Health Reform:Legislative Update-Relief for Small Groups Under the Affordable Care Act (ACA)

On Monday, Congress and President Obama together repealed one of the Affordable Care Act’s most onerous provisions, which prohibited so-called “small groups” (mostly groups with less than 50 employees) from offering health plans with deductibles higher than $2,000 for single coverage and $4,000 for family coverage. This comes as very welcome news to small businesses, who are frequently the most in need of additional options and flexibility when it comes to offering employees comprehensive, affordable health insurance via higher deductibles and other cost-sharing mechanisms. It is also great news for employers wanting to couple their insurance plans with health reimbursement arrangements (HRAs), which federal agencies previously rejected as permissible ways… Read More

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Crozer-Keystone Health System No Longer In Network with Cigna-Healthspring MAPD Plans

Please be advised of a change in the Cigna-HealthSpring provider network which may impact some of your customers. Starting May 1, 2014, Crozer-Keystone Health System will no longer be available to Cigna-HealthSpring members for hospital, home health or ancillary (surgery and other similar treat­ments) services. In a few days, we will mail the attached letter to the affected membership to advise them of this change. Please note that Crozer-Keystone health system primary care and specialty group doctors are still part of the Cigna-HealthSpring network. Only hospital, home health and ancillary services are leaving the network beginning May 1, 2014. Cigna-HealthSpring members currently under an active treatment plan may continue to… Read More

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Client Testimonial: Mike Hilbert

Ed, thank you for your recent endorsements. And especially thank you for helping my wife and I sail through the new Affordable Care Act. You and your team made the complicated seem simple and select the plan best suited for our health insurance needs. Thanks again!! Mike Hilbert Sales Pros for Hire   PS- I have already received and paid my April payment and can print temporary insurance cards from the  website.

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The Truth Agents/Brokers & FFM Navigators The Patient Protection and Affordable Care Act

The Truth Agents/Brokers & FFM Navigators The Patient Protection and Affordable Care Act Shared with permission from B. Ronnell Nolan, HIA, CHRS-President/CEO – HAFA Financial Media Group, LLC, Centennial, CO, compiles this information annually. There are approximately 1.2 million licensed insurance agents nationally. The 1.2 million does not include the staff of licensed agents employed throughout the United States. After adding the staff, imagine the millions of people that Agents represent, educate and protect on a daily basis! With the passing of the ACA, Health Agents for America, Inc. was formed to create a tool box for Agents to use in educating the citizens of their local communities. HAFA is known to… Read More

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Feds: Navigators don’t need E&O coverage

Enclosed in the 279 pages of proposed rules released Friday by the Department of Health and Human Services for the public health insurance exchanges is an answer, sort of, to a question brokers have raised for more than a year — who will be liable for navigators’ mistakes? n the section of the rules discussing navigators, the Obama administration’s document says “a state or an exchange must not require that all navigators be agents or brokers or carry errors and omissions coverage.” Further, the rule says that if navigators were to be required to carry E&O insurance, this would disqualify them from being considered a “community and consumer-focused nonprofit group.” Federal law… Read More

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IBC: New Lab Provider Effective July 1-IMPORTANT NOTICE

Independence Blue Cross (IBC) has selected Laboratory Corporation of America® Holdings (LabCorp), as its exclusive, nationally-based provider of laboratory services, effective July 1, 2014. The change applies to all Personal Choice®/PPO and Keystone Health Plan East product lines, and affects all individual, group commercial, and Medicare members, for services rendered in the Philadelphia five-county area, and in the contiguous counties. Effective July 1, 2014, Quest Diagnostics laboratories will be an out-of-network provider for Personal Choice and Keystone Health Plan East. IBC will continue to contract with certain local and regional laboratories… Click to download the bulletin

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IBC: July 1 rate increase for individual medically underwritten plans

IBC: We want to let you know that the monthly rates for our individual medically underwritten plans will increase in July 2014. We are notifying members muchearlier than is required to give them the opportunity to enroll in a plan that is compliant with the Affordable Care Act (ACA). The reason for the rate increase. We understand that it can be difficult to afford quality health insurance coverage. While we continue to work hard to keep costs down, the cost of health care continues to rise along with our member utilization. This is why it’s necessary for Independence Blue Cross (IBC) to implement an 11.5 percent rate increase. Click the link below to read… Read More

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Client Testimonial: Kristine Kreisher

We received this email from one of our clients this week, Kristine Kreisher, and wanted to share:   Dear Ed: I spent a month and a half calling Blue Cross, getting the run around, and given incorrect information. I make a phone call/send an email to you both and within a couple hours everything is taken care of and corrected!!! You guys are awesome!!! Thank you soooooo much for getting this all taken care of!!!! Kris Kreisher February 2014   We love happy clients!

