Continue Reading

Losing your employer provided health insurance?

Losing your health insurance through work? No worries the Total Benefit Solutions, Inc team of professionals can help you get affordable coverage to fill in the gap between employers! https://www.totalbenefits.net (215)355-2121

Continue Reading

Are you an applicable large employer, or not? That’s the question!

Calculating Your FTE Count Are you an applicable large employer, or not? That’s the question! To answer this question you’ll need to add up your full-time employees plus the full-time equivalent of part-time employees. For some businesses, this may have been simple, but not for all. This is how you determine your FTE count. Full-Time Employees: Any employee who works an average of at least 30 hours per week in a given month. Or at least 130 hours of service in a given month. Full-Time Equivalent: The full-time equivalent of part-time employees is the number of hours worked by all your part-time employees in a given month divided by 120. For example: two employees… Read More

Continue Reading

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

Continue Reading

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

Continue Reading

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

Continue Reading

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

Continue Reading

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

Continue Reading

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

Continue Reading

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  

Continue Reading

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  

Continue Reading

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

Continue Reading

New Jersey Issues 2020 Individual Mandate Reporting Requirements

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

Continue Reading

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.

Continue Reading

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

Continue Reading

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!   

Continue Reading

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

Continue Reading

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!

Continue Reading

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

Continue Reading

What is an HRA and How It May See A Major Change Soon..

Before we get into how rules for HRAs may be changing, we should discuss what an HRA is and how it works. A Health Reimbursement Account (sometimes referred to a Health Reimbursement Arrangement) is an employer-funded group health plan that reimburses employees, tax-free, for qualified medical expenses up to a certain amount per year. This type of policy does not replace Medical Insurance and is usually coupled with a High-Deductible policy. Unlike an Health Savings Account (HSA), the Employee can not help to fund the account.  Like HSAs though, there are maximum allowed contributions. In 2018, an Employer can fund an HRA up to $5,050 for a Single Employee and $10,250… Read More

Continue Reading

FAQ Suggests Employers Include Marketplace Options with COBRA Notices

On June 21, 2016, the Departments of Labor, Health and Human Services, and the Treasury (collectively, the “Departments”) issued the 32nd Affordable Care Act (“ACA”) FAQ describing information that may be appropriate to include with COBRA notices. Many wondered if it were appropriate to provide information and if so, what kind of information could be provided about the Health Insurance Marketplaces/Exchanges (“Marketplaces”) so that COBRA-eligible individuals could consider health coverage alternatives available through the Marketplaces and possibly investigate whether they may be eligible for premium tax credits and cost-sharing reductions. Click the link to download the entire bulletin

Continue Reading

Amerihealth NJ: No Longer Providing COBRA Administration

  AmeriHealth New Jersey has announced that they will no longer provide administrative services for the continuation of coverage under the Consolidated Omnibus Reconciliation Act (COBRA) and Retiree Billing services. AmeriHealth NJ will discontinue COBRA administration and Retiree Billing services in 2016 for customers on the following schedule: For customers renewing January 1 through July 31, COBRA administration services will end on December 31, 2016. For customers renewing August 1 through December 31, services will end on their 2016 renewal date. Approximately 30 days before COBRA administration services end, COBRA members will be notified that their COBRA plan is being transferred to another service provider, and their COBRA eligibility will continue uninterrupted.  … Read More

Continue Reading

IBC: Effective January 1, 2015, HIPAA Certificates of Creditable Coverage are no longer required

On February 24, 2014, the United States Departments of Health and Human Services issued a final rule that addressed the requirement to provide HIPAA Certificates of Creditable Coverage (HIPAA Certificates) under the Affordable Care Act (ACA). As the ACA prohibits pre-existing condition exclusions, the new rule eliminates the requirement to provide HIPAA Certificates beginning December 31, 2014. What does this mean for members?  Previously, when coverage was terminated for a member or his/her dependents, Independence Blue Cross (Independence) issued a HIPAA Certificate. Because the ACA prohibits the application of pre-existing condition exclusions, which applies to both grandfathered and non-grandfathered health plans, these certificates are no longer required. Effective January, 1,… Read More

Continue Reading

Health Reform: 2015 Annual Open Enrollment Period

Annual Open Enrollment & Effective Dates The annual open enrollment period (AEP) for 2015 begins on November 15th 2014 and ends on February 14th 2015. The open enrollment period is the time when you can change, or purchase a new qualified health plan (QHP) on a guaranteed enrollment basis. You do not need a special election period, or a life change event to enroll during the annual open enrollment period. The chart below illustrates the effective dates for enrollments taken during the annual open enrollment period.             Effective Dates for 2015 Annual Open Enrollment Period

Continue Reading