Royal Caribbean Travel Insurance Requirements – We’ve Got You Covered!

  Beginning August 1, 2021 and going through to December 31, 2021, Royal Caribbean Cruises departing from ports out of Florida will require unvaccinated passengers age 12 years and older to procure valid travel insurance prior to boarding. Coverage requirements include $25,000 per person in medical coverage and $50,000 per person for emergency medical evacuation with no COVID-19 exclusions. Don’t let this requirement halt your travel plans!  We have Trip Protection and global health insurance plans provide coverage that meet these requirements, as well as offering additional coverage like baggage loss/delay benefits and trip cancellation/interruption benefits. If you have any questions please contact your Total Benefit Solutions, Inc health insurance… Read More

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MHPNJ : Important Plan Cancellation Status Information

Affiliated Physicians and Employers Master Trust (“APEMT”) and Members Health Plan New Jersey (“MHPNJ”) want to take the time to let you know they value the support that you have provided them over the years. APEMT/MHPNJ (the “Plan”) is ceasing to write business and is beginning an orderly wind down of the Plan. The financial deficiency the Plan has been facing for the past several months has not been sufficiently cured in the time period prescribed by New Jersey law. Therefore, the Board of Trustees on behalf of the Plan is implementing an orderly wind down of the plan. Please be advised that you must terminate their coverage with the Plan and seek new… Read More

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Group Business: Independence Blue Cross and AmeriHealth NJ COBRA and Mini-COBRA Premium Assistance

  COBRA Premium Assistance Available to Eligible Group Members Through September 2021 Under the recently passed American Rescue Plan Act of 2021 (ARPA), eligible group members who elect COBRA (including state‑based “Mini‑COBRA”) continuation coverage due to an involuntary job loss or a reduction in hours within the past year may be eligible for 100 percent coverage of their monthly health insurance premiums. This temporary premium assistance will be provided at no cost to the employer or to the group member through September 30, 2021. Employers should consult the U.S. Department of Labor and IRS websites for more information. Obtaining Mini-COBRA Premium Assistance For groups subject to state continuation plans (referred to as Mini‑COBRA typically for those with 19 or fewer… Read More

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2021 Second Quarter Compliance Bulletins Compilation

This document is a valuable resource, putting all of the latest health care reform news and updates in one location! 

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Independence: Using the e-bill feature

From Independence Blue Cross: There’s an easy way to simplify your administration and reduce costs —make secure eBill payments through our employer portal at ibx.com, anytime and anywhere… Download ebill bulletin    

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Achieve Well-being Rewards

Independence Blue Cross (Independence) offers a new way to help your employees achieve their health goals. Reward employees for completing activitiesNothing helps motivate action like the promise of rewards!*Achieve Well-being tools available on ibx.com and on the IBX mobile app create personalized action plans that make it easy for your employees to earn tokens and badges for completing their well-being goals.New for 2021, your employees can now receive a $150 gift card by completing the following required activities: Annual check-up with PCPFlu shotGet digitally engagedMember portal registrationMDLIVE.com registrationWell-being profileOpt-in to digital messaging at ibx.com Once your employees complete all six activities through the Achieve Well-being tool they can redeem a… Read More

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Supreme Court Dismisses Latest Challenge to the ACA

The “individual mandate” provision of the ACA as originally enacted in 2010 required most U.S. residents to obtain minimum essential health insurance coverage or pay a monetary penalty. The individual mandate penalty withstood a legal challenge in 2012 when the Supreme Court ruled itwas a valid exercise of Congress’ taxing power. However, Congress effectively eliminated the individual mandate penalty by reducing it to zero effective January 1, 2019. Download Supreme Court Dismisses Latest Challenge to the ACA

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SCOTUS Upholds Affordable Care Act Ruling

  The Supreme Court has dismissed a challenge to ObamaCare, leaving the industry as is for employers and individuals. By a 7-2 vote on Thursday, the justices left the entire law intact in ruling that Texas and two individuals had no right to bring their lawsuit in federal court. The Supreme Court of the United States heard oral arguments on November 10, 2020, as to the question of whether the Affordable Care Act’s Individual Mandate provision is constitutional. This case, California vs. Texas is the latest challenge against the Affordable Care Act (ACA) and the second time the Justices addressed the constitutionality of the Individual Mandate portion of that law.… Read More