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Humana-When to Enroll: Important Deadlines under the Affordable Care Act

Have you enrolled? Open enrollment is ending soon! Do you know when? Watch this video from Humana and learn more, then call your Total Benefit Solutions Advisor at (215)355-2121 and get enrolled without any further delay!  

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Total Benefit Solutions Now Offering Online Enrollment with Consult-A-Doctor PLUS

Healthcare… the way it should be! Are you tired of waiting multiple weeks to go see your doctor, only to find yourself taking time off work so you can drive through traffic and sit in the waiting room for what seems like forever? Have you ever felt overwhelmed by the stress and anxiety of a difficult life situation and wished you had someone you could trust to hold your hand and walk you through to the other side?  Then welcome to CADRPlus, an innovative new health care program that gives you unlimited, 24/7 access to doctors and other industry professionals from the comfort and convenience of your phone or computer,… Read More

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Health Reform: Final Rule Issued Regarding Health Insurance Provider Fee

Beginning in 2014, a health insurance provider fee applies to covered entities engaged in the business of providing health insurance for United States health risks. United States health risks include the health risk of a U.S. citizen or a resident alien including those living abroad. Thus, insurers issuing expatriate policies covering a U.S. citizen or resident alien living abroad are subject to the fee. Medical, dental and vision carriers in the insured marketplace are subject to this fee. This fee does not apply to self-insured employer-sponsored plans. Click the link below to download the bulletin. Final Rule Issued Regarding Health Insurance Provider Fee  

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Relief for Vision, Dental and EAP Benefits and New Wraparound Coverage

The Departments of Labor, Treasury and HHS issued a proposed rule that provides helpful guidance regarding certain excepted benefits, including vision benefits, dental benefits, employee assistance programs (EAPs) and certain wraparound programs. Click the link below to download the bulletin. Relief for Excepted Benefits-012414R

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Healtcare Reform Law

Health Reform: Final Regulations Issued on Employer Penalty

On February 10, 2014, the IRS released final regulations implementing the Employer Shared Responsibility provision under the Affordable Care Act (ACA) for 2015 (the “employer penalty”). This guidance is lengthy and provides helpful clarification in many areas. We are in the process of reviewing the guidance, but you will find some key aspects of this rule below: The employer penalty will apply to employers with 100 or more full-time equivalent employees starting in 2015. For employers with 50-99 full-time equivalent employees, there is a one-year delay and the employer penalty provision will start in 2016. Click the link below to download the bulletin. Final Regulations Issued on Employer Penalty – 021114R

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Video: Who can help me enroll?

Who can help you enroll on a new affordable care act plan? Remember an independent broker like Total Benefit Solutions Inc can still help you enroll on a plan on the Federal Healtcare Exchange or off at no additional cost to you. Your independent broker is still truly your healthcare advocate! Another simple yet educational video from Humana:  

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Healtcare Reform Law

First PCORI Fees Due by July 31, 2013

Revised IRS Form 720 Now Available for Employers Sponsoring HRAs and Other Self-Insured Plans to Report and Pay PCORI Fees   First PCORI Fees Due by July 31, 2013 The IRS has revised Form 720, Quarterly Federal Excise Tax Return, for employers sponsoring certain self-insured health plans to report and pay new fees imposed under Health Care Reform to fund the Patient-Centered Outcomes Research Institute (PCORI). The fees, which must be reported annually on the second quarter Form 720 and paid by its due date, July 31st, are based on the average number of lives covered under a plan. Affected Self-Insured Plans PCORI fees are imposed on plan sponsors of… Read More

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