OneExchange Employer FAQs

  1. Who manages retiree benefits?OneExchange.
  2. Must the retiree (and spouse) establish a joint HRA if both are eligible?Yes – and that is a good thing. The most efficient way for this program to work for the retiree, and cover all possible combinations of retiree and dependent relationships, is with a joint HRA where applicable. This is also an advantage to the employer since the administration costs of the program apply only once (to the account itself and not separately to retiree and spouse) and they both have access to the entire reimbursement fund in the account.
  3. Must retiree (or spouse) purchase retiree supplemental insurance through OneExchange only?Yes – and that is a good thing too. The program is only available to retirees of ICSO H&W companies through the Health Reimbursement Accounts and program established by OneExchange. This should not be perceived as an unreasonable limitation or barrier since unless the ICSO H&W program has 150 or more retiree participants we would not be able to offer the HRA’s, or the individual counseling/advice that is such an important part of the program, to any ICSO H&W retiree.
  4. How much are the providers of the post-65 retiree program being paid?There are actually several entities who must receive compensation in order for this program to be made available to retiree’s. ICSO H&W itself will receive most of the $850 HRA administrative fee and this is to cover its costs – including ongoing legal, administrative, and operating expenses. NAMIC receives no additional compensation for OneExchange program participation (other than the annual program management fee it receives to help administer the entire set ICSO H&W programs and services). Gibson (our broker) will receive a one-time $100 per participant from OneExchange; and OneExchange will receive the commissions already built into Medicare supplement insurance costs (premiums) that retirees will pay for their coverage.
  5. If the retiree finds a supplemental plan outside the OneExchange program that can be purchased for less can they do that?Essentially, the answer here will be No. First – it is difficult to see how a retiree can find a lower price as OneExchange has multiple markets available to them in every state. Second, the only way retirees can access employer funded reimbursements through the HRA is via the OneExchange program, so if a retiree purchases coverage outside the OneExchange program, they can’t get reimbursed for it through the OneExchange HRA. Finally, in order for this benefit plan (including the HRA; the advice and counsel from OneExchange advisors; the ongoing administration/enrollment) to be made available to any ICSO H&W participant we must have 150 or more retirees participating. If participants choose to “go their own way” with a supplemental plan (after taking advantage of setting up the HRA account and perhaps counseling with the OneExchange advisor to find the best plan option) that would make the plan totally unworkable – and likely unavailable – for everyone else.
  6. Does the $850 administrative fee apply per person (i.e., separately to both retiree and spouse) or just to the HRA account?The $850 administrative fee applies to the 07/01/13 -12/31/13 term, and once per year thereafter, to each HRA account. When the HRA account is a joint account for both a retiree and spouse – the fee is still only a single $850 fee.
  7. What happens to funds in a joint HRA if one party dies – do the funds already in the account remain available to the surviving spouse?Yes.
  8. A retiree is not yet 65 (or spouse is not yet 65) – is there guaranteed issue for current and future employees/retirees when they turn 65?As long as retiree or spouse are eligible for Medicare when you turn 65, the plan options provided within the OneExchange program are guaranteed issue.
  9. Can you explain whether there is any tax impact for receiving reimbursements out of an HRA account and whether an account can accumulate interest on any unused funds within it?Good news – the HRA account is a tax advantaged benefit – meaning that the reimbursements the retiree receives for qualified medical expenses from the employer-funded HRA are not considered taxable income. However, interest does not accumulate on any unused funds in the HRA.
  10. Why did ICSO H&W decide to offer only four HRA funding levels to employers?Another great question. As you can imagine, providing a program that can be made available to as many employers and their retirees as possible, yet in a way that does not create a costly and complex administrative process, is a challenge. These four options are an attempt to strike an appropriate balance between flexibility for employers and program efficiency and costs. Also, please keep in mind that the ICSO H&W plan arrangement with OneExchange is somewhat unusual (OneExchange usually is working with only a single employer with more than 150 retirees, not 40+ different employers with 150+ retirees, as is the case with the ICSO H&W plan). In fact, having four options is a bit of an accommodation by OneExchange for this program. ICSO H&W will monitor these funding levels going forward to ensure they present viable choices for employers and their retirees.
  11. What expenses can be reimbursed through the HRA account?HRA funds can be used on premiums for healthcare, prescription, dental or vision, out of pocket costs (co-pays, deductibles), Part B premium, eyeglasses, hearing aids, and anything deemed a healthcare expense. (ICSO H&W Plan, as the Plan sponsor, makes final determination of what funding can and cannot be used for)
  12. Can the HRA account be used to pay for prescription copays and coinsurance costs?Yes, however we caution retirees that enter into the coverage gap or “donut hole” not to use the HRA for prescription costs as these expenses are intended to be true out of pocket expenses to the insured.
  13. What happens with surviving spouses of retired employees? Could they stay on the plan or are they subject to COBRA and eventually required to find another carrier?An employer can continue to provide HRA funding to the surviving spouse and/or eligible dependents until their demise if that is the employers stated company policy.
