Mental Health Conditions Can Trigger FMLA

The Wage and Hour Division of the U.S. Department of Labor released a Fact Sheet related to mental health conditions and the Family and Medical Leave Act, clarifying what constitutes a serious mental health condition. As always, please contact your Total Benefit Solutions Inc health insurance specialists with any questions or concerns at (215)355-2121.

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Horizon NJ: Covid-19 Resource Guide Update

Horizon has worked to address coverage matters and adjust business practices to help our members and customers during the COVID-19 public health emergency. Many of the accommodations we made are described in the COVID-19 Resource Guide. Recent key updates include the reinstatement of actively at work and waiting period requirements. As always, please contact your Total Benefit Solutions Inc health insurance specialists with any questions or concerns at (215)355-2121.

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Independence: Changes to the Value and Select formularies for April 1

Changes to the Value and Select formularies for April 1 Independence Blue Cross is making changes to the Value and Select Drug Program® (Select) formularies effective April 1, 2022. Updates are made to the Value and Select formularies quarterly.The updated lists for April 1 are available now on our website. Select the appropriate link to view the Value or Select formulary. The updated list can be found under “Formulary drug documents.” Changes that result in positive member experiences happen quarterly in January, April, July, and October. Examples of these changes include new drugs and generics being added to the formularies, tier changes that can result in lowering member cost‑share, and utilization management removal.Negative formulary changes… Read More

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Temporary Telehealth Relief for HSA Plans

On March 15, 2022, the President signed government funding legislation, the Consolidated Appropriations Act, 2022 (“CAA-22”), into law. The legislation includes a prospective extension of relief that allows first dollar coverage of telehealth services from April 1, 2022 through December 31, 2022. This relief allows individuals with High Deductible Health Plans (“HDHPs”) to receive free telehealth services prior to the satisfaction of their minimum deductible and remain eligible to make Health Savings Account (“HSA”) contributions….

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2021 MLR Rebate Checks Recently Issued to Fully Insured Plans

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COBRA Subsidy Termination Notice Reminder

AEIs must be provided with a notice of expiration of the COBRA subsidy between August 16 and September 15, 2021. The notice must explain the date that the premium assistance will expire and that the individual may be eligible for coverage without any premium assistance through COBRA, a group health plan, the Marketplace, or Medicare/Medicaid.

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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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Achieve Well-being Rewards

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SCOTUS Upholds Affordable Care Act Ruling

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New Mandatory Preventive Items and Services

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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

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What is Blue Card PPO?

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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

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Can Employers Ask for Proof of Vaccination?

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Family Dental & Vision Plans

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What is Modified Adjusted Gross Income (MAGI)?

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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

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What is a Qualified High Deductible Health Plan?

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What Is a Health Savings Account?

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