Employer Guideline Change for Medicare Beneficiaries

[toddoxley]

If an employer requires all employees that are eligible for medicare to disenroll from the group plan and go onto a medicare supplement or MAPD plan is this a discriminatory lawsuit waiting to happen?

The employer will continue to provide the same dollar amount to the employee for the medicare plan that they were paying for the group Plan.

 

[DS4]

Responsibilities of Employers Under MSP


As an employer, you must:

• Assure that your plans identify those individuals to whom the MSP requirement applies;
• Assure that your plans provide for proper primary payments where by law Medicare is the secondary payer;
• Assure that your plans do not discriminate against employees and employees' spouses age 65 or over, people who suffer from permanent kidney failure, and disabled Medicare beneficiaries for whom Medicare is secondary payer; and,
• Accurately complete and submit Data Match reports timely on identified employees.

 

[toddoxley]

Is it discriminatory to require all employees that are eligible for medicare to enroll in a individual Medicare Supplement and PDP plan paid for by the employer?

 

[LOM58]

Yes, it is. And, the employer may not provide an inducement to the employee (i.e. premium assistance) to drop group coverage and enroll in a MedSupp.

 

[DS4]

Is it discriminatory to require all employees that are eligible for medicare to enroll in a individual Medicare Supplement and PDP plan paid for by the employer?

Yes, see below,
IRS-SSA-CMS Data Match | Centers for Medicare & Medicaid Services

 

[Mick_Keyou]

Yes, it is. And, the employer may not provide an inducement to the employee (i.e. premium assistance) to drop group coverage and enroll in a MedSupp.

LOM58, are you 100% sure on that? I thought I heard that the employer could if the employee agreed on the arrangement.

 

[LOM58]

Yes, I am sure. An employee may voluntarily drop group coverage making Medicare primary, but an employer may not offer to pay for a Medicare Supplement (or just pay the employee to drop coverage making Medicare primary) to induce the employee to drop group coverage. If there is an employee contribution to the group plan, sometimes it is cheaper for the Medicare eligible employee to drop group coverage and buy a supplement, but again, at their expense.

 

[DS4]

An employee may voluntarily drop group coverage making Medicare primary, but an employer may not offer to pay for a Medicare Supplement (or just pay the employee to drop coverage making Medicare primary) to induce the employee to drop group coverage.

100% true..............