HHS Issues Rules for Retiree Care Reimbursements

Final interim rules unveiled Tuesday, May 4, detail the requirements that employers must meet to receive federal reimbursement of claims by pre-Medicare-eligible retirees.

Under a $5 billion program—authorized by the new health care reform law—employers with health care plans covering retirees from age 55 through 64 will be reimbursed for 80 percent of such retirees’ claims between $15,000 and $90,000.

The Department of Health and Human Services’ rules specify that only health care expenses incurred after June 1, 2010, are eligible for reimbursement. Health benefits that qualify for reimbursement include medical, hospital, surgical, prescription drug, mental health and other benefits that may be specified by the HHS secretary.

To receive reimbursement, health care plans must have programs in place that save costs or have the potential to save costs for participants with chronic and high-cost conditions, according to a White House fact sheet. 

Filed by Jerry Geisel of Business Insurance, a sister publication of Workforce Management. To comment, e-mail editors@workforce.com.

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