My company has been with Total Benefits Solutions for years. Ed and his knowledgeable team of brokers is a great resourc…e for all type of medical insurance and coverage. Thanks for the great service throughout the years! -Denis Sinelkov, President Media Components, Inc
Continue ReadingEd, thank you for your recent endorsements. And especially thank you for helping my wife and I sail through the new Affordable Care Act. You and your team made the complicated seem simple and select the plan best suited for our health insurance needs. Thanks again!! Mike Hilbert Sales Pros for Hire PS- I have already received and paid my April payment and can print temporary insurance cards from the website.
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The Truth Agents/Brokers & FFM Navigators The Patient Protection and Affordable Care Act Shared with permission from B. Ronnell Nolan, HIA, CHRS-President/CEO – HAFA Financial Media Group, LLC, Centennial, CO, compiles this information annually. There are approximately 1.2 million licensed insurance agents nationally. The 1.2 million does not include the staff of licensed agents employed throughout the United States. After adding the staff, imagine the millions of people that Agents represent, educate and protect on a daily basis! With the passing of the ACA, Health Agents for America, Inc. was formed to create a tool box for Agents to use in educating the citizens of their local communities. HAFA is known to… Read More
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Enclosed in the 279 pages of proposed rules released Friday by the Department of Health and Human Services for the public health insurance exchanges is an answer, sort of, to a question brokers have raised for more than a year — who will be liable for navigators’ mistakes? n the section of the rules discussing navigators, the Obama administration’s document says “a state or an exchange must not require that all navigators be agents or brokers or carry errors and omissions coverage.” Further, the rule says that if navigators were to be required to carry E&O insurance, this would disqualify them from being considered a “community and consumer-focused nonprofit group.” Federal law… Read More
Continue ReadingUpon renewal in 2014 small groups will be automatically “mapped” to a new ACA compliant metallic plan. Find your new recommended 2014 Blue Solutions plan using the chart below. To make your renewal even easier we’ve identified the plan that most closely matches your current plan. Or you can choose from among 36 other options to suit your needs. More comprehensive coverage Blue Solutions health plans now cover Essential Health Benefits like pediatric dental and vision. Your health plan also continues to cover doctor visits, hospital admissions, emergency room treatments, maternity care, lab tests, X-rays, prescriptions, and vision benefits for both children and adults. Click the link below to download the… Read More
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For plan years beginning on or after January 1, 2014, a group health plan and an insurance carrier offering group health insurance coverage may not apply any waiting period that exceeds 90 days. This rule applies to both grandfathered and non-grandfathered plans. It should be noted that nothing in the Affordable Care Act requires a group health plan or carrier to have a waiting period Click here to download the bulletin
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Independence Blue Cross (IBC) has selected Laboratory Corporation of America® Holdings (LabCorp), as its exclusive, nationally-based provider of laboratory services, effective July 1, 2014. The change applies to all Personal Choice®/PPO and Keystone Health Plan East product lines, and affects all individual, group commercial, and Medicare members, for services rendered in the Philadelphia five-county area, and in the contiguous counties. Effective July 1, 2014, Quest Diagnostics laboratories will be an out-of-network provider for Personal Choice and Keystone Health Plan East. IBC will continue to contract with certain local and regional laboratories… Click to download the bulletin
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IBC: We want to let you know that the monthly rates for our individual medically underwritten plans will increase in July 2014. We are notifying members muchearlier than is required to give them the opportunity to enroll in a plan that is compliant with the Affordable Care Act (ACA). The reason for the rate increase. We understand that it can be difficult to afford quality health insurance coverage. While we continue to work hard to keep costs down, the cost of health care continues to rise along with our member utilization. This is why it’s necessary for Independence Blue Cross (IBC) to implement an 11.5 percent rate increase. Click the link below to read… Read More
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We love making our clients happy! I received this email just the other day and I wanted to share. This client had an abundance of trouble enrolling through the healthcare.gov website until we got involved: Dear Jennifer – thanks so much for everything! I’m so happy to be insured and I couldn’t have done it without you! Aaron G
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We received this email from one of our clients this week, Kristine Kreisher, and wanted to share: Dear Ed: I spent a month and a half calling Blue Cross, getting the run around, and given incorrect information. I make a phone call/send an email to you both and within a couple hours everything is taken care of and corrected!!! You guys are awesome!!! Thank you soooooo much for getting this all taken care of!!!! Kris Kreisher February 2014 We love happy clients!
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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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Have you enrolled? Open enrollment is ending soon! Do you know when? Watch this video from Humana and learn more, then call your Total Benefit Solutions Advisor at (215)355-2121 and get enrolled without any further delay!
