- 168
I have a potential client turning 65 in June. He's working indefinitely and currently his small employer (less than 20 employees) pays for his and his wife's group health coverage. The employer's cost for both is ~$1,400/mo. in premium. Their current plan has a $200 individual deductible, and it sounds like that's the max OOP too. However, it has no Rx coverage. Employer said he'll continue to cover him and his wife after he turns 65 too.
Since the company has <20 employees, he has to sign up for Medicare Part A and Part B which will cost $104.90/mo. Also, since the group plan has no credible drug coverage, he'll be on the hook for the Part D LEP if he stays only with the group plan.
So my thoughts are: he can get Part B + medsupp + PDP for ~$250/mo. If the employer is willing to continue to pay for his health ins, why not drop both of them off the group, pay for his Medicare coverage, and pay for her ACA plan? I'm sure she can get something just as good as the current group coverage for less than $1,150/mo., which will save the employer money.
My questions are:
1) Can the employer pay her ACA premium, or possibly her OOP expenses like deductibles and co-insurance too?
2) Can the employer also pay for his Part B premium and/or medsupp & PDP?
3) If yes, does anything special need to be done for the employer to set it up? Would these healthcare costs be paid outright by the employer, or more of a reimbursement? I'm not sure if this would be considered taxable income for the employee, or a tax-deductible expense for the employer (or even if the current group plan is now).
4) Can the employer drop them from the group so that she is involuntarily losing coverage, eligible for an SEP, and even a subsidy (they would qualify)?
5) If he decides to stay on the group plan, can he sign up for a standalone PDP to avoid the LEP?
Since the company has <20 employees, he has to sign up for Medicare Part A and Part B which will cost $104.90/mo. Also, since the group plan has no credible drug coverage, he'll be on the hook for the Part D LEP if he stays only with the group plan.
So my thoughts are: he can get Part B + medsupp + PDP for ~$250/mo. If the employer is willing to continue to pay for his health ins, why not drop both of them off the group, pay for his Medicare coverage, and pay for her ACA plan? I'm sure she can get something just as good as the current group coverage for less than $1,150/mo., which will save the employer money.
My questions are:
1) Can the employer pay her ACA premium, or possibly her OOP expenses like deductibles and co-insurance too?
2) Can the employer also pay for his Part B premium and/or medsupp & PDP?
3) If yes, does anything special need to be done for the employer to set it up? Would these healthcare costs be paid outright by the employer, or more of a reimbursement? I'm not sure if this would be considered taxable income for the employee, or a tax-deductible expense for the employer (or even if the current group plan is now).
4) Can the employer drop them from the group so that she is involuntarily losing coverage, eligible for an SEP, and even a subsidy (they would qualify)?
5) If he decides to stay on the group plan, can he sign up for a standalone PDP to avoid the LEP?