MCM Agency

Get set Get ready, open enrollment for Medicare choices are around the corner. Follow us for tips on what's new in the Medicare Arena. Did someone say Long Term Care and Medicare? Nope those 2 don't work together. Follow us for tips and tricks on how to manage your Long Term Care (custodial needs) in your state

Cold lobster salad with all the fixins!!

Excellent help for those of you wanting to know more about your Medicare rights. Sign up or share Hope you will find their information informative and helpful. NOTE they are a not for profit group helping seniors with Medicare related information

MI Pro Courses - Medicare Interactive Welcome to Medicare Interactive Pro (MI Pro), an online curriculum designed to empower any professional to better help their own clients, patients, employees, retirees, […]

Coordination of Benefits: Everything You Need to Know COB, or coordination of benefits, occurs when an individual is in possession of more than one insurance policy and it comes to processing a claim.

The Medicare open enrollment is in full swing. Most people have questions.
Are advantage plans something I should consider? How do they differ from Supplemental/ Medigap plans?
Do I have to use Network medical service providers/facilities?
What about changes in Prescription Drug plans?
What are Give Back plans?
Do my plans provide Dental?
If so do I have to use a dentist only in Network?
Dec 7th is the last day for change.
Give us a call. We are here to help!

Send a message to learn more

Annual Medicare Open Enrollment is in Full Swing. Give us a call to help you choose a plan designed to me meet your needs. 25 years of educating people just like you!
Ask for Max 914 714 2216.

Cool face yoga

Lift & Sculpt with FaceYogaMonna on Instagram: "We need to work on the in -and outside to achieve results🌟 In this video you’ll have a small massage routine that will give you and your pretty face an instant lift me up feeling. Enjoy it an... Lift & Sculpt with FaceYogaMonna shared a post on Instagram: "We need to work on the in -and outside to achieve results🌟 In this video you’ll have a small massage routine that will give you and your pretty face an instant lift me up feeling. Enjoy it an remember to not overdo the moves💚 ...

How will the future of Part D and certain coverage under your part B will change for 2023 and 2024. AARP brings you a simplified explanation. More to come.

AARP® Official Site - Join & Explore the Benefits AARP is the nation's largest nonprofit, nonpartisan organization dedicated to empowering Americans 50 and older to choose how they live as they age.

We've been waiting for years for the government to give Medicare the ability to negotiate the prices for our part D drugs. Hopefully this will do the trick! Read on.... call 914 714 2216 for help with any Medicare product.

Column: Landmark U.S. healthcare bill sets stage for lower Medicare prescription drug costs The climate and healthcare legislation that Congress is set to approve later this week includes the most important improvements to the Medicare program in nearly two decades. The changes aim to address one of the biggest concerns of seniors: the fast-rising cost of prescription drugs.

Finally Medicare approves No Cost Home COVID tests. Read the full article.
Questions? We are here to help answer them. Call Max @ 914 714 2216

CMS Says Medicare Will Cover At-Home COVID Tests at No Cost Earlier today, the Centers for Medicare & Medicaid Services (CMS) announced plans to make over-the-counter (OTC) COVID-19 tests available to people with Medicare at no cost by “early spring.” According to the agency, “[u]nder the new initiative, Medicare beneficiaries will be able to access up...

Balance Billing what you need to know. Effects people with Group/Individual/Gov't sponsored plans etc.
Medicare already has a similar provision for surprise billing so this isn't changing how the law protects those people covered
by those programs Read more and remember when in need of immediate answers or if you have a specific question, please
feel free to call Max 914 714 2216

What You Need to Know about the Biden-Harris Administration’s Actions to Prevent Surprise Billing | CMS On July 1, 2021, the Biden-Harris Administration, through the U.S. Departments of Health and Human Services (HHS), Labor, and the Treasury, as well as the Office of Personnel Management, issued “Requirements Related to Surprise Billing; Part I,” an interim final rule with comment period that wil...

