2010-09-10 / Top Stories

ACA Helps Employers, Unions Cover Early Retirees

The U.S. Department of Health and Human Services announced the first round of applicants accepted into the Early Retiree Reinsurance Program. Nearly 2,000 employers, representing large and small businesses, State and local governments, educational institutions, non profits, and unions have been accepted into the program and will begin to receive reimbursements for employee claims this fall.

Created by the Affordable Care Act to help serve as a bridge to the new health insurance Exchanges in 2014, the Early Retiree Reinsurance Program provides $5 billion in financial assistance to employers and unions to help them maintain coverage for early retirees age 55 and older who are not yet eligible for Medicare. Businesses and other employers and unions that are accepted into the program will receive reimbursement for medical claims for early retirees and their spouses, surviving spouses, and dependents. Savings can be used to reduce employer health care costs, provide premium relief to workers and families, or both. The program ends on January 1, 2014 when state health insurance exchanges are up and running.

“In these tough economic times, it is difficult for employers to keep up with skyrocketing health care costs for employees and retirees. Many Americans who retire before they are eligible for Medicare see their life savings disappear because of medical bills and exorbitant rates in the individual health insurance market,” said Health and Human Services Secretary Kathleen Sebelius. “The Affordable Care Act’s Early Retiree Reinsurance Program will make it a little easier for employers to provide high-quality health benefits to their retirees as we work to put in place market reforms to lower costs for all.”

Rising health care costs have made it difficult for employers to provide quality, affordable health insurance for workers and retirees while also remaining competitive in the global marketplace. The percentage of large firms providing workers with retiree health coverage has dropped from 66 percent in 1988 to 29 percent in 2009. Health insurance premiums for older Americans are four times more expensive than they are for young adults, and the deductible these enrollees pay is, on average, almost four times that for a typical employer-sponsored insurance plan.

The Department of Health and Human Services’ Office of Consumer Information and Insurance Oversight has approved nearly 2,000 plans representing a broad range of employers from 50 states and the District of Columbia into the Early Retiree Reinsurance Program in this first round of approvals.

Starting in September, approved applicants can begin submitting claims dating back to June 1, 2010 and, starting in October, approved applicants will receive reinsurance payments on those claims. This policy allows more health benefit claims to qualify for reinsurance payments for plans this year.

“There has been a tremendous amount of interest from businesses and organizations from across New York since the Early Retiree Reinsurance Program was announced just a few months ago,” said Sebelius. The approved applications represent nearly every sector of the economy: 32 percent of applications came from businesses, 26 percent from state and local governments, 22 percent from union sponsors, 14 percent from schools and other educational institutions, and 5 percent from non profits. The nearly 2,000 approvals announced today are a subset of applications that have been received. HHS’ Office of Consumer Information and Insurance Oversight is continuing to accept and review additional applications in the order in which they were submitted.

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