Health Reform: Affordable Care Act Business/Plan Sponsor Checklist for 2015/2106 This bulletin features a checklist, including descriptions of key topics, to guide you through Affordable Care Act compliance in 2015-2016. Click the link to download the ACA Checklist: ACA Checklist for 2015-2016-082214R Should you have any questions, please contact your Total Benefit Solutions Inc., account manager directly at (215)355-2121.
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Annual Open Enrollment & Effective Dates The annual open enrollment period (AEP) for 2015 begins on November 15th 2014 and ends on February 14th 2015. The open enrollment period is the time when you can change, or purchase a new qualified health plan (QHP) on a guaranteed enrollment basis. You do not need a special election period, or a life change event to enroll during the annual open enrollment period. The chart below illustrates the effective dates for enrollments taken during the annual open enrollment period. Effective Dates for 2015 Annual Open Enrollment Period
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IBC has become aware that potentially misleading information about member cost-sharing (e.g., copayment, coinsurance, deductible) is being distributed on documents that display the Quest Diagnostics name and logo. The information indicates that members can continue using Quest Diagnostics after July 1 without additional member financial impact or cost-sharing. Please be assured that Quest Diagnostics will be an out-of-network provider effective July 1, 2014. For more information click here. Related: Changes to IBC lab network click here
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Independence Blue Cross (IBC) has selected Laboratory Corporation of America® Holdings (LabCorp) as sole national provider of outpatient laboratory services. As the July 1, 2014 effective date approaches, we’d like to give you an update on how the change is being implemented. LabCorp continues to open new locations in the area IBC is pleased to share that 29 new LabCorp Patient Service Centers have opened as of June 16. An additional 18 sites are planned to open by June 30, and several more this summer, to provide even more access for IBC membership. You can find a complete list of LabCorp Patient Service Centers by visiting www.LabCorp.com and selecting Find… Read More
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Updated Model COBRA Election Notice Includes Information Regarding Health Insurance Exchanges Revised Notice Informs Individuals of New Coverage Alternatives A revised Model COBRA Election Notice is now available for group health plans to inform eligible employees and dependents of the right to continuation of coverage under federal law and how to make an election when a qualifying event occurs. The updated model notice includes information regarding coverage alternatives that will be available through the new Health Insurance Exchanges (also known as Marketplaces). COBRA Election Notice Requirement COBRA (the Consolidated Omnibus Budget Reconciliation Act) generally applies to group health plans sponsored by employers with 20 or employees (including both full-… Read More
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A number of clients have asked about changes to the IBC pharmacy network. Based on these questions we have found out that indeed there are a few. The changes are related specifically to Walgreens and Rite Aid. The changes only affect the following customers: Clients who have chosen one of the Bronze plans Clients who have enrolled on one of the proactive suite of plans. Rite Aid and Walgreens are not in network for these customers. We asked IBC for further clarification and we received this from a previous press release: Starting in 2014, IBC will introduce a new pharmacy network called the FutureScripts Preferred Pharmacy Network. This network is… Read More
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The three agencies responsible for the implementation of health care reform (Treasury, Health and Human Services, and Labor) released a joint set of Frequently Asked Questions on cost sharing limits. Health care reform places a limit on the dollar amount of out-of-pocket expenses that a participant may be charged in a year. In 2014, that limit is $6,350 for self-only coverage and $12,700 for other coverage. In 2015, the limit increases to $6,600 for self-only coverage and $13,200 for other coverage. The guidance clarifies that if an out-of-network provider charges an amount greater than the amount allowed by the plan (i.e., balance bills the amount above the usual and customary… Read More
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Hospital Indemnity Plans as a “wrap” Many clients have asked how they can supplement their employees coverage when they get enrolled through the affordable care act healthcare.gov marketplace. Employers are permitted to offer wrap plans that consist of “excepted benefits”. A group Hospital Indemnity plan can fit the bill and provide a comprehensive financial support plan for a family dealing with a medical crisis. It also allows the employee to make a more prudent health plan selection by giving them coverage for any large deductibles, co-pays or cost sharing scenarios. Hospital Indemnity plans are available to individuals too. Download more information on Shelterpoint’s Hospital Indemnity plan Below is a… Read More
