#getcoveredNJ – Page 5 – Total Benefit Solutions Inc

Heathcare Reform: Important New Guidance on Affordability

June 6, 2013February 6, 2022Ed MacConnell

In order to receive a subsidy in the Health Insurance Marketplace (formerly referred to as the Exchange), generally an individual must not be eligible for affordable coverage under an eligible employer sponsored plan that provides minimum value. Additionally, large employers looking to avoid penalty exposure must offer all full-time employees (and their dependents) affordable coverage that meets minimum value. Although final regulations were published back in February, further clarification was needed on the health benefits considered in determining the share of benefit costs paid by a plan. Click the link below to read the rest of the article. Minimum Value and Affordability-060513R

Health Reform: Cost Sharing Limits

June 6, 2013February 6, 2022Ed MacConnell

Effective the first plan year that begins on or after January 1, 2014, all non-grandfathered group health plans (both insured and self-insured) , regardless of size, must comply with annual cost-sharing limitations on out-of-pocket maximums. Click the link below to download and review the entire notice. Health Reform-cost sharing limits

Health Reform: Contraceptive Coverage and Non-Profit Organizations

June 4, 2013February 6, 2022Ed MacConnell

Under the ACA, most health plans must cover women’s preventive services, including contraception, without charging a co-pay or deductible. The interim final rules provided that group health plans established or maintained by religious employers were exempt from these requirements. Guidance issued subsequent to the final rules established a temporary enforcement safe harbor for group health plans established or maintained by certain non-profit organizations that have religious objections to contraceptive coverage. The safe harbor is in effect until the first plan year that begins on or after August 1, 2013. Please click the link below to download and review the guidance. Health reform- contraceptive coverage and Non Profits

Health Reform: Exchange Notice Requirements

June 3, 2013February 6, 2022Ed MacConnell

Open enrollment for health insurance coverage through the Exchange (now referred to as the Health Insurance Marketplace) begins October 1, 2013. The Affordable Care Act creates a new Fair Labor Standards Act (FLSA) section that requires employers to provide each employee at the time of hiring, as well as current employees, a written notice that includes information regarding the new Health Insurance Marketplace. Earlier materials referred to this notice as the “Exchange Notice,” however, it is now referred to as the “Notice of Coverage Options. Click the link below to download and view the notice. Health Reform-Exchange Notice

Health Reform Update: Shop Exchanges

June 3, 2013February 6, 2022Ed MacConnell

Individuals and small employers will be able to purchase private health insurance through a new marketplace called “The Exchange” beginning in 2014. Each state that chooses to operate an Exchange must also establish a Small Business Health Options Program (“SHOP”) that assists eligible small businesses in providing health insurance options for their employees. Click the link below to download and review the entire notice. Health reform-Shop Exchange Facts

Exchange Notice Must Be Provided to Current and New Employees

May 27, 2013February 6, 2022Ed MacConnell

Following a delay in the original effective date, employers will need to comply with the new requirement to provide each employee a written notice with information about a Health Insurance Exchange (also known as a Marketplace) beginning this fall. Employers are required to provide the written notice to each current employee not later than October 1, 2013, and to each new employee at the time of hiring beginning October 1, 2013(for 2014, a notice will be considered provided “at the time of hiring” if it is provided within 14 days of an employee’s start date). Model language that employers may use to satisfy the notice requirement is available from the U.S. Department… Read More

Is There a List of Providers Who Have Been Excluded From Medicare Because of Fraud?

May 22, 2013February 6, 2022Ed MacConnell

Yes. The Department of Health and Human Services and its Office of the Inspector General excluded a total of 3,131 individuals and entities from participation in federal health care programs in 2012. Click here to read the story.

89 charged in Medicare fraud busts in 8 cities

May 20, 2013February 6, 2022Ed MacConnell

WASHINGTON (AP) — Nearly 100 people, including 14 doctors and nurses, were charged for their roles in separate Medicare scams that collectively billed the taxpayer-funded program for roughly $223 million in bogus charges in a massive bust spanning eight cities, federal authorities said Tuesday. Click here for the story.

New Guidance on SBC’s

May 19, 2013February 6, 2022Ed MacConnell

Under health care reform, plan participants and beneficiaries must be provided a 4-page summary of benefits and coverage (“SBC”) and uniform glossary. This requirement is effective for open enrollment periods that begin on or after September 23, 2012. For participants and beneficiaries who enroll in group health plan coverage outside of open enrollment (e.g., newly eligible individuals and special enrollees), the SBC must be provided beginning on the first day of the first plan year that begins on or after September 23, 2012. This requirement is an ongoing one and, as open enrollment season approaches, the Departments of Labor, Health and Human Services, and Treasury have issued updated guidance and… Read More

IBC-Important update-changes to group plan selection requirements

May 19, 2013February 6, 2022Ed MacConnell

We would like to share some important updates and reminders about the Summary of Benefits and Coverage (SBC), under the Affordable Care Act (ACA), including information about off-anniversary benefit changes, obtaining SBCs through our brochure and giveaway system (BAGS), and SBC postcards that are sent to members. Under the ACA both group health plans (customers) and health insurance issuers (health insurers) are required to provide the SBC to participants under certain circumstances. ACA 60-day notification requirement for off-anniversary benefit changes For customers who make off-anniversary material modifications (e.g., benefit changes) that affect the content of the SBC, participants in the customer’s group health plan must receive notification of the change… Read More

