retiree health ins - how to propose to Employer?

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JohnFiscal
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retiree health ins - how to propose to Employer?

Post by JohnFiscal » Tue Jan 09, 2018 3:02 pm

hi all, I am approaching retirement (66) this year. My wife is 10 years younger than me so health care insurance for her is a big concern. Especially now with the disruption in the Affordable Care Act. I barely know how to proceed. From what I see it doesn't even seem to be possible or practical to go to some insurance agent and buy over-the-counter health insurance (at least, here in Florida), it has to be through the exchanges.

I work for a small professional company (family-owned) with maybe 40 employees in two offices (two states). Our health insurance policy seems to be based on a contract with the home state (Texas).

I'm wondering if I could ask my employer to carry my wife and I after I retire, with me paying our premium. I guess as a "retiree" plan. Of course, this would entail paying additional for myself for this insurance on top of Medicare, but perhaps it would be worthwhile. I'm not certain if this is even permitted under health insurance plans in general or ours in particular.

No one has ever retired from the company before so this is entirely new ground.

Any help on this (and how to propose to the company) will be appreciated.

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dm200
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Re: retiree health ins - how to propose to Employer?

Post by dm200 » Tue Jan 09, 2018 3:16 pm

JohnFiscal wrote:
Tue Jan 09, 2018 3:02 pm
hi all, I am approaching retirement (66) this year. My wife is 10 years younger than me so health care insurance for her is a big concern. Especially now with the disruption in the Affordable Care Act. I barely know how to proceed. From what I see it doesn't even seem to be possible or practical to go to some insurance agent and buy over-the-counter health insurance (at least, here in Florida), it has to be through the exchanges.
I work for a small professional company (family-owned) with maybe 40 employees in two offices (two states). Our health insurance policy seems to be based on a contract with the home state (Texas).
I'm wondering if I could ask my employer to carry my wife and I after I retire, with me paying our premium. I guess as a "retiree" plan. Of course, this would entail paying additional for myself for this insurance on top of Medicare, but perhaps it would be worthwhile. I'm not certain if this is even permitted under health insurance plans in general or ours in particular.
No one has ever retired from the company before so this is entirely new ground.
Any help on this (and how to propose to the company) will be appreciated.
As is commonly cited, "Everything is negotiable". BUT -

1. I doubt this could work for such a long period (ten years). Maybe - BUT I suspect the company would have to have a legally proper plan and (maybe or probably) offer it in a non-discriminatory way.

2. I doubt you "need" coverage after you retire because you qualify for Medicare. Fully and objectively evaluate Medicare Advantage (MA) plans in your area. I think there are many MA plans in many areas of Florida. I really doubt paying for full coverage while on Medicare is financially justified.

3. Does the company have a "retirement plan" or are those who retire treated the same as those who just quit?

4. For a shorter period, your wife probably can qualify for COBRA - although perhaps not.

5. For your wife, what is wrong with purchasing a policy on an exchange?

6. How long do you plan on working there? [and I assume have coverage for your wife]

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Steelersfan
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Re: retiree health ins - how to propose to Employer?

Post by Steelersfan » Tue Jan 09, 2018 3:20 pm

JohnFiscal wrote:
Tue Jan 09, 2018 3:02 pm
hi all, I am approaching retirement (66) this year. My wife is 10 years younger than me so health care insurance for her is a big concern. Especially now with the disruption in the Affordable Care Act. I barely know how to proceed. From what I see it doesn't even seem to be possible or practical to go to some insurance agent and buy over-the-counter health insurance (at least, here in Florida), it has to be through the exchanges.

I work for a small professional company (family-owned) with maybe 40 employees in two offices (two states). Our health insurance policy seems to be based on a contract with the home state (Texas).

I'm wondering if I could ask my employer to carry my wife and I after I retire, with me paying our premium. I guess as a "retiree" plan. Of course, this would entail paying additional for myself for this insurance on top of Medicare, but perhaps it would be worthwhile. I'm not certain if this is even permitted under health insurance plans in general or ours in particular.

No one has ever retired from the company before so this is entirely new ground.

Any help on this (and how to propose to the company) will be appreciated.
I'm pretty sure if they created a plan for you they'd have to offer it to any other employees who retire as long as the plan exists for you. But then if they canceled the plan when you retired and others had joined in, they'd surely be very upset and maybe have legal recourse.

Andyrunner
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Re: retiree health ins - how to propose to Employer?

Post by Andyrunner » Tue Jan 09, 2018 3:41 pm

I'm going with very unlikely. I work in benefits and deal with our retirees at times.

First off unless they have a definition for a retiree, your really just quitting and living off your savings. To be a retiree of the company they need to have a definition of what a retiree is (for example age 65+ with 10yrs of service). Now as for keeping track of retirees and collecting premiums etc, it is a lot of work. With a company size of 40 people, I bet they only have one or two HR people. In the end Id ask, what is the worst that can happen? They fire you? Then you get COBRA and unemployment before you retire?