Medicare Part B Base monthly premiums rose dramatically to over $170 per person for 2022. This is one of the largest annual increases ever.
Due primarily to the availability to a new Alhzheimer drug, that is delivered mostly via infusion. Most infusion medications are then covered under part B vs Part D as most would assume. News recently came out that the cost of this expensive drug may be half of what initially was expected.
The Centers for Medicare are now reconsidering the part B premiums for 2022. There is a good possibility that the CMS, will roll back or reduce going foward the part B premiums.
Keep up on all the many changes in Medicare by visiting our website frequently or call us with any Medicare questions you may have. 914 714 2216 ask for Max

Is Medicare the right choice for your wallet. We are here to help! Adjustment Changes for 2022. Something to think about as you consider leaving your employer plan when you work for a company with 20+ employees.
914 276 0469 MCM ask for Max

What is the income-related monthly adjusted amount (IRMAA)? For high-income Medicare beneficiaries, Part B and Part D premiums will include an additional charge based on MAGI.

Help everyone win the fight to keep the drug prices down. The ever increasing Rx prices are making it impossible for all Americans to buy much needed medication at affordable prices. Its especially hitting those folks in the middle who aren't eligible for EXTRA help from the state or the Federal gov't. We are asking you to keep our voices heard in Congress. Let Medicare negotiate with the pharmaceutical companies, like they do in all the other countries Please share and add your name below to let the politicians know you want to keep the pricing of our medications reasonable. Its a shame that people have to purchase drugs from other countries because they just can't afford the sky rocketing costs. Read below and don't forget to add your name or write to your congress person and do it today.

Deal Would Allow Medicare to Negotiate Drug Prices A historic agreement means older Americans may no longer have to choose between paying for food or medications. ​AARP has long fought for Rx reforms.

Get ready to pay even more for your Part B premiums. Read this article to understand why you are paying more if you earn above certain thresholds. This is called Income Related Monthly Adjusted Amount or IRMAA. In 2021 Part B average for those earning under $88k single or $176 filing jointly was $148.50 per month per person. Anticipated increase this year 2022 will be about $10 more per person per month. Yup upwards to $158.50 per per person per month. With 6 varying levels of income, you could be paying over $500 per month per person if your income is above $500k to a max of $750K. You might be thinking those earning income like that should pay more, but with Baby Boomers working longer, and those retirees who saved well and are drawing down their IRA's, you may be in for a little sticker shock. If your earnings in 2020 were above $91k single or $182K a couple you pay more for both part B and Part D. Both premiums are either taken from your SS or if you aren't drawing yet, then you pay quarterly once you apply for Medicare. Your adjustment is taken from your federally filed income tax and is referred to your "Modified Adjusted Gross Income" from 2 years prior so as an example, if you are new to Medicare, SS bases your Part B and Part D IRMA from your 2019 income taxes. There is an appeals process if your lifestyle has changed and your can file it as soon as it occurs, such as retiring, losing an income due to a death, divorce etc, reduction in income from other sources. Medicare isn't free, but we can show you to make the most of your Medicare Coverage. Call us today 914 276 0469 ask for Max.

2021 2022 Medicare Part B Part D IRMAA Premium Brackets You pay higher Medicare Part B and Part D premiums if your income exceeds certain thresholds. Here are the IRMAA income brackets for 2021 and 2022.

Paycheck Protection isn't just a Covid term! How many of you have thought, what would you do if you couldn't work due to a temporary or long term sickness or accident? Call MCM 914 276 0469 to learn about the affordable way you can have peace of mind knowing you could still provide income for your everyday needs with an income protection plan.

Its getting to be that time again,
THE MEDICARE MAZE open enrollment begins Oct 15 runs thru Dec 7th.
Don't be left in the dark about what's free and how to secure the best program designed specifically for your needs and pocket. Call us at 914 276 0469 ask for Max. We're here to help.

SELF EMPLOYED? Lost your group coverage? Young and Healthy but your income is low? There is help for you all.

If you're self-employed, you can use the individual Health Insurance Marketplace® to enroll in flexible, high-quality health coverage that works well for people who run their own businesses.

You’re considered self-employed if you have a business that takes in income but doesn’t have any employees.

You can enroll with the help of MCM brokers, Marc Altneu through the Marketplace if you’re a freelancer, consultant, independent contractor, or other self-employed worker who doesn’t have any employees. If your business has even one employee (other than yourself, a spouse, family member, or owner), you may be able to use the SHOP Marketplace for small businesses to offer coverage to yourself and your employees. See "How do I know if I’m self-employed or a small employer?" Want to see if you can receive a hefty Tax credit in addition to taking a deduction for providing employee benefits for your employees? Call us at MCM Agency Inc 914 276 0469. Ask for Marc or Max. We are always happy to advise you on the latest and most cost effective way to provide benefits. When you offer BIG COMPANY Choices you keep & attract happy employees! Now what employer doesn't want that?

