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April 30, 2020

Medicare and the Alliance Health Plan

By Teresa Hunter, Alliance Benefits

Approaching age 65, with many companies sending out mass amounts of Medicare documents and sales brochures, you may find yourself frozen between the stacks of information not knowing how to even begin on the Medicare path. We have great news for you! As a participant of the Alliance Health Plan, you do not have to walk this road alone. Not only is Alliance Benefits still here to help you, but we are also excited to announce our new partnership with Medicare Transition Services, licensed advisors available to you at no cost who will provide guidance, education, and assistance.

Am I Required to Enroll in Medicare?

The first step is answering this question, “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 medical plan will be your “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 an EIN/Tax ID number is considered an “Employer.”

Small Employer Guidelines

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.

Large Employer Guidelines

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 the primary payer of your medical claims. This is true 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. Health Savings Account (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 of (1) to enroll in Medicare Part D now and end eligibility for HSA contributions or (2) to postpone enrollment in Medicare Part D and pay a higher premium in the future to continue benefiting from Employer contributions to their HSA.

What Happens to Coverage for My Spouse and/or Children?

An employee of the C&MA must remain enrolled in the plan to continue covering a spouse and/or child(ren). 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 does not affect 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. 

Alliance Benefits Resources

Alliance Benefits has put together two documents you can also find on our website:

   Frequently Asked Questions (FAQ) – Small Employer

   HSA Changes Once on Medicare

Now available on our website is a Medicare Resources page which you can find by visiting alliancebenefits.org/resources/medicare. Included on this page are the Medicare Transition Services contact information, their “Medicare Guidebook,” and a link to their website which contains short videos and other educational resources.

Additional Medicare Resources

The official site for Medicare is medicare.gov. Their website is full of helpful information including forms and resources. The “Medicare and You” handbook is available under the Resources section on their website. Pages 4–9 of “Medicare and You” contain easy-to-read descriptions of Medicare options, the parts of Medicare, and guidance on 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 additional 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 email huntert@cmalliance.org. Thank you for allowing us to serve you. We are Better Together!

 

Teresa joined Alliance Benefits in June 2008 and came to The Christian and Missionary Alliance with 10 years of experience in various administrative positions. Teresa manages the data entry for health coverage enrollments, terminations, and changes for participants on domestic and international health plans. She also processes the monthly billing of health insurance premiums, monthly HSA uploads, Fellowship Fund payroll, and handles Medicare details for participants on the health plan.


Posted in: Health Plan Tools