2024 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

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Choosing the Right Health Insurance: HMO vs. PPO

When it comes to health insurance, understanding the differences between various plans is crucial for making an informed decision. Two common types of health insurance plans are Preferred Provider Organizations (PPOs) and Health Maintenance Organizations (HMOs). While both offer coverage for medical expenses, they have distinct features that can significantly impact your healthcare experience and costs. In this blog, we’ll explore three key differences between PPOs and HMOs to help you decide which one aligns better with your needs. 1. Network Flexibility: PPO: Preferred Provider Organizations are known for their expansive networks of healthcare providers. This includes a wide array of specialists and the option to seek care from out-of-network… Read More

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Annual Enrollment Period: Your Path to Tailored Medicare Coverage

Are you ready to take charge of your healthcare journey? The Annual Enrollment Period (AEP) is swiftly approaching, and it’s your golden opportunity to customize your Medicare coverage to align perfectly with your evolving health needs. At Total Benefits, we’re here to guide you through this crucial period, ensuring that your Medicare plan reflects your unique requirements and aspirations for a healthy future. AEP: Your Key to Tailored Coverage: Circle the dates on your calendar: AEP commences on October 15 and concludes on December 7. These six weeks are a window of empowerment, during which you hold the reins to make changes that suit you best. Whether you’re seeking enhanced… Read More

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Mark Your Calendars for These Crucial Medicare Dates!

We’ve got some important dates coming up that you’ll want to circle on your calendars. Your Medicare choices are about to take center stage, and we’re here to help you navigate them like a pro! Pre-Annual Election Period (Pre-AEP) – Starting 10/1 Get ready to dive into the world of Medicare choices! The Pre-AEP is your head start, your chance to gather information and get prepared for what’s ahead. It’s like laying the groundwork for a solid plan that suits your needs. Medicare Annual Election Period (AEP) – Starting 10/15 This is the moment you’ve been waiting for! The AEP kicks off on October 15, and it’s your golden opportunity… Read More

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Understanding When Your Medicare Coverage Starts

Approaching 65 or exploring Medicare? Knowing when your coverage begins is vital for your protection and preparation. Enrollment timing is key for activating your benefits. Let’s simplify the essentials of when your Medicare coverage starts. Initial Enrollment Opportunity Medicare coverage launch centers around your Initial Enrollment Period, typically when you turn 65. This 7-month period spans 3 months before and after your 65th birthday. Coverage Commencement Date Your coverage initiation hinges on your sign-up month during the Initial Enrollment Period. Note that coverage always begins on the first day of the month. Late Part A Enrollment Opting for Part A after 65? Coverage begins six months back from your sign-up… Read More

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Understanding the Plan Annual Notice of Change (ANOC) in Medicare

Staying informed about your healthcare coverage is vital, especially when it comes to Medicare plans. One key document that plays a significant role in this process is the “Plan Annual Notice of Change” or ANOC. What is the ANOC? If you’re enrolled in a Medicare plan, the ANOC is your compass for upcoming changes. Every fall, your plan sends you this crucial document, detailing any adjustments that will take effect in January. These changes encompass a range of aspects, from coverage modifications to shifts in costs and more. When Can You Expect It? Mark your calendars for September. This is the month when the ANOC usually arrives, providing you with… Read More

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Medicare Coverage of Home Health Care: Booklet

This booklet describes the home health care services that Medicare covers, and how to get those benefits through Medicare. If you get your Medicare benefits through a Medicare health plan (not Original Medicare) check your plan’s membership materials and contact the plan for details about your Medicare-covered home health benefits. Download the Medicare Coverage of Home Health Care: Booklet to help you understand the home health services that Medicare covers and much more. As always if you have any questions or concerns about this bulleting please contact your Medicare health insurance experts at Total Benefit Solutions, Inc (215)-355-2121

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What’s New in the 2023 ACA Open Enrollment?

The 2023 Affordable Care Act (ACA) Open Enrollment period is upon us, marking a significant milestone as Health Insurance Marketplaces open their doors for the tenth year. From November 1, 2022, to January 15, 2023, individuals and families have the opportunity to secure comprehensive healthcare coverage. In this blog post, we’ll delve into the key changes and updates for this year’s open enrollment, focusing on insights gathered from the Kaiser Family Foundation’s informative article titled “Nine Changes to Watch in Open Enrollment 2023” [source: www.kff.org/policy-watch/nine-changes-to-watch-in-open-enrollment-2023/]. As the ACA Open Enrollment enters its tenth year, changes abound, ensuring improved access, affordability, and assistance for individuals and families seeking healthcare coverage. Staying… Read More

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Are Health Insurance Premiums Tax Deductible?

Health insurance premiums can be tax-deductible under certain conditions in the United States. However, please note that tax laws and regulations can change, so it’s essential to consult a tax professional or the latest IRS guideline for the most up-to-date information. Typically, if you are self-employed or have health insurance coverage through your employer and pay your premiums with after-tax dollars, you may be eligible to deduct the premiums on your federal income tax return. This deduction is generally reported on Schedule 1 of Form 1040, which is used to calculate your Adjusted Gross Income (AGI). Keep in mind that there are specific requirements and limitations for deducting health insurance… Read More

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Navigating Health Insurance for “gig” Economy Entrepreneurs

For self-employed individuals or today’s gig workers, obtaining health insurance can be a bit different compared to traditional employer-sponsored plans. Empower yourself with a range of valuable choices to explore! Take a moment to peruse the document below, where you’ll find a comprehensive list of options available to you. We’re committed to providing exceptional support, so please don’t hesitate to reach out to our dedicated Total Benefit Solutions health insurance specialists at (215)-355-2121. We’re here to answer any questions or address any concerns you may have.

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Insights 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

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