What is a Direct Primary Care plan?

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Health Insurance 101: The Moop

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What is a minimum essential coverage (MEC) plan?

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What Are Trial Rights for Medicare Advantage?

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Coverage for Covid 19

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Onboarding Employees with Total Benefit Solutions

This quick and simple video shows you how easy it is to enroll your employees onto your group health insurance and benefits when you are working with Total Benefit Solutions, Inc! Make it easier for you call us today at (215)355-2121

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Reminders for Medicare CMS Notice and 1094-1095 filing

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Social Distancing Tips!

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DOL Penalties Increase for 2021

The Department of Labor (DOL) published the annual adjustments for 2021 that increase certain penalties applicable toemployee benefit plans. Private employers, including non-profits, should ensure employees receive required notices timely (SBC, CHIP, SPD, etc.)to prevent civil penalty assessments. In addition, employers should ensure Form 5500s are properly and timely filed, ifapplicable. Finally, employers facing document requests from EBSA should ensure documents are provided timely, asrequested.

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New Jersey Issues 2020 Individual Mandate Reporting Requirements

employer reporting for the 2020 calendar year under New Jersey’s individual health insurance mandate

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What is an urgent care center like?

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What is the NYHCRA Form?

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Aetna Attain: more than discounts, actual rewards

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CMS: New Individual HRA Guidance

As always if you have any questions about this update please reach out to your Total Benefit Solutions Inc account manager at (215)355-212

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Review us on Google

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What is my Max Out of Pocket?

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Think You’re Covered With Original Medicare?

Medicare in 2020   Everyone has heard of Medicare and over the years, here at Total Benefit Solutions have posted numerous articles explaining how Medicare works. We even wrote out a post about the history of Medicare a little over a year ago (That post can be found here ). However, nothing in the Insurance World stays still and every so often we like to revisit this sector of the Insurance Market and explain how Medicare works with some updates. This way, whether you’re new to Medicare, or you’ve been on it for a while, you are up-to-date on how your Insurance Plan works! Original Medicare (Part A and Part… Read More

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Full Self-Service Compliance Center At No Additional Charge to You!

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SHOP Rules Finalized, Enrollment Forms Simplified

The 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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New York Health Exchanges Offer 50% Drop in Premiums

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

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IBC: Important change to claims processing for PPO plans

Independence 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

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Health Reform: Research Filing Fees Due July 31

The 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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Health Reform: Aetna to distribute MLR rebates

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

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NJDOBI Issues Amendments to Rating Rules under PPACA

NJDOBI 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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Healtcare Reform Law

Health Insurance Marketplaces (Exchanges): Informational Video

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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