EMPLOYER FLASH: Upcoming Changes to Group Medicare Plans.

Health Alliance has upcoming changes to our Group Medicare Advantage and Group Prescription Drug Plans for 2025. Beginning January 1, 2025, Health Alliance is discontinuing all of our stock Group Medicare Advantage plans, most of our customized non-standard Group Medicare Advantage plans, and all of our stand-alone Group Prescription Drug Plans (PDP). We will still be offering Group Medicare Advantage plans, and groups will be able to select a plan that mirrors one of our individual Medicare Advantage plan designs.

Group Medicare Advantage:

The changes to our Group MA plan offerings in 2025 are brought on by the new prescription drug requirements in the Inflation Reduction Act. We are recommending all groups move to individual plan options that include re-vamped coverage including pharmacy, dental, OTC, and eyewear benefits. Your employees will also have access to our broad provider network of more than 25,000 providers – all while not breaking the bank.

Current groups who are up for renewal on January 1, 2025 will automatically be mapped to the closest plan design to their currently offered plan. Your recommended plan mapping will be released with the renewal. If the recommended plans do not meet your members’ needs, please work with your client consultant to discuss the possibility of a non-standard plan option. Approval of non-standard plans are up to the discretion of underwriting and management.

Renewal exhibits will be available in early September. Please contact your Client Consultant with any questions and concerns as we move forwarded with the upcoming plan changes.

Group Prescription Drug Plans (PDP):

Also driven by the new prescription drug requirements in the Inflation Reduction Act, we will no longer offer stand-alone Group Prescription Drug Plans (PDP), also known as Group Part D Plans. For groups that want to offer prescription drug coverage to eligible Medicare members, we encourage them to offer one of our Medicare Advantage Plans.

Groups who currently offer a Group PDP will not receive a renewal for that plan in 2025.  If you have any questions, please contact your Client Consultant.