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Near the end of 2013, the IRS issued Notice 2013-47 that permits a cafeteria plan to provide for the use of up to $500 of any unused amount remaining in the health FSA in the immediately following plan year (the “carryover” provision). This provision is optional, requires a plan amendment, and cannot be offered if the cafeteria plan allows a grace period. One of the outstanding questions around the carryover provision is the effect it has on HSA eligibility. Recently, the Office of Chief Counsel for the Internal Revenue Service issued a memorandum that informally addresses the interaction of the carryover on HSA eligibility and provides some solutions that may allow an individual retain… Read More
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Calculator May Help Small Businesses Determine SHOP Eligibility The U.S. Department of Health & Human Services has developed a Full-Time Equivalent (FTE) Employee Calculator to help small employers determine whether they qualify for the Small Business Health Options Program (SHOP). Background SHOP is available as an option for qualified small employers to purchase employee health coverage. The federal government is running the program in states that chose not to operate their own SHOP Marketplace (Exchange). For 2014, employers are generally eligible to purchase health coverage through the federally-facilitated SHOP Marketplace if they have 50 or fewer full-time equivalent employees (FTEs), including part-time employees. (For example, 2 part-time employees… Read More
Continue ReadingPlease be advised that Independence Blue Cross (IBC) is offering a new portfolio of Dental and Vision Care plans for adults (aged 19 and older) featuring low out-of-pocket costs and access to a large network of providers. These plans will be available for sale online, by phone, and by mail beginning on April 30, 2014, for June 1 effective dates. Offering individual customers Specialty Services products like Adult Dental and Vision Care emphasizes customer choice and helps give members the protection they need by protecting one of their most valuable assets — wellness. 15% discount on Bundled Dental and Vision IBC offers two Dental PPO plans and two Vision Care… Read More
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The IRS has released the 2015 cost-of-living adjustments affecting HSAs and HDHPs. The 2015 IRS HSA limits are increasing for 2015. Click to download the bulletin
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As you may already know, the Independence Blue Cross Special Care SM* health care plan will terminate on June 30, 2014. Because the Special Care plan is ending, the individuals who are currently enrolled in this plan will be eligible for a special enrollment period to sign up for a plan that is compliant with the Affordable Care Act (ACA). Special Care members qualify for a special enrollment period All Special Care members will be eligible for a special enrollment period , which will allow them to enroll in an individual or family health plan. Members will have from May 1 to August 29, 2014 to enroll in a health plan… Read More
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COMPLIANCE NOTICE: Individual Health Plans as Employee Benefits Under the Affordable Care Act (ACA) Released on September 13, 2013, IRS Notice 2013-54 addresses the viability of individual health insurance plans as a tax-advantaged employee benefit under the Affordable Care Act (ACA). Unfortunately, the news was not good for employers wanting to offer such plans to their employees: the IRS determined that such plans are prohibited under the ACA. PLEASE CLICK BELOW TO DOWNLOAD THE RELEASE FROM AMERIFLEX… COMPLIANCE_ Individual Health Plans as Employee Benefits Under the Affordable Care Act
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SHOP for Small Group Customers Buying a plan through SHOP versus direct Buying plans through the Small Business Health Options Program, or SHOP, provides an advantage only for employers with fewer than 25 employees that are eligible for a tax credit provided by the Affordable Care Act (ACA). If customers are not eligible for this tax credit, there is no advantage to purchasing a plan through SHOP. This is because… Click here to download the SHOP bulletin
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Tandigm Health’s innovative coordinated care model will provide higher-quality care, lower costs Independence Blue Cross (Independence) and DaVita HealthCare Partners today announced the creation of Tandigm Health. This unique joint venture, based in Philadelphia, Pa., will help deliver high-quality, affordable care to the region by combining the expertise of one of the country’s largest, most innovative Blue insurers and a nationally recognized pioneer of physician-centric coordinated care. Click here to read the bulletin Click here to read the press release from the IBC website
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In an effort to meet the enrollment challenges that many are facing under healthcare reform, Total Benefit Solutions Inc has designed a custom form for our clients to use. Using this form and submitting it to Total Benefit Solutions Inc will enable our Marketplace trained and certified licensed independent brokers to assist you in the enrollment process from the registration right through the enrollment! Remember as your independent broker we always work in your best interests, not an insurance company. We represent you, our client and not an insurer or government agency. Click the link below to open the form and get started! When completed, just click the link to… Read More
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