Upon retirement or when COBRA coverage is coming to an end…..What should retirees consider when looking for Healthcare Insurance?
The Intel Retiree Organization has received requests from US retirees coming up to the period when COBRA runs out to help them understand key learnings from other retirees who have gone through the process of getting healthcare insurance after COBRA.
Upon retirement from Intel or when your COBRA coverage is coming to an end, and you are thinking about healthcare insurance options for your future, the first thing to consider is, what is your age? If you are under 65, then the next consideration is your financial situation and how much can you afford to pay in monthly premiums for health insurance coverage. You have basically three options available to you if you are under age 65 and not yet Medicare eligible.
Option 1: You can consider pre-Medicare IRMP (Intel Retiree Medical Plan) which is available to retirees of any age up to age 65. Premiums for IRMP tend to be on the higher side when compared to other options, however, the benefits of the plan are comprehensive coverage with relatively low deductable, and maximum out of pocket limits.
Option 2: You can purchase insurance on the open market. You can search and shop for a policy on your own through the internet or you can request the assistance of a licensed health insurance broker/agent at no added cost to you.
Option 3: You can purchase health insurance through your state or federal Health Insurance Marketplace otherwise known as the Affordable Care Act Exchange. The benefit of getting your coverage through the exchange is that you may qualify for financial subsidies to offset the premium and co-payment costs depending on your household income and size. All plans meet the ACA minimum essential coverage requirement (bronze, silver, gold, and platinum) and have generally higher deductable, co-pay, and maximum out of pocket limits. While premiums for these plans are competitive, they are not necessarily lower than what you can get on your own through option 1 or 2.
If you are on COBRA and you decide that you would like to move to a different healthcare insurance plan, here are some considerations:
- During the Open Enrollment period (of the Healthcare Marketplace) you can drop your COBRA coverage and get a plan through the Marketplace (ACA Exchanges) instead. This is true even if your COBRA coverage hasn’t run out (you haven’t completed the 18 months).
- If your COBRA coverage (typically 18 months) is ending outside Open Enrollment (you have completed the typical COBRA coverage period of 18 months and it is not yet Open Enrollment time), you qualify for a special enrollment period. This means you can enroll in a private health plan through the Marketplace (ACA Exchanges). You may qualify for tax credits that can lower your monthly premiums and for lower out-of-pocket costs. This will depend on your household size and income.
- If you are ending your COBRA coverage early outside Open Enrollment (prior to the completion of the typical COBRA coverage of 18 months and it is not yet Open Enrollment time), you will not be able to enroll in a Marketplace (ACA Exchange) plan at all, with or without lower costs. However, you can purchase an individual healthcare plan on the open market. You will not be eligible for tax credits that lower your monthly premiums on healthcare plans available through the Marketplace (ACA Exchanges) because you aren’t purchasing through the marketplace.
- At any time you can end your Cobra coverage and purchase healthcare insurance on the open market through an insurance broker. The Intel Retiree Organization has a list of several healthcare insurance brokers that retirees at Intel have used and recommend. If you reside in Oregon, California, or Arizona and are interested in contacting one of these brokers you can go to http://intelretiree.com/insurance-brokers/
- For state specific information on purchasing Individual healthcare insurance on the open market, you can click here: http://www.naic.org/state_web_map.htm. Click on your state to find this information.
- For more detailed information, you can click on: https://www.healthcare.gov/what-if-i-currently-have-cobra-coverage/ and read more about your options for Healthcare Insurance if you have COBRA.
The information outlined above, on your healthcare insurance options while on COBRA, is our best effort to interpret and assist, however we are not the experts and we encourage you to contact the appropriate resources to validate your individual situation and impact.
- Intel provides a medical plan for retirees of all ages. The IRMP is designed to provide access to comprehensive medical coverage.
- You can sign up for IRMP CIGNA co-insurance plan (if you are not Medicare eligible) or an IRMP Indemnity Plan (for Medicare eligible). The Medicare Plans can be purchased with and without prescription drug options.
- The SERMA program is provided to help eligible retirees purchase health insurance for themselves and their dependents. If you have a SERMA account it can be used for IRMP premiums or for reimbursement for certain other types of health insurance premiums.
- IRMP offers one plan for the not-yet Medicare eligible, the plan does not qualify for a Health Savings Account.
- Health Insurance regulations and rates vary by state.
- If you find insurance that you prefer on the open market, you can change to the new insurance before COBRA runs out.
