Total Benefit Solutions, Inc

09/01/2025

https://www.linkedin.com/posts/edmacconnell_are-we-leaving-a-burden-or-blessing-join-activity-7368274395213045761--gcQ?utm_source=share&utm_medium=member_desktop&rcm=ACoAAAAa9mIB2tUGdXQW32cM86-2QxAqF3MPeJM

Are We Leaving a Burden or Blessing? Join us for our next special event with preofessional speaker, advanced planning specialist and senior advocate Scott Mitchell A Seminar for Adults (Lunch Provided): Topics Include: - Organizing Your Important Documents - Veterans Benefits - Emergency Record Guid...

08/29/2025

At Highmark, we value the trust you place in us and are committed to providing timely and transparent information. As we look ahead to 2026, we want to inform you that we are adjusting plan availability on external quoting and enrollment platforms. This decision has been carefully considered to ensure that our broker partners are prioritizing plans that offer a long-tenure with Highmark....

At Highmark, we value the trust you place in us and are committed to providing timely and transparent information. As we look ahead to 2026, we want to inform you that we are adjusting plan availab…

08/17/2025

The Affordable Care Act (ACA) imposes a fee on issuers of specified health insurance policies and plan sponsors of applicable self-insured health plans to help fund the Patient-Centered Outcomes Re…

08/12/2025

On June 25, 2025, the U.S. Department of Health and Human Services (HHS) published a final rule to implement newstandards for the Affordable Care Act’s (ACA) Marketplaces (or Exchanges). According to HHS, improper Exchangeenrollments, enabled by weakened verification processes and expanded premium subsidies, have triggered “widespreadfraud.” The final rule’s changes are intended to address these problems with the goal of improving health care affordability…...

On June 25, 2025, the U.S. Department of Health and Human Services (HHS) published a final rule to implement newstandards for the Affordable Care Act’s (ACA) Marketplaces (or Exchanges). According …

08/08/2025

Join Mark Zinman each week as he explores a new topic that you may not have learned about before or given recent consideration. Mark takes a unique approach to financial literacy and education, presenting information in a way that makes sense to those not well-versed in financial matters, as well as those who want to expand their existing knowledge base.

This week's episode serves as part one of a two part series! Join Mark and Monica as they dive into key concepts to keep in mind before and during the interv...

08/07/2025

Employers that sponsor group health plans should provide certain benefit notices during their plans’ open
enrollment periods.

Some of these notices, such as the Summary of Benefits and Coverage (SBC), must be provided at open enrollment time. Other notices, such as the Women’s Health and Cancer Rights Act (WHCRA) notice, must be distributed annually. Although
these annual notices may be provided at different times throughout the year, employers often choose to include them in their open enrollment materials for administrative convenience. Some of these notices may be included in the plan’s Summary Plan
Description (SPD) or detailed benefits summary provided by a health insurance issuer or third-party administrator (TPA).
In addition, employers should review their open enrollment materials to confirm that they accurately reflect the terms and
cost of coverage. In general, any plan design changes for 2026 should be communicated to plan participants either through an
updated SPD or a Summary of Material Modifications (SMM). Ask us today for our compliance overview chart!

08/05/2025

The Affordable Care Act (ACA) imposes a fee on issuers of specified health insurance policies and plan sponsors of applicable self-insured health plans to help fund the Patient-Centered Outcomes Research Institute (PCORI). The IRS has provided this helpful chart for more information on whether a type of insurance coverage or arrangement is subject to the fee. Note that self-insured health plans include health reimbursement arrangements (HRAs) and level-funded arrangements....

The Affordable Care Act (ACA) imposes a fee on issuers of specified health insurance policies and plan sponsors of applicable self-insured health plans to help fund the Patient-Centered Outcomes Re…

08/01/2025

Medicare advantage (MA) has experienced a fast growth in the last few years, which has created a significant opportunity for Congress to upgrade the program to better serve beneficiaries, especially in rural areas. With over half of Medicare beneficiaries now enrolled in MA plans, these individuals enjoy lower healthcare costs, access to supplemental benefits, and improved health outcomes compared to traditional fee-for-service Medicare....

Medicare advantage (MA) has experienced a fast growth in the last few years, which has created a significant opportunity for Congress to upgrade the program to better serve beneficiaries, especiall…

07/23/2025

In March 2025, the Cigna Healthcare Medicare business was acquired by Health Care Service Corporation. As Cigna Healthcare Medicare navigates this change, their focus remains on providing continuity and trust in the Medicare options you rely on. They are dedicated to renewing their brand while ensuring the same exceptional products and benefits you have come to expect. The HealthSpring brand is a well-respected name, that reflects Cigna’s commitments to providing quality benefits....

In March 2025, the Cigna Healthcare Medicare business was acquired by Health Care Service Corporation. As Cigna Healthcare Medicare navigates this change, their focus remains on providing continuit…

07/21/2025

The recent PA state legislation, Act 1, marks a significant advancement in women’s healthcare by mandating health plans to cover supplemental diagnostic radiology services and genetic screenings for those at increased risk of breast cancer and BRCA mutations. This legislation is designed to eliminate out-of-pocket costs for these essential health services, ensuring that women who need these screenings can access them without financial barriers....

07/11/2025

As of August 3, significant changes will occur regarding preferred diabetic testing supplies for Medicare Advantage plans. LifeScan OneTouch@ products will no longer be covered, and Ascensia Contour products will be introduced as a new preferred option effective June 1, 2025. Members will still have access to a selection of preferred brands with a $0 copay, including multiple Accu-Chek and Contour products such as:...

As of August 3, significant changes will occur regarding preferred diabetic testing supplies for Medicare Advantage plans. LifeScan OneTouch@ products will no longer be covered, and Ascensia Contou…

06/27/2025

On June 23, 2025, health insurance plans revealed significant commitments aimed at simplifying and streamlining prior authorizations for better care access. These initiatives are built on existing efforts to enhance patient connections to necessary care while reducing the administrative burden on healthcare providers. Such changes promise to improve overall patient experience and access to evidence-based treatments, aligning with the industry's goal of delivering affordable healthcare....

On June 23, 2025, health insurance plans revealed significant commitments aimed at simplifying and streamlining prior authorizations for better care access. These initiatives are built on existing …