Introducing AFLAC Individual Dental Ask us today for more informtion on an AFLAC Individual Dental plan. Just call our office at (215)355-2121 and a dedicated member of our client service team will be happy to answer your questions or send you detailed benefit information.
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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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From Health Care Reform Digest: Since the IRS and Treasury published Notice 2013-54 in September 2013, pre-tax employer reimbursement of an employee’s individual health insurance premiums has been a hot topic of conversation. Historically, many employers have provided this type of benefit in lieu of offering a group health plan – a strategy that now needs to be reevaluated as a result of regulations implementing the Patient Protection and Affordable Care Act (PPACA). Q1. What are the consequences to the employer if the employer does not establish a health insurance plan for its own employees, but reimburses those employees for premiums they pay for health insurance (either through a qualified health… Read More
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The Comparative Effectiveness Research Fee is now known as the Patient-Centered Outcomes Research Institute (PCORI) Fee. The Patient Protection and Affordable Care Act (the Act) imposes a new Patient-Centered Outcomes Research Institute (PCORI) fee, formerly the comparative effectiveness research fee, on plan sponsors and issuers of individual and group policies. The first year of the fee is $1 per covered life per year, the second year the fee adjusts to $2 per covered life and then it’s indexed to national health expenditures thereafter until it ends in 2019. Click here to download this bulleting regarding the timely payment of the fees. Purpose of the Fee The assessed fees are to… Read More
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Frequently asked questions (“FAQs”), prepared jointly by the Departments of Labor (“DOL”), Health and Human Services (“HHS”), and the Treasury (collectively, the “Departments”),were issued with respect to various Affordable Care Act (“ACA”) requirements, including their effect on COBRA and CHIPRA notices…Topics Include: Updated COBRA And CHIPRA Notices Out-Of-Pocket Maximum Requirements Generic Drugs Balance Billing Reference-Based Pricing Coverage Of Preventive Services Health FSA Carryover And Excepted Benefits Effect of Carryover on Excepted Benefits Determination Summary Of Benefits And Coverage Click here to download the bulletin from our partners at Emerson Reid.
Continue ReadingThis presentation is intended to convey general information about the employer health care tax credit under the affordable care act and is not an exhaustive analysis. Information contained in this presentation may change as guidance develops. Total Benefit Solutions inc and Emerson Reid do not provide legal or tax advice. For advice specific to your situation, please consult an attorney or other professional. Click here to download “nuts and bolts” Download Small Business Health Care Tax Credit FAQ’sFAQs
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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
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This briefing is applicable to all brokers writing Pennsylvania based employers We have updated our eligibility guidelines as it relates to sole proprietors, owners, partners, W-2 employees and husband / wife groups for 2014. These updates have been made to maintain compliance with state and federal requirements. Please review the updates we have outlined below. We thank you for your continued collaboration. The following applies to Small Group Pennsylvania new business and renewals: The definition of an employer is now one W-2 common law employee. This accommodates an owner with at least one “enrolling” W-2 common law employee who is not a spouse and not an owner. Sole proprietors, owners… 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
Continue ReadingThe CBS Evening News (4/20, story 8, 1:55, Glor) reported Sunday night that “visitors to the to Affordable Care website are being advised to take steps to protect themselves” from Heartbleed, the online security flaw. Mark Albert reported over the weekend, healthcare.gov made the move to “reset everyone’s account password.” Saturday evening, the NBC Nightly News (4/19, story 7, 0:25, Holt) reported that people “with accounts on healthcare.gov are being told to change their passwords after review found that the website was vulnerable to the security breach bug.” The Hill (4/19, Wilson) “Hillicon Valley” blog reported that the call to change log in information for the site were “out of… Read More
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The Affordable Care Act calls for individuals to have qualifying health insurance coverage for each month of the year, have an exemption, or make a shared responsibility payment when filing his or her federal income tax return. You may be exempt from the requirement to maintain qualifying health insurance coverage, called minimum essential coverage, and may not have to make a shared responsibility payment when you file your next federal income tax return. You may be exempt if you: Have no affordable coverage options because the minimum amount you must pay for the annual premiums is more than eight percent of your household income, Have a gap in coverage… 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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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. Click here to download the 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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Why does IBC collect member-level information about tobacco use? Under the Affordable Care Act (ACA), premium rates for health insurance coverage in the individual and small group markets may be based on family size, geography, age and tobacco use. In order to follow with this guideline and accurately rate each group, Independence Blue Cross (IBC) collects member-level tobacco use information to create group premiums for new and renewing group customers. Click the link below to download the IBC document that covers the most common questions about rating tobacco users in small group in PA. Tobacco Status For Small Group Customers Flyer
Continue ReadingThe 2014 Group Health Plans Notices Calendar in now available! All-in-One Health Plan Notices Calendar and Downloadable Model Notices Our 2014 calendar provides bottom line information on group health plan required notices and filings, including who must receive them, who must provide them and when notices are due. At last, the notices you need are available in one convenient location, including: Health Care Reform Notices (includes new SBC template for 2014 and information on required PCORI filings) COBRA Notices HIPAA Notices (includes information on elimination of creditable coverage certificates and new model Notice of Privacy Practices) Special Health Care Notices (Women’s Health and Cancer Rights, Mental Health Parity… Read More
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On Monday, Congress and President Obama together repealed one of the Affordable Care Act’s most onerous provisions, which prohibited so-called “small groups” (mostly groups with less than 50 employees) from offering health plans with deductibles higher than $2,000 for single coverage and $4,000 for family coverage. This comes as very welcome news to small businesses, who are frequently the most in need of additional options and flexibility when it comes to offering employees comprehensive, affordable health insurance via higher deductibles and other cost-sharing mechanisms. It is also great news for employers wanting to couple their insurance plans with health reimbursement arrangements (HRAs), which federal agencies previously rejected as permissible ways… Read More
Continue ReadingWe are pleased to announce that Edward T MacConnell, President of Total Benefit Solutions has earned the certification of Certified Voluntary Worksite Professional from the National Association of Health Underwriters. Voluntary/Worksite products are not new to the employee benefit industry. However, the surge of interest in these products has accelerated as employers seek ways to help attract and retain talent. The industry has responded swiftly with new products, new features, new enrollment technologies and many changes to the underwriting rules of these products. This has created new responsibilities for agents, brokers and consultants as advising clients in this area will differentiate their value to the consumers they serve. Certified Voluntary Worksite… Read More
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The Washington Post has reported that HHS has released regulations extending the Marketplace open enrollment deadline to around mid-April for individuals who began, but did not complete, a Marketplace application. The extension appears to be based on a self-certification (honor) system, in which individuals attest that they could not timely complete the Marketplace application before the March 31 deadline. This extension may have an impact on employer-sponsored plans to the extent individuals have more time to elect Marketplace benefits and therefore may decline employer-sponsored coverage at the next OE. Keep in mind that IRS cafeteria plan rules currently do not recognize enrollment in a Marketplace plan as a qualified status… Read More
Continue ReadingOur friends at Zane Benefits recently shared this comic and I enjoyed it so much I thought you might like it too: Click here to see the rest of the comic on zanebenefits.com Click here to see the rest of the comic on zanebenefits.com
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