CMS Regulations = New Process

Regulations from the Centers for Medicare & Medicaid Services (CMS) restrict our ability to classify certain Medicare Advantage enrollees as Non-Active for premium-related purposes. In other words, CMS regulations prohibit us from providing premium refunds to individuals enrolled in a Medicare Advantage plan, based on the number of hours worked if that number exceeds eligibility rules.

What does this mean?
If you are enrolled in the Medicare Advantage Program and work to earn enough health and welfare credit hours to meet the eligibility requirements for Active coverage, the plan is required to reclassify you as an Active Plan participant. Your coverage will then move from Medicare coverage to Active Plan coverage, and as such, premium refunds will no longer apply.

What about Plan B coverage?
If you earn enough credit hours to move to Active Plan coverage, our office will notify you of your coverage change. At that time, we will make recommendations for how to proceed with your required Medicare Plan B coverage.

If you have any questions about how your health coverage may be affected if you are working after retirement, please contact Participant Services by email at [email protected] or by phone at 314.644.4802, option 1.