In today’s world, the rising costs of healthcare have left many Americans grappling with the financial burden of medical expenses. While comprehensive health insurance is essential, fixed indemnity health insurance has emerged as a valuable supplemental resource, offering financial protection to individuals when they need it the most. This blog explores the concept of fixed indemnity health insurance and its importance in providing financial peace of mind to Americans. Fixed Indemnity Insurance: This supplemental insurance differs from major medical plans. It pays a fixed sum directly to you when specific medical events, like doctor visits or hospital stays, occur. While it doesn’t cover all the essential health benefits mandated by… Read More
Continue ReadingMedicare Supplement Insights: Protecting Your Wallet
In a world where healthcare costs are a growing concern for many, Medicare Supplement coverage has emerged as a reliable solution to bridge the gaps in original Medicare. As we delve into the latest data from 2021, including insights from the National Association of Insurance Commissioners (NAIC), the California Department of Managed Health Care, and the Medicare Current Beneficiary Survey (MCBS) from 2020, a compelling narrative about the significance of Medicare Supplement plans unfolds. Key Takeaways: 1. A Majority Embrace Medicare Supplement: In 2020, a staggering 54% of original Medicare enrollees without additional insurance coverage, such as Medicaid or employer-provided insurance, turned to Medicare Supplement policies for added peace of… Read More
Continue Reading2024 ACA Affordability Shake-Up: Are You Ready?
Are you ready for some important news regarding the Affordable Care Act (ACA)? The IRS has just released an update that could impact your organization’s healthcare offerings. In this blog post, we’ll break down the latest announcement and what it means for employers and employees alike. If you’re interested in diving deeper, be sure to download our PDF for more information. IRS Announces 2024 ACA Affordability Indexed Amount The IRS recently made an important announcement in Revenue Procedure 2023-29 regarding the Affordable Care Act’s (ACA) affordability indexed amount under the Employer Shared Responsibility Payment (ESRP) requirements. This announcement is significant for employers as it affects the calculation of penalties related… Read More
Continue ReadingCMS announces lower Medicare Part D premium for 2024
According to an official statement by the Centers for Medicare and Medicaid Services (CMS) on Monday, the projected average total premium for Part D beneficiaries is anticipated to decrease by 1.8% in 2024. This reduction would bring the average monthly premium down to $55.50 from the 2023 figure of $56.49. The computed average monthly premium for Medicare Part D coverage in 2024, at $55.50, encompasses the combined average basic premium and the supplementary premium for plans featuring enhanced coverage. CMS emphasizes that this projection offers the most precise estimate of individuals’ 2024 Part D premium expenses. In addition to this update, CMS has disclosed several other important figures for the… Read More
Continue ReadingCracking the Code: Navigating Health Cost Surge in 2023
Managing Health Costs in 2023 Multiple industry and benefits sources are predicting health insurance premium increases in the range of five to eight percent for 2023. An analysis by Aon is forecasting a 6.5% increase. The Society for Human Resource Management (SHRM) is expecting a bump of 5.6%, based on a prediction by Mercer. The International Foundation of Employee Benefit Plans says employers are anticipating a 7.5% increase. The country’s oldest actuarial consulting firm, Buck, has forecast an increase in the range 5.8% to 6.9%. If you have any questions or concerns about this news please contact your Total Benefit Solutions, Inc health insurance specialists at (215)-355-2121
Continue ReadingInsights into Self-Funding and Deductibles: A Look at Healthcare Trends for Large Firms
Self-Funding Popular – Especially for Large Firms Many larger firms self-fund their health plans or pay for some workers’ health services directly – rather than through the use of health insurance. Nearly two-thirds (65%) of covered workers are in self-funded plans. That includes 20% of workers at small firms and 82% at large firms. Deductibles for Most Most employees with health insurance have a cost share before their insurance begins to pay benefits. Among those with single coverage, the average annual deductible is $1,763, similar to the $1,669 average in 2021. For most plan types, the single coverage deductible is higher for employees at small firms. The average is $2,543… Read More
Continue ReadingRequest to lower an Income-Related Monthly Adjustment Amount (IRMAA)
If you’ve had a life-changing event that reduced your household income, you can ask to lower the additional amount you’ll pay for Medicare Part B and Part D. Life-changing events include marriage, divorce, the death of a spouse, loss of income, and an employer settlement payment. Amended income tax returns Call +1 800-772-1213 and tell the representative you want to lower your Medicare Income-Related Monthly Adjustment Amount (IRMAA) if you had an amended income tax return. Fax or mail your request Fill out the Medicare Income-Related Monthly Adjustment Amount-Life-changing Event (SSA-44) (PDF) form. Fax or mail your completed form and evidence to a Social Security office. For support completing this task call +1 800-772-1213… Read More
Continue ReadingDoes a Health Savings Account (HSA) have Reimbursable Expenses?
