SHOP for Small Group Customers Buying a plan through SHOP versus direct Buying plans through the Small Business Health Options Program, or SHOP, provides an advantage only for employers with fewer than 25 employees that are eligible for a tax credit provided by the Affordable Care Act (ACA). If customers are not eligible for this tax credit, there is no advantage to purchasing a plan through SHOP. This is because… Click here to download the SHOP bulletin
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Near the end of 2013, the IRS issued Notice 2013-47 that permits a cafeteria plan to provide for the use of up to $500 of any unused amount remaining in the health FSA in the immediately following plan year (the “carryover” provision). This provision is optional, requires a plan amendment, and cannot be offered if the cafeteria plan allows a grace period. Click here to download the bulletin
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Tandigm Health’s innovative coordinated care model will provide higher-quality care, lower costs Independence Blue Cross (Independence) and DaVita HealthCare Partners today announced the creation of Tandigm Health. This unique joint venture, based in Philadelphia, Pa., will help deliver high-quality, affordable care to the region by combining the expertise of one of the country’s largest, most innovative Blue insurers and a nationally recognized pioneer of physician-centric coordinated care. Click here to read the bulletin Click here to read the press release from the IBC website
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Why does IBC collect member-level information about tobacco use? Under the Affordable Care Act (ACA), premium rates for health insurance coverage in the individual and small group markets may be based on family size, geography, age and tobacco use. In order to follow with this guideline and accurately rate each group, Independence Blue Cross (IBC) collects member-level tobacco use information to create group premiums for new and renewing group customers. Click the link below to download the IBC document that covers the most common questions about rating tobacco users in small group in PA. Tobacco Status For Small Group Customers Flyer
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HR360: Job Description Builder A well-developed job description will help you review employee performance, and hire the best candidates. Our online Job Description Builder is so simple to use. With our efficient tool, you can transform a blank page into a professionally-developed job description in minutes. Just follow these simple steps: Choose from our comprehensive library of job descriptions Check off tasks and activities as well as skills associated with the job Select from the list of physical demands or the job/ work environment or add your own. Print out a complete job description in Word or in an Excel Spreadsheet—it’s that easy! HR360 is a web based subscription service… Read More
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The Protecting Access to Medicare Act of 2014, legislation extending the “doc fix” for Medicare payments, also includes a provision that repeals the maximum deductible limits applicable to many small group health plans. As you recall, deductible limits for non-grandfathered small group plans are capped under the ACA at $2,000 for single coverage and $4,000 for family coverage effective for the first plan year on or after January 1, 2014. This legislation repeals the deductible limits as of the date health care reform was enacted (March 23, 2010). Click here to download the bulletin
Continue ReadingThe 2014 Group Health Plans Notices Calendar in now available! All-in-One Health Plan Notices Calendar and Downloadable Model Notices Our 2014 calendar provides bottom line information on group health plan required notices and filings, including who must receive them, who must provide them and when notices are due. At last, the notices you need are available in one convenient location, including: Health Care Reform Notices (includes new SBC template for 2014 and information on required PCORI filings) COBRA Notices HIPAA Notices (includes information on elimination of creditable coverage certificates and new model Notice of Privacy Practices) Special Health Care Notices (Women’s Health and Cancer Rights, Mental Health Parity… Read More
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On Monday, Congress and President Obama together repealed one of the Affordable Care Act’s most onerous provisions, which prohibited so-called “small groups” (mostly groups with less than 50 employees) from offering health plans with deductibles higher than $2,000 for single coverage and $4,000 for family coverage. This comes as very welcome news to small businesses, who are frequently the most in need of additional options and flexibility when it comes to offering employees comprehensive, affordable health insurance via higher deductibles and other cost-sharing mechanisms. It is also great news for employers wanting to couple their insurance plans with health reimbursement arrangements (HRAs), which federal agencies previously rejected as permissible ways… Read More
Continue ReadingWe are pleased to announce that Edward T MacConnell, President of Total Benefit Solutions has earned the certification of Certified Voluntary Worksite Professional from the National Association of Health Underwriters. Voluntary/Worksite products are not new to the employee benefit industry. However, the surge of interest in these products has accelerated as employers seek ways to help attract and retain talent. The industry has responded swiftly with new products, new features, new enrollment technologies and many changes to the underwriting rules of these products. This has created new responsibilities for agents, brokers and consultants as advising clients in this area will differentiate their value to the consumers they serve. Certified Voluntary Worksite… Read More
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The Washington Post has reported that HHS has released regulations extending the Marketplace open enrollment deadline to around mid-April for individuals who began, but did not complete, a Marketplace application. The extension appears to be based on a self-certification (honor) system, in which individuals attest that they could not timely complete the Marketplace application before the March 31 deadline. This extension may have an impact on employer-sponsored plans to the extent individuals have more time to elect Marketplace benefits and therefore may decline employer-sponsored coverage at the next OE. Keep in mind that IRS cafeteria plan rules currently do not recognize enrollment in a Marketplace plan as a qualified status… Read More
Continue ReadingOur friends at Zane Benefits recently shared this comic and I enjoyed it so much I thought you might like it too: Click here to see the rest of the comic on zanebenefits.com Click here to see the rest of the comic on zanebenefits.com
Continue ReadingEd, thank you for your recent endorsements. And especially thank you for helping my wife and I sail through the new Affordable Care Act. You and your team made the complicated seem simple and select the plan best suited for our health insurance needs. Thanks again!! Mike Hilbert Sales Pros for Hire PS- I have already received and paid my April payment and can print temporary insurance cards from the website.