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New Mandatory Preventive Items and Services

  Most plans will be required to cover new preventive items and services beginning later this year, or in 2022 or 2023 (depending on the plan year), including ones related to Hepatitis B virus infection screenings and colon cancer screenings. Non-grandfathered group health plans must provide coverage for in-network preventive items and services and may not impose any cost-sharing requirements (such as a copayment, coinsurance, or deductible) with respect to those items or services. Click to Download New Mandatory Preventive Items and Services – 2021 Update

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Tax Advantaged Benefit Documents

This site is dedicated to providing employers with the tools they need to successfully establish these written plans with SPDs at the lowest cost possible.

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Alternatives to Health Insurance Benefits

 Sometimes clients offer other alternative benefits to their employees. The reasons for doing this are many but depending on the earnings of their workforce, offering a group medical plan will eliminate any health insurance subsidy. In those cases offering a group health insurance benefit can come off as a penalty for the employees. By offering alternative benefits our experts can help the employees enrolled on a subsidized health insurance plan and still get good if not great benefits from their employer!  ICHRA: with an ICHRA the employer can give the employees money towards their health insurance purchase.  The ICHRA allows the employer to do so with untaxed dollars and the… Read More

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What is Blue Card PPO?

Many clients ask us about Blue Card PPO and how it works. Blue Card PPO is typically attached to our clients policies who are enrolled on an IBC Personal Choice PPO or National Network PPO or a Horizon Blue Cross plan with National Access. You can tell if you have this on your plan if your card has the PPO Traveling Briefcase ppo logo.   It’s important to note that members who have a Keystone HMO, Amerihealth or Horizon HMO or local EPO do NOT have Blue Card PPO.  How Does the BlueCard Program Work? BlueCard® PPO Medical Plan The BlueCard Preferred Provider Organization (PPO) medical plan gives you the freedom to… Read More

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Top 10 Questions to Ask Your Benefits Broker

Analyzing these ten critical questions in relation to your organization’s needs will help you make a more informed decision about your benefits broker

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IRS Guidance Clarifies DCAP Relief

The IRS released Notice 2021-26 to address taxation of Dependent Care Assistance Programs (“DCAPs”) as it relates  to the relief afforded under Section 214 of the Consolidated Appropriations Act, 2021 (“CAA”) and the increased DCAP limit under the American Rescue Plan Act of 2021 (“ARPA”).

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CMS Announces Medicare Plan Finder Improvements

Source: medicare.gov   This week, the Centers for Medicare & Medicaid Services (CMS) announced plans to improve and update the Medicare Plan Finder (MPF) and the Health Plan Management System (HPMS). HPMS is the system that Medicare Advantage and Part D plans use to provide data about their plan offerings to Medicare, and the MPF is the online tool that allows beneficiaries to evaluate, compare, and enroll in those plans. The changes will be in place for the start of the Medicare Open Enrollment Period starting on October 15 for 2022 plans. Many of the forthcoming MPF changes reflect suggestions that Medicare Rights and other advocates have made over the years to increase the tool’s… Read More

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Can Employers Ask for Proof of Vaccination?

From our partners at TOTAL HIPAA: As states reopen and companies invite employees back into the workplace, an employee’s vaccination status will become an important factor in minimizing workplace health risks and returning business to normal operations.  Can employers implement a mandatory vaccination program? What do laws like the Americans with Disabilities Act (ADA) and federal agencies like the Equal Employment Opportunity Commission (EEOC) have to say about this? Click the link below to read the rest at Total HIPAA… Can Employers Ask for Proof of Vaccination?

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Family Dental & Vision Plans

We have a number of stand-alone dental and vision plans from Davis Vision, VSP and Delta Dental. You can review, compare and enroll on plans in minutes! https://brokers.dentalforeveryone.com/?id=B3F52EA5-F0E3-40B4-B1DB-0F060AE09478

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What is Modified Adjusted Gross Income (MAGI)?

