Retirees Cheated: Federal Law And NAIC Regulations Ignored

92 views
A+A-
Reset

Retirees Cheated: Federal Law And NAIC Regulations Ignored

The election is over, the $2,000 prescription drug cap is in place but plan D premiums, deductions, and copays in 2025 may be significantly higher. We will report on details later.

We are set to lobby for reinsurance protection for derisked pension plans. Also, we are not confident that attacks on Social Security and Medicare are over but are ready to respond.

The American Retiree Education Foundation (AREF), NRLN’s research affiliate, spent six (6) months collecting survey information and personalized comments from IBM, AT&T, AVAYA, and TVA retirees and their respective NRLN Associations and Chapters about Medigap plan terminations.

In September we began a similar study using survey information about Medicare Advantage (MA) plan terminations. MA plans were terminated nationwide by Humana, CVS-Health Aetna, Centene – WellCare and Cigna claiming that terminated plans were unprofitable. A combined total of 1.1 million retirees became vulnerable because of these nationwide cessations and terminations of plans.

Federal law and the National Association of Insurance Commissioners (NAIC) regulations require that those affected by such terminations be eligible for a Guarantee Issue Right (GIR) and Special Enrollment Period (SEP). Eligibility would trigger a formal letter from insurance companies and company-sponsored plan administrators.

About half of those whose Medigap plans were ceased or terminated were not notified of a GIR. We expect the same outcome for MA plans but lack data to validate it for all 1.1 million affected.

WHAT ARE GIRs and SEPs and ARE THERE CONSEQUENCES IF I’M CHEATED OUT OF ONE?

A GIR notice assures those who lose coverage due to cessation or termination, that they have the right to buy new coverage at the best available market premium and other terms, and that you may not be rejected due to the existence of current or past medical conditions – we collected current Medigap G premiums, then compared them with lowest available premiums – savings averaged 30%.

More important, those with serious or chronic health problems such as cancer, diabetes, kidney, or heart diseases, etc. must be accepted by insurance companies, avoiding the 20% coinsurance loss.

The SEP guarantee means that you would have a period of up to 63 days to find a replacement plan.

We will advise you by email when we post study details and NRLN’s lobby requests for action on behalf of affected retirees with Medigap and MA plans on nrln.org website. We will need your help.

Bill Kadereit, President

National Retiree Legislative Network

National Retiree Legislative Network
Based in Washington, D.C., the National Retiree Legislative Network (NRLN) is the only nationwide organization solely dedicated to representing the interests of retirees and future retirees. Formed in 2002, the NRLN’s endeavors to secure federal legislation to protect retirees’ employer-sponsored pensions and benefits in addition to keeping Social Security and Medicare strong.

This website uses cookies to improve your experience. We'll assume you're ok with this, but you can opt-out if you wish. Accept Read More...

Verified by MonsterInsights