Ways to Save Money on Your Prescription Drugs

Prescriptions costs are skyrocketing. We all know that. But did you know that there are several ways for people to save money on their monthly medications? As health insurance plans are becoming more catastrophic in nature, that means that people will need to become better health care consumers. Sometimes that means using the tools that the insurance company offers at no charge. Sometimes it means using discounts and other resources that are available outside the health plan. Here are a few ways, some already widely known and others not so much, to help drop down your costs at the Pharmacy. While this is not a comprehensive list of money-saving ideas, it is… Read More

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Important Info! HSA Limits for 2019

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Aetna Funding Advantage (AFA) is a new self-funded option for small groups

Aetna Funding Advantage (AFA) is a self-funded option that provides all of the financial and plan design flexibility of a traditional arrangement with special features designed to help companies with as few as 2 employees achieve even greater savings on their health insurance. Ask us today if self funding could be a good fit for your organization! Call your Total Benefit Solutions Inc. account manager at (215)355-2121 for more information! Learn more here: AFA-Customer-Flyer New! Minute Clinic Benefit! $0 Copay Minute Clinic Visits Flyer More Documents for downloading: Springboard Marketplace Your Online Administration and Enrollment Portal AFA AppleWatch Wellness Flyer AFA Sample Usage Reports Aetna & Teledoc for AFA AETNA… Read More

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Congress Passes Tax Reform Bill

    On December 20, 2017, the House and Senate sent President Trump the Tax Cuts and Jobs Act for signature. The House of Representatives passed their version of the bill on November 16, 2017 while the Senate passed their version on December 2, 2017. Because the versions were not identical, a Tax-Bill Conference Committee was formed from members of the Senate and the House of Representatives to negotiate the text of the combined bill. After the finalized text was approved and released by the committee, the House and Senate each passed the combined bill (which happened on December 20th in the House and December 19th in the Senate) before… Read More

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Aetna Funding Advantage for Small Businesses

Aetna Funding Advantage (AFA) is a new self-funded option that provides all of the financial and plan design flexibility of a traditional arrangement with special features designed to help companies with as few as 2 employees achieve even greater savings on their health insurance. The benefits of self-funding have traditionally been considered by larger companies. But Aetna Funding Advantage has changed that. It is specifically designed to be attractive and affordable for small businesses like yours. Watch this short video and download the documents below for some information. As always please contact your Total Benefit Solutions dedicated account manager at (215)355-2121 if you have any questions, concerns or would like to learn… Read More

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Guidance Issued on QSEHRAs

  Under the Affordable Care Act, a health reimbursement arrangement (HRA) must be integrated with a group health plan (as it could not meet the market reform provisions on its own) and was not able to reimburse employees for individual premiums. However, on December 13, 2016, President Obama signed into law the “21st Century Cures Act” which established QSEHRAs (a special standalone HRA). Click to Download Guidance Issued on QSEHRAs This guidance is big news for small groups who would prefer to provide a reimbursement as opposed to a group health plan. Please contact your Total Benefit Solutions account manager at (215)355-2121 if you have any questions or concerns.  

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2018 Individual Health Insurance Open Enrollment: PA Independence Individual Consumer Plans and Rates

  Individual Health Insurance Open Enrollment 2018! Don’t do it yourself! Our dedicated professionals are here to help you take the fits out of the benefit planning process!  One mistake and you could be stuck with a bad plan all year! We work with all available plans both on the healthcare.gov marketplace and off! Have your own expert help you! Our experts are trained to help you Choose between on and off exchange options Maximize any subsidy eligibility. Help you understand the cost sharing subsidies Help you choose the plan that is the best fit for you Explain the differences between the plan design and your out of pocket expectations Fill… Read More

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The Mental Health Parity and Addiction Equity Act

The Mental Health Parity and Addiction Equity Act (MHPAEA) applies to employers with at least 51 employees offering a group health plan that includes any mental health and substance use disorder (MH/SUD) benefits. MHPAEA also applies to non-grandfathered insured plans in the small group market. Download the bulletin below for more information. As always please contact your Total Benefit Solutions account manager at (215)355-2121 if you have any questions or concerns. Download Mental Health Parity  

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2018 Inflation Adjusted Amounts for HSAs

