NONPROFITS & Medicare Coverage

May 2, 2019

  1. asher
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    asher Super Genius

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    Hello All,

    I have a referral in NY who works for a nonprofit. She is told their group health plan thru
    BCBS will terminate when she becomes 65 because she is medicare eligible.
    So my prospect asked "will you pay for my medicare supplement?"
    She was told they can't do that-it's illegal?
    My prospects husband works for another nonprofit and that nonprofit pays for his AARP
    supplement.
    Any thoughts or input much appreciated.
     
    asher, May 2, 2019
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  2. somarco
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    somarco GA Medicare Expert

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    Your prospect should quit her job and go to work for her husband's company.

    If you continue to work past age 65, your employer can reimburse for Part B and D premiums. If a Section 105 plan is in place they can pay for your supplement plan as well.
     
    somarco, May 2, 2019
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  3. asher
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    asher Super Genius

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    thank you
     
    asher, May 2, 2019
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  4. Lindsay Engle
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    Lindsay Engle New Member

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    According to the Centers for Medicare and Medicaid Services, it’s illegal for employers to contribute to Medicare premiums. The exception is employers who set up a 105 Reimbursement Plan for all employees. This plan deducts money from the employees’ salaries to purchase individual insurance policies. Beneficiaries who participate can be reimbursed for Medicare premiums.
     
  5. vic120
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    vic120 Guru

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    There are many group Medicare plans in NY, Ive taken a bunch of some bad ones
     
    vic120, May 3, 2019
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  6. somarco
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    somarco GA Medicare Expert

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    The notice allows employers to pay Medicare Part B or D premiums for retired employees in retiree-only plans, as retiree-only plans are not subject to the ACA market reforms. Employers can only pay Medicare premiums for active employees “if the employer payment plan is integrated with a group health plan,” Jost pointed out. For instance, the associated group plan must offer “minimum value” by covering (without cost-sharing) at least 60 percent of the actuarial value of services provided by physicians and hospitals. The premium payment plan must be limited to Medicare Part B or D premiums and excepted benefits, including Medigap premiums.

    “Employers offering such an arrangement remain subject to other legal requirements, such as the Medicare as secondary payment requirements,” Jost noted.
    Premium Payment Plans Nixed for Small Employers, IRS Says
     
    somarco, May 3, 2019
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  7. yorkriver1
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    yorkriver1 Guru

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    Working on one of these now referred to me this week, T65, Medicare 8/1/2019. My upline's compliance dept gave the same info as you have here. As a group under 20 with only 1 age 65 employee, a further reading into the compliance notes says no formal plan needs to be in place for 2 or fewer age 65, and ok for employer to pay costs.
    My question is, how does the employer pay Part B, D and Medicare supplement? Direct to each source? Reimburse the employee?
     
  8. Travis Price
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    Travis Price Guru

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    The government agency that I work for pays for the Med Supp if you opt to go to Medicare at 65. This is given as a payment to the employee.

    I would argue that the "easiest" way would be for the employer to reimburse.
     
  9. somarco
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    somarco GA Medicare Expert

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    Phyllis, I would defer to the employer's accountant on that. No reason to get tangled up in offering accounting/tax advice and have it run afoul.
     
    somarco, Jul 11, 2019
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  10. yorkriver1
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    yorkriver1 Guru

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    Yes, great advice from you as usual. Actually, our compliance research document provides notice to the employers to contact legal/tax advice. I am an inquiring mind that wants to know, however.
     
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