#healthinsurancenearby – Page 13 – Total Benefit Solutions Inc

IRS Announces Medical Mileage Rate Increase

June 28, 2022June 24, 2022Ed MacConnell

To offset high gas prices, on June 9, 2022, the Internal Revenue Service (IRS) announced an increase in the 2022 standard medical mileage rate for the final six months of 2022. Effective July 1, 2022, the new rate for when an automobile is used to obtain medical care is 22 cents per mile for the remainder of 2022, which is an increase from the rate of 18 cents per mile effective January 1 – June 30, 2022. Mileage to and from a medical service is generally an eligible expense under a Healthcare Flexible Spending Account, Health Reimbursement Arrangement, or Health Savings Account. Click here to learn more. As always, please… Read More

Mental Health Conditions Can Trigger FMLA

June 27, 2022June 24, 2022Ed MacConnell

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.

What is the IRMAA Surcharge?

June 23, 2022July 7, 2022Ed MacConnell

What is the IRMAA Surcharge? The income-related monthly adjustment amount (IRMAA) sliding scale is a set of statutory percentage-based tables used to adjust Medicare Part B and Part D prescription drug coverage premiums. The higher the beneficiary’s range of modified adjusted gross income (MAGI), the higher the IRMAA. Want to apply for relief from the IRMAA charges? The form required is posted below, just download and complete the form!

Horizon NJ: Covid-19 Resource Guide Update

June 23, 2022June 23, 2022Ed MacConnell

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.

Total Benefit Solutions, Inc partners with GRAVIE

June 20, 2022June 16, 2022Ed MacConnell

What Employers Have to Say: Gravie is Revolutionizing the Industry Gravie is rebuilding health benefits from the bottom up by keeping the focus on who matters most: the consumer. That customer-centered attention might seem obvious, but it’s long overdue in the health benefits industry. The savings and improved outcomes numbers speak for themselves, but if you still need convincing, don’t just take our word for it. Employers from organizations large and small, across industries, and throughout the country have shared how Gravie’s modern and innovative approach to health benefits are impacting their businesses and their employees for the better. Across all our solutions, we are hearing from employers that we’re making their… Read More

Oxford/UHC: New Reward Program Encourages Pediatric Covid 19 Vaccinations

June 10, 2022June 10, 2022Ed MacConnell

COVID-19 vaccines are an important step in helping to lessen the spread of the disease. While many adult New Yorkers have been vaccinated, vaccination rates among children remain relatively low. To encourage pediatric vaccination, we are offering New York-situs subscribers whose dependents are enrolled in a fully insured UnitedHealthcare or Oxford plan a $100 pre-paid Target Gift Card. The New York Pediatric COVID-19 Vaccination Reward program is in effect May 5, 2022 through October 1, 2022. Criteria for the New York UnitedHealthcare and Oxford Pediatric COVID-19 Vaccination Reward program Dependent child(ren) must be enrolled on an active subscriber’s New York UnitedHealthcare or Oxford fully insured plan. Dependent must be eligible for the… Read More

2022 Patient-Centered Outcomes Research Trust Fund (“PCORTF”) Fees

May 23, 2022May 23, 2022Ed MacConnell

2022 Patient-Centered Outcomes Research Trust Fund (“PCORTF”) Fees May 23, 2022 This Allied Update serves as a reminder that the annual Patient-Centered Outcomes Research Trust Fund (“PCORTF”) fees are due by July 31, 2022. By way of background, at the end of 2019, the Federal Government reauthorized the annual payment of fees by health insurers and group health plans into the PCORTF until 2029. (Such payments were previously set to expire for plan years ending on or after October 1, 2018 and before October 1, 2019, and beyond.) The fee is due by July 31 of the calendar year immediately following the last day of the plan year in which… Read More

Support for your emotional health

May 12, 2022May 11, 2022Ed MacConnell

Virtual care visits from MDLIVE® IBC members pay $0 cost-share* You have access to care from therapists, psychologists, and psychiatrists who can help with concerns likeanxiety, depression, and panic disorders. With telebehavioral health from MDLIVE, you pay $0 costshare* for a confidential visit in the comfort of yourhome, or wherever you are. Choose to have your virtual care visit by video chat, using the MDLIVE website or mobile app, or by phone.

2023 Inflation Adjusted Amounts for HSAs

May 11, 2022Ed MacConnell

The IRS released the inflation adjustments for health savings accounts (“HSAs”) and their accompanying high deductiblehealth plans (“HDHPs”) effective for calendar year 2023, and the maximum amount that may be made newly available forexcepted benefit health reimbursement arrangements (“HRAs”). All limits have increased from the 2022 amounts, somesignificantly.