If I were you Id look at the exchange, with the reduced income Id think you might qualify for a subsidy. I would also talk to a local broker, you might be surprised on what you can get.

JohnFiscal
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Re: retiree health ins - how to propose to Employer?

Post by JohnFiscal » Tue Jan 09, 2018 3:43 pm

Thanks for the comments guys.

I plan to retire at FRA (so, this year). So I won't be working here much longer.

There is no "retirement plan" other than 401K. And COBRA. (and there is no full time HR person. "hey, do we even have one here now that X quit?")

I am the oldest employee. The owner is a few years younger. He appears to want to keep the company going under his direction (though not day to day management), don't know if he will continue as an "employee". There are a very few other folks who are in the range of 10-15 years younger than me (50-55), the remaining employees are mostly in 20's and 30's, and a couple in their 40's. So it will be 10 years at least before anyone else will be retiring (if they do). Then probably 10 more years after that.

I agree that I don't need separate coverage (other than Medicare) but to get the continuing "retiree" coverage for my wife I assume that I would have to be on there to be the "retiree" (I'm thinking this would not be "retiree" coverage but that I would continue under the company's normal plan). My objective in this is that "perhaps" the whole cost for this would still be less than buying for my wife on the health care exchange.

JohnFiscal
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Re: retiree health ins - how to propose to Employer?

Post by JohnFiscal » Tue Jan 09, 2018 3:48 pm

Andyrunner wrote:
Tue Jan 09, 2018 3:41 pm
I'm going with very unlikely. I work in benefits and deal with our retirees at times.

First off unless they have a definition for a retiree, your really just quitting and living off your savings. To be a retiree of the company they need to have a definition of what a retiree is (for example age 65+ with 10yrs of service). Now as for keeping track of retirees and collecting premiums etc, it is a lot of work. With a company size of 40 people, I bet they only have one or two HR people. In the end Id ask, what is the worst that can happen? They fire you? Then you get COBRA and unemployment before you retire?

If I were you Id look at the exchange, with the reduced income Id think you might qualify for a subsidy. I would also talk to a local broker, you might be surprised on what you can get.

Thank you Andy. I am thinking you are correct ("unlikely") but I figure it's worth asking about (here and at work).

I have been here quite a long time (since around 1997). You bring up a good point, I should ask about "what are my retiree benefits?"

To be clear, what I am looking for is not a "special" package for insurance. I am thinking (wonder if) that I can just continue on the company's group policy while paying the premium myself (a' la COBRA)

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dm200
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Re: retiree health ins - how to propose to Employer?

Post by dm200 » Tue Jan 09, 2018 4:04 pm

My objective in this is that "perhaps" the whole cost for this would still be less than buying for my wife on the health care exchange.
Perhaps not. As long as the ACA caps the age based individual premiums at 3X younger folks, then the ACA individual plans may be just as good. The company probably would have to spend money coming up with such a retiree "plan". In addition, there is the probability that insuraing your wife might bump up the costs (since she is older) on average.

I would be concerned about pre-existing condiitons exclusions. Even before the ACA prohibited such exclusions, continuous coverage from one plan to another generally prohibited them - although at sometimes increased costs. So, it seems that even if many aspects of the ACA change, many of the pre-existing condition exclusion prohibitions will remain.

My suggestion if you you and your wife to fully evaluate any and all individual plans available - including costs, quality of healcare, continuity (probability of staing on the same type plan), transition to Medicare, etc. If available in your area, look at Medicare Advantage plans and whether the HMO type has a similar ACA plan. For example, my wife enrolled in the Kaiser HMO before she was eligible for medicare. Then, two years ago, when she qualified for medicare - she chose the Kaiser plan. It was a seamless transition - same ID, same doctor(s), same facilities, same records. All that changed was a MUC, MUCH lower monthly cost and most copays dropped as well.

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Re: retiree health ins - how to propose to Employer?

Post by adamthesmythe » Tue Jan 09, 2018 6:19 pm

I have heard of employers that would allow coverage of a spouse after retirement under COBRA for more than the required 18 months.

Doing this doesn't cost the employer much (you pay the full cost plus 2%, their only cost is any possible increase in insurance cost due to one more old beneficiary).

BUT COBRA is quite expensive AND this is extra trouble and potential extra cost for the employer.

You can propose it, but I'm not sure I see a reason for them to do it, except to be good guys.

mouses
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Re: retiree health ins - how to propose to Employer?

Post by mouses » Tue Jan 09, 2018 6:31 pm

I'm nor sure how much disruption there is with ACA. I have not followed the tax bill closely in that regard, but I think the general concern is that what they did may cause premiums to rise. But that is maybe not this year, which gives you some breathing space.