Want more answers to:
How do I apply for Health coverage if I'm self-employed?
How do I know if I’m self-employed or a small employer?
What if I leave my job, lose my job-based coverage, and become self-employed?
What if I’m self-employed and then get a job that offers health coverage?
What if I’m self-employed and my spouse has coverage through a job?
What if I have COBRA coverage?
Call us we are here to help!

Get started with Medicare
Medicare is health insurance for people 65 or older or for those who have been covered by Social Security Disability for 24 months.. You’re first eligible to sign up for Medicare 3 months before you turn 65. You may be eligible to get Medicare earlier if you have a disability, End-Stage Renal Disease (ESRD), or ALS (also called Lou Gehrig’s disease).

Follow these steps to learn about Medicare, how to sign up, and your coverage options. Learn about it at your own pace.

Click the link and follow along.
https://www.medicare.gov/basics/get-started-with-medicare
Then give us a call at MCM 914 714 2216, we are here to help!

Get started with Medicare | Medicare Medicare is health insurance for people 65 or older. You’re first eligible to sign up for Medicare 3 months before you turn 65.

April brought us ARPA. This law includes many items good for employees who lost their benefits during this past year due to the pandemic.
One important change:is the Cobra Law. You may be entitled to free benefits including medical dental and vision if you were termed due to Covid reductions of hours, furloghs etc. Read below or call to discuss 914 714 2216
This article was reprinted from a law firm:
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Free And Extended COBRA Coverage Under The American Rescue Plan Act oF 2021
By Matthew A. Secrist and Gregory J. Viviani of Squire Patton Boggs (US) LLP
March 16, 2021
Section 9501 of the American Rescue Plan Act of 2021 (the “ARPA”)[1] requires employers to extend offers of free COBRA coverage to certain individuals for the period from April 1, 2021 through September 30, 2021. The ARPA then provides tax credits as means of offsetting the costs of the free COBRA coverage. The law also requires employers to extend offers of COBRA coverage to other individuals whose right to COBRA coverage previously ended.

This blogpost reviews who is eligible for free coverage, how the tax credits work, eligibility for extended coverage, and some potential issues pertaining to insurance coverages.

Background
The “COBRA Law”[2] is a federal law that generally obligates employers with group health plans to offer covered employees and covered dependents (“COBRA qualified beneficiaries”) the right to continue coverage under the group health plan in certain circumstances where the coverage otherwise would cease. For purposes of the COBRA Law, group health plans include medical, prescription drug, dental and vision plans.

Primarily relevant here, the COBRA Law requires an employer to offer continuation of coverage for 18 months when coverage is lost due to a covered employee’s reduction in work hours or termination of employment (other than on account of gross misconduct).

A qualified beneficiary’s right to COBRA coverage ceases if the individual becomes covered under another group health plan that does not contain an exclusion or limitation with respect to a preexisting condition. COBRA rights also cease if a qualified beneficiary comes entitled to Medicare, after electing COBRA coverage.

Employers are permitted to charge qualified beneficiaries up to 102% of the medical plan’s costs of the coverage.

Free COBRA Coverage
Under Section 9501 of the ARPA, free COBRA coverage must be offered to COBRA qualified beneficiaries who are enrolled for COBRA coverage under a group health plan on April 1, 2021 and thereafter, if coverage under the plan is lost, or previously was lost, due to a covered employee’s:

reduction in work hours (e.g., layoff, furlough, etc.), or

termination of employment (other than a voluntary termination).
The offer of free COBRA coverage will cease if an individual becomes eligible for other group health plan coverage or Medicare.

Thus, free COBRA coverage must be offered on a prospective basis for losses of coverage that occur from April 1, 2021 through September 30, 2021, on account of a covered employee’s reduction in work hours or termination of employment (other than voluntary).

In addition, free COBRA coverage also must be offered to the following types of qualified beneficiaries and other individuals:

Qualified beneficiaries who are enrolled for COBRA coverage as of April 1, 2021, on account of a covered employee’s prior reduction in hours or termination of employment (other than voluntary) and prior election of COBRA coverage.

