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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The IRS Code has numerous provisions designed to help employers

Employer Strategies and Solutions to Substantially Reduce:   the high cost of Health Insurance; the cost for Out-of-Pocket Medical Expenses; the cost for Dependent Day Care Expenses; the cost for Parking and Transit Expenses; cost of Self-Employed Healthcare Expenses; Employer Matching Payroll Taxes by 8%; Employee Income Taxes by 30%. The IRS Code has numerous provisions designed to help employers provide essential benefits to their employees tax-free. This saves the employee approximately 30% in income taxes on expenses they’re already paying for, and because the employees have reduced their taxable income, the employer realizes a reduced matching payroll tax liability of approximately 8%. Everybody saves money. To take advantage of… Read More

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Video: Our New Online Enrollment System

Watch this short video to get a quick overview of our new employee enrollment system with Ease Central!   As always please contact your Total Benefit Solutions account manager at (215)355-2121 if you have any questions about our new enrollment system with Ease Central!

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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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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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UnitedHealthcare and Optum take action to support Orlando shooting tragedy

Those Grieving Over Orlando Can Get Free Mental Health Services Thanks To This Insurance Company: UnitedHealthcare and Optum, two health benefits companies of UnitedHealth Group, are offering free mental health services for anyone affected by the shooting in Orlando that killed 49 people over the weekend. The resources are available to anyone in the country, whether they are insured by the group or not. Optum will operate a 24/7 helpline, and users can speak to a trained mental health professional for as long as they need. click here for more information

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2015 Compliance Compilation

The attached resource file is a compilation of all of our compliance bulletins for 2015 provided by our business partners at Emerson Reid and your benefits support team. Click the link below to download the entire 2015 compilation: 2015 Compliance Compilation    

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Health reform: CMS releases SHOP HOW-TO video for employees

 CMS releases SHOP video for employees   The SHOP enrollment for employees video has been posted by CMS. Please keep in mind that the employer group needs to be set up on the SHOP first. Please contact your Total Benefit Solutions, Inc account manager if you have any questions about setting your organization up as a SHOP employer. Total Benefit Solutions, Inc is a certified SHOP independent broker. Click the video below to watch the video.      

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Lost your health coverage?

  Losing other health coverage, including losing a job-based plan, aging off a parent’s coverage at 26, losing coverage through divorce, losing eligibility for Medicaid or CHIP, and similar events. Coverage can take effect: The first day of the month after you enroll and after the loss of coverage Enrollment window: From 60 days before to 60 days after losing your other coverage Important: If you leave your job for any reason and lose your job-based health coverage, you qualify for a Special Enrollment Period. But you don’t get an SEP if you voluntarily drop: a job-based plan without leaving your job; an individual insurance plan; unexpired COBRA coverage; or… Read More

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Lost your health coverage?

  Losing other health coverage, including losing a job-based plan, aging off a parent’s coverage at 26, losing coverage through divorce, losing eligibility for Medicaid or CHIP, and similar events. Coverage can take effect: The first day of the month after you enroll and after the loss of coverage Enrollment window: From 60 days before to 60 days after losing your other coverage Important: If you leave your job for any reason and lose your job-based health coverage, you qualify for a Special Enrollment Period. But you don’t get an SEP if you voluntarily drop: a job-based plan without leaving your job; an individual insurance plan; unexpired COBRA coverage; or… Read More

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How do the HMO Proactive Plans and “Tiered Network” plans work?

Tiered or Narrow Network Plans: Under the Affordable Care Act, insurance carriers have introduced “tiered network”, or narrowed network plans. Keystone Proactive Plans have a ” 3 tiered” network of providers. Although each carrier has different types of networks and benefit levels, the plans have the same general concept, steering the members by giving them a choice of providers that offer medical services at a lower out of pocket expense. Choosing a more expensive provider or facility may cost the member more out of pocket costs. United Healthcare offers 3 tiers in their “Navigate” plans, and Aetna uses “Savings Plus” designated providers to split the provider network into “designated” or “non designated” participating… Read More

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Reality Check: The Price Of Not Buying Health Insurance

MINNEAPOLIS (WCCO) — Minnesotans have until Feb. 15 to sign up for health care insurance or pay a tax penalty. Click here for the full story Still need insurance? Click here!

