Medicare Advantage Employer Group (EGWP) Plan Options
Support your employees and retirees once they become Medicare-primary with Group Medicare plans made to fit their needs. It’s another way to help retain top talent, letting your employees know you’re there for them every step of the way, even after they retire.
Request QuoteOr call (888) 384-4840 (TTY 711).
Plans Made Easy
Plans That Fit
We work with you to find the plan that fits the needs of your organization.
Less Paperwork
We administer the plan, which means less paperwork for you.
Member Materials
We send plan materials, including an ID card and policy, to all new members and upon renewal.
No Yearly Enrollment Period
Medicare primary members and retirees can enroll in a Group Medicare plan at any time during the year.
How It Works
Employer Contribution Toward Premium
You can contribute anything from $0 to the full amount for enrollee premiums. If retirees within the organization qualify for different levels of employer contribution, you can establish those levels.
Billing Options
We can do a group bill or bill members individually.
Dedicated Employer Group Client Consultant
You have a single point of contact for all questions about Group Medicare benefits. This representative can help with every aspect of your plan.
Low-Income Subsidy
Members may qualify for the Extra Help program from the federal government for help paying their monthly premium and prescription drug copayments. If retirees qualify for assistance, the premium billed for those members will be reduced by the amount of assistance they receive. This can vary from member to member, and you must pass the subsidy to the member’s portion of the premium. State help may also be available for certain people who qualify.
Eligibility
Medicare primary members and retirees with Medicare Parts A and B are eligible for Group Medicare coverage. If your group has fewer than 20 total employees, active employees ages 65 and over might also be eligible. Underwriting isn’t required. Members must continue to pay their Medicare Part B premium if not otherwise paid for under Medicare or by another third party.
Group Medicare Plans
HMO-POS
Point of Service
Employers can choose this if they’re based in North Carolina and at least 51% of their eligible Medicare primary members and retirees reside in Medicare Advantage-licensed counties. These plans combine some aspects of both HMO and PPO plans.
Resources and Materials
Medicare Advantage Resources
Pharmacy Coverage
Help your Medicare primary members and retirees get the prescription medication they need. Our Medicare Part D (drug coverage) formulary lists the drugs we cover. (Generally, we only cover drugs that are listed.)
Group Medicare FormularySee our Pharmacy Coverage Requirements for more details.
Large Provider Network
Employer Contribution Toward Premium