The IRS released the inflation adjustments for health savings accounts (HSAs) and their accompanying high deductible health plans (HDHPs) effective for calendar year 2018. All limits increased from 2017 amounts. Click to download the bulletin below and as always contact your Total Benefit Solutions account manager at (215)355-2121  if you have any questions or concerns regarding this notice.   Click Here to Download 2018 Inflation Adjusted Amounts for HSAs

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Recent Developments Regarding the Employer Mandate

Applicable large employers (ALEs) may be resting easy, having had no notification from the IRS of 2015 or 2016 assessments under the Employer Mandate of the Affordable Care Act (the ACA) and having reasonably expected that the Republican-led administration would limit or choose not to enforce this mandate. With the status of health care reform uncertain, the IRS has taken additional steps regarding the mandate, once again updating its website with FAQs on Employer Mandate penalties that build on information released in January (before the change in administration). Briefly, the guidance is included in the bulletin. Download the bulletin here

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House Passes Bill to Repeal ACA

Just six weeks after the House leaders failed to muster the votes to pass an earlier version of the American Health Care Act (AHCA), the House Republicans narrowly passed their health care bill to repeal and replace Obamacare with a 217 to 213 vote on Thursday… Click the link below to download the bulletin with important points: Download House Passes Bill to Repeal Obamacare

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Video: Our New Online Enrollment System

Watch this short video to get a quick overview of our new employee enrollment system with Ease Central!   As always please contact your Total Benefit Solutions account manager at (215)355-2121 if you have any questions about our new enrollment system with Ease Central!

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Small Businesses May Be Able to Keep Existing Health Coverage Through Calendar Year 2018

Small Businesses May Be Able to Keep Existing Health Coverage Through Calendar Year 2018   A previously extended transitional policy which allows health insurance issuers, at their option, to continue group coverage that would otherwise be terminated or cancelled has been extended further—to policy years beginning on or before October 1, 2018, provided that all policies end by December 31, 2018. Health insurance issuers that renew coverage under the extended policy are required to provide standard notices to affected small businesses for each policy year. Extended Transitional Policy At the option of the states, issuers that have renewed policies under the transitional policy continually since 2014 may be permitted to… Read More

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Trump Issues Executive Order To Curb Some Parts Of ACA.

Trump Issues Executive Order To Curb Some Parts Of ACA. The New York Times  (1/20, Davis, Pear, Subscription Publication) reported that on Friday, President Donald Trump issued an executive order  to government agencies directing them “to scale back as many aspects of the Affordable Care Act as possible, moving within hours of being sworn in to fulfill his pledge to eviscerate Barack Obama’s signature health care law.” According to the Times, the one-page order “has symbolic as well as substantive significance, allowing Mr. Trump to claim he acted immediately to do away with a health care law he has repeatedly called disastrous, even while it remains in place and he… Read More

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Health Reform: 4th Quarter 2016 Compliance Compilation

Download a digest of our fourth quarter compliance bulletins. This digest includes the following bulletins:  Transitional Reinsurance Fee Form Now Available 10/14/2016 Final 2016 Forms 1094-C and 1095-C Available 10/25/2016 November 2017 Cost of Living Adjustments 11/01/2016 Relief Extended for Premium Reimbursement Programs for Student Employees 11/02/2016 Updates Regarding the NJ Small Employer Health Benefits Program 11/07/2016 Election Results and the ACA: Preliminary Thoughts 11/10/2016 16 Extension of Deadline for 2016 Forms 1095-C 11/21/2016 Adjusted PCOR Fee for Fifth Filing Year Released 11/22/2016 December Beware of Phishing Email Disguised as HIPAA Privacy Audit Letter 12/13/2016   Click here to download the 4th quarter compliance compilation

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New Law Exempts Certain Small Employer HRAs From ACA Market Reforms

New Law Exempts Certain Small Employer HRAs From ACA Market Reforms Gaddiel Gonzalez-Brown & Brown Consulting President Obama has signed into law the 21st Century Cures Act, which, among other things, allows small employers to offer new “qualified small employer health reimbursement arrangements” to reimburse employees for qualified medical expenses, including individual health insurance premiums, for years after December 31, 2016. Small employers are defined as those with fewer than 50 full-time equivalent employees who do not offer a group health plan.   Background Under prior agency guidance, stand-alone HRAs (except for retiree-only HRAs and HRAs consisting solely of excepted benefits) and HRAs used to purchase coverage on the individual… Read More

