Medicare Secondary Payer Considerations for Small Employers

This guide provides an overview of Medicare Secondary Payer (MSP) considerations specifically for small employers. It outlines how MSP rules differ for small employers compared to larger ones, particularly regarding the employer’s group health plan as a secondary payer to Medicare. The document details the implications of these rules on benefit offerings for Medicare-eligible employees, emphasizing the importance of understanding how group health plans are affected by MSP regulations. It explains the coordination of benefits process and highlights the specific requirements that do not apply to small employers when their group health plan is the secondary payer. Additionally, the guide discusses plan design options available to small employers, including the potential exclusion of Medicare-eligible employees, limiting coverage to secondary payments, and reimbursement arrangements for Medicare premiums. It also addresses the ACA exceptions relevant to these reimbursement arrangements, ensuring compliance with regulations while providing support to employees.