A couple of people have mentioned Medicare Advantage for you. I still prefer Medicare + Medigap myself.

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dm200
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Re: retiree health ins - how to propose to Employer?

Post by dm200 » Tue Jan 09, 2018 6:52 pm

adamthesmythe wrote:
Tue Jan 09, 2018 6:19 pm
I have heard of employers that would allow coverage of a spouse after retirement under COBRA for more than the required 18 months.
Doing this doesn't cost the employer much (you pay the full cost plus 2%, their only cost is any possible increase in insurance cost due to one more old beneficiary).
BUT COBRA is quite expensive AND this is extra trouble and potential extra cost for the employer.
You can propose it, but I'm not sure I see a reason for them to do it, except to be good guys.
1. No, COBRA is not, in my opinion, "expensive". It is the same (possible 2% added) as the cost for employees. it just "seems" expensive because the COBRA recipient pays the full cost.

2. Yes - there is potential, sometimes likely, extra trouble and expense.

delamer
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Re: retiree health ins - how to propose to Employer?

Post by delamer » Tue Jan 09, 2018 7:58 pm

dm200 wrote:
Tue Jan 09, 2018 6:52 pm
adamthesmythe wrote:
Tue Jan 09, 2018 6:19 pm
I have heard of employers that would allow coverage of a spouse after retirement under COBRA for more than the required 18 months.
Doing this doesn't cost the employer much (you pay the full cost plus 2%, their only cost is any possible increase in insurance cost due to one more old beneficiary).
BUT COBRA is quite expensive AND this is extra trouble and potential extra cost for the employer.
You can propose it, but I'm not sure I see a reason for them to do it, except to be good guys.
1. No, COBRA is not, in my opinion, "expensive". It is the same (possible 2% added) as the cost for employees. it just "seems" expensive because the COBRA recipient pays the full cost.

2. Yes - there is potential, sometimes likely, extra trouble and expense.
The other issue is that with a smallish company of 40 employees, one serious, expensive illness on the part of a covered employee or dependent can cause premiums to jump in the future. So high risk for the employer to cover anyone that it doesn’t need to for business reasons or as required by law.

Check out your state’s ACA exchange but also talk to a couple insurance agents about covering your wife. I assume your wife can’t get coverage through her own employment?

quantAndHold
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Re: retiree health ins - how to propose to Employer?

Post by quantAndHold » Tue Jan 09, 2018 7:58 pm

I’m in a similar position myself. I’m on COBRA right now, which will end in the middle of 2018. I decided to “retire” at age 53 about five minutes after the election, and have been on pins and needles about healthcare ever since.

I checked the price of the ACA plans vs COBRA, and for my megacorp employer’s plan COBRA was cheaper. Your small company employer plan may be more. My plan right now is to go with an ACA plan when COBRA runs out. In 2018, there isn’t enough difference in the price with or without subsidies for me to worry about it. But since the tax plan happened, I suspect that in 2019 or 2020, I’ll be wanting to “manage my income” in order to qualify for a subsidy. You may well be able to do something similar.

J295
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Re: retiree health ins - how to propose to Employer?

Post by J295 » Tue Jan 09, 2018 7:59 pm

Would your wife qualify for premium tax credits under ACA?

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munemaker
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Re: retiree health ins - how to propose to Employer?

Post by munemaker » Tue Jan 09, 2018 8:14 pm

adamthesmythe wrote:
Tue Jan 09, 2018 6:19 pm
I have heard of employers that would allow coverage of a spouse after retirement under COBRA for more than the required 18 months.
It is not a matter of employers allowing a spouse to be on COBRA until Medicare age, even if it is longer than 18 months. If the retiree is on Medicare, I believe the employer is REQUIRED to provide COBRA coverage to the spouse until such spouse reaches Medicare age, even if it goes beyond 18 months. The employer does not have the option to allow or not allow this; it is required. COBRA has to be continuous though, from the time the employee retired. The spouse can't take ObamaCare and then switch to COBRA later; that won't work.

staythecourse
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Re: retiree health ins - how to propose to Employer?

Post by staythecourse » Tue Jan 09, 2018 8:15 pm

If you were the employer would you do this if asked? There is no advantage for them. It is more accounting headaches. It is a dangerous precedent to set for other retirees who have worked and any future ones once they hear about them doing it for your family.

Can your wife get a job just part time to cover the cost of health insurance for herself?

Good luck.
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munemaker
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Re: retiree health ins - how to propose to Employer?

Post by munemaker » Tue Jan 09, 2018 8:20 pm

staythecourse wrote:
Tue Jan 09, 2018 8:15 pm
If you were the employer would you do this if asked? There is no advantage for them.
The employer will do this if asked in order to comply with the law. The advantage to the employer is they will not be sued or fined by the Department of Labor.