In addition, it appears that free COBRA coverage must be offered to qualified beneficiaries who are in a regular COBRA coverage election and can elect COBRA coverage with an effect date that is retroactive back to April 1, 2021 or before.

If any of the foregoing rules do apply, the offer of free COBRA coverage must be made effective as of April 1, 2021. However, free COBRA coverage does not have to be extended past the end of what would have been the normal expiration date for the underlying COBRA coverage period (e.g., 18 months from the date of a covered employee’s termination of employment or reduction in work hours).

Extensions of COBRA Coverage
The law provides special COBRA enrollment rights under a group health plan for the following individuals who are not enrolled for COBRA coverage as of April 1, 2021:

An individual who previously had the right to elect COBRA coverage on account of a covered employee’s prior reduction in work hours or termination of employment (other than voluntary).

An individual who was previously covered under the group health plan via a valid COBRA election of coverage, but subsequently had that coverage discontinued before April 1, 2021.

The law is unclear in these two situations whether an offer of free COBRA coverage must be made. We are hopeful that the DOL will issue guidance on this point.

Note that the latter rule seems to apply to anyone who was previously on COBRA, and without regard to the type of COBRA “qualifying event”.

If any of the foregoing rules apply, the offer of extended COBRA coverage must be made effective as of April 1, 2021. However, COBRA coverage does not have to be extended past the end of what would have been the normal expiration date for the underlying COBRA coverage period (e.g., 18 months from the date of a covered employee’s termination of employment or reduction in work hours).

Termination of Employment Issues
Section 9501 of the ARPA introduces a new concept to the COBRA law. Under Section 9501 of the ARPA, the offer of free COBRA coverage does not have to be made if the employee’s termination of employment was “voluntary”.
It is not clear whether a mutual termination of employment will or will not be considered “voluntary” under the law. Given that there are tax credits being provided to help offset the employer’s costs, and that an employer can be subject to liability for failure to offer free COBRA coverage, we believe it would be wise for employers to be cautious when determining that an offer of free COBRA coverage does not have to be made because an employee’s termination of employment was voluntary.

In addition, note that previously, COBRA coverage did not have to be offered if an employee’s termination of employment was on account of “gross misconduct”. That exception still applies. Thus, if a qualified beneficiary was not offered COBRA coverage previously because an employee’s termination on account of gross misconduct, free COBRA coverage does not now have to be offered to that person. Nor would free COBRA coverage have to be offered prospectively to an employee whose termination of employment is on account of gross misconduct.

Notice and Election Issues
Fortunately, the law requires the Department of Labor to issue within 30 days, a model notice for employers to use to advise qualified beneficiaries of their rights under the law. Plan administrators are required to give notices to eligible qualified beneficiaries by not later than May 30, 2021.

Once an eligible qualified beneficiary receives a notice, the individual is entitled to a 60 day period to elect the COBRA coverage. Any coverage elections will be made retroactive back to April 1, 2021.

Plan Administrators should be gathering information now to get ready to send out the required notices. In general, COBRA notices can be sent by first class mail to the last known address of a qualified beneficiary. However, it might be advisable under these circumstances to send a letter that has a return receipt.

If there are missing qualified beneficiaries, it is advisable for an employer to at least take some common sense actions to locate them. For example, former co-workers may know the whereabouts of a missing qualified beneficiary. The employer also might have a telephone number or home E-Mail address that might be used to contact a missing qualified beneficiary.

On an ongoing basis, as employees have reductions in work hours and terminations of employment (other than voluntary), COBRA notices will also need to be revised or supplemented to advise qualified beneficiaries of their rights to free COBRA. Again, the DOL is supposed to be issuing a model notice.

Notices of free COBRA will also have to explain that an individual’s right to free COBRA will cease if the individual is eligible for coverage under another group health plan. The law also provides a tax penalty if an individual fails to notify the group health plan that the individual is eligible for coverage under another group health plan. The tax penalty generally is $250 (or a much higher amount if the failure is intentional). The notice to the individual will also have to explain the employee notice and potential penalties.

Finally, the law also imposes another notice obligation. If a qualified beneficiary does elect free COBRA coverage, the plan administrator is required to notify the individual 15 – 45 days before the free COBRA coverage will expire. Again, the DOL is supposed to provide a model notice.