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Updated Healthcare Reform Calculators

Total Benefit Solutions Inc. has updated our healthcare reform calculators on our website, https://www.totalbenefits.net Calculators include: How much tax credit is my small group eligible for? What are the conditions required to get the tax credit? Pay or Play Mandate penalty-What is my risk as a group? Individual Subsidy Calculator Click here to get to our healthcare reform calculators.

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2014 Compliance Bulletin Compilation

Download our 2014 Compliance Bulletin Compilation, featuring all of our released compliance bulletins for the entire year!  Topics include, Health Savings Accounts, The Individual Mandate, Employer “pay or play” mandate, exemptions, FSA carryovers and much, much more. All of the bulletins are in an easy to search format for your convenience. 2014 Compliance Compilation – Download As always please contact your Total Benefit Solutions account manager at (215)355-02121 if you have any further questions or concerns.

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Plan cost inaccuracies found on HealthCare.gov

Consumers who have complex medical diagnoses that require specialty drugs should carefully examine the health insurance plans offered through the public exchange system to avoid incurring high costs for those drugs. But that task will be complicated by inaccuracies on the public exchange website. That’s the conclusion of an analysis of public exchange plans by Avalere Health. The study, in which researchers went through all available plans looking for “hidden” drug costs, found that silver plans in particular tend to place such drugs in specialty tiers in their 2015 formularies. Avalere said that 17 percent of silver plans contain two or more specialty drug tiers that will drive up out-of-pocket… Read More

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Total Benefits Introduces New Compliance and Health Reform Education Center

Total Benefits Comply is our new Compliance and Health Reform Education Center where we will keep a copy of our health care reform bulletins throughout the year, in an easy  to view format, along with short informative videos. This new resource makes it easier to quickly find the answers to your reform questions and download a short, to the point bulletin. At Total Benefit Solutions Inc., we are dedicated to providing the information and advice that our clients need to remain compliant and make informed healthcare decisions. If you have any further questions please contact you Total Benefit Solutions account manager  at (215)355-2121 Click here for Total Benefits Comply.

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IBC: Effective January 1, 2015, HIPAA Certificates of Creditable Coverage are no longer required

On February 24, 2014, the United States Departments of Health and Human Services issued a final rule that addressed the requirement to provide HIPAA Certificates of Creditable Coverage (HIPAA Certificates) under the Affordable Care Act (ACA). As the ACA prohibits pre-existing condition exclusions, the new rule eliminates the requirement to provide HIPAA Certificates beginning December 31, 2014. What does this mean for members?  Previously, when coverage was terminated for a member or his/her dependents, Independence Blue Cross (Independence) issued a HIPAA Certificate. Because the ACA prohibits the application of pre-existing condition exclusions, which applies to both grandfathered and non-grandfathered health plans, these certificates are no longer required. Effective January, 1,… Read More

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Total Benefit Solutions Introduces New Individual Health Plan Private Exchange

Total Benefit Solutions is proud to announce that our newest development, in partnership with RX health is now available. Our new site, the Total Benefit Solutions Exchange can help consumers compare, choose and enroll on a new health insurance plan either on the healthcare marketplace or off. It can help find your subsidy, secure it and get enrolled!   https://totalbenefits.rxhealthinsurance.com/Shopping/14/1/     Log on today, get enrolled and stay legal!