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dm200
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Re: retiree health ins - how to propose to Employer?

Post by dm200 » Tue Jan 09, 2018 8:25 pm

munemaker wrote:
Tue Jan 09, 2018 8:20 pm
staythecourse wrote:
Tue Jan 09, 2018 8:15 pm
If you were the employer would you do this if asked? There is no advantage for them.
The employer will do this if asked in order to comply with the law. The advantage to the employer is they will not be sued or fined by the Department of Labor.
However long COBRA would be offered, if the company stops offering employee health insurance or goes out of business - no COBRA.

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Steelersfan
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Re: retiree health ins - how to propose to Employer?

Post by Steelersfan » Tue Jan 09, 2018 8:30 pm

munemaker wrote:
Tue Jan 09, 2018 8:20 pm
staythecourse wrote:
Tue Jan 09, 2018 8:15 pm
If you were the employer would you do this if asked? There is no advantage for them.
The employer will do this if asked in order to comply with the law. The advantage to the employer is they will not be sued or fined by the Department of Labor.
It appears as though the spouse can only extend her benefit for an additional 18 months after the original 18 month period:


Q11: How long does COBRA coverage last?

COBRA requires that continuation coverage extend from the date of the qualifying event for a limited period
of 18 or 36 months. The length of time depends on the type of qualifying event that gave rise to the COBRA
rights. A plan, however, may provide longer periods of coverage beyond the maximum period required by law.
When the qualifying event is the covered employee's termination of employment or reduction in hours of
employment, qualified beneficiaries are entitled to 18 months of continuation coverage.
When the qualifying event is the end of employment or reduction of the employee's hours, and the employee
became entitled to Medicare less than 18 months before the qualifying event, COBRA coverage for the
employee's spouse and dependents can last until 36 months after the date the employee becomes entitled to
Medicare.
For example, if a covered employee becomes entitled to Medicare 8 months before the date his/her
employment ends (termination of employment is the COBRA qualifying event), COBRA coverage for his/her
spouse and children would last 28 months (36 months minus 8 months).


https://www.dol.gov/sites/default/files ... nsumer.pdf

livesoft
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Re: retiree health ins - how to propose to Employer?

Post by livesoft » Tue Jan 09, 2018 8:32 pm

You could propose the following:

Your company gets a contract/proposal for work that only you can provide. You don't retire and keep working on that contract/proposal. The contract/proposal actually comes from a new company that you will form tomorrow. You pay the cost of the contract/proposal from your new company, your current company keeps you on the payroll to fulfill this contract, and you keep health insurance. So money goes from your portfolio and SS to your current company back to you as salary and health insurance. It costs your current company nothing because you are paying for the contract that employs you.
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delamer
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Re: retiree health ins - how to propose to Employer?

Post by delamer » Tue Jan 09, 2018 8:34 pm

munemaker wrote:
Tue Jan 09, 2018 8:14 pm
adamthesmythe wrote:
Tue Jan 09, 2018 6:19 pm
I have heard of employers that would allow coverage of a spouse after retirement under COBRA for more than the required 18 months.
It is not a matter of employers allowing a spouse to be on COBRA until Medicare age, even if it is longer than 18 months. If the retiree is on Medicare, I believe the employer is REQUIRED to provide COBRA coverage to the spouse until such spouse reaches Medicare age, even if it goes beyond 18 months. The employer does not have the option to allow or not allow this; it is required. COBRA has to be continuous though, from the time the employee retired. The spouse can't take ObamaCare and then switch to COBRA later; that won't work.

I can’t find any evidence for such a legal requirement in an online search. I did find this:

https://www.huffingtonpost.com/jim-t-mi ... 76335.html

InMyDreams
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Re: retiree health ins - how to propose to Employer?

Post by InMyDreams » Tue Jan 09, 2018 9:01 pm

JohnFiscal wrote:
Tue Jan 09, 2018 3:02 pm
I work for a small professional company (family-owned) with maybe 40 employees in two offices (two states). Our health insurance policy seems to be based on a contract with the home state (Texas).
Can a wise, knowledgeable person also address the question - how does COBRA apply to a small (40 employee) company?

There are states that had implemented a state-wide insurance law before the ACA - Massachusetts, for example. Not sure about other ones.

staythecourse
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Re: retiree health ins - how to propose to Employer?

Post by staythecourse » Tue Jan 09, 2018 9:03 pm

munemaker wrote:
Tue Jan 09, 2018 8:20 pm
staythecourse wrote:
Tue Jan 09, 2018 8:15 pm
If you were the employer would you do this if asked? There is no advantage for them.
The employer will do this if asked in order to comply with the law. The advantage to the employer is they will not be sued or fined by the Department of Labor.
Did I miss something? They have no responsibilities to offer retirees health insurance from what I gathered from the OP. It seems the OP wanted to ask them as almost a favor.

