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COVID National Emergency Ends Early; Plan Sponsor Action Required

Cory Jorbin, Esq.

Despite originally announcing that both the COVID Public Health Emergency and National Emergency would end on May 11, President Biden has signed a resolution ending the National Emergency effective as of April 10, 2023.

Plan sponsors will now have less time to react to the end of the National Emergency, but this does not mean that all COVID coverage mandates or extensions have ended.

What Is Ending?
The end of the National Emergency brings the end of the “Outbreak Period” which gives additional time for individuals to:

  • elect and pay for COBRA,
  • exercise HIPAA Special Enrollment Rights to change plan elections mid-year, and
  • file claims and request appeals of adverse claim decisions under ERISA.

In today's blog post we'll address what's ending, what's not ending, and what plan sponsors need to now do.

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Topics: Medicare

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Employer Guide; Medicare Coordination of Benefits

David Rook

When a plan participant or beneficiary has Medicare and other health insurance, such as employer group health plan insurance, retiree coverage, or Medicaid, there can often be confusion as to which insurance pays first on claims.

Coordination of benefits (COB) rules, which are specified in plan documents or insurance policies, decide which insurance pays first. One plan is considered the primary payer that covers most expenses, while the secondary plan covers any remaining allowable expenses not covered by the primary plan.

The COB allows health plans to provide health or prescription drug coverage to individuals receiving Medicare to determine their payment responsibilities. This helps ensure that the total amount paid by all insurance plans does not exceed the total costs of the health care expenses for Medicare-covered services and items.

Today's blog post provides a general overview of COB rules under Medicare.

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Topics: Medicare

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What Baby Boomers Retiring Means for Your Employee Benefits

David Rook

Human resources personnel are used to helping older employees transition into retirement. But now that baby boomers are retiring en masse, it seems to be happening all the time. In fact, as many as 10,000 baby boomers are putting in their retirement papers every single day, and while not all 10,000 will be in your company, you’ll probably be dealing with quite a few.

As all these boomers retire, your employee benefits package may need to undergo some changes and you may experience a shift in the cost of providing medical benefits as well. Here are some of the things you need to keep in mind as the baby boomers on your staff begin to retire.

Employee Benefits and Medicare

As your baby boomer employees near retirement age, some of their spouses might be a step ahead of them. The way employee benefits work with Medicare is sometimes complicated — especially when it comes to HSAs, which may be a major theme of the bulk of questions posed by those looking to retire. If your employees need to learn more about how to navigate Medicare, and if they should drop their spouse from your employer-sponsored coverage, make sure you’re as informed as possible regarding the regulations at hand before advising them.  

A frequently asked question by those turning 65 concerns penalties. People who are still working and enrolled in an employer-sponsored health plan aren’t likely to incur penalties for enrolling in Medicare late. However, it’s common for people turning 65 to enroll in Medicare Part A even if they’re still enrolled in their employer-sponsored program because it’s free (provided that the person has worked and paid into Medicare for at least ten years).

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Topics: Employee Benefits, Multi-Generational, HSA regulations, Retirement Planning, Medicare

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How Employee Benefits Work When An Employee Qualifies For Medicare

Jeff Griffin

Around 10,000 baby boomers turn 65 every single day, which means 10,000 more people become eligible for Medicare. If your human resources department hasn’t yet been inundated with questions from your older employees about Medicare eligibility, they will at some point — and soon.

After all, many boomers are choosing to work a bit longer than the standard retirement age of 65 for a variety of reasons — some are still physically able to work, so they’re taking advantage of it, others are trying to save more for retirement (because so many people haven’t saved nearly enough, if anything), and others just aren’t ready to give up their day jobs yet.

It’s possible that some of your employees have deferred Medicare eligibility because they haven’t actually retired yet, but some people who are still employed find it’s cheaper to take the leap into Medicare (and all its parts) than to stay on their employer-sponsored health plan (though many choose to enroll in both). That said, it’s not quite that cut and dry when it comes to those enrolled in health savings accounts (HSAs) through high deductible health plans (HDHPs).

Here are the things that need to be considered when an employee or covered spouse turns 65:

Medicare Part A

With the exception of those employees actively contributing to an HSA, there’s really no reason for them not to enroll in Part A, which covers hospitalization, home health care, care at nursing homes, and hospice care. As long as employees have worked and paid Medicare taxes during a minimum 10-year period of time (the period of time deemed long enough by the government), Medicare Part A comes premium-free (however, it does come with coinsurance). The situation gets a bit more complicated when employees who are ready to enroll in Medicare are also contributing to an HSA.

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Topics: Employee Benefits, HSAs, HSA regulations, Retirement Planning, Medicare

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