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Health Reform: Guidance Issued-Employer Reimbursement of Individual Policies

  Previously, the Departments of Labor (“DOL”), Health and Human Services (“HHS”) and the Treasury (collectively, the “Departments”) explained that  HRAs and employer payment plans cannot reimburse individual policies. On November 6, the Departments issued their twenty-second set of FAQs which make clear that: An employer cannot offer employees cash to reimburse the purchase of an individual policy, without regard to whether the employer treats the money as pre-tax or post-tax to the employee. Such arrangements are subject to the market reform provisions of the Affordable Care Act (“ACA”), including prohibition on annual limits and the requirement to provide certain preventive services without cost sharing with which it cannot comply. Such… Read More

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Health Reform: Healthcare.Gov Sneak Preview

Healthcare.Gov Sneak Preview Announced Yesterday, Affordable Care Act customers can peek at 2015 prices for the program’s health plans today after the government released a “window-shopping” feature overnight Here is a direct link to the 2015 “sneak preview”: https://www.healthcare.gov/see-plans/ If you have any questions or concerns about your 2015 enrollment, please contact Total Benefit Solutions at (215)355-2121

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2015 Health Reform: Prepare for Health Insurance Open Enrollment

Preparing for 2015 Open Enrollment Getting prepared for open enrollment 2015 has been a major challenge. Total Benefit Solutions is dedicated to serving all of our clients throughout this second annual open enrollment period. With that in mind our offices will be open on the weekend of November 15th 2014 to help you get enrolled. Open enrollment for individual plans begins November 15th, 2014 and ends February 15th 2015. Anyone who enrolls prior to the 15th of the month will be effective the 1st of the next month. This is important because you must enroll by December 15th in order for your plan to be effective on January 1st, 2015… Read More

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Health Reform: CMS finalizes auto-enrollment process for current Marketplace consumers

CMS finalizes auto-enrollment process for current Marketplace consumers CMS finalized its policy regarding how current Health Insurance Marketplace individual customers will renew their plans in 2015. Individuals who do not make an active 2015 plan selection will be auto-enrolled in the same plan with the same premium tax credit and other financial assistance, if applicable, as the 2014 plan year. Individuals are encouraged to return to the Marketplace to determine their current and accurate 2015 premium tax credit or cost-share reduction financial assistance.   Click here to read the entire release.   As always if you have any questions, concerns or need assistance enrolling, contact your Total Benefit Solutions ACA… Read More

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Health Reform: Eligibility for the SHOP Marketplace

Eligibility Requirements for the SHOP Marketplaces In 2015, small businesses that offer coverage through the Federally-facilitated SHOP (FF-SHOP) may be able to offer employees a choice of QHPs and qualified dental plans (QDP) within a given metal level or issuer, or a single QHP or QDP. To qualify for an FF-SHOP, a business must: Be located in an FF-SHOP’s service area (generally a state) Have at least one eligible employee on payroll Have 25 or fewer full-time equivalent (FTE) employees on payroll This methodology includes part-time employees, but not seasonal employees (those working fewer than 120 days per year). While the FF-SHOP must determine eligibility using the definitions above, State-based SHOP… Read More

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Health Reform: Guaranteed Renewability

Guaranteed Issue and Guaranteed Renewability The Affordable Care Act requires health insurance issuers to offer all of their individual market and group market plans to any applicant in the state. It also requires health insurance issuers to accept any individual who applies for those policies, as long as the applicant agrees to the terms and conditions of the policy, including the payment of premiums. This provision is called “guaranteed issue.” Coverage offered through and outside the Marketplaces may restrict guaranteed issue coverage to certain enrollment periods. Additionally, the Affordable Care Act requires health insurance issuers to offer to renew or continue in force coverage at the option of the policyholder. This… Read More

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Heath Reform: 5 States Will Have Early Access to Online Functions of the Federally-Facilitated SHOP Marketplace

‘SHOP Early Access’ Available in Delaware, Illinois, New Jersey, Ohio, and Missouri Starting in late October, small employers, agents, and brokers in Delaware, Illinois, New Jersey, Ohio, and Missouri will be able to experience some of the key new online functions of the federally-facilitated Small Business Health Options Program (FF-SHOP), according to the U.S. Department of Health and Human Services. The online SHOP Marketplace is expected to be available nationwide on November 15, 2014. SHOP Early Access During the “SHOP Early Access,” small employers in the five selected states will be able to use HealthCare.gov to take several initial steps in the enrollment process, including: Establishing a Marketplace SHOP account; Assigning an agent or… Read More

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