If it is not illegal then they can do WHATEVER they want and will do WHATEVER they want to generate the highest profit margin they can and offering services they don't legally have to and having to pay someone to oversee it is not a win for them.

I never really understood a lot about business until I started running my own practice. There is a TOTAL difference of how you view things as the owner and as the employee and most of the time what is good for one is not good for the other.

Good luck.
"The stock market [fluctuation], therefore, is noise. A giant distraction from the business of investing.” | -Jack Bogle

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Steelersfan
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Re: retiree health ins - how to propose to Employer?

Post by Steelersfan » Tue Jan 09, 2018 9:27 pm

InMyDreams wrote:
Tue Jan 09, 2018 9:01 pm

Can a wise, knowledgeable person also address the question - how does COBRA apply to a small (40 employee) company?
Q3: What group health plans are subject to COBRA?

The law generally applies to all group health plans maintained by private-sector employers with 20 or more
employees, or by state or local governments.


https://www.dol.gov/sites/default/files ... sumer.pdf

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Re: retiree health ins - how to propose to Employer?

Post by tibbitts » Tue Jan 09, 2018 9:29 pm

JohnFiscal wrote:
Tue Jan 09, 2018 3:02 pm
hi all, I am approaching retirement (66) this year. My wife is 10 years younger than me so health care insurance for her is a big concern. Especially now with the disruption in the Affordable Care Act. I barely know how to proceed. From what I see it doesn't even seem to be possible or practical to go to some insurance agent and buy over-the-counter health insurance (at least, here in Florida), it has to be through the exchanges.

I work for a small professional company (family-owned) with maybe 40 employees in two offices (two states). Our health insurance policy seems to be based on a contract with the home state (Texas).

I'm wondering if I could ask my employer to carry my wife and I after I retire, with me paying our premium. I guess as a "retiree" plan. Of course, this would entail paying additional for myself for this insurance on top of Medicare, but perhaps it would be worthwhile. I'm not certain if this is even permitted under health insurance plans in general or ours in particular.

No one has ever retired from the company before so this is entirely new ground.

Any help on this (and how to propose to the company) will be appreciated.
I'm not an expert but I believe what you want would be extremely difficult for the employer, and may involve costs well beyond your premium. But there's no harm in asking, particularly if the owner is going to retire and might not have thought of this eventuality for himself.

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munemaker
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Re: retiree health ins - how to propose to Employer?

Post by munemaker » Tue Jan 09, 2018 9:44 pm

staythecourse wrote:
Tue Jan 09, 2018 9:03 pm
munemaker wrote:
Tue Jan 09, 2018 8:20 pm
staythecourse wrote:
Tue Jan 09, 2018 8:15 pm
If you were the employer would you do this if asked? There is no advantage for them.
The employer will do this if asked in order to comply with the law. The advantage to the employer is they will not be sued or fined by the Department of Labor.
Did I miss something?
It is explained above. If the employee retires and is on Medicare, the employer must provide COBRA to the surviving spouse until the spouse is on Medicare, for up to 36 months.

The OP apparently needs a lot more than 36 months, so this is of only minor help.

staythecourse
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Re: retiree health ins - how to propose to Employer?

Post by staythecourse » Tue Jan 09, 2018 10:02 pm

munemaker wrote:
Tue Jan 09, 2018 9:44 pm
staythecourse wrote:
Tue Jan 09, 2018 9:03 pm
munemaker wrote:
Tue Jan 09, 2018 8:20 pm
staythecourse wrote:
Tue Jan 09, 2018 8:15 pm
If you were the employer would you do this if asked? There is no advantage for them.
The employer will do this if asked in order to comply with the law. The advantage to the employer is they will not be sued or fined by the Department of Labor.
Did I miss something?
It is explained above. If the employee retires and is on Medicare, the employer must provide COBRA to the surviving spouse until the spouse is on Medicare, for up to 36 months.

The OP apparently needs a lot more than 36 months, so this is of only minor help.
That is my point that has nothing to do with what is being asked. He asked for continued insurance for spouse up to 10 years by his employer and was not asking about coverage through COBRA.

Good luck.
"The stock market [fluctuation], therefore, is noise. A giant distraction from the business of investing.” | -Jack Bogle

mouses
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Re: retiree health ins - how to propose to Employer?

