#medical #medicare #medicalplans #Medicaid #healthplans #totalbenefitsolutions #employee benefits #healthinsurance

Stephanie Spancake Total Benefit Solutions Inc

Beyond Sick Leave: Integrating HRAs and Group Health

June 17, 2026June 18, 2026Ed MacConnellNo Comments

Beyond Sick Leave: Integrating HRAs and Group Health Managing mandatory sick leave is just one piece of the employee retention puzzle. At Total Benefit Solutions Inc, we believe in a holistic approach. If you’re already paying for mandatory sick leave, you might be looking for ways to balance your budget elsewhere without sacrificing the quality of your benefits. This is where Health Reimbursement Arrangements (HRAs) come into play. HRAs allow employers to reimburse employees for medical expenses (and sometimes premiums) tax-free. They are an excellent tool for small to mid-sized businesses navigating the PA sick leave patchwork. HRA Plan Design Options for 2026: Section 105 HRA (For 1 Employee or… Read More

Medicare Secondary Payer Rules: 15 Things You Need to Know to Avoid Penalties.

June 17, 2026June 18, 2026Ed MacConnellNo Comments

Let’s be honest: talking about Medicare Secondary Payer (MSP) rules is about as exciting as watching paint dry, if that paint were also trying to fine you thousands of dollars. But if you’re a small business owner or an HR manager, ignoring these rules is like playing a high-stakes game of poker where the dealer is the federal government and they’ve already seen your hand. Medicare is a bit like that friend who always "forgets" their wallet when the check comes. They’re happy to help, but only after everyone else has chipped in first. Knowing when Medicare pays first (primary) and when they pay second (secondary) isn’t just a matter… Read More

The Driver’s Dilemma: Why You’re Not ‘Stuck’ Without Health Insurance (Even If You’re 1099)

June 16, 2026June 18, 2026Ed MacConnellNo Comments

Meet Sal. Sal has been driving for Uber and Lyft in the Philadelphia area for three years. He loves the flexibility, being his own boss means he never misses his daughter’s soccer games. But there’s one thing that keeps Sal up at night: the "Driver’s Dilemma." As a 1099 independent contractor, Sal doesn’t have an HR department. He doesn’t have a benefits package waiting for him in an app menu. For a long time, Sal believed he was "stuck" either paying full price for a plan that cost more than his car payment or crossing his fingers and hoping he didn’t get sick. If you’re a driver, delivery person, or… Read More

ICHRA Admin: Who’s Actually the Best? A No-Nonsense Comparison for 2026

June 14, 2026June 18, 2026Ed MacConnell

Internal Note for Ed Hey Ed, Buckle up, because the ICHRA vendor landscape in 2026 is starting to look like a high-speed tech race, but with more compliance paperwork. Here’s the skinny on why I picked these specific players for the blog. If you’re dealing with a small shop (under 50 lives), PeopleKeep is still the automated king of “set it and forget it.” But if you’re hunting whales (200+ employees), SureCo and Remodel Health are the heavy hitters because they actually know how to talk to a CFO without making their head explode. The most important part for us? Broker friendliness. I’ve highlighted who actually respects our AOR status… Read More

Hoop-Jumping for Health: The New ACA Rules Coming in 2027

June 12, 2026June 18, 2026Ed MacConnell

Just when you thought you had a handle on your health insurance, the rules are changing again. If you’ve been following the news lately, you might have heard that the Centers for Medicare & Medicaid Services (CMS) is rolling out some significant updates for the ACA Marketplace (the federal exchange where you buy individual health plans). These changes aren't hitting the ground until plan year 2027, but at Total Benefit Solutions Inc, we believe in staying ahead of the curve. While these new rules are designed to protect you from fraud and unauthorized plan switches, they do add a few more "hoops" for you to jump through during the enrollment… Read More

The $110-a-Day Mistake: Why Your Insurance Certificate Isn’t Enough

June 12, 2026June 18, 2026Ed MacConnell

If you are a small business owner offering group health insurance for employers, you likely take pride in providing benefits that protect your team. You probably have a folder, digital or physical, filled with shiny brochures from your insurance carrier, a "Certificate of Coverage," and perhaps a Summary of Benefits and Coverage (SBC). You might think, "I have my documents. I’m compliant." Unfortunately, that belief is a common misconception that could cost your business thousands of dollars. In the world of federal regulation, there is a massive gap between what the insurance company provides and what the law requires you, the employer, to provide. This gap is known as the… Read More

Main Line Health vs. UnitedHealthcare: Will You Lose Your Doctor on July 1st?

