IBM Medicare Extend Health Transition Questions, Questions, Questions

I just created a list of questions for Extend Health and thought I would post them up as they might help you think about what you want to ask them as you begin to understand this change.  Also, I don't understand the HRA subsidy so ignore what I said in my last post.  I believe I am wrong about the premium subsidy going into the HRA because on page 9 of their brochure they imply that the SHAP process stays the same.  My questions so far are: 

1.       Are all the Extend Health plans traditional CMS Medicare plans that are currently in the marketplace? Will there be any unique offerings like the IBM secondary medical plan that only kicks in after $4000+ deductable?  That was not a CMS approved plan.

2.       There are no CMS approved plans for dental or vision insurance as separate plans.  Will these still be offered as separate insurance plans or is the only way to get this coverage going to be  through a Medicare Advantage plan?

3.       If the offerings are all traditional CMS plans are Medigap plans then subject to the same state rules as CMS Medigap plans?  Like not being able to switch Medigap plan types once you make a selection unless that plan type goes away.  Will Medigap plans be subject to state rules such as age rated and zip code rated premiums?

4.       Does Medigap ‘guaranteed right”  still apply even if someone only used the IBM’s prescription drug plan in 2013 and had no secondary insurance?

5.        Will there be any non-CMS structured offerings like IBM’s prescription drug offering that had no donut hole and capped at $3500 of pay out – e.g, it was a CMS qualified plan because it was creditable coverage but not at all structured like a CMS part D plan. If there are any such plans will they still be subject to the higher premium rule for higher income individuals?

6.       Your brochure (page 6) implies you will only be offering Medicare Advantage plans that include prescription drug insurance.  Is that true?

7.       Both my husband and I are IBM retirees.  Is there any financial advantage to us enrolling separately versus as husband and wife?

8.       If I don’t buy insurance through Extend Health in 2014 am I precluded from buying through the exchange in future years? I am not an Access Only retiree.  What is that?

9.       What is subsidized IBM group coverage?  My husband receives a Medicare part B premium subsidy and he gets reimbursed through SHAP reimbursement.  Your brochure implies (page 9) that the process will be the same and it is not part of the HRA process and subsidized coverage.  Is that correct?

10.    You say your current insurance pool covers about 500K users for the companies you serviced before IBM contracted with you.  What is the current typical wait time for them to get answers to their questions? When IBM retirees join the pool how big will the pool become and what is your anticipated typical wait time to accommodate that big an influx of people?

A Little More Information

I did a little research about private exchanges and urge you do do the same - I just used google and found several articles about how companies are moving to these exchanges. I also went online to extendhealth.com and created a profile, scheduled an appointment on October 1st. I tried looking at the plans that will be offered but that information won't be available until October! They will be sending me a BS enrollment guide now that I have built a profile but that will be a generic description of the types of plans that will be offered.

From everything I have read so far it appears that we will be offered the same type of plans that are in the general market place. If you look on page 6 of the big brochure you will receive you see the generic options. That probably means offerings like the IBM secondary plan of $0 with a $4000+ deductible or Aetna Integration A will be gone - there is nothing like that in the marketplace - certainly not at that price - unless IBM subsidizes such an offering ... it doesn't sound like that is their plan. I think what IBM is doing is paying Extend Health to be the total administrator for selecting plans from the marketplace and that Extend Health will have more negotiating power with insurance companies because they have a huge pool of people who are generally healthier even though they are old farts because they tend to be upper middle class so EH will get "better" premium prices than one can get from AARP, for example. The interesting thing is if we have a claim complaint we have to deal with the specific insurance company --- not Extended Health and IBM is now totally out of it.

There is also a lot about an "HRA". I think I know what that is and, once again, IBM is messing around with people.  I know someone who retired in 1996 and gets a subsidy to pay his part B medicare premiums. It caps at $800 and he has to file to receive it - the deadline to do so is one year later. Well, now that subsidy goes to an HRA account with Extend Health. In order to receive it one must be using Extend Health insurance plans (even though some people don't want to use IBM offerings) and the withdrawal claims must be done within the claim year. Shame on IBM! People who retired earlier than 1996 had an even better deal - and, of course, are older - so the likelihood that they will screw it up and IBM will not have to pay the money is even better!

I am also wary that if you decide not to use Extend Health or screw up and forget to sign up you lose this health benefit for the rest of your life. I don't know what "Access Only" retirees are but it applies to them - it is not clear if it applies to us. They are really messing with people because they know old people do screw up.

Several friends and I plan to meet in the next week or two and create a list of questions. Then we will each call the information number to ask the questions and compare our answers. Stay tuned!

Big changes coming to the IBM Medicare options in 2014

I don't have the package yet but someone sent me the following link:

 www.extendhealth.com/ibm

There is a video on the website that is worth watching but it is basically content free when it comes to details. 

They use the word "Exchange" in the description which is unfortunate because people will get confused that this is somehow related to the Affordable Care Act.  It is NOT.  What IBM is doing is basically offloading our health insurance benefits to a third party who then decides what options to offer to us and at what price based on whatever subsidy IBM pays them.  My guess is IBM will freeze or shrink that payment over the years so our insurance benefit will eventually offer not much. We don't know what the offerings are yet but there are a few big changes that I think I see but don't completely understand. 

It looks like we will be offered traditional Medigap policies.  That means they are subject to the state Medigap rules.  In some states there are pre-existing condition wait periods and/or if you didn't buy a Medigap when you first turned 65 you can never buy one.  There may be a "guaranteed right" issue that can be used to override the second condition.  I don't know.  There will also now be zip code based premiums for Medigaps.  That means that policies in New York will be more expensive than policies in, say, Ohio.  Also, if you get any kind of subsidy from IBM (e.g., part B premium payments) IBM will now put that money into an HRA and then you have to file claims against that HRA to access the money.

More to come - just wanted to give you an early warning. 

Here's my biggest fear for our future - the next thing IBM will offload is our pension plan ala what some other companies have done.  That means they will be converted into an insurance company annuity or will offer a deeply discounted lump sum payment.  So, any ERISA rules governing the pension no longer apply.