Dental & Vision Plans for Families

  Getting a quality dental plan when you are self employed or don’t have employer coverage can be a real challenge.  But don’t worry! The professionals at Total Benefit Solutions, Inc work for your benefit! We have provided this easy to use online portal to help you shop, compare and enroll on a great plan of your choice!  We can walk through the options with you or you can enroll on the portal on your own, whatever you choose! Questions about these dental benefits? Just give us a call (215)355-2121.  Click here to find and compare dental and vision plans!   

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Anthem Blue Cross: New agreement with Trinity Health System extends access through 2025

August 20, 2021 We notified you last month that the previous agreement with Trinity Health System ended August 1. They have reached a new agreement that will assure continued access to affordable healthcare at Trinity Health hospitals, physicians, and affiliated care providers through 2025. We will continue our collaborative work to serve the community and look for innovative ways to help solve challenges together. Questions? reach out to your Total Benefit Solutions group account manager at (215)355-2121 https://www.totalbenefits.net

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Medicare Supplement Plan F or G?

  Many of our clients ask what is the “best” Medicare supplement that they can buy. While there is no overall “best”, the Medicare Supplement Plan F is generally considered the most comprehensive coverage among Medicare supplements due to the fact that most services are covered without any member co-pay or cost sharing at all. Keep in mind that Medicare supplements, like Plan F do not cover prescriptions and that a beneficiary with Medicare supplement will need to have other coverage for prescription drug coverage. For most beneficiaries becoming eligible, Plan G is the new F. A little known fact about Medicare supplements is that they do not have an… Read More

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AmeriHealth New Jersey prepares to comply with new Transparency requirements

From Amerihealth NJ: Health care and health insurance are among the most regulated industries in the U.S., making compliance a crucial requirement for success. AmeriHealth New Jersey has a strong track record of compliance to local, state, and federal guidelines, and we are working to comply with the new Consolidated Appropriations Act (CAA) and Transparency in Coverage Rule (TCR) requirements. We have been focused on transparency for our members for years, and we are now further sharpening our efforts related to transparency and accountability pertaining to the recent legislation for which we have developed an enterprise-wide implementation program to ensure requirements are met. We have a cross-functional team that is… Read More

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HHS Extends Public Health Emergency until October 18, 2021

  On July 19, 2021, the Secretary of Health and Human Services (“HHS”), announced that the administration will renew the COVID-19 pandemic Public Health Emergency, scheduled to expire on July 20, 2021. This will once again extend the period for an additional 90 days and as a result, numerous temporary benefit plan changes will remain in effect. As previously noted, in a letter sent to state governors, HHS indicated that the agency expects that the Public Health Emergency will likely remain in place for all of 2021. While not formal agency action, it appears that HHS intends to continue to renew the Public Health Emergency through, at least, the end… Read More

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Royal Caribbean Travel Insurance Requirements – We’ve Got You Covered!

  Beginning August 1, 2021 and going through to December 31, 2021, Royal Caribbean Cruises departing from ports out of Florida will require unvaccinated passengers age 12 years and older to procure valid travel insurance prior to boarding. Coverage requirements include $25,000 per person in medical coverage and $50,000 per person for emergency medical evacuation with no COVID-19 exclusions. Don’t let this requirement halt your travel plans!  We have Trip Protection and global health insurance plans provide coverage that meet these requirements, as well as offering additional coverage like baggage loss/delay benefits and trip cancellation/interruption benefits. If you have any questions please contact your Total Benefit Solutions, Inc health insurance… Read More

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How To Find a Doctor You Trust

How to Find a Doctor You Trust Get a list of in-network providers: Call your insurance company or look at their plan materials for a list of doctors in their network. You’ll usually pay less to see a doctor in your network than a doctor who’s out-of-network. You can also call your Broker and they can help assist you in getting the names of Doctors near you that accept your plan. Do your research: Ask friends and family if they recommend their doctors. You may even be able to read online reviews for doctors in your area. Online reviews are a great way to gauge things such as bedside manner and wait… Read More