June 11, 2026June 18, 2026Ed MacConnell

If you live in the Philadelphia suburbs, you probably know Main Line Health (MLH) as the backbone of local healthcare. From Lankenau Medical Center to Paoli Hospital, their physicians and facilities have been staples in our community for decades. However, a major contract dispute with UnitedHealthcare (UHC) is threatening to disrupt care for thousands of families. As of right now, the clock is ticking toward a June 30, 2026, deadline. If a new agreement isn’t reached by then, Main Line Health will officially become an out-of-network provider for most UnitedHealthcare commercial and Medicare Advantage plans starting July 1st. At Total Benefit Solutions Inc., we’ve seen these "carrier vs. provider" battles… Read More

Medicare Secondary Payer Rules: 15 Things You Need to Know to Avoid Penalties.

June 10, 2026June 18, 2026Ed MacConnell

Let’s be honest: nobody wakes up on a Tuesday morning and thinks, “I can’t wait to dive into the federal Medicare Secondary Payer (MSP) statutes!” Unless, of course, you work here at Total Benefit Solutions Inc. For the rest of the sane world, MSP rules are about as exciting as watching paint dry, until you get hit with a penalty that costs more than your company’s holiday party. If you are a small to medium-sized business owner, you are likely already juggling group health insurance for employers while trying to keep costs down. You might even be exploring affordable group health insurance options like Level funded health insurance or Reference… Read More

Disaster Special Election Periods in several states

July 15, 2024July 12, 2024Mirasol Bandong

This is an important announcement for customers in Arizona, California, Florida, Iowa, Kansas, Maryland, Minnesota, New Mexico, North Carolina, Oregon, Texas and West Virginia and for those with business in these states. The counties below are under a federal or state designated SEP due to an emergency. Applications for disaster SEP are only accepted as long as the SEP declaration is in place. For the most recent information, if a deadline is not specified below, please use Producers’ University’s Ongoing SEP tracker. Applications for SEPs submitted after the declaration date of that SEP will not be accepted. IMPORTANT : Please be aware The SEP begins on the date of the incident’s start, if that occurs earlier, or on… Read More

What is your Medicare Part D ANOC?

September 30, 2023September 30, 2023Ed MacConnell

The Annual Notice of Change (ANOC) is a document that Medicare Advantage and Medicare Part D prescription drug plans are required to send to their members every year. The ANOC outlines any changes in coverage, costs, and more that will be effective in January 1. If you’re enrolled in a Medicare plan, your plan will send you an ANOC each fall. The ANOC includes information about any changes to your plan’s coverage, costs, and service area that will be effective in January 1. It’s important to review the ANOC carefully to understand how your plan’s coverage and costs may change in the upcoming year. If you have any questions or concerns about the changes, you can contact… Read More

10 Things to Know About Medicaid Managed Care

March 23, 2023March 16, 2023Ed MacConnell

Managed care is the dominant delivery system for Medicaid enrollees. With 72% of Medicaid beneficiaries enrolled in comprehensive managed care organizations (MCOs) nationally, plans have played a key role in responding to the COVID-19 pandemic and are expected to work with states in conducting outreach and providing support to enrollees during the unwinding of the continuous enrollment requirement. While managed care is the dominant Medicaid delivery system, states decide which populations and services to include in managed care arrangements which leads to considerable variation across states. Additionally, while we can track state requirements for Medicaid managed care plans, plans have flexibility in certain areas including in setting provider payment rates… Read More

ACA special enrollment period opens soon for people losing Medicaid coverage

March 17, 2023March 16, 2023Ed MacConnell

The Centers for Medicare and Medicaid Services (CMS) will open an ACA special enrollment period (SEP) for people losing Medicaid coverage due to the end of the COVID-19 public health emergency (PHE). The PHE ends May 11. The ACA SEP aims to maintain continuity of coverage as people transition from Medicaid into a Marketplace-qualified health plan. It runs March 31 to July 31, 2023. Have any questions regarding this notice? Don’t hesitate to contact your Total Benefit Solutions health insurance specialists today at (215)355-2121.

Pandemic Aid Package Includes Relief From High Premiums

March 10, 2021March 10, 2021Ed MacConnell

Tag: #medical #medicare #medicalplans #Medicaid #healthplans #totalbenefitsolutions #employee benefits #healthinsurance

Beyond Sick Leave: Integrating HRAs and Group Health

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Medicare Secondary Payer Rules: 15 Things You Need to Know to Avoid Penalties.

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The Driver’s Dilemma: Why You’re Not ‘Stuck’ Without Health Insurance (Even If You’re 1099)

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ICHRA Admin: Who’s Actually the Best? A No-Nonsense Comparison for 2026

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Hoop-Jumping for Health: The New ACA Rules Coming in 2027

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The $110-a-Day Mistake: Why Your Insurance Certificate Isn’t Enough

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Main Line Health vs. UnitedHealthcare: Will You Lose Your Doctor on July 1st?

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Medicare Secondary Payer Rules: 15 Things You Need to Know to Avoid Penalties.

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Disaster Special Election Periods in several states

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What is your Medicare Part D ANOC?

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10 Things to Know About Medicaid Managed Care

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ACA special enrollment period opens soon for people losing Medicaid coverage

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Pandemic Aid Package Includes Relief From High Premiums

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