are required by federal law to inform the Centers for Medicare and MedicaidServices within 60 days after the beginning of the plan year about the creditable status of the plan’s prescription drugcoverage. Final 2020 Forms 1094-C and 1095-C IssuedApplicable large employers must furnish the 2020 Forms 1095-C to its full-time employees by no later than Tuesday, March 2, 2021. Download Reminders for Medicare CMS Notice and 1094-1095 filing  

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DOL Penalties Increase for 2021

The Department of Labor (DOL) published the annual adjustments for 2021 that increase certain penalties applicable toemployee benefit plans. Private 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, ifapplicable. Finally, employers facing document requests from EBSA should ensure documents are provided timely, asrequested. Download DOL Penalties Increase for 2021

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New Jersey Issues 2020 Individual Mandate Reporting Requirements

employer reporting for the 2020 calendar year under New Jersey’s individual health insurance mandate

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What is an urgent care center like?

These days most health insurance plans are looking for ways to reduce the cost of providing health care.  Recently the use of urgent care centers has increased in popularity because the costs are lower than emergency care and the care is often more efficient.   What are urgent care centers like? Take a few minutes to watch this short video from Independence Blue Cross to find out more! Questions about Urgent Care Centers and your coverage? As always contact your Total Benefit Solutions Inc account manager at (215)355-2121.

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What is the NYHCRA Form?

What is the NYHCRA Form? For clients going into a self insured plan for the first time, this question always comes up.  The employer always has the option to participate in the pool or not but we always encourage them to participate for their own protection. This only comes into play when a member of a group seeks or gets medical treatment in New York For groups who do not elect into the Pool If there are New York state residents that incur in-patient claims in New York there is an alternative covered lives payment based on the resident’s location and this can be up to an additional 27.28% of… Read More

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Aetna Attain: more than discounts, actual rewards

Aetna attain is more than just a wellness discount!  Take 2 minutes to watch this short video and then ask your Total Benefit Solutions account manager (215)355-2121 how your group can benefit from Aetna Attain!   

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CMS: New Individual HRA Guidance

As always if you have any questions about this update please reach out to your Total Benefit Solutions Inc account manager at (215)355-212

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Review us on Google

 At Total Benefit Solutions we strive to provide our clients with the best service and support when shopping, enrolling and servicing their health insurance all year long. We appreciate having the opportunity and as always “We Work for Your Benefit”.  If you have worked with us, please help us get some feedback by  reviewing us on Google.  You’ll need to be logged in to your Google account to do so. Click here to rate us!

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What is my Max Out of Pocket?

In health insurance, you may have heard of the “maximum out-of-pocket  or MOOP.” Here’s a quick overview of how it works, including which costs count towards it, and what happens after your maximum out-of-pocket (MOOP)  is met. Max Out of Pocket Presentation

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HSA/HDHP Limits Increase for 2020

On May 28, 2019, the IRS released Revenue Procedure 2019-25 to announce the inflation-adjusted limits for health savings accounts (HSAs) and high deductible health plans (HDHPs) for 2020. These limits include: The maximum HSA contribution limit; The minimum deductible amount for HDHPs; and The maximum out-of-pocket expense limit for HDHPs. These limits vary based on whether an individual has self-only or family coverage under an HDHP.  The IRS limits for HSA contributions increase for 2020. Eligible individuals with self-only HDHP coverage will be able to contribute up to $3,550 for 2020, while eligible individuals with family HDHP coverage will be able to contribute up to $7,100 for 2020. The HDHP… Read More

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Court Strikes Down Association Health Plan Rules

On March 28th, 2019, a Federal District Court in the District of Columbia struck down significant portions of the Department of Labor’s (DOL’s) Association Health Plan (AHP) Final Rule. Specifically, the Court found the DOL “failed to reasonably interpret” ERISA when issuing these rules: • expanding the definition of “employers” to include disparate groups of employers with no other commonality of interest other than geographic location; and • bringing working owners without employees within ERISA’s framework. This ruling effectively eliminates the expansion of AHPs to certain employers and working owners who do not meet the original parameters to be a part of an AHP. Click below to download the complete… Read More

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Medicare Won’t Cover This Key Expense…

Dental costs can take a huge bite out of seniors’ finances, even if they have Medicare. And many Seniors have to tap into their Retirement Funds to cover treatment.

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Why Offer an HRA to Your Employees?

Healthcare Reimbursement Arrangement, typically referred to as an HRA, can be utilized by employers to reduce their overall healthcare costs without placing additional financial burden on their employees. An HRA allows the employer to pay for eligible expenses with pre-tax dollars. The employer decides what expenses are eligible, within the IRS guidelines, leaving a lot of flexibility in plan design. Typically an HRA is coupled with a High Deductible Health Plan and the HRA pays for either the entire deductible or a portion of the deductible. With this type of a plan the premium savings often outweigh the potential claims that the employer would have to pay if every employee… Read More

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How 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 might be a good for for your health plan!

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Change of Income? When and How to Notify the Marketplace.

One of the benefits of getting your Health Insurance through the Marketplace is the tax credit applied to your premium, which makes your costs much more affordable. However, when determining how much your tax credit will be, you use an estimate on your income for the following year. Life is always changing, so if your income changes, if your Family size changes or even being offered Healthcare in some other way it is IMPORTANT to alert the Marketplace of these changes or you may end up owing money back to the Government when you file your taxes at the end of the year. Here we will talk about which types… Read More

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