Employer Group Plan

Employer Group Plan

 

As group health insurance premiums continue to increase, employers are looking for creative ways to help their employees access care while keeping their own costs under control. As a result, we’ve received a number of questions about whether employers can pay for Medicare premiums for their active and/or retired employees. In many cases, the answer is "Yes." An increasing number of employers have employees working past age 65. We are here to help you navigate the Medicare maze and avoid potential obstacles and pitfalls that face the aging working class.

For groups under 20, Medicare secondary payor rules don’t apply. When a company has fewer than 20 employees, Medicare is primary and the group plan is secondary, and because insurance companies can pay as if an employee has Medicare Part B, whether he or she actually does or not, it’s often to an employee’s advantage to drop off the group plan and sign up for Medicare and a supplement instead. And now, thanks to the recent guidance, in many cases, the employer can even help these employees with the cost.

The June 2019 HRA Rule allows employers to meet the Patient Protection and Affordable Care Act (PPACA) requirements by offering an Individual Coverage HRA that requires employees and any covered dependents to be enrolled in individual health insurance coverage; or Medicare Parts A and B, or Part C; in order to receive reimbursements for medical care expenses from the Individual Coverage HRA. Reimbursements by the Individual Coverage HRA may include premiums and cost sharing for individual health insurance coverage, and for Medicare.

• Employers may begin offering Individual Coverage HRAs as of January 1, 2020.

For more information, call us at 601-962-4428 or fill out this form



 

*Resources referenced are from Medicare.gov, Resource: Health Reimbursement Arrangements and Other Account-Based Group Health Plans – Final Rule, CMS.Gov. We are not affiliated with any government agency. Last accessed Mar 2022