HealthCare.gov Notices New Class of Individual Employer Policies

May 2, 2022Ed MacConnell

hCare.gov managers are signaling that they think individual coverage health reimbursement arrangements matter. The regulators in charge of the federal Affordable Care Act public exchange system today gave ICHRAs official attention, by adding an ICHRA use reporting requirements for the insurers that sell coverage through HealthCare.gov. Click here for the full story on Think Advisor.com

Free or Nearly Free Health Coverage Through New Jersey’s Expanded Access”

April 19, 2022April 18, 2022Ed MacConnell

The new Expanded Access Special Enrollment Period allows qualifying consumers with an annual household income of up to 200% of the federal poverty level to enroll in a health plan throughout the year. New Jersey’s Governor Phil Murphy and Department of Banking and Insurance Commissioner Marlene Caride have introduced a new “Expanded Access” initiative, which allows residents at certain income levels to continue to enroll in free or nearly free health coverage through Get Covered New Jersey. The new Expanded Access Special Enrollment Period allows qualifying consumers with an annual household income of up to 200% of the Federal Poverty Level (FPL) to enroll in a health plan throughout the year. This population will… Read More

Employers in Philadelphia Are Required to Provide Paid COVID Relief

April 9, 2022April 5, 2022Ed MacConnell

Employers in Philadelphia, PA with 25 or more employees must provide up to 40 hours of additional paid sick leave to eligible employees when they are unable to work for certain COVID-19 related reasons. The new measure became effective on March 9, 2022 and will extend through the end of 2023. It covers employees who are unable to work for the following reasons: To care for self or a family member showing symptoms of COVID-19 To care for self or a family member exposed to COVID-19, in order to self-isolate As a result of childcare or school closures To obtain a COVID-19 test or vaccine, or to recover from injury,… Read More

HHS Adjusts Civil Monetary Penalties Again for HIPAA, MSP, and SBC Violations

April 4, 2022Ed MacConnell

HHS has announced adjustments of civil monetary penalties for statutes within its jurisdiction. The latest amounts are based on a cost-of-living increase of 1.06222%. These adjustments are effective for penalties assessed on or after March 17, 2022, for violations occurring on or after November 2, 2015. Here are highlights of the adjustments potentially affecting employer-sponsored health plans: HIPAA Administrative Simplification. HIPAA administrative simplification encompasses standards for privacy, security, breach notification, and electronic health care transactions. HIPAA has four tiers of violations that reflect increasing levels of culpability, with minimum and maximum penalty amounts within each tier and an annual cap on penalties for multiple violations of an identical provision. The indexed… Read More

Temporary Telehealth Relief for HSA Plans

March 31, 2022Ed MacConnell

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….

How does level funding health insurance work?

March 17, 2022March 17, 2022Ed MacConnell

Level funding (also called alternate funding) is a group health insurance product available to employers. It behaves just like a fully-insured product, and allows some groups to get coverage at more competitive rates than traditional fully insured ACA plans. How does level funding work? An employer pays a set monthly cost into an account, like a ” premium”. This “premium” money is then used to pay claims for employee health care. If there’s any money left in the account at the end of the plan year, it goes back to the employer. If employee claims spending exceeds the funds in the account, the health insurer covers the difference. If there are any large… Read More

2022 Federal Poverty Guidelines Announced

February 3, 2022February 6, 2022Ed MacConnell

Open Enrollment may be over, but consumers may still be able to enroll in Marketplace coverage

February 2, 2022February 2, 2022Ed MacConnell

Member Cost Sharing for Most Telemedicine and Telehealth Visits Will Resume Effective February 3, 2022

February 2, 2022February 2, 2022Ed MacConnell

If Pennie Customers Missed the Deadline to Enroll Because of COVID-19 Impacts – They Now Have Until January 31st to Enroll!

January 25, 2022January 25, 2022Ed MacConnell

Pennsylvania Individual Open Enrollment Deadline

December 10, 2021December 10, 2021Ed MacConnell

2021 MLR Rebate Checks Recently Issued to Fully Insured Plans

September 22, 2021September 21, 2021Ed MacConnell

AmeriHealth New Jersey prepares to comply with new Transparency requirements

August 19, 2021August 19, 2021Ed MacConnell

HHS Extends Public Health Emergency until October 18, 2021

August 17, 2021August 16, 2021Ed MacConnell

COBRA Subsidy Termination Notice Reminder

August 16, 2021August 16, 2021Ed MacConnell

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.

SCOTUS Upholds Affordable Care Act Ruling

June 22, 2021June 22, 2021Ed MacConnell

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