Post by mouses » Wed Jan 10, 2018 7:39 am

munemaker wrote:
Tue Jan 09, 2018 9:44 pm
staythecourse wrote:
Tue Jan 09, 2018 9:03 pm
munemaker wrote:
Tue Jan 09, 2018 8:20 pm
staythecourse wrote:
Tue Jan 09, 2018 8:15 pm
If you were the employer would you do this if asked? There is no advantage for them.
The employer will do this if asked in order to comply with the law. The advantage to the employer is they will not be sued or fined by the Department of Labor.
Did I miss something?
It is explained above. If the employee retires and is on Medicare, the employer must provide COBRA to the surviving spouse until the spouse is on Medicare, for up to 36 months.

The OP apparently needs a lot more than 36 months, so this is of only minor help.
It gives them three years breathing room, and who knows what will happen with the ACA by then. Possibly something beneficial instead of it being chopped at.

scifilover
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Re: retiree health ins - how to propose to Employer?

Post by scifilover » Wed Jan 10, 2018 9:08 am

Chances are, with only 40 lives covered, that your employer is getting coverage via an association or other group of small employers. These types of plans are often of the cookie cutter variety in which there are few options on the medical side. And, without a real HR department there is probably zero chance of making any changes to the plan. And in any event changing any employee benefit plan is an expensive process.

When there is this much difference in age between the marriage partners, often the younger one will find coverage through his/her own employment. Is this a possibility for you?

ICMoney
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Re: retiree health ins - how to propose to Employer?

Post by ICMoney » Wed Jan 10, 2018 1:05 pm

I think there may be some incorrect information on this thread - the company isn't obligated by law to cover the spouse for the 10 years until her Medicare eligibility through COBRA or any other means. My understanding (as others on this thread have stated) is they are only obligated by law to offer her COBRA for the 18 months after termination plus a possible short extension if she qualifies for it, not to exceed 36 months of COBRA in total. As others have mentioned, the company could set up a retiree healthcare plan that allows OP and/or spouse to remain on the plan (i.e. until age 65, or indefinitely), but there are additional costs associated with setting this up, accounting for, and administering it which the company will need to cover. Also, many companies offering retiree health insurance seem to have been moving away from allowing retirees to remain on the company's plan (because it's expensive to the company, they can get ACA coverage, etc.).
Steelersfan wrote:
Tue Jan 09, 2018 8:30 pm

It appears as though the spouse can only extend her benefit for an additional 18 months after the original 18 month period:


Q11: How long does COBRA coverage last?

COBRA requires that continuation coverage extend from the date of the qualifying event for a limited period
of 18 or 36 months. The length of time depends on the type of qualifying event that gave rise to the COBRA
rights. A plan, however, may provide longer periods of coverage beyond the maximum period required by law.
When the qualifying event is the covered employee's termination of employment or reduction in hours of
employment, qualified beneficiaries are entitled to 18 months of continuation coverage.
When the qualifying event is the end of employment or reduction of the employee's hours, and the employee
became entitled to Medicare less than 18 months before the qualifying event, COBRA coverage for the
employee's spouse and dependents can last until 36 months after the date the employee becomes entitled to
Medicare.
For example, if a covered employee becomes entitled to Medicare 8 months before the date his/her
employment ends (termination of employment is the COBRA qualifying event), COBRA coverage for his/her
spouse and children would last 28 months (36 months minus 8 months).


https://www.dol.gov/sites/default/files ... nsumer.pdf
My understanding of this is that, given the OP's age, the spouse could only be on COBRA for up to the maximum of:
1. 18 months, and
2. 36 months minus number of months OP is over age 65.

So spouse will not be able to continue COBRA for the full 36 months since OP is already age 66, but may be able to eke out a few additional months of COBRA beyond the 18 months required.
dm200 wrote:
Tue Jan 09, 2018 6:52 pm
adamthesmythe wrote:
Tue Jan 09, 2018 6:19 pm
I have heard of employers that would allow coverage of a spouse after retirement under COBRA for more than the required 18 months.
Doing this doesn't cost the employer much (you pay the full cost plus 2%, their only cost is any possible increase in insurance cost due to one more old beneficiary).
BUT COBRA is quite expensive AND this is extra trouble and potential extra cost for the employer.
You can propose it, but I'm not sure I see a reason for them to do it, except to be good guys.
1. No, COBRA is not, in my opinion, "expensive". It is the same (possible 2% added) as the cost for employees. it just "seems" expensive because the COBRA recipient pays the full cost.

2. Yes - there is potential, sometimes likely, extra trouble and expense.
COBRA *is* expensive to the employer - not just to the former employee paying 102% of premiums. Those who elect COBRA are expected to be higher cost on average (i.e. have expensive conditions that need to be treated, are older, etc.) so their medical expenses are assumed to be much higher than 102% of premiums. In other words, there's antiselection among COBRA electors, so the company is still subsidizing COBRA to some extent.

Best,
ICM

jalbert
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Re: retiree health ins - how to propose to Employer?

Post by jalbert » Wed Jan 10, 2018 1:38 pm

Suggest looking at the Florida exchange before forming an opinion about that option.

