1. Medicare & HR for The Aging Workforce
Stephen Porto
Cool insuring agency

2. Important to Know Medicare Review Aging Workforce Statistics
Federal Guidelines for Working Individuals Eligible for Medicare
Compliance Considerations for HR Professionals
What Employees 65 and Over Should Do
Why Moving to Medicare While Employed May Make Sense
Guiding Medicare Eligible Employees: Questions to Confirm

3. Medicare Review What is Medicare and who administers Medicare?
Who is eligible for Medicare?
Enrollment periods

4. Medicare Coverage Options Outside of Employer Group Coverage

5. Medicare Monthly
Payments
For 2019

6. Part B Late Enrollment Penalty
In most cases, if you don’t sign up for part B when you’re first eligible, you’ll have to pay a late enrollment penalty. You’ll have to pay this penalty for as long as you have Part B. Your monthly premium for Part B may go up 10% of the standard premium for each full 12-month period that you could have had Part B, but didn’t sign up for it. Also, you may have to wait until the General Enrollment Period (from January 1 to March 31) to enroll in Part B. Coverage will start July 1 of that year.
Usually, you don’t pay a late enrollment penalty if you meet certain conditions that allow you to sign up for Part B during a Special Enrollment Period.
IF you have limited income and resources, your state may help you pay for Part A, and/or Part B. You may also qualify for Extra Help to pay for your Medicare prescription drug coverage.

7. Part D Late Enrollment Penalty
The late enrollment penalty is an amount added to your Medicare Part D monthly premium.
You may owe a late enrollment penalty if, for any continuous period of 63 days or more after your
Initial Enrollment Period is over, you go without one of these:
• A Medicare Prescription Drug Plan (Part
• A Medicare Advantage Plan (Part C) (like an HMO or PPO)
• Another Medicare health plan that offers Medicare prescription drug
coverage
• Creditable prescription drug coverage
Note: If you get Extra Help, you don't pay the late enrollment penalty.

8. Aging Workforce Statistics

11. Federal Guidelines for Working Individuals Eligible for Medicare

12. Premium Reimbursement Arrangements
Primary Payer
Medicare is primary payer for employer groups less than 20 employees and secondary for employer groups 20 employees or more.
Premium Reimbursement Arrangements
Medicare Premium Reimbursement Arrangements ARE ALLOWED for Employers with less than 20 employees:
If an employer offers group health insurance and Medicare-eligible employees are given the option to sign up for that group health coverage, the employees can choose to waive the group health coverage and the employer can reimburse the employees for Medicare Part B, Medicare Part D, and Medicare Supplement Insurance premiums. This must be done non-discriminatorily.
Note that to the extent such an arrangement is available to active employees, it may be subject to restrictions under other laws such as the Medicare Secondary Payer (MSP) provisions.
Medicare Premium Reimbursement Arrangements ARE NOT ALLOWED for Groups with 20+ Employees.

13. Compliance Considerations
For HR Professionals
Educate
Do not incentivize when a group of 20 or more employees
Do not discriminate
Payroll and HSA limitations

14. What Employees Eligible For
Medicare Should Do
Most should enroll into Part A
Consider Part B, avoid LEP
Confirm credible Part D coverage, avoid LEP
Consider benefits of moving to Medicare

15. Why Moving to Medicare While Employed May Make Sense

18. CASE STUDY
When Moving to
Medicare Makes Sense

19. Guiding Medicare Eligible Employees: Questions to Confirm
Employer with <20 Employees
Has the employee enrolled into Part A?
Has the employee enrolled into Part B?
Will the employee have credible Part D
coverage?
Is a Medicare Supplement, Advantage, Part
D plan beneficial? (Consider covered
dependents and prescription needs.)
Will we offer a Medicare premium
reimbursement arrangement?
Employer with 20+ Employees
Should the employee enroll into Part A?
Should the employee enroll into Part B?
Will the employee avoid potential penalties?
Is a Medicare Supplement, Advantage, Part
D plan beneficial? (Consider premium cost
comparison, benefit comparison, covered
dependents, prescription needs, income level
of employee.)

20. Your Speaker
Stephen is an Account Executive in Cool Insuring Agency’s Employee Benefits Division specializing in group health, dental, life and disability insurance.  He joined Cool Insuring in Prior to Cool Insuring Stephen was employed by The Ayco Company where he worked within the Wealth Strategy/Wealth Transfer group.  Stephen specializes group benefits and ACA consulting as well as new business development.
Stephen can be reached at or X 184
Stephen J. Porto