The figure used to determine eligibility for premium tax credits and other savings for Marketplace health insurance plans and for Medicaid and the Children’s Health Insurance Program (CHIP). MAGI is adjusted gross income (AGI) plus these, if any: untaxed foreign income, non-taxable Social Security benefits, and tax-exempt interest. Contact you Total Benefit Solutions health insurance specialist for assistance with calculating your MAGI. For many people, MAGI is identical or very close to adjusted gross income. MAGI doesn’t include Supplemental Security Income (SSI). MAGI does not appear as a line on your tax return. 

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What is Balance Billing?

When a provider bills you for the difference between the provider’s charge and the allowed amount. For example, if the provider’s charge is $100 and the allowed amount is $70, the provider may bill you for the remaining $30. A preferred provider may not balance bill you for covered services. Ask your health insurance experts at Total Benefit Solutions today how to avoid balance billing charges!

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PEOPLE RISK MANAGEMENT

Employees are usually a business’s biggest asset. Conversely, those same employees are also the biggest risk. If you have employees,you have employee-centric exposures, also known as people risks. These risks are rapidly increasing and evolving, and what were onceconsidered minor problems are now potentially disastrous for businesses.  Download HR Solutions

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What is a Qualified High Deductible Health Plan?

Qualified HDHPs Enrollment in a qualified HDHP is a requirement for establishing and maintaining a health savings account. The chassis for a qualified HDHP is the same as described in Chapter 1, but it must also conform to certain federal guidelines: A qualified HDHP must specify both a minimum annual deductible and a maximum annual out-of-pocket (OOP) expense limit, as set every year by the IRS. The minimum annual deductible is just that—the minimum amount that the insured must pay before the plan pays any benefit. The maximum annual OOP expense limit is the cap on the sum of the annual deductible and all out-of-pocket expenses the insured must pay for covered expenses under the… Read More

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What Is a Health Savings Account?

A health savings account is a special purpose financial account that allows a consumer to save and pay for medical expenses on a tax-favored basis. Funds deposited into an HSA are not taxed; the funds in the account grow tax free; and the money accumulated in the account can be withdrawn tax free to pay for qualifying medical expenses. In effect, an HSA owner uses the account in a manner similar to a checking account to cover his or her (or his or her family’s) medical expenses. There are no income restrictions or requirements on who may or may not open and contribute to an HSA. The HSA—the account and its funds—belongs… Read More

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ARPA Update from United Healthcare COBRA Services

The American Rescue Plan Act (ARPA) of 2021 was signed into law on March 11, 2021. ARPA provides temporary premium assistance for COBRA continuation coverage. The premium assistance is available for the period beginning April 1, 2021 (or prospectively from the date of the qualifying event if the qualifying event is after April 1, 2021) through September 30, 2021 or the end of the qualified beneficiary’s 18-month COBRA eligibility period, whichever is earlier. The premium assistance may end earlier if the assistance eligible individual becomes eligible for another group health plan or Medicare. The premium assistance is available to certain assistance eligible individuals who are eligible for COBRA continuation coverage… Read More

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Aetna Small Group (2-100) Insured & Small Group Aetna Funding Advantage FAQ
Health Plan options for business owners during COVID-19 pandemic

Aetna is mindful of the many challenges our small business customers and their employees are facing as a result of the COVID-19 pandemic. Many are experiencing slower sales, reductions in hours, layoffs and more. The attached Frequently Asked Questions (FAQ) includes our current responses to questions we know are top of mind for many of Small Group Insured and Small Group Aetna Funding Advantage Self-Insured customers. These responses will remain in effect until June 30, 2021 unless otherwise specified. We will continue to evaluate and update our responses as the situation evolves. Downlaod FAQ: Commercial Small Group COVID-19 FAQ

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Get Dental and Vision Quotes Now!

Enjoy next-day coverage on most dental insurance plans. There are no enrollment fees with any plans. Preventive visits, such as exams and cleanings, are covered at 100% with network providers.

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