Despite the changes made to ACA in 2017, individual health insurance is still in much better shape than before ACA. Prior to ACA, going through an insurance broker did not prevent the insurance companies from being able to deny coverage based on age or health status, including refusal to renew a policy if you had a medical claim for a condition requiring on-going care.

And you can still enroll for health insurance directly through an insurance company. The advantages to doing so are minimal: the enrollment process will be shorter, and there may be a few plans offered that are not offered on the exchange (in the state where I reside the overwhelming majority of individual plans are offered both through the exchange and through direct enrollment).

The downsides of direct enrollment are that you will not be eligible for a premium tax credit, and there may be some plans available on the exchange but not through direct enrollment. Either way the protections of ACA against denial or termination of coverage are in place.

I understand having concerns about the future of individual insurance, but employers can eliminate retiree health insurance as well.
Last edited by jalbert on Wed Jan 10, 2018 2:47 pm, edited 3 times in total.
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munemaker
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Re: retiree health ins - how to propose to Employer?

Post by munemaker » Wed Jan 10, 2018 1:55 pm

staythecourse wrote:
Tue Jan 09, 2018 10:02 pm
munemaker wrote:
Tue Jan 09, 2018 9:44 pm
staythecourse wrote:
Tue Jan 09, 2018 9:03 pm
munemaker wrote:
Tue Jan 09, 2018 8:20 pm
staythecourse wrote:
Tue Jan 09, 2018 8:15 pm
If you were the employer would you do this if asked? There is no advantage for them.
The employer will do this if asked in order to comply with the law. The advantage to the employer is they will not be sued or fined by the Department of Labor.
Did I miss something?
It is explained above. If the employee retires and is on Medicare, the employer must provide COBRA to the surviving spouse until the spouse is on Medicare, for up to 36 months.

The OP apparently needs a lot more than 36 months, so this is of only minor help.
That is my point that has nothing to do with what is being asked. He asked for continued insurance for spouse up to 10 years by his employer and was not asking about coverage through COBRA.

Good luck.
Using COBRA would kick the can down the road for 3 years. With the health insurance market being so dynamic, better alternatives may be available at that time. That's why I think it may be of some help.

Some people think COBRA is limited to 18 months and the OP may not have known that it can be available for 3 years under certain circumstances, so I do think it was worth mentioning. So I do think it is relevant.

randomguy
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Re: retiree health ins - how to propose to Employer?

Post by randomguy » Wed Jan 10, 2018 2:57 pm

munemaker wrote:
Wed Jan 10, 2018 1:55 pm

Using COBRA would kick the can down the road for 3 years. With the health insurance market being so dynamic, better alternatives may be available at that time. That's why I think it may be of some help.

Some people think COBRA is limited to 18 months and the OP may not have known that it can be available for 3 years under certain circumstances, so I do think it was worth mentioning. So I do think it is relevant.
The downside is that people on ACA plans might get grandfathered into future plans while people on COBRA have to buy on the open market (i.e. your preexisting conditions will be considered) so there might only be worse options available. Obviously we have no way of knowing.

Realistically I am not sure why any company would want to cover a group of high cost enrollees(i.e. anyone over 50) much less go out of their way to rework their plan to accommodate them. Unless the owner or other important person need this, I don't see it happening.

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munemaker
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Re: retiree health ins - how to propose to Employer?

Post by munemaker » Wed Jan 10, 2018 9:53 pm

randomguy wrote:
Wed Jan 10, 2018 2:57 pm

... people on ACA plans might get grandfathered into future plans while people on COBRA have to buy on the open market (i.e. your preexisting conditions will be considered) ...
I guess anything is possible.

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dm200
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Re: retiree health ins - how to propose to Employer?

Post by dm200 » Thu Jan 11, 2018 9:09 am

munemaker wrote:
Wed Jan 10, 2018 9:53 pm
randomguy wrote:
Wed Jan 10, 2018 2:57 pm
... people on ACA plans might get grandfathered into future plans while people on COBRA have to buy on the open market (i.e. your preexisting conditions will be considered) ...
I guess anything is possible.
Sure, BUT (as best I recall and understand) even before the ACA prohibitions against exclusion of pre-existing condition exclusions, there was mandatory coverage of pre-existing conditions for some (or all?) types of continuous insurance coverage. So, even if the ACA requirements are rolled back, it seems to me that if you have uninterrupted coverage - you would not have a problem. Is this correct?

delamer
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Re: retiree health ins - how to propose to Employer?

