The Affordable Care Act (ACA) requires group health plans and health insurance issuers to provide coverage for certain people seeking early retirement. This requirement is sometimes called the ” Early Retiree Reinsurance Program.”
What is the Early Retiree Reinsurance Program(ERRP)?
The ERRP was created by the Affordable Care Act to help companies and other organizations provide health coverage to their early retirees. The program reimburses participating employers and health insurance carriers for a portion of the cost of health benefits provided to retirees who are age 55 or older and who are not eligible for Medicare.
The program is designed to help employers and carriers manage the medical expenses of health care for people who retire early, and to encourage companies to continue offering health coverage to this group of workers.
To be eligible for reimbursement, a plan sponsor or health insurance issuer must:
1. Be providing health benefits to early retirees (i.e., those who are not yet eligible for Medicare) and their spouses, dependents, and survivors;
2. Be experiencing an increase in the cost of providing health insurance options to early retirees;
3. Agree to participate in the program for a period of two years.
If you are a plan sponsor or health insurance issuer that is interested in participating in the ERRP, you can find more information on the federal government website for Centers for Medicare & Medicaid Services (CMS) https://www.cms.gov/.
Options for Early Retirement Health Coverage
If you’re an early retiree (under age 65) and not eligible for Medicare, you have a few options for health coverage:
1. Stay on your employer’s health plan. If your employer offers health benefits to retirees, you may be able to continue your coverage under the plan. You’ll usually have to pay the full premium yourself, although some employers may contribute a portion of the cost.
2. Purchase an individual health insurance policy. If you’re unable to continue your coverage under your employer’s plan, you can purchase an individual health insurance policy in the marketplace. Depending on your income and family size, you may qualify for financial assistance to help pay for your premiums and other out-of-pocket expenses.
The Health Insurance Marketplace for Early Retirees
If you’re an early retiree, you can shop for health insurance in the health insurance marketplace — just like people who are not yet eligible for Medicare. You’ll be able to compare health plans and choose the one that best meets your needs and budget.
If you’re married, you and your spouse can each apply for coverage in the marketplace. If you have children under age 26, they can also be covered under your plan.
In most states, the marketplace is run by the federal government. You can visit Healthcare.gov to find out more about the marketplace in your state.
How to Get Help Paying for Early Retiree Health Insurance Benefits
If you’re an early retiree with a low or moderate income, you may qualify for financial assistance to help pay for your health insurance premiums and other out-of-pocket costs.
The amount of financial assistance you’ll receive is based on your income and family size. To see if you qualify, you can use the marketplace’s “estimator tool.”
If you qualify for financial assistance, you’ll be able to choose from a selection of health plans with different levels of coverage — including some “platinum” plans that have low deductibles and out-of-pocket costs.
You can learn more about the financial assistance available in the marketplace by visiting Healthcare.gov.
How to Enroll in Early Retiree Health Coverage
If you’re interested in enrolling in early retiree health insurance, you can do so through the marketplace.
You can visit Healthcare.gov to find out more about the enrollment process. If you’re not sure which health plan is right for you, you can use the marketplace’s ” Plan Finder” tool to compare different plans and find the one that best meets your needs and budget.
Once you’ve chosen a plan, you’ll be able to enroll online or by mail. If you have any questions about the enrollment process, you can contact the marketplace call center at 1-800-318-2596.
Types of Group Health Insurance Plans
Group health insurance plans are offered by employers and other organizations. These plans can be a good option for early retirees, as they often have lower premiums than individual health insurance plans.
There are two main types of group plans:
Health Maintenance Organizations (HMOs):
With an HMO plan, you’ll usually need to select a primary care physician (PCP) from within the plan’s network. Your PCP will coordinate your care and refer you to specialists within the network when necessary. HMO plans typically have lower monthly premiums than other types of plans, but they also have higher out-of-pocket costs when you need care.
Preferred Provider Organizations (PPOs):
With a PPO plan, you’ll have more flexibility in choosing your doctors and other providers. You can see any provider that participates in the plan’s network, but you’ll pay less if you use providers that are considered “preferred.” PPO plans typically have higher monthly premiums than HMOs, but they also have lower out-of-pocket costs when you need care.
If you’re considering enrolling in a group health insurance plan, you should contact the employer or organization offering the plan to find out more about the coverage and costs.
Consider a Short-term Health Insurance Policy.
Short-term health insurance policies are designed to provide temporary coverage for people who are between jobs or waiting for their employer-sponsored health insurance to begin.
Short-term health insurance policies typically have lower premiums than other types of health insurance, but they also have fewer benefits. Most short-term health insurance policies don’t cover pre-existing conditions, and they often have lifetime and annual benefit limits.
If you’re considering enrolling in a short-term health insurance policy, you should compare the coverage and costs of different policies before you decide on a plan.
Get coverage through a government program. If you’re a U.S. citizen or legal resident, you may be eligible for coverage through a government health insurance program like Medicaid or the Children’s Health Insurance Program (CHIP).
These programs provide free or low-cost health insurance to people with low incomes. To be eligible for coverage, you’ll need to meet certain income requirements.
If you think you might be eligible for coverage through Medicaid or CHIP, you should contact your state’s Medicaid office or the CHIP program in your state for more information.
Buy an individual health insurance policy. If you’re not eligible for coverage through a government program or a group health insurance plan, you can purchase an individual health insurance policy on your own.
Individual health insurance policies are offered by private insurance companies. You can shop for individual health insurance policies online, through a broker, or directly from an insurance company.
You can also purchase a short-term health insurance policy to cover yourself until you’re eligible for Medicare. Short-term health insurance policies are available through some insurance companies and online health insurance marketplaces.
What is Long-term Care Insurance?
Long-term care insurance is a type of insurance that helps pay for the cost of long-term care services. Long-term care services can include help with activities of daily living, such as bathing, dressing, and eating. Long-term care insurance policies typically have age and health requirements, and they usually don’t cover pre-existing conditions.
If you’re thinking about purchasing a long-term care insurance policy, you should compare the coverage and costs of different policies before you decide on a plan. You can purchase long-term care insurance through an insurance company.