Continue ReadingHealthcare… the way it should be! Are you tired of waiting multiple weeks to go see your doctor, only to find yourself taking time off work so you can drive through traffic and sit in the waiting room for what seems like forever? Have you ever felt overwhelmed by the stress and anxiety of a difficult life situation and wished you had someone you could trust to hold your hand and walk you through to the other side? Then welcome to CADRPlus, an innovative new health care program that gives you unlimited, 24/7 access to doctors and other industry professionals from the comfort and convenience of your phone or computer,… Read More
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Beginning in 2014, a health insurance provider fee applies to covered entities engaged in the business of providing health insurance for United States health risks. United States health risks include the health risk of a U.S. citizen or a resident alien including those living abroad. Thus, insurers issuing expatriate policies covering a U.S. citizen or resident alien living abroad are subject to the fee. Medical, dental and vision carriers in the insured marketplace are subject to this fee. This fee does not apply to self-insured employer-sponsored plans. Click the link below to download the bulletin. Final Rule Issued Regarding Health Insurance Provider Fee
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The Departments of Labor, Treasury and HHS issued a proposed rule that provides helpful guidance regarding certain excepted benefits, including vision benefits, dental benefits, employee assistance programs (EAPs) and certain wraparound programs. Click the link below to download the bulletin. Relief for Excepted Benefits-012414R
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On February 10, 2014, the IRS released final regulations implementing the Employer Shared Responsibility provision under the Affordable Care Act (ACA) for 2015 (the “employer penalty”). This guidance is lengthy and provides helpful clarification in many areas. We are in the process of reviewing the guidance, but you will find some key aspects of this rule below: The employer penalty will apply to employers with 100 or more full-time equivalent employees starting in 2015. For employers with 50-99 full-time equivalent employees, there is a one-year delay and the employer penalty provision will start in 2016. Click the link below to download the bulletin. Final Regulations Issued on Employer Penalty – 021114R
Continue ReadingEffective January 1, 2014 for new business and as existing groups renew thereafter, Husband and Wife only and Partner only businesses are no longer eligible for Small Group coverage. There are differences on how each state* will handle immediate family members who are also employees. Sole Proprietors Sole proprietors, owners and their immediate family members forming a business are not considered employees and may only buy insurance through the Individual Marketplace. Sole proprietors reporting on Schedule C cannot form a group health plan without having at least one non-spouse common-law employee.** * The FFM states (e.g., NJ, PA, DE) will abide by the above within the SHOP (Small Group Exchange Marketplace). In… Read More
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Beginning January 1, 2014, taxpayers (with certain limited exemptions) will be assessed a tax for any months during which they or their dependents lack minimum essential coverage. An individual has three choices: (1) qualify for an exemption, (2) get minimum essential coverage (with or without government assistance if under the Exchange), or (3) pay the individual mandate. Click here for the full story
Continue ReadingThe Small Business Health Options Program’s (SHOP) place along the Affordable Care Act’s (ACA) timeline. It’s now being packaged for mass consumption and soon will be stocked on store shelves across all 50 states. Click here to read more…
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Empire State approves plans to be sold by 17 insurers and lower expected premiums may ease fears that next year’s implementation of the biggest parts of the Affordable Care Act would send prices soaring… Click here to read the story
Continue ReadingIndependence Blue Cross (IBC) will begin notifying customers later this week regarding a change in how claims for certain out-of-network providers will be processed under their IBC Personal Choice® PPO health plan. This change impacts fully insured, self-funded, and Individual commercial Personal Choice® PPO plans only. There is no impact to Medicare plans. Effective November 1, 2013, members who have claims submitted by providers who participate in the Highmark Blue Shield (Highmark) professional provider network inside IBC’s five-county service area will be subject to higher out-of-pocket costs and may also be subject to balance billing. Currently, claims submitted by a participating Highmark professional provider are processed as out of network and applied… Read More
Continue ReadingThe Research Fee filing deadline is July 31, 2013 for self-funded medical plans and HRAs Insurance carriers will report and pay the Fee for fully insured plans. If an employer has several self-insured arrangements with the same plan year, they are subject to a single fee. An HRA integrated with a self-funded plan providing major medical coverage will not incur a separate fee specific to the HRA if the HRA and plan are established or maintained by the same plan sponsor. Click below to download the bulletin Research Fees Due Interested in our free Health Care Reform Checklist? send an email
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By August 1st, Aetna is scheduled to mail rebate notices and checks to policyholders and subscribers whose plans are due a rebate under the Minimum Medical Loss Ratio provision of the Affordable Care Act. For group plans, rebate checks will be sent to the policyholder, with few exceptions. Please click the link below to download the bulletin. Click to download
Continue ReadingNJDOBI Issues Amendments to IHC and SEH Rating Rules under PPACA For rates applicable to all rating periods beginning on or after January 1, 2014, carriers are directed to: Formulate rates in the IHC market to achieve a required 300 percent maximum ratio between premiums for the highest rated individual policyholder and the lowest rated individual policyholder in the State. Age factor categories should be in the following increments: children ages 0 through 20, one-year age bands for adults ages 21 through 63, and a single age band for adults ages 64 and over; Formulate rates in the SEH market without regard to gender. Age factor categories should be in… Read More
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Beginning in 2014, individuals and small businesses with up to 50 employees can purchase insurance through online exchanges, also called “health insurance marketplaces.” Each exchange will offer a choice of health plans that meet certain benefit and cost standards. In 2016, businesses with up to 100 employees will be able to participate. Coventry Health/Aetna recently released this easy to understand video that may help you understand the new exchange or” marketplace” system of buying health insurance. Click here to watch the six minute long video.
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