Annual Out-Of-Pocket Maximum Adjustments Announced for 2023

On December 28, 2021, the Department of Health and Human Services (“HHS”) published the “payment parameters” portion of its Annual Notice of Benefit and Payment Parameters for 2023 (“the Notice”). HHS historically publishes the Notice as a proposed rule and then finalizes the rule. The guidance clarifies that, beginning with the 2023 calendar year, the payment parameters portion of the Notice will be published by January of the year preceding the applicable calendar year. This guidance is considered a final rule that addresses certain provisions of the Affordable Care Act (“ACA”). For more information contact your friends at Total Benefits Solutions! Reach out to us at (215)355-2121

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Additional Guidance Addresses ACA Preventive Care Mandate

As part of FAQ 51, the Departments of Labor, Health and Human Services, and the Treasury (together, the “Departments”) issued guidance clarifying severalAffordable Care Act (“ACA”) preventive care coverage issues applicable to non-grandfathered group health plans. As background, non-grandfathered group health plans must cover certain in-network preventive care items and services without cost-sharing. Click the link below to download the bulletin. As always contact your health insurance specialists at Total Benefit Solutions, Inc if you have any additional questions or concerns (215)355-2121 https://www.totalbenefits.net

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2021 MLR Rebate Checks Recently Issued to Fully Insured Plans

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How is COBRA health insurance affected if I am disabled?

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AmeriHealth New Jersey prepares to comply with new Transparency requirements

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Ways to Save Money on Your Prescription Drugs

Prescriptions costs are skyrocketing. We all know that. But did you know that there are several ways for people to save money on their monthly medications? As health insurance plans are becoming more catastrophic in nature, that means that people will need to become better health care consumers. Sometimes that means using the tools that the insurance company offers at no charge. Sometimes it means using discounts and other resources that are available outside the health plan. Here are a few ways, some already widely known and others not so much, to help drop down your costs at the Pharmacy. While this is not a comprehensive list of money-saving ideas, it is… Read More

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Aetna Funding Advantage (AFA) is a new self-funded option for small groups

Aetna Funding Advantage (AFA) is a self-funded option that provides all of the financial and plan design flexibility of a traditional arrangement with special features designed to help companies with as few as 2 employees achieve even greater savings on their health insurance. Ask us today if self funding could be a good fit for your organization! Call your Total Benefit Solutions Inc. account manager at (215)355-2121 for more information! Learn more here: AFA-Customer-Flyer New! Minute Clinic Benefit! $0 Copay Minute Clinic Visits Flyer More Documents for downloading: Springboard Marketplace Your Online Administration and Enrollment Portal AFA AppleWatch Wellness Flyer AFA Sample Usage Reports Aetna & Teledoc for AFA AETNA… Read More

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Aetna Funding Advantage for Small Businesses

Aetna Funding Advantage (AFA) is a new self-funded option that provides all of the financial and plan design flexibility of a traditional arrangement with special features designed to help companies with as few as 2 employees achieve even greater savings on their health insurance. The benefits of self-funding have traditionally been considered by larger companies. But Aetna Funding Advantage has changed that. It is specifically designed to be attractive and affordable for small businesses like yours. Watch this short video and download the documents below for some information. As always please contact your Total Benefit Solutions dedicated account manager at (215)355-2121 if you have any questions, concerns or would like to learn… Read More

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Guidance Issued on QSEHRAs

  Under the Affordable Care Act, a health reimbursement arrangement (HRA) must be integrated with a group health plan (as it could not meet the market reform provisions on its own) and was not able to reimburse employees for individual premiums. However, on December 13, 2016, President Obama signed into law the “21st Century Cures Act” which established QSEHRAs (a special standalone HRA). Click to Download Guidance Issued on QSEHRAs This guidance is big news for small groups who would prefer to provide a reimbursement as opposed to a group health plan. Please contact your Total Benefit Solutions account manager at (215)355-2121 if you have any questions or concerns.  

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2018 Individual Health Insurance Open Enrollment: PA Independence Individual Consumer Plans and Rates

  Individual Health Insurance Open Enrollment 2018! Don’t do it yourself! Our dedicated professionals are here to help you take the fits out of the benefit planning process!  One mistake and you could be stuck with a bad plan all year! We work with all available plans both on the healthcare.gov marketplace and off! Have your own expert help you! Our experts are trained to help you Choose between on and off exchange options Maximize any subsidy eligibility. Help you understand the cost sharing subsidies Help you choose the plan that is the best fit for you Explain the differences between the plan design and your out of pocket expectations Fill… Read More

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BREAKING: Aetna to withdraw from New Jersey Small Employer ACA market in 2018

Aetna to withdraw from New Jersey Small Employer ACA market in 2018  Due to mounting financial losses and an uncertain marketplace outlook, Aetna has made the decision to leave the Individual market in New Jersey. Regrettably, this decision also impacts our New Jersey small employer ACA insured medical products. New Jersey law requires a carrier to withdraw from the insured small employer market if it is withdrawing from the individual market.  As such, Aetna will withdraw all of its commercial (fully insured) medical plans offered in the small employer health insurance market. What this means Health insurance coverage for New Jersey small employer clients will end at midnight on the… Read More

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