- You can sign up at the open enrollment period for the Federal Health Insurance Marketplace even if you haven’t completed the typical 18 month term of COBRA.
- IRMP does not provide dental benefits and vision benefits are separate from IRMP. If you choose to try to come close to replicating your employee benefits in retirement, you would want to look for dental plans on the open market and select either the Vision Benefit option at Intel’s Open Enrollment or Vision coverage on the open market.
- If the non-Intel spouse needs/selects IRMP, then the Intel spouse must also choose IRMP. Otherwise, the Intel retiree can be on IRMP and their spouse can be on another insurance plan on the open market.
- If you purchase insurance on the open market, spouses may have two different healthcare insurance policies.
- Non Medicare (typically under age 65) retirees note: If you or your dependent(s) are under age 65 and choose not to enroll in IRMP upon your retirement or after COBRA coverage sponsored by Intel ends, you must provide proof of 18 months of continuous health care coverage, without a break in coverage of 63 days or more, for your dependents to enroll in IRMP at a future date. A HIPAA certificate from a group/employer health plan, COBRA coverage or another form of proof of continuous coverage from an individual insurance plan, VA or TRICARE satisfies this requirement to enroll in IRMP.
- Most Intel retirees view IRMP as a good health care insurance plan but, generally more expensive than other plans on the open market. Retirees may be able to find plans on the open market at lower costs.
- IRMP with Medicare: This is an indemnity policy NOT a supplemental policy. Medicare pays 80% of covered items. This insurance does NOT pay the 20% of the medical bill that is not covered by Medicare. (This uncovered amount can be covered by purchasing a supplemental policy.) Medicare does pay these expenses after an annual out-of pocket max has been paid by the retiree. The IRMP also provides coverage for some items not otherwise covered by Medicare including some benefits, for example, for eye care and hearing services.
- You can find supplemental insurance policies for Medicare recipients through specific websites (e.g. AARP, Blue Cross, etc.) and http://www.medicare.gov/
- DO NOT let your coverage lapse! Know when decisions need to be made; make them and communicate them in time to make the deadlines. Remember it is OK to drop COBRA early – before it runs out.
- To learn more, information from state insurance commissioners is in the ‘tips and tricks from retirees article on finding insurance on the open market. (http://intelretiree.com/health-care/finding-insurance-on-the-open-market/)
- Health insurance exchanges have been set up for every state as mandated by the Affordable Healthcare Act.
- We have the names of three insurance brokers (in Arizona, California, and Oregon) who retirees have worked with and recommend. http://intelretiree.com/insurance-brokers/
- It is recommended that retirees read the full details of the plans, as only ‘Key Points’ are highlighted here. There are many more important details.
- The Affordable Healthcare Act may continue to impact much of the above information.
- If you have other questions, after looking at this material you can send an email to our mailbox. (firstname.lastname@example.org)
- If you have children that are dependents (as defined by the IRMP plan document) you can insure those dependents through IRMP.
For all of the important details please go to and read the following links:
To read the plan description for COBRA: go to: http://intelretiree.com/intel-benefits/retirement-time-line/
- click on the Intel Retiree Medical Plan My Health Benefits under Retirement core benefits (note: there are 2 pages here, an overview and then the login screen for the My Health Benefits Website)
- If you have never established an account with My Health Benefits previously the process to get a login ID is shown.
- Enter My Health Benefits website using your password
- Go to Knowledge center, plan information
- Go to Cobra Continuation Coverage (under the heading Pay, Stock and Benefits handbook)
- NOTE: see section 11.7 re: COBRA ending
Links to the website where you can read all about IRMP and SERMA and understand what’s covered by the IRMP insurance and the costs
- In My Health Benefits, Knowledge Center
- To read an overview of IRMP (Intel Retiree Medical Plan) and SERMA look under the heading Pay, Stock & Benefits, section 18.54
- To find the specifics of IRMP look under the heading Additional Information for IRMP Summary Plan description
- To find the costs of IRMP look under the heading Plan Rates for 2012 IRMP monthly premiums
- NOTE: IRMP specifics, See page 23 for a summary of benefits coverage for CIGNA (pre Medicare) and page 47 for a summary of benefits for Medicare coordinating policies. On page 47/48 you can see the coverage provided by IRMP that is not covered by Medicare.
To find information about Medicare, here is a link http://www.medicare.gov/index.html