Employees can use the HSA to pay for Code §213(d) medical expenses, expenses such as expenditures for medical care, to the extent that such amounts are not reimbursed by insurance or any other source. Medicines and drugs (other than insulin) can be qualified medical expenses only if they are prescribed. Under the CARES Act, employers can also allow for reimbursement of OTC drugs. With certain exceptions, qualified medical expenses do not include payments for health insurance premiums or coverage contributions toward self-funded health coverage. However, the expense for coverage under any of the following will be an HSA-qualified medical expenses: HSA funds may not be used to pay insurance premiums… Read More
Continue ReadingWhat is an expected benefit Health Reimbursement Arrangement?
An excepted benefit Health Reimbursement Arrangement (HRA) allows employers to finance additional medical care, like vision or dental coverage, coinsurance and copayments for individual health insurance coverage, short-term limited-duration insurance, or other health care costs not covered by their primary group plan. Excepted benefit HRAs cannot be used to reimburse individual health insurance coverage premiums, group health plans premiums (other than COBRA or other group continuation coverage), or Medicare premiums. However, an excepted benefit HRA can be used to reimburse premiums for individual health insurance coverage or group health plan coverage that consists solely of excepted benefits. This type of HRA, like the individual coverage HRA, allows rollover of unused… Read More
Continue ReadingWhat is copayment?
A fixed amount ($20, for example) you pay for a covered health care service after you’ve paid your deductible. Let’s say your health insurance plan’s allowable cost for a doctor’s office visit is $100. Your copayment for a doctor visit is $20. If you’ve paid your deductible: You pay $20, usually at the time of the visit. If you haven’t met your deductible: You pay $100, the full allowable amount for the visit Copayments (sometimes called “copays”) can vary for different services within the same plan, like drugs, lab tests. and visits to specialists. Generally plans with lower monthly premiums have higher copayments. Plans with higher monthly premiums usually have… Read More
Continue ReadingMedicare Part D Notification Requirements
Employers sponsoring a group health plan with prescription drug benefits are required to notify their Medicare-eligible participants and beneficiaries as to whether the drug coverage provided under the plan is “creditable” or “non-creditable” prior to October 15th, 2018. Please follow this link for more information: Medicare Part D Notification Requirements As always, if you have any questions or concerns about this notification or your specific policy, please contact us at 215-355-2121
Continue ReadingThe History of Medicare
A brief history of Medicare in America Landmark social program now covers 58.5 million Americans By Steve Anderson Discussion about a national health insurance system for Americans goes all the way back to the days of President Teddy Roosevelt, whose platform included health insurance when he ran for president in 1912. But the idea for a national health plan didn’t gain steam until it was pushed by U.S. President Harry S Truman.On November 19, 1945, seven months into his presidency, Truman sent a message to Congress, calling for the creation of a national health insurance fund, open to all Americans. The plan Truman envisioned would provide health coverage to individuals, paying for such typical expenses… Read More
Continue ReadingPrevent Osteoporosis with Screenings
10 Facts About Osteoporosis By Kathleen Hall This silent disease significantly raises your risk for fractures and disability. 1. Losing bone density is a normal part of aging. We reach peak bone mass between ages 25 and 30, and then slowly lose begin to start losing bone mass at age 40. For women, reduced levels of estrogen after menopause accelerate bone density loss. “Women lose 1.5 to 2 percent of their bone density per year in the first 10 years after menopause,” says Laura Ryan, MD, clinical associate professor of medicine in the division of endocrinology, diabetes, and metabolism at The Ohio State University Wexner Medical Center in Columbus. 2. You don’t lose… Read More
Continue ReadingNew Medicare Card Mailing Update!
Check the Status of Your New Card *Cards have finished mailing to American Samoa, the Northern Mariana Islands, Guam, and to people who get RRB benefits. Three Things To Know Your new card will automatically come to you. You don’t need to do anything as long as your address is up to date. If you need to update your address, visit your My Social Security. Once you get your new Medicare card, destroy your old Medicare card and start using your new card right away. Your new Medicare Number is a unique combination of numbers and letters. Your new number uses numbers 0 thru 9. The letters S, L, O,… Read More
Continue ReadingThe Four Stages of Medicare Part D (2018)
The Four Stages of Medicare Part D Coverage
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