  14. How is eligibility for the HRA plan determined? Will this plan be available to ineligible retirees in the future?Retiree eligibility is determined the same is it currently is, a retiree must be age 55 with 14 years and 1 hour of service. If a participating employer currently provides coverage for post 65 retirees and pays a portion of the premium, then those retirees would be eligible for the HRA.
  15. I believe it was stated that unused HRA funds would rollover indefinitely, as long as the retiree is surviving. Is this the case?Yes.
  16. Can HRA funds be used to cover income-based penalties for Medicare D?Any penalties that would become part of the supplement or Part D premium could be paid through the HRA.
  17. As we begin to have retirees age into the OneExchange program, how far in advance of their 65th birthday will they need to enroll with OneExchange?We will start communicating with retirees aging in to Medicare 120 days prior to their 65th birthday. Retirees can enroll in a plan up to three months before the month they turn 65.
  18. Is any interest earned on HRA accounts?No, HRA accounts do not accrue any interest.
  19. Since OneExchange not only advises retirees, but acts as broker to purchase whatever supplements are chosen, do commission levels and plan prices vary on same plan if purchased through OneExchange or directly by retiree?Commission levels are set by each carrier and are built into plan premiums so they would not differ based on whether the plan is purchased through OneExchange or directly by the retiree.
  20. IRS rules permit use of HRA funds to reimburse for long term care insurance. Is there anything in the ICSO and OneExchange arrangement that prohibits that?While the IRS does permit the use of HRA funds to reimburse for long term care insurance, it is the intention of the ICSO H&W plan in conjunction with OneExchange to provide a replacement plan for their current retiree health insurance plan and therefore the HRA funds through ICSO will be not be available for long term care insurance.
  21. Can HRA funds be used for dental and vision plan premiums and expenses?OneExchange will have some dental and vision plan options available that can be included in the HRA. Out-of-pocket dental and vision expenses that are eligible under IRS Section 213(d) will be reimbursable through the HRA.
  22. Do ICSO members continue to pay Aetna direct for coverage?No. The ICSO member/retiree would be set up by OneExchange to pay the carrier that they end up choosing directly (the carrier might incidentally end up being Aetna), and then get reimbursed from their HRA account through OneExchange for those paid premiums as long as funds remain in their account.
  23. How do retirees fund the post 65 HRA account?Retirees do not fund the HRA account as it is funded by the employer. If a retiree goes over the funded amount from the employer, he or she would be responsible for the difference.
  24. Does the funding have to be made up front in its entirety?Yes, funding is required up front so that full funding is available to the member at the beginning of the plan year.
  25. What kinds of plans are available to retirees thru OneExchange?Retirees have access to an array of Medicare Advantage, Medicare Supplemental, and Prescription Drug plans through OneExchange’s exchange as offered by 75 of the most competitive and service oriented insurance companies in the nation.
  26. How many plan options are available thru OneExchange?Across the United States OneExchange offers over 4,000 plan options across 75 carriers. Due to the fact that pricing differs from zip code to zip code, their national exchange footprint ensures that retirees will have access to the best price and plan design depending on their zip code and unique health needs.
  27. What is the main drawback to the OneExchange program?The communication of such a change to retirees is usually the hardest part; however OneExchange will run the communication campaign with the help of ICSO. OneExchange has transitioned over 225 groups ranging in size from 10 retirees to 90,000 so they have a time tested communication campaign that works. In this case, the employer and retiree have shown financial improvement in most tested scenarios as well as from a plan design standpoint which makes communication of such a change a bit easier.
  28. How would the retirees know which plan to choose from?Retirees will have an enrollment call with a licensed, carrier appointed Benefit Advisor through OneExchange. They will help guide the retiree to the best carrier/plan for not only the retiree’s needs, but also their spouse. The spouse and the retiree can also choose different plans as their health needs may differ. Benefit advisors will perform cost analytics for the retirees on health plans as well as model drug plan usage of the drugs they are currently taking to identify the best possible Prescription Drug plan. 100% of calls are recorded to ensure accuracy.
  29. Are there any tax implications for the post 65 retirees?There are no tax implications to retirees.
  30. Is this program available to pre-65 retirees?No, there is currently not a program available for pre-65 retirees through ICSO.
  31. What is the difference in a Plan F and Plan N?A Plan F pays 100% of all cost not covered by A and B. A retiree with this plan could visit any Medicare participating provider and never have to pay out of pocket.A Plan N has all of the same components of the F except a retiree would have to pay $20 Doctor Visit Co-pay, and $50 Emergency room co-pay. Plan N tends to be 25-35% cheaper than an F.
  32. Will retirees be required to provide proof of current prescription drug coverage creditability under Medicare Part D?ICSO has provided a formal notification of group coverage termination to OneExchange for all current retiree health plan enrollees that should provide the verification that carriers will need that the retiree has had creditable prescription drug coverage under the current retiree health plan through ICSO. If any further verification is required, it will be provided through ICSO.