What Is Seniors Choice?

Seniors Choice is one of the best group retiree medical plans on the market today! Although Seniors Choice is not a Medicare Supplement, it has some similarities, such as picking up benefits where Medicare leaves off. This product was created 20 years ago to help employers find solutions to their escalating group retiree and employee medical costs.  This special program was created with the best interest of the member in mind. No physician's network or network of hospitals - they have the freedom to choose any physician or hospital within the U.S.!

Is there a need for this product?

Today there are more people turning 65 than there are being born in the United States! Large municipalities and employers are facing bankruptcy due to the rising cost of retiree medical benefits.  The rising cost of health care is staggering, and now employers face having more retirees to cover for their medical than they do active employees.  Nobody knew that people would live as long as they do or that technology and medicine would sustain life as it does today.  Now we have people working well into their 70s because of the lack of resources that would allow them to retire earlier.

Why Seniors Choice and not a Medicare Supplement?

Seniors Choice carriers unique features that a traditional Medicare Supplement does not.  Benefits can be flexible because it is filed as a group retiree medical plan.  Seniors Choice is regulated by each state's department of insurance.  This gives us the flexibility to change benefits to fit the market at any time we feel it beneficial to the members.

What are the basic benefits?

• Deductible options ranging from $0 to $4,000
• Office visit co-pay to any physician (no network)
• Excess charges beyond Medicare allowable covered under basic plan

What are the benefits to offering them Seniors Choice vs. a Medicare Supplement?

• Premium contribution can be pre-taxed dollars under a Section 125 Plan.
• Employer receives tax benefits just like any other group plan.
• Seniors Choice offers the best Part D Rx plan, where a traditional Medicare Supplement does not have one.
• If an employer has a HSA (Health Savings Account) in place, they can continue to use this account for Seniors Choice.  When they retire, they can use the funds to even pay the Seniors Choice premiums.
• Portability: When this senior employee decides to retire, they can take this plan with them no matter where they move within the U.S.!

What is TEFRA?
Tax Equity and Fiscal Responsibility Act

An employer must comply with TEFRA regulations once they reach the 20 or more employees threshold.  The "20 or more employees" threshold is met when an employer has 20 or more full-time and/or part-time employees for each working day in each of 20 or more calendar weeks in the current calendar year or the preceding calendar year.  The 20 calendar weeks do not have to be consecutive.  The requirements are based on the number of employees, not the number of individuals covered under the medical plan.

What are the requirements of TEFRA?

• Requires 20 or more full-time and part-time employees
• Must cover full-time employees age 65+ on employer sponsored group plan

What is the definition of a non-TEFRA Group?

An employer group with less than 20 full-time and part-time employees combined.

What are the optional benefits?

• Skilled nursing (101 - 365 additional days)
• Foreign travel
• Private duty nursing
• Comprehensive wellness
• At home recovery

Part D prescription benefits:

Seniors Choice Part D Prescription Plan is a creditable Part D program with three options to choose from, including our high option plan that has full coverage through the coverage gap (donut hole).  Underwritten by Medco Containment Life Insurance Company.

How does this plan vs. a Medicare Supplement benefit a large employer?

• Because Seniors Choice requires an employer sponsorship, it opens another choice to their retirees that otherwise would not exist.  This would leave them with only a traditional Medicare Supplement offered on an individual basis.
• Always guaranteed issue at any age 65 and over
• Flexible benefits designed to offer retirees choices
• Large group rates that make sense to the member
• Open enrollment every year that allows sponsors and members to make changes including adding benefits with no underwriting required!

How does this plan vs. a Medicare Supplement benefit a small employer (less than 20 employees part time and full time)?

If you have someone who is actively at work and is 65+ years of age and qualifies for the employer group insurance plan, you can take them off and put them on Seniors Choice.

Frequently Asked Questions

Contact:
Tonia Pettitt
770-662-8510 local
800-533-5969 Toll free
Tonia@DiversifiedSeniorAdvisors.com