Post by delamer » Thu Jan 11, 2018 11:57 am

dm200 wrote:
Thu Jan 11, 2018 9:09 am
munemaker wrote:
Wed Jan 10, 2018 9:53 pm
randomguy wrote:
Wed Jan 10, 2018 2:57 pm
... people on ACA plans might get grandfathered into future plans while people on COBRA have to buy on the open market (i.e. your preexisting conditions will be considered) ...
I guess anything is possible.
Sure, BUT (as best I recall and understand) even before the ACA prohibitions against exclusion of pre-existing condition exclusions, there was mandatory coverage of pre-existing conditions for some (or all?) types of continuous insurance coverage. So, even if the ACA requirements are rolled back, it seems to me that if you have uninterrupted coverage - you would not have a problem. Is this correct?

That is my understanding too, although I don’t know that there is any guarantee of affordable coverage.

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dm200
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Re: retiree health ins - how to propose to Employer?

Post by dm200 » Thu Jan 11, 2018 12:00 pm

delamer wrote:
Thu Jan 11, 2018 11:57 am
dm200 wrote:
Thu Jan 11, 2018 9:09 am
munemaker wrote:
Wed Jan 10, 2018 9:53 pm
randomguy wrote:
Wed Jan 10, 2018 2:57 pm
... people on ACA plans might get grandfathered into future plans while people on COBRA have to buy on the open market (i.e. your preexisting conditions will be considered) ...
I guess anything is possible.
Sure, BUT (as best I recall and understand) even before the ACA prohibitions against exclusion of pre-existing condition exclusions, there was mandatory coverage of pre-existing conditions for some (or all?) types of continuous insurance coverage. So, even if the ACA requirements are rolled back, it seems to me that if you have uninterrupted coverage - you would not have a problem. Is this correct?
That is my understanding too, although I don’t know that there is any guarantee of affordable coverage.
I agree - not necessarily "affordable" (where 'affordable' is different for different folks)

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midareff
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Re: retiree health ins - how to propose to Employer?

Post by midareff » Thu Jan 11, 2018 12:08 pm

My former employer, a municipal government in Florida allows/allowed me to keep my wife on their insurance after I retired until she becomes Medicare eligible. I pay the cost of her insurance as a monthly deduct from my State's retirement check. It's $570 a month + co-pays for office visits and drugs. It's roughly equivalent in cost to my Medicare + United AARP Plan F.

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flamesabers
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Re: retiree health ins - how to propose to Employer?

Post by flamesabers » Thu Jan 11, 2018 12:26 pm

randomguy wrote:
Wed Jan 10, 2018 2:57 pm
Realistically I am not sure why any company would want to cover a group of high cost enrollees(i.e. anyone over 50) much less go out of their way to rework their plan to accommodate them. Unless the owner or other important person need this, I don't see it happening.
+1.

Optional fringe benefits are provided to recruit and/or retain people. If you're going to negotiate for a new fringe benefit, (i.e. retiree health insurance) the time to do it is when you're at the peak of your career, not at the end of it. When you're retiring or otherwise leaving the company anyway, you have no leverage to use against your employer. Since most of his co-workers are much younger then him, I imagine their prime concern regarding health insurance isn't so much having retiree health insurance but rather minimizing the premiums they're paying to get health insurance in the present day.

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Re: retiree health ins - how to propose to Employer?

Post by Careful » Thu Jan 11, 2018 9:37 pm

dm200 wrote:
Tue Jan 09, 2018 4:04 pm
My objective in this is that "perhaps" the whole cost for this would still be less than buying for my wife on the health care exchange.
Perhaps not. As long as the ACA caps the age based individual premiums at 3X younger folks, then the ACA individual plans may be just as good. The company probably would have to spend money coming up with such a retiree "plan". In addition, there is the probability that insuraing your wife might bump up the costs (since she is older) on average.

I would be concerned about pre-existing condiitons exclusions. Even before the ACA prohibited such exclusions, continuous coverage from one plan to another generally prohibited them - although at sometimes increased costs. So, it seems that even if many aspects of the ACA change, many of the pre-existing condition exclusion prohibitions will remain.

My suggestion if you you and your wife to fully evaluate any and all individual plans available - including costs, quality of healcare, continuity (probability of staing on the same type plan), transition to Medicare, etc. If available in your area, look at Medicare Advantage plans and whether the HMO type has a similar ACA plan. For example, my wife enrolled in the Kaiser HMO before she was eligible for medicare. Then, two years ago, when she qualified for medicare - she chose the Kaiser plan. It was a seamless transition - same ID, same doctor(s), same facilities, same records. All that changed was a MUC, MUCH lower monthly cost and most copays dropped as well.
ACA is still law of the land, except for the individual mandate. So, can't exclude for pre-existing conditions.

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Re: retiree health ins - how to propose to Employer?

Post by JohnFiscal » Thu Jan 11, 2018 9:58 pm

OP here. Thank you all for the ideas, comments, thoughts, information, and opinions. It's been quite helpful and more than I anticipated. Thank you, Bogleheaders.

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