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Health Reform: Cost of Living Adjustments, Individual Penalty, HSA limits & more for 2017

    On October 25 and 27, 2016, the IRS released cost of living adjustments for 2017 under various provisions of the Internal Revenue Code (the Code). Some of these adjustments may affect your employee benefit plans. These adjustments include but are not limited to the following: Cafeteria Plans Qualified Transportation Fringe Benefits Requirement To Maintain Minimum Essential Coverage (Individual Penalty) Highly Compensated Non-Grandfathered Plan Cost-Sharing Limits H.S.A. Annual contribution limitation, catch up contribution and minimum deductibles Key Employee   Click here to download the bulletin   As always if you have any additional questions or concerns, please contact your dedicated Total Benefit Solutions, Inc. account manager at (215)355-2121.

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Health Reform: IRS Extends Due Date for Furnishing Form 1095-B/C.

IRS Extends Due Date for Furnishing Form 1095-B/C. As applicable large employers and employers with self-funded health plans are working on their Affordable Care Act compliance preparations, the IRS announced an extension of a key ACA deadline. Notice 2016-70 extends the due date for furnishing Form 1095-B and Form 1095-C from January 31, 2017 to March 2, 2017.  The Notice also extends transition relief from penalties if an employer makes a “good faith effort” to comply with reporting requirements. This relief is welcome news for employers who are still working on their compliance approach. A copy of the notice can be downloaded here.

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Election Results and the ACA

With the outcome of the 2016 elections now official, the Republicans will hold the majority in both chambers of Congress and control of the White House beginning in 2017. Since President-elect Trump ran on a platform of “Replace and Repeal” of the Affordable Care Act (ACA), we anticipate that acting on this campaign promise will be one of the top priorities of the new Trump administration. We anticipate there will be significant disruption for individuals, employers, brokers and carriers across the country. Click here to read the latest bulletin

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IBC: Plans to remove exclusions for gender reassignment surgery coverage

  In a July Independence Edge article, we shared that the U.S. Department of Health and Human Services (HHS) had issued a final rule for the nondiscrimination provision (section 1557) of the Affordable Care Act (ACA). While the nondiscrimination provision itself is not new, the final rule provides expanded clarity on coverage for gender reassignment surgery and related services. In addition, it provides guidance on treating individuals consistent with their gender identity, and not denying or limiting health services usually only available to individuals of one gender. Beginning with renewals on or after January 1, 2017, the exclusion for gender reassignment surgery has been removed from all commercial plans. Members… Read More

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HHS Penalties Increase

  On September 6, 2016, the Department of Health and Human Services (“HHS”) issued an interim final regulation that adjusts civil penalties for inflation. The interim final regulation does not follow the usual procedures that offer a notice and comment period. As such, a Notice of Proposed Rulemaking has not been issued and a comment period is not provided due to potential delay in the applicability of the regulation. Click to download this bulletin For more information please contact your Total Benefit Solutions account manager at (215)355-2121

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HR 360:Most Common Summary Plan Description (SPD) Mistakes

One of the most important documents participants must receive automatically when becoming covered under a health benefit plan that is subject to ERISA (the federal Employee Retirement Income Security Act) is a summary of the plan, called the Summary Plan Description or SPD. The fact is, many employers are confused about this very important ERISA-required disclosure, which can put them at risk. Click this link to download the publication

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Total Benefits & Healthiest You

Healthiest You is more than a typical Teledoc benefit. Whenever members have questions or they are simply not feeling well, they can effortlessly connect to a 24×7 telehealth hotline for the diagnosis and treatment of illness, second opinions and consultations. They have board-certified, licensed physicians in every state waiting to provide exceptional care. They can even prescribe medication and save a trip to the doctor’s office, whether members are at home or on the road. Want more information? Click here to see the site.  

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Critically Important: Insurance for Serious Illness

Good news: You’ve got health insurance (at least, all Americans are required to or pay a penalty). Bad news: It doesn’t cover everything. Especially if something really bad happens, like a heart attack or stroke. Yes, a decent major medical plan will cover many of the health-related expenses related to a serious illness. But you’d likely still be left with significant out-of-pocket costs for deductibles and copayments. Medical insurance also doesn’t usually cover other related costs, such as travel to treatment centers, child care during absences or recovery, home modifications or rehabilitation charges. And if you lose income while you’re unable to work, you could have a tough time paying… Read More

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