Skip to main content

Medicare vs. Employer Health Coverage

Question:
Can a church with an active employee 65 years of age drop the employee's health coverage in favor of assisting the Medicare eligible employee with Medicare premiums?

Answer:
"The Age Discrimination in Employment Act (ADEA) which is administered by the Equal Employment Opportunity Commission requires employers of 20 or more employees to offer to their age 65 or over employees and to the age 65 or over spouses of employees of any age, the same coverage, and under the same conditions, as they offer to employees and employees" spouses under age 65."
(https://secure.ssa.gov/poms.nsf/lnx/0600620177)

The following source addresses employer reimbursements of Medicare premiums: "In general, when an employee (or his or her spouse) is eligible for Medicare due to age, an employer may reimburse his or her Medicare premiums only when: 1 The employer’s group health plan is a secondary payer to Medicare because the employer has fewer than 20 employees; AND 2 The reimbursement arrangement complies with the ACA because it is integrated with the employer’s group health plan (or covers fewer than two employees)."
https://www.careplusbenefits.com/Portals/0/InSite/Compliance/2015%20Compliance%20Bulletins/LegislativeAlert4515PayingEmployeesMedicarePremiums121115.pdf

"Medicare beneficiaries are free to reject the employer coverage, in which case they retain Medicare as the primary coverage. When Medicare is primary payer, employers cannot offer such employees or their spouses secondary coverage of services covered by Medicare. However, an employer may offer a supplemental plan that covers items and services not covered by Medicare such as eyeglasses or routine dental care."
https://secure.ssa.gov/poms.nsf/lnx/0600620177

As can be observed from SSA.gov, employees otherwise eligible for health coverage through their employer cannot be denied coverage because of their Medicare eligibility. However, some organizations with one employee, for example, have dropped their plans and increased taxable cash compensation to assist the employee with the cost of Medicare.



Comments

Popular posts from this blog

Qualified Small Employer HRAs

On December 13, 2016, President Obama signed the 21st Century Cures Act, allowing qualified small employers to offer Health Reimbursement Arrangements (HRA) that follow certain terms.

After the Affordable Care Act was passed, the IRS originally determined that an HRA was not a qualified group health plan. The Cures Act overrules this decision. HRAs are again an option for qualifying small employers.

To be eligible, the small employer must have fewer than 50 employees and must not offer a group health plan to any of its employees.

The Qualified Small Employer Health Reimbursement Arrangement (QSEHRA) must be subject to the following terms.
No salary reduction contributions may be made (i.e., 100% employer-funded).Employer must receive proof of employee’s minimum essential coverage.Reimbursements must be for qualifying medical expenses.Reimbursements for any year cannot exceed $4,950 (or $10,000 for family coverage), which will be adjusted annually for inflation.Employer must offer the …

Gifts Paid Out of Church Funds: Form 1099-MISC Requirements

Question:
 A church gave a wedding gift of $1000 to a couple who are church members. No goods or services were provided by the couple in exchange for the gift.  Is a Form 1099-MISC required? 
Answer: In the following answer, we assume that the couple are not employees of the church from whom the gift could not be viewed as compensation for their services. Also, the amount seems to be small enough to avoid any concerns of "private inurement."

Accordingly, no Form 1099-MISC is required. According to the 2017 IRS Instructions for Form 1099-MISC a Form 1099-MISC is only required for payment of goods or services. The requirements are as follows:
"File Form 1099-MISC, Miscellaneous Income, for each person to whom you have paid during the year:  At least $10 in royalties (see the instructions for box 2) or broker payments in lieu of dividends or tax-exempt interest (see the instructions for box 8);  At least $600 in:  1. Rents (box 1);  2. Services performed by someone who is not your …

Revised Form I-9 Released

The U.S. Citizenship and Immigration Services released a revised Form I-9. All new hires after January 21, 2017, must complete the revised Form I-9. All prior released versions of Form I-9 will be invalid for new hires.

Employers are required to have a completed hard copy of Form I-9 on file for each employee. Current employees do not need to re-complete the revised form.

More information on Form I-9 can be found on the USCIS website.