Solutions

From Consulting and Alternative Funding to Enrollment and Claim Support

Small Business Employee Benefits

For a small business, shopping for group health insurance is more difficult now than ever. The Affordable Care Act has introduced an array of benefit and pricing variables that make it difficult to find the right plan for you and your employees at a price you can afford. Add to that the host of new compliance regulations, tax-related products and guidelines, wellness programs and funding methods and, well, managing benefits can be a full-time job! At Total Benefit Solutions, Inc., our team of experts can help you sort through these complexities to design a benefit program that’s the right fit for you company. Our vast array of internal resources coupled with strategically chosen vendors allows us to craft a strategy that will not only work for you today, but for years ahead as well.


Health Care Reform / Compliance Guidance

The complexity of regulations that impact employers as a result of the Affordable Care Act, IRS and other employee related legislation can be a tremendous burden carrying stiff penalties, fees and interest for non-compliance. On top of that, rules and regulations are constantly changing from year to year, requiring an on-going, regular review of practices. Our team of experts can help you develop an effective strategy for maintaining compliance in a way that allows you to progress toward your business goals.


Renewal Marketing

Every year, businesses are faced with a renewal deadline for their group benefit programs, allowing them an opportunity to perform a thorough review of each plan and making revisions, when necessary. Strategic planning for the renewal process is critical, as it can assure that the benefits offered by the company are the proper fit for the needs and circumstances of both the employer and employee.

We begin preparation for each renewal year several months in advance, formulating a strategy with you based on a review of the latest market products, innovations and trends, along with your firm’s objectives. From this plan we negotiate with several leading carriers to obtain the benefit package that best suits your vision and your employee’s needs, at pricing that works for you.


Medicare

With the increasing number of individuals continuing to work past age 65, there’s a good chance your business either has or will have Medicare eligible employees on the payroll. There’s also a good chance that either the individual or the benefits representative at your company will have questions about Medicare benefits, enrollment or related issues. Medicare is loaded with confusing language, similar plan names, critical deadlines and a complex rating schedule. Our Medicare experts can educate and assist you and your employees to evaluate the best coverage, compare carriers, navigate the enrollment process and field any questions that may arise.


Ancillary Benefit Programs

Ancillary benefit programs, when designed properly, provide employees with the ability to fill any needed gaps in coverage at rates lower than what they would be able to obtain on their own. Additionally, by offering products and services like critical illness insurance, hospital indemnity insurance, life and disability insurance, long term care insurance, dental and vision insurance, pre-paid legal and stand alone wellness, businesses can increase employee morale, productivity and work efficiency all increase…enhancing the firm’s growth and competitiveness.


Alternative Funding

Today, there are a multitude of different funding strategies available to groups of virtually all sizes. With our knowledge and expertise, we can work with you to discover if an alternative funding model can benefit the unique demographics and utilization of your workforce. Properly fitted, one of these alternative funding solutions could help you generate substantial cost savings and greater transparency without sacrificing the level of benefits you offer your employees.


Enrollment and HRIS Solutions

The rapid expansion of human resource and benefit administration technology solutions is enabling employers to significantly increase operating efficiencies in areas that are often described as the “backbone” of their business. But there are a multitude of vendors claiming solutions that include payroll, onboarding to retirement, schedule management, benefit administration and other human resource related features. Choosing the right solution is the key to obtaining the maximum satisfaction and performance from an HRIS system, as it can lead to better talent recruitment and retention, more accurate processing of all HR and benefits related functions and increased flexibility for employees with self-service tools.


Selecting a Third Party Administrator (TPA)

Proper selection of a third party administrator for administration of your company’s insurance program is critical for a successful experience. Vendors should be evaluated with a focus on their competency regarding all aspects of benefit administration, compliance issues, customer service and client communication as well as their size and location of their operation and competitiveness of costs and fees. When properly designed and executed, a self-funded program has the ability to produce a smooth process for all employees and yield valuable savings for the employer.


Understanding the Coding of Health Plans from MEC to Metallic

Choosing the right insurance plan for you (and your family) is not an easy task. The Affordable Care Act (ACA) has introduced major changes to the way carriers traditionally marketed their health plans to the public and introduced a volume of new terms, requirements and complexities, many of which may sound confusing to the general public. From terms like “minimum essential coverage” to the various metallic plan categories of Bronze, Silver, Gold and Platinum, a solid foundation of knowledge is essential in order to find the coverage required at an affordable price.


Vendors to Assist with Consumer Driven Administrative Services

Business owners today can increase their control over employee benefit programs and increasing insurance costs by introducing consumer driven administrative services, such as Health Savings Accounts (HSAs), Flexible Savings Accounts (FSAs), Health Reimbursement Accounts (FSAs) and/or Premium Only Plans (POP). Additionally, the same vendors offering these services can often assist you in preventing costly penalties and taxes by working with you to provide COBRA Administration, 5500 Preparation, help with 1094 and 1095 filings, nondiscrimination testing and ERISA Compliance.