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The Truth Agents/Brokers & FFM Navigators The Patient Protection and Affordable Care Act Shared with permission from B. Ronnell Nolan, HIA, CHRS-President/CEO – HAFA Financial Media Group, LLC, Centennial, CO, compiles this information annually. There are approximately 1.2 million licensed insurance agents nationally. The 1.2 million does not include the staff of licensed agents employed throughout the United States. After adding the staff, imagine the millions of people that Agents represent, educate and protect on a daily basis! With the passing of the ACA, Health Agents for America, Inc. was formed to create a tool box for Agents to use in educating the citizens of their local communities. HAFA is known to… Read More
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Enclosed in the 279 pages of proposed rules released Friday by the Department of Health and Human Services for the public health insurance exchanges is an answer, sort of, to a question brokers have raised for more than a year — who will be liable for navigators’ mistakes? n the section of the rules discussing navigators, the Obama administration’s document says “a state or an exchange must not require that all navigators be agents or brokers or carry errors and omissions coverage.” Further, the rule says that if navigators were to be required to carry E&O insurance, this would disqualify them from being considered a “community and consumer-focused nonprofit group.” Federal law… Read More
Continue ReadingUpon renewal in 2014 small groups will be automatically “mapped” to a new ACA compliant metallic plan. Find your new recommended 2014 Blue Solutions plan using the chart below. To make your renewal even easier we’ve identified the plan that most closely matches your current plan. Or you can choose from among 36 other options to suit your needs. More comprehensive coverage Blue Solutions health plans now cover Essential Health Benefits like pediatric dental and vision. Your health plan also continues to cover doctor visits, hospital admissions, emergency room treatments, maternity care, lab tests, X-rays, prescriptions, and vision benefits for both children and adults. Click the link below to download the… Read More
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For plan years beginning on or after January 1, 2014, a group health plan and an insurance carrier offering group health insurance coverage may not apply any waiting period that exceeds 90 days. This rule applies to both grandfathered and non-grandfathered plans. It should be noted that nothing in the Affordable Care Act requires a group health plan or carrier to have a waiting period Click here to download the bulletin
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Independence Blue Cross (IBC) has selected Laboratory Corporation of America® Holdings (LabCorp), as its exclusive, nationally-based provider of laboratory services, effective July 1, 2014. The change applies to all Personal Choice®/PPO and Keystone Health Plan East product lines, and affects all individual, group commercial, and Medicare members, for services rendered in the Philadelphia five-county area, and in the contiguous counties. Effective July 1, 2014, Quest Diagnostics laboratories will be an out-of-network provider for Personal Choice and Keystone Health Plan East. IBC will continue to contract with certain local and regional laboratories… Click to download the bulletin
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In an effort to meet the enrollment challenges that many are facing under healthcare reform, Total Benefit Solutions Inc has designed a custom form for our clients to use. Using this form and submitting it to Total Benefit Solutions Inc will enable our Marketplace trained and certified licensed independent brokers to assist you in the enrollment process from the registration right through the enrollment! Remember as your independent broker we always work in your best interests, not an insurance company. We represent you, our client and not an insurer or government agency. Click the link below to open the form and get started! When completed, just click the link to… Read More
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