Tuesday, October 29, 2013

IBM Extend Health Transition - Yet Another Rule Change for HRA access?

I was looking at the www.ibmemployee.com website yesterday and there were postings saying that the requirement to get the HRA subsidy has changed (again).  They say now only the retiree needs to buy either a medical plan or a prescription drug plan from Extend Health to gain access to the HRA subsidy for both the retiree and the spouse's reimbursement of insurance premiums and out of pocket medical expenses.  The retiree's spouse does not have to purchase an EH plan. The posting included an email from Dr. Rhee with that information.
I have not verified this with an Extend Health agent but, if it is true, it is important to know.  I also don't understand why we are not being officially notified of these substantive rule changes and have to find out by word of mouth.  This change means you can buy most of the plans that are a best fit for your medical needs irrespective of whether or not EH sells the insurance.
I also should mention that it may be risky to buy a medigap plan through Extend Health as the way to gain access to your HRA.  The rules on this are not clear and maybe IBM will fix the following delimma.
Right now, if you are able to buy a medigap plan with guarantee issue because the IBM group insurance you have is ending in 2013 then you cannot be denied by the medigap insurance company.  However, once you've bought the EH medigap plan your guarantee issue right ends unless you live in a state that requires continuous enrollment.  Very few states require it.  New York and Connecticut do. 
So, what's the big deal about that?  Well, suppose in 2015 Extend Health is no longer selling that medigap insurance plan you bought through them in 2014.  That can happen because the insurance company decides they no longer want EH as an insurance agent.  Does that mean you've lost your access to your HRA subsidy unless you buy another plan through EH?  You might be able to keep your subsidy access by buying, during Medicare Fall Enrollment, a part D insurance plan EH sells - if a plan they offer cover your drugs. If not, then you might have a problem.  You can only switch to a new medigap plan EH does sell if your state has continuous enrollment.    You have no guarantee issue right to do so in other states and therefore can be denied or charged a higher premium.  The medigap plan you bought in 2014 is not ending - EH just isn't selling it anymore.  That's the delimma.
I don't have a solution for the situation beyond making IBM aware of the problem.  They set the rules.  They can eliminate the requirement to buy any insurance from EH the same way they are changing the other rules.


No comments:

Post a Comment