Important Guidance Issued on Notice of Exchange

May 13, 2013February 6, 2022Ed MacConnell

Open enrollment for health insurance coverage through the Exchange (now referred to as the Health Insurance Marketplace) begins October 1, 2013. The Affordable Care Act creates a new Fair Labor Standards Act (FLSA) section that requires employers to provide each employee at the time of hiring, as well as current employees, a written notice that includes information regarding the new Health Insurance Marketplace. Click this link to download this important announcement… Exchange Notice – 051013R

2014 HSA limits announced

May 13, 2013February 6, 2022Ed MacConnell

Click the link below to download the announcement. 2014 HSA Limits – 050813R

Regulation Issued on Small Group Exchange Plans

May 13, 2013February 6, 2022Ed MacConnell

Individuals and small employers will be able to purchase private health insurance through a new marketplace called “The Exchange” beginning in 2014. Each state that chooses to operate an Exchange must also establish a Small Business Health Options Program (“SHOP”) that assists eligible small businesses in providing health insurance options for their employees. Click the link to download the rest of the announcement… SHOP Exchanges – 050813R

Health Savings Account – HSA 2014 Rules & Requirements

May 9, 2013February 6, 2022Ed MacConnell

Health Savings Account – HSA 2014 Rules & Requirements The IRS recently announced the health savings account rules and requirements for 2014. The HSA contribution limits and out-of-pocket maximums have been increased. 2014 HSA Contribution Limits For calendar year 2014, the annual HSA contribution limits are: Individuals (self-only coverage) – $3,300 (up $50 from 2013) Family coverage – $6,550 (up $100 from 2013) HDHP minimum required deductibles The High Deductible Health Plan (HDHP) required deductibles for an HSA did not change from 2013 to 2014: $1,250 for self-only coverage $2,500 for family coverage Out-of-pocket maximum The annual out-of-pocket expenses include deductibles, co-payments, and other amounts, but not premiums. The… Read More

Health Insurance Premium Tax Credit for Small Groups

May 7, 2013February 6, 2022Ed MacConnell

To help you estimate your potential tax credit amount, input the data into the calculator to determine your estimated potential health insurance savings under the new health reform law. .. click here

Aetna introduces the Premium Savings Plan for Healthcare Reform

May 7, 2013February 6, 2022Ed MacConnell

The Premium Savings program allows you to keep the plan you have, as allowed under the ACA. Doing so will help you to limit disruption in a changing health care environment. Plus,it gives you the time you need to assess your business needs in the future. Aetna clients have the option to: Canceltheir current policy and add a new 12 month policy with a new renewal date of Sept., Oct., Nov. or Dec. 2013. In some states, customers may be able to retain current benefits and rate levels through September-December 2014. Maintain their existing policy and renewal cycle ending in 2014 and move to plans and rates that comply with 2014 ACA regulations at… Read More

United Healthcare offering early renewal option

May 7, 2013February 6, 2022Ed MacConnell

Due to the expected rate increases, and uncertainty caused by the PPACA implementation date of January 1st 2014, United Healthcare is allowing groups who renew in the first quarter of the year to roll their renewal back to December 2013. This is an opportunity for United Healthcare clients to renew early and also lock in their plan and rates for most of the year 2014. More details will be following soon. Please contact us if you have any questions or concerns at 215/355-2121. Want more information from United Healthcare on reform? Click here for a guide for employers.

Healthcare Reform Presentation at Gloucester County Tea Party

May 4, 2013February 6, 2022Ed MacConnell

Healthcare Reform Presentation at Gloucester County Tea Party Edward T. MacConnell CBC, CHRS will be speaking at the Gloucester County Tea Party Patriots meeting on May 22nd. The Topic is Health Care Reform and You! Meeting Start time is 7:00 at the Gloucester County Library, in MullicaHill Branch, 389 Wolfert Station Road Mullica Hill (East of NJ Rte 45, Bridgeton Pike) at 7:00 PM to 8:30 PM. To reserve your seat contact Rose at 856-228-9249

Ed MacConnell & Terry Farber Esq. to speak at Arden Courts of Warminster

May 4, 2013February 6, 2022Ed MacConnell

Questions about Medicare, Medicaid, Long Term Care and Elder Law Planning? Join us for a Q+A session with Edward T. MacConnell CBC, CHRS and Elder Law Attorney Terry Farber on May 16th 2013 at Noon. Location: Arden Courts at Warminster, 779 W County Line Road, Hatboro PA 19040 Call to reserve your seat: Sarah Gawlinski-Greenstein, (215)957-5182 . The presentation starts at 12 Noon.

What is Critical illness Insurance?

May 3, 2013February 6, 2022Ed MacConnell

What is Critical Illness Insurance? Why is it an important addition to your health coverage? Join our friends at Humana for this quick and concise description. ..

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