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Showing posts with label insurance. Show all posts
Showing posts with label insurance. Show all posts
U.S. to Retirees on health insurance
Chicago has proposed a plan to migrate most of its 30,000 under-65 retirees to the state exchanges by 2017. The ACA's exchanges offer employers a way to cap or reduce their exposure to rising retiree health costs, most often without actually reducing the benefits provided.
"Companies are looking to save money, but not materially change the benefits retirees receive," says John Grosso, who leads a task force on retiree health care at Aon Hewitt. Only 7 percent of private sector employers offered health benefits to early retirees in 2010, and 6 percent offered it to Medicare-eligible retirees, according to the federal Agency for Healthcare Research and Quality (AHRQ). It's much more common among large companies: at businesses with 1,000 or more workers, 32 percent offered health coverage to Medicare-eligible retirees in 2011, and 38 percent offered it to early retirees.
The percentage of state government units offering retiree health insurance to Medicare-eligible workers was 63 percent in 2010, down from 89 percent in 2003, according to AHRQ.
Most retirees over 65 are enrolled in Medicare Part A (hospitalization) and Part B (outpatient services). Some employers are replacing in-house retiree drug coverage with group Part D plans. Meanwhile, for pre-Medicare retirees, the ACA's exchanges offer tax credits to offset premiums costs for families with incomes between 100 percent and 400 percent of the federally defined poverty guideline. "Employers aren't comfortable just putting retirees out there figure out how to evaluate 30 different plans in their zip code," Grosso says.
For Medicare-eligible retirees who lose employer coverage, the first decision is whether to stick with traditional fee-for-service Medicare or enroll in an all-in-one Medicare Advantage plan, says Paula Muschler, manager of the Allsup Medicare Advisor, a Medicare plan selection service.
Most Medicare Advantage plans are managed care health maintenance organizations (HMOS) or preferred provider organizations (PPOs). Muschler notes that a loss of employer-provided supplemental coverage triggers a 63-day open enrollment for Medigap, no matter your age, from the time you lost employer-provided coverage.
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Healthcare Reform to End
Oberai, 62, works with at-risk pregnant women for a nonprofit agency in Port Charlotte, Florida. The health insurance choices for workers like Oberai will change dramatically next year with final implementation of national healthcare reform. The Affordable Care Act (ACA) prohibits insurers from turning away applicants for pre-existing conditions, and that's expected to turn the key for workers facing "job lock" - people who need to leave their jobs but can't afford to lose healthcare coverage.
Nearly half (47 percent) of workers retire earlier than planned, and 55 percent cite a health or disability issue as the cause, according to the Employee Benefit Research Institute.
"I've talked with a lot of people who need to leave their jobs because of health problems - but they need the health insurance," says Kathleen Stoll, director of health policy for Families USA, a nonprofit health care advocacy group. A recent study by the Urban Institute's Health Policy Center and Georgetown University's Health Policy Institute forecast that health reform will boost the number of self-employed people by 1.5 million. Older workers who want to jump ship also will benefit from provisions of the ACA designed to control the cost of insurance purchased in new state health insurance exchanges - markets where Americans will be able to shop for a healthcare plan, comparing benefits and prices. Insurers are permitted to set premium rates three times higher for applicants over the age of 50. Tax credits are available to families with incomes between 100 percent and 400 percent of the federally-defined poverty guideline. The law also offers reduced copayments and deductibles for families up to 250 percent of the poverty level. How does that compare with existing group coverage offered by employers? Last year, the average worker contribution for an individual policy was $951, according to the Kaiser Family Foundation. For workers buying family coverage, the average contribution was $4,316.
In the exchanges, Kaiser estimates that a household with two 55-year-old adults and 2014 income of $50,000 would pay $4,750 for a "silver" plan, which covers 70 percent of healthcare costs. Are the workers mostly older?
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