Archived Insight | February 18, 2021

Retiree Medical Coverage: Are You Getting the Best Value?

While many organizations have moved away from offering retiree medical benefits to avoid the future financial obligations of such programs, some employers still offer them as a key component of their employee value proposition.

This is particularly important as we see Americans living longer and potentially lacking means to afford necessary healthcare in their later years.

retiree medical coverage

Why retiree medical?

By continuing to offer retiree medical benefits, organizations can reap important benefits:

  • Avoid the costs of retirement delays: One study showed that employers pay an additional $10,000 to $50,000 in costs for every year an employee delays retirement because they can’t afford it.
  • Dramatically reduce the medical costs for Medicare-eligible employees through timely retirement
  • Improve retention of future stars by encouraging talent succession
  • Improve retirement readiness and awareness
  • Offer more robust key employee compensation packages

Balancing benefits, costs and risk

While the advantages of a well-designed retiree medical program are clear for most participants, employers need to balance this benefit with the costs and risks of the coverage. Best practices suggest that employers ask themselves the following questions:

  • Have we looked into the savings offered from the private Medicare exchange market and/or Medicare Advantage programs?
  • Are we maximizing the Rx government subsidies for our Medicare retiree population?
  • How long has it been since the program was updated to reflect retiree population health trends?
  • Is the program compliant with appropriate legal obligations, such as HIPAA privacy and security standards?

Optimizing your retiree medical offering

You can optimize your retiree medical offering by looking at the 3 Rs of cost containment:

  1. Redefining eligibility requirements: Tie eligibility to service levels, consider institutional goals for workforce planning and review spouse coverage rules
  2. Restructuring benefits: Create tier for new hires, reduce benefits for future retirees and eliminate Rx benefits for Medicare-eligible participants
  3. Rethinking cost sharing: Move to a flat dollar employer share, fund while employees are active via defined contribution plans, and leverage Medicare private exchanges

Questions about retiree medical coverage?

We're here to help. Get in touch. 

See more insights

Two Businessmen Are Discussing During A Meeting In A Modern Office

Pension Plans’ Evolving Journeys to Improved Funded Status

Gain actuarial and investment perspectives on how pension plans work and retirement plan dynamics that support improving funded status.
Hispanic Male At A Doctors Appointment With A Black Female Doctor Checking Blood Pressure

Reasons to Consider an On-Site or Near-Site Clinic

On‑site and near‑site clinics can reduce costs, improve access and experience, and deliver ROI while strengthening health and wellness programs.
Consultant And Pharmacist Manager Reviewing Paperwork In Pharmacy

Recurring Pharmacy Audits Strengthen PBM Accountability

Through recurring pharmacy audits, a purchasing entity found $1 million in unrealized discounts and rebates while strengthening fiduciary oversight.

This page is for informational purposes only and does not constitute legal, tax or investment advice. You are encouraged to discuss the issues raised here with your legal, tax and other advisors before determining how the issues apply to your specific situations.

Don't miss out. Join 16,000 others who already get the latest insights from Segal.