What is a Group Retiree Medical Plan?

A group retiree medical plan is a health insurance option that employers can sponsor for their retirees that provides supplemental coverage to Medicare. These plans can be 100% voluntary or they can be employer funded. Group Retiree Medical plans can be setup with direct bill to the member/policyholder or they can be put on a group bill. These plans can be setup many different ways to meet the needs of employers wanting to offer retiree benefits.

Benefits of a Retiree Plan

Group retiree medical plans usually mimic a Medicare Supplement plan. These plans are not Medicare Supplements but merely copy their benefits. Medicare plans are standardized and have to file differently than a group retiree medical plan.

Retiree plans usually have deductible options starting at $0 and ranging up to $2,000 or more. The 20% coinsurance is usually covered at 100% (minus some co-pays for doctor or outpatient visits).

There are no networks with these plans. They supplement Medicare so as long as the provider accepts Medicare this coverage is allowed; however, if the doctor does not take Medicare this policy is unable to provide coverage.

How do we start a Group Retiree Medical Plan

To setup a retiree plan you will need to have some basic information on the group and what type of coverage the group will want to provide. Here are some basic questions you will be asked:

1. Will this be voluntary or employer paid?
2. How many retirees would be eligible for coverage (ages 65+)?
3. Are retirees currently on the group health insurance plan?
4. Is the current group health plan fully-insured or self funded?
5. Company information such as name, address, contact and business type will all be asked.
6. Do you have census data? (Some carriers require Gender, DOB and zip code)
7. Do you have claims experience?

Some insurance companies will ask more than the questions above and other companies will ask less but this is what you should be prepared to answer when setting up a plan.

If you need help setting up a group retiree medical plan contact MWG Senior Services at 1-877-936-2991. We are a branch of Morgan-White Group that handles senior insurance products.

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