March 27, 2019

Medicare and the Alliance Domestic Health Plan

By Teresa Hunter, Alliance Benefits

Navigating decisions regarding Medicare as you approach age 65 can be overwhelming, especially with all the information flooding into your mailbox from companies who want to sell you their Medicare products. As a C&MA employee and a participant on the Alliance Health Plan, the first question you need answered is, “Am I required to enroll in Medicare if I am not retiring at age 65, since I already have coverage under my employer?” Employer size determines which coverage is “primary payer” of medical claims. Therefore, the size of your employer determines whether the Alliance plan will require you to enroll in Medicare at age 65. The Alliance Health Plan is a multi-employer church health plan. Each individual church/location on the health plan with its own EIN/Tax ID number is considered an “Employer.”

  • If your C&MA employer has fewer than 20 employees (a “Small Employer” by Medicare guidelines) and you plan to remain enrolled in the Alliance Health Plan once you turn 65, the Alliance plan will require you to enroll in Medicare Part A (Hospital), B (Medical), and D (Prescription) on your eligibility date. Medicare coverage will become the primary payer of your medical claims ahead of the Alliance plan. Because the Alliance plan requires you to enroll in Medicare, your employer will receive discounts to the monthly premiums charged by Alliance Benefits.
  • If your C&MA employer has 20 or more employees (a “Large Employer” by Medicare guidelines) the Alliance plan does not require you to enroll in any part of Medicare because the Alliance Health Plan remains primary payer of your medical claims, even if you opt to enroll in Medicare while on your employer plan. It is very important to know that the medical portion of the Alliance Health Plan is considered “creditable” employer coverage, but our prescription plan is considered by Medicare as “non-creditable” coverage. You can still choose to postpone enrollment in Medicare. But because our prescription plan is non-creditable, Medicare Part D will charge you a penalty (a higher monthly premium) for prescription coverage in the future if you do not enroll when first eligible. HSA contributions must stop once an employee is enrolled in any part of Medicare. Participants turning 65 who work for a Large Employer have the choice whether to enroll in Medicare Part D now and end eligibility for HSA contributions or postpone enrollment in Medicare Part D and pay a higher premium in the future in order to continue benefiting from Employer contributions to their HSA.

Spouses on the Alliance Health Plan turning 65 are subject to the same rules for Medicare enrollment. Discounts are not available to spouses on the plan. The HSA offered with the Alliance Health Plan is solely owned by the employee. Spouse Medicare status has no effect on the employee’s HSA eligibility to make and receive contributions. As long as you remain an eligible employee of the C&MA, you can continue coverage on the Alliance Health Plan at age 65 regardless of whether or not you are enrolled in Medicare. Also, an employee of the C&MA must remain enrolled in the plan to continue covering a spouse and/or child(ren).

Rest assured, you are not alone, and Alliance Benefits is here to serve you. While we are not licensed brokers of Medicare and cannot provide legal advice, we are happy to talk through the information to help you understand what this means for you. We have put together a few documents you can find on our website.

Another good place to start understanding your Medicare options is, the official site for Medicare. Their website is full of helpful information, forms, and resources. The 2019 “Medicare and You” handbook is available under the Resources section on their website. Pages 3 – 8 of “Medicare and You” contain easy-to-read descriptions of Medicare options, the parts of Medicare, and guidance how to use the handbook to get started with Medicare. Throughout its pages, the handbook explains what Medicare covers, knowing your rights, and so much more.

For assistance from Alliance Benefits regarding Medicare and the Alliance Health Plan, please call Teresa Hunter at (800) 700-2651, press 1 and then 3, or my email is Thank you for allowing us to serve you.  We are Better Together!


Teresa joined Alliance Benefits in June 2008. She came to The Christian and Missionary Alliance with 10 years of experience in secretarial and administrative positions.

Teresa handles data entry for health coverage enrollments, terminations, and changes for participants on the domestic and international health plans. She also processes monthly billing of health insurance premiums, Fellowship Fund payroll, and handles Medicare correspondence for participants on the health plan.

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