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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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End of Summer Social Media Drive 2018

Please help us get the word out on social media in August & September You Could Win a $25-$100 Amazon Gift Card!!! While everyone is getting ready for the End of Season BBQs, gearing up for Back-to-School, and trying to fit in as much adventure as possible the next few weeks, we here at Total Benefit Solutions are getting ready for our busiest time of year: Open Enrollments! Your friends and family members may not be concerned with the open enrollment period.. YET, but it is quickly approaching and we’d like to help them! As always, We appreciate all the referrals and recommendations that we get online from everyone, but we… Read More

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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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Breaking News: CMS Announces Open Enrollment Dates and More

CMS issued final rule to increase choices and encourage stability in health insurance markets for 2018 The Centers for Medicare & Medicaid Services (CMS) issued the final Market Stabilization rule to help lower premiums and stabilize individual and small group markets, and to increase choices for Americans. Individuals obtaining coverage in the Marketplace created by the Affordable Care Act have faced double-digit premium increases, fewer plans to choose from, and a market that continues to be threatened by insurance issuer exits.*  The CMS rule is designed to provide some relief for patients and issuers now. “CMS is committed to ensuring access to high quality affordable healthcare for all Americans and… Read More

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Relief for Small Employers with HRAs

On December 13, 2016, President Obama signed into law the “21st Century Cures Act” which allows small employers without group medical plans to reimburse individual premiums and other medical expenses of employees under health reimbursement arrangements (“HRAs”), effective with the 2017 plan year, and provides relief from penalties to all small employers reimbursing individual premiums of employees for earlier plan years. In addition, the Cures Act provides a medical innovation package that funds medical research, accelerates cutting-edge treatments for rare diseases, and makes significant reforms to the mental health system. The Issue An employer cannot offer employees cash to reimburse the purchase of an individual policy, without regard to whether… Read More

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Individual and Family Open Enrollment-2017 Important Updates

As many people know by now there are many big changes with individual and family plans for open enrollment 2017. For anyone who is currently enrolled on one of the following your plan will NOT be renewed for 2017 and you will have to pick a new plan and/or a new insurer: Aetna: all plans cancelling  in PA/NJ/NC/FL  Aetna plans only remain in Delaware in our service area United Healthcare: All ACA plans cancelling. Short term plans are still available Oscar: All plans in NJ cancelling Health Republic: All plans in NJ cancelling Highmark and Capitol Blue Cross: No longer paying broker compensation Geisinger: No longer paying broker compensation Independence Blue… Read More

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ACA Individual 2017 Open Enrollment Important Update

2017 ACA ” Obamacare” plans open enrollment important update. The annual open enrollment period opens on November 1st 2016 and ends January 31st 2017. Independence Blue Cross will be the only insurer available in 2017 in the Philadelphia 5 County Area. With the passing of the Affordable Care Act changes come annually or even more often. Unfortunately not all of those changes are benefiting the consumer. This year here are some major changes that our clients on Individual Non Medicare plans need to be aware of… If you are a enrolled on an ACA compliant plan with Aetna or United Healthcare your plan is going away. Neither Aetna or United… Read More

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HHS Penalties Increase

  On September 6, 2016, the Department of Health and Human Services (“HHS”) issued an interim final regulation that adjusts civil penalties for inflation. The interim final regulation does not follow the usual procedures that offer a notice and comment period. As such, a Notice of Proposed Rulemaking has not been issued and a comment period is not provided due to potential delay in the applicability of the regulation. Click to download this bulletin For more information please contact your Total Benefit Solutions account manager at (215)355-2121

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ACA: Important Implementations & Delays in 2016

As our third year of the ACA Open Enrollment Period arrived, it’s time to examine some of the new implementations in 2016. Some of the major components, especially those affecting businesses were delayed or deferred since the passage of the Affordable Care Act in 2010. This year is considered to be a big year due to the “full implementation” of the employer mandate as well as a number of changes, repeals, and moratoriums on other sections of ACA. Some of the key changes are listed below: CHANGES AND IMPLEMENTATIONS Full implementation of the Employer Mandate Currently it is not mandated that employers provide health care to their employees. Moving forward, however, if… Read More