Tax Credits and Insurance Company Issues

In an effort to help offset the costs of providing free COBRA coverage, the law makes available tax credits that may be taken against employer Medicare taxes. The tax credits are based on the COBRA premiums that would have been payable by the qualified beneficiary for the relevant free COBRA coverage.

This portion of the law has an unusual twist. Except as may otherwise be provided by the Secretary of the Treasury, the tax credits are provided to the following persons:

If the plan is a multiemployer plan, the multiemployer plan itself.

If the plan is fully or partially self-insured, to the employer that sponsors the plan (including state and local governmental employers).

If the plan is not described above, to the insurance company

If an employer has a fully insured plan, presumably the employer will have to continue to pay premiums to the insurer for the enrollment of any qualified beneficiaries. However, the law provides that the tax credit goes to the insurance company, and not to the employer.

Under this scenario, the law does not seem to obligate an insurer to give the employer any portion of the tax credits as an offset to employer premiums. Thus, apparently the employer will need to negotiate with the insurer to have the insurer’s tax credits used as an offset the employer’s premiums that are due under the plan for the qualified beneficiaries.

In the case of a self-insured plan, the employer will directly receive the tax credits. However, a secondary issue might be lurking in relation to the employer’s coverage under a stop-loss insurance policy.

The law does not address stop-loss policy coverage. Thus, self-insured employers may want to promptly determine whether the plan’s stop-loss coverage will apply to claims incurred by COBRA qualified beneficiaries who obtain free COBRA coverage or extended enrollment rights under the ARPA. If the stop-loss policy will not apply to claims from those qualified beneficiaries, the employer may want to try to negotiate with the stop-loss carrier for additional coverage.

* * *

[1] P.L. 117-2, effective March 11, 2021.

[2] For private sector employers, the “COBRA Law” is contained in Part 6 of Subtitle B of Title I of the Employee Retirement Income Security Act (ERISA) (29 U.S.C. §601 et. seq.). Tax law penalties for failure to comply are contained in Section 4980B of the Internal Revenue Code. State and local governmental employers are subject to certain provisions of the Public Health Service Act (42 U.S.C. §300bb-1 et. seq.).

© Copyright 2020 Squire Patton Boggs (US) LLP
National Law Review, Volume XI, Number 75
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Eligibility and payment of COBRA premiums paid at 100% through Federal subsidies are discussed in this article. This can mean 1000's of prior or current employees who lost their medical, dental or vision may be able to reconsider their coverage options. Please read this VERY IMPORTANT article regarding Employer and Employee responsibility under the American Recovery Plan specifically addressing COBRA subsidiaries.
At MCM we care about your benefits!

The American Recovery Plan Provides (Generous and Administratively Challenging) COBRA Subsidies | JD Supra The recently enacted American Rescue Plan Act of 2021 (the “Act”) creates a federal subsidy covering 100% of COBRA premiums for certain employees and...

A quick overview of the American Rescue Plan Act of 2021

American Rescue Plan Act of 2021 | Alert On March 11, 2021, President Biden signed the American Rescue Plan Act of 2021 into law.

Silver sneakers available with Supplemental Plan through various Supplemental & Advantage plans
Call 914 714 2216 and ask about how you can get enrolled for FREE :) Its good to take control of your health!
Home videos, exercise equipment and classes at various gyms across the country!

Take Control of Your Health Be sure to switch to a health plan that has SilverSneakers!

MEDICARE INFO:
March 31 ends your second
Open Enrollment Period for anyone who wants to change their Medicare Advantage, Medicare Part D plans or return to original MEDICARE.

Just for laughs
I’ve reached an age where my train of thought often leaves the station without me!!

“Do you know the present value of your husband’s policy?” the life insurance agent asked his client.

“What do you mean?” countered the woman.

“If you should lose your husband, what would you get?” asked the agent.

The woman thought for a minute, then brightened up and said, “Probably a poodle.”

Sorry guys, I couldn't resist reposting this one!!!

Tomorrow December 7th, ends the Medicare Annual Enrollment Period, but you can still buy a Supplemental or Gap policy all year long.
Give us a call to see if we can help you find a plan designed to meet your specific needs. 914 714 2216 ask for Max. You'll be glad you did!