What is a Special Enrollment Period (SEP) and what qualifies a consumer for an SEP?

A Special Enrollment Period (SEP) is a time outside the annual Open Enrollment period when individuals may enroll in or change qualified health plans (QHPs). Individuals qualify for SEPs based on certain life events. Note that consumers can also qualify for an SEP during Open Enrollment; in certain situations, such as an SEP due to the birth of a child, an SEP during Open Enrollment can allow qualifying consumers’ coverage to start sooner than it would have if they had enrolled during Open Enrollment without the SEP. Events that permit an SEP include: Loss of qualifying health coverage (Note: This SEP does not include loss of coverage due to nonpayment… Read More

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Get connected with the IBX Smartphone App

Download the free IBX app for your iPhone or Android to help you make the most of your Independence Blue Cross health plan. With new and improved features, the IBX app gives you easy access to your health care coverage 24/7, wherever you are. As always contact your Total Benefit Solutions, Inc health insurance professionals if you have any questions about this bulletin. Click here to read more.

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Open Enrollment Tips from Total Benefit Solutions!

As always, please contact your Total Benefit Solutions health insurance specialists today at (215)355-2121.

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Blue KC: Employer/Group Open Enrollment Dates – Mark Your Calendar

Blue KC is pleased to offer two open enrollment deadlines – one for physical ID cards and one for digital ID cards – to provide flexibility to new and renewing groups. Benefit information and open enrollment files/eligibility updates must be submitted to Blue KC based on the following schedule to ensure new ID cards are available to members by January 1, 2023: November 1, 2022 – Paperwork Deadline November 21, 2022 – Eligibility File – Physical ID Card December 16, 2022 – Eligibility File – Digital ID Card Please note: Small groups that make plan changes after this timeframe will receive updated ID cards once their plan changes have been… Read More

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Key Differences: Medigap Open Enrollment, AEP, and ICEP

Medigap Open Enrollment Period: six (6) month period starting the first of the month a beneficiary turns 65 or enrolls into Part B, whichever is later. Once in a lifetime EXCEPT for Guaranteed Issue situation or beneficiaries under 65. Annual Election Period (AEP): Medicare Advantage or PDP ONLY. Every year from October 15th to December 7th. Initial Coverage Election Period (ICEP): Medicare Advantage Only. With most ICEPs, occurs 3 months prior, the month of and 3 months after a beneficiary’s 65th birthday. The professionals at Total Benefit Solutions, Inc are here to help you understand your Medicare health insurance choices. Call us today at (215)355-2121.

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Open Enrollment Tips!

As always, please contact your Total Benefit Solutions health insurance specialists at today at (215)355-2121.

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Medigap Open Enrollment Period

Most beneficiaries get ONE Medigap Open Enrollment Period. The Medigap Open Enrollment Period cannot be changed or repeated. Under 65 Medicare beneficiaries get another Medigap Open Enrollment Period when they turn 65. As always, please contact your Total Benefit Solutions, Inc health insurance specialists with any questions or concerns at (215)355-2121.

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Guaranteed Issue Rights

Guaranteed Issue (GI) rights are rights the beneficiary has in certain situations when insurance companies must offer certain Medigap policies. There are ONLY 7 situations where Guaranteed Issue Rights apply. Two of the most common are: Beneficiary is in a Medicare Advantage Plan, and the plan is leaving Medicare or stops giving care in their area, or the beneficiary moves out of the Medicare Advantage plan’s service area. Beneficiary has Original Medicare and an employer group health plan (including retiree or COBRA coverage) or union coverage that pays after Medicare pays and that plan is ending. Just like with the Medigap Open Enrollment Period, during a Guaranteed Issue: No eligibility… Read More

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IRS Health Savings Account Adjusted Amounts for 2023

The IRS has released the 2023 cost-of-living adjustments for Health Savings Account (HSA) contribution limits, HDHP deductibles, and out-of-pocket maximums. To read the official IRS release, click here. As always, please contact your Total Benefit Solutions health insurance specialists at (215)355-2121.

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What kind of plans can participate in the Part D Senior Savings Model?

Most Medicare Part D plans that people choose from during Open Enrollment can participate in the Model. This includes stand-alone Medicare Part D Prescription Drug Plans (PDPs) as well as Medicare Advantage Prescription Drug plans (MA-PDs) that offer enhanced alternative Part D coverage. Private fee-for-service plans (PFFS plans), employer/union only direct contact plans (local coordinated care plans, prescription drug plans, PFFS plans), section 1876 cost contract plans, dual-eligible special needs plans (D-SNPs), section 1833 health care prepayment plans, Program of All-Inclusive Care for the Elderly (PACE) organizations, Medicare-Medicaid plans, and religious fraternal benefit plans (local coordinated care plans and PFFS plans) aren’t eligible to participate in the Model. Please contact… Read More

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Best Time to Buy a Medigap Policy

The best time to buy a Medigap policy is during the Medigap Open Enrollment Period. The Medigap Open Enrollment Period lasts for 6 months and begins on the first day of the month a beneficiary turns 65 or enrolls in Part B, whichever is later. Under 65 Medicare beneficiaries get a second Medigap Open Enrollment Period when they turn 65. The professionals at Total Benefit Solutions, Inc are here to help you understand your Medicare health insurance choices. Call us today at (215)355-2121.

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What is Medicare?

With Open Enrollment for Medicare in full swing, it’s important to know your benefits and how they work together. Here is an easy to understand article so you fully understand Medicare’s Parts  in order to customize coverage that works for you! Here at Total Benefit Solutions, Inc we have highly trained and certified Medicare Enrollment Specialists to help you each step along the way. If your Medicare options confuse you, or you just want the piece of mind of having a Broker review your needs prior to selecting a plan, feel free to reach out to us at 215-355-2121! You only have until December 7th to choose a plan for… Read More

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