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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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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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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Stand-Alone HRAs for Small Employers are Back!

Stand-Alone HRAs for Small Employers are Back! The 21st Century Cures Act, signed by President Obama on December 13, 2016, gave small employers a means of providing employees help with their individual insurance premiums and other out-of-pocket qualified medical expenses without violating the provisions of the Affordable Care Act (ACA). Small employers can now provide a specific kind of Health Reimbursement Arrangement (HRA) to help employees with the costs of individual health coverage. According to the statutory language under “Title XVIII – Other Provisions” of the Act, qualified small employer health reimbursement arrangements (QSEHRAs) are not considered “group health plans” and do not have to adhere to ACA market reforms,… Read More

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Total Benefit Solutions: New Starmark Self Insured Plans for Small Groups

Total Benefit Solutions is proud to announce that we are now appointed with Starmark to provide affordable and predictable self insured medical plans to small businesses. Starmark® administers self-funded health benefit plans exclusively for smaller businesses nationwide. Employers choose from extensive plan design choices to create a self-funded health plan to meet their unique needs and budget, while stop-loss insurance from Trustmark Life Insurance Company provides protection against large covered claims. Click Here To View A Client Testimonial Click here for more information and to watch a short video about these products and how your organization might benefit from a self insured plan.

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The PCOR filing deadline is August 1, 2016 for all self-funded medical plans and HRAs for plan years ending in 2015…

The PCOR filing deadline is August 1, 2016 for all self-funded medical plans and HRAs for plan years ending in 2015. The IRS has also issued FAQs that address how the PCOR fee works with a self-insured health plan on a short plan year.  Please note that for those with an HRA plan, and HRA is ” self insurance” and you are required to file and pay the PCOR fee. Please download the document below for more details and links to specific resources. Download PCOR Fee Filing Reminder for Self-Insured Plans

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Key Facts You Need to Know About: Cost-Sharing Reductions

A recent analysis shows that more than 2 million marketplace enrollees who are eligible for cost-sharing reductions (CSRs) are foregoing this extra level of financial assistance by enrolling in plans that do not qualify. Consumers can receive CSRs only if they enroll in a silver level plan through their marketplace. Many of those who chose not to receive CSRs are likely enrolling in bronze plans with lower premiums but higher out-of-pocket costs. It’s important to communicate the benefits and trade-offs of receiving CSRs to the consumers you are assisting, especially those with significant health care needs. To learn more about cost-sharing reductions, check out this helpful resource from the Center on Budget… Read More

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IRS Penalties for Small Employers Reimbursing Individual Health Insurance Premiums Will Not Apply Until July 2015

IRS Penalties for Small Employers Reimbursing Individual Health Insurance Premiums Will Not Apply Until July 2015 IRS Notice 2015-17 provides limited transition relief from the assessment of excise taxes for small employers who reimburse, or directly pay, the premium for an employee’s individual health insurance policy. Prohibited Plans An “employer payment plan” is an arrangement under which an employer reimburses an employee for some or all of the premium expenses incurred for an individual health insurance policy, or an arrangement under which the employer uses its funds to directly pay the premium for an individual health insurance policy covering the employee. Pursuant to prior agency guidance, employer payment plans are… Read More

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Updated Healthcare Reform Calculators

Total Benefit Solutions Inc. has updated our healthcare reform calculators on our website, https://www.totalbenefits.net Calculators include: How much tax credit is my small group eligible for? What are the conditions required to get the tax credit? Pay or Play Mandate penalty-What is my risk as a group? Individual Subsidy Calculator Click here to get to our healthcare reform calculators.

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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

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IRS Coordinates Cafeteria Plan Rules with the ACA:Two New Election Changes Allowed

Two New Election Changes Allowed Existing cafeteria plan rules make it difficult (if not impossible) for participants to revoke pre-tax salary reduction elections mid-year and enroll in qualified health plan coverage through the Health Insurance Marketplace (the “Marketplace,” sometimes referred to as the “Exchange”).  To provide additional flexibility, the IRS issued Notice 2014-55, creating new opportunities for a participant to change mid-year an otherwise irrevocable cafeteria plan election. Click here to Download the Entire Bulletin      

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IBC: New Cost Care Estimator

Independence Blue Cross (Independence) is excited to announce the addition of the Care Cost Estimator (CCE) to our consumer transparency tools. The new online CCE tool will help educate members about covered services, treatment options, and anticipated out-of-pocket costs as they apply to their specific health plan. The CCE tool is available at www.ibxpress.com beginning on September 12, 2014, for PPO members who have migrated to our new operating platform. For customers who have not yet migrated, the CCE tool will become available to PPO members on your renewal date, in conjunction with the migration. To access the CCE tool, members must log in to their account at www.ibxpress.com, where they… Read More

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Heath Reform: 5 States Will Have Early Access to Online Functions of the Federally-Facilitated SHOP Marketplace

‘SHOP Early Access’ Available in Delaware, Illinois, New Jersey, Ohio, and Missouri Starting in late October, small employers, agents, and brokers in Delaware, Illinois, New Jersey, Ohio, and Missouri will be able to experience some of the key new online functions of the federally-facilitated Small Business Health Options Program (FF-SHOP), according to the U.S. Department of Health and Human Services. The online SHOP Marketplace is expected to be available nationwide on November 15, 2014. SHOP Early Access During the “SHOP Early Access,” small employers in the five selected states will be able to use HealthCare.gov to take several initial steps in the enrollment process, including: Establishing a Marketplace SHOP account; Assigning an agent or… Read More

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Total Benefit Solutions to partner with ThinkHR

        In another effort to enhance our client experience and bring value to our small business clients, Total Benefit Solutions is proud to announce that we have entered into an agreement to provide Think       HR. Soon our clients will get an introductory e-mail with instructions on how to access their complimentary ThinkHR account. We expect to have this resource available to our clients in September 2014, just in time for this year’s open enrollment period!   Think HR will help our clients: Stay up to date with the latest news and resources Remain compliant with best practices from HR professionals Build tools like job… Read More

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IRS Highlights Stiff Penalty for Reimbursing Individual Premiums

From Health Care Reform Digest: Since the IRS and Treasury published Notice 2013-54 in September 2013, pre-tax employer reimbursement of an employee’s individual health insurance premiums has been a hot topic of conversation.  Historically, many employers have provided this type of benefit in lieu of offering a group health plan – a strategy that now needs to be reevaluated as a result of regulations implementing the Patient Protection and Affordable Care Act (PPACA).   Q1.  What are the consequences to the employer if the employer does not establish a health insurance plan for its own employees, but reimburses those employees for premiums they pay for health insurance (either through a qualified health… Read More

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IRS: HSA Contributions and limits for 2015 Released

The IRS has released the 2015 cost-of-living adjustments affecting HSAs and HDHPs. The 2015 IRS HSA limits are increasing for 2015. Click to download the bulletin

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