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Now Available from Total Benefit Solutions: Low Cost ERISA Wrap SPD Documents

Wrap Summary Plan Description (SPD) If you offer group health insurance you’re now required by ERISA law, enforced by the Department of Labor and now the Affordable Care Act, to distribute a Wrap SPD within 120 days of the Plan’s effective date. The ERISA and ACA required Group Health Insurance Wrap SPD document is now available for a $99 one-time fee. You only update your Wrap SPD document as your benefit options change. The low cost Wrap SPD document is limited to fully insured group health insurance plans only.     Here are the Wrap SPD document requirements by ERISA and the Affordable Care Act as succinctly as possible: If… Read More

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IBC Breaking News: Changes to SEP On-Exchange Verification Process

Changes to SEP On-Exchange Verification Process Starting June 17th, 2016 individuals enrolling in coverage through a Special Enrollment Period (SEP) on the Marketplace will need to provide specific documents to verify eligibility for certain SEPs, including: Loss of minimum essential coverage Change in primary place of living Birth Marriage Adoption, placement for adoption, placement for foster care, or child support or other court order Individuals who apply for these SEPs will be sent an Eligibility Notice for 2016 Coverage by the Centers for Medicaid and Medicare Services. To confirm eligibility and avoid a disruption of coverage, individuals must provide the required documents for each SEP by the deadline indicated within… Read More

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Notice of Subsidies in the Federal Marketplace

The Affordable Care Act (“ACA”) requires each Health Insurance Marketplace (“Marketplace”) to notify any employer whose employee was determined to be eligible for Advance Premium Tax Credits (“APTC”) and Cost Sharing Reductions (“CSR”) because the employee attested that he or she was not: • enrolled in employer sponsored coverage, or • eligible for employer coverage that is affordable and meets minimum value requirements. In 2016, the Federally-Facilitated Marketplace (“FFM”) will begin issuing these notices to employers. State-based Marketplaces began this notification process in 2015. Click the link to download the complete bulletin. Download Notice of Subsidies in the Federal Marketplace

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New ACA Delays/Extensions/Eliminations Chart–Download Free

With so many different ACA provisions, HR360’s simple new chart provides you and your clients with a clear understanding of the key requirements that have been delayed, extended, or eliminated under the Affordable Care Act.  Our business partner, HR360’s simple chart features important ACA delays, extensions, and eliminations, including: Eliminated automatic enrollment provisions Delay of the “Cadillac” tax Extension of information reporting deadlines Download ACA_Delays_Extensions_and_Eliminations

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Departments issue new ACA FAQ’s

The Departments of Labor, the Treasury, and Health and Human Services (collectively, the “Departments”) have issued the 31st set of Affordable Care Act (“ACA”) frequently asked questions (“FAQs”). This time, the Departments address a wide range of topics including preventive services, disclosure obligations, coverage in connection with approved clinical trials, reference-based pricing, the Mental Health Parity and Addiction Equity Act, and the Women’s Health and Cancer Rights Act. Below is a brief summary of the guidance issued on these topics. Click the link below to download the bulletin.   Download Departments Issue 31st set of FAQs

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Health Care Reform: 8 things the IRS wants small employers to know about the health care tax credit

  The Affordable Care Act’s small business health care tax credit is designed to encourage small employers to offer health insurance coverage to their employees. Click the link below to download the whitepaper 8 things the IRS wants small employers to know about this credit: 8 Things to Know About the Small Business Health Care Tax Credit For more information about the Small Business Health Care Tax Credit contact your Total Benefit Solutions, Inc account manager at (215)355-2121 or visit your ThinkHR library at www.thinkhr.com and log in.     Watch a video below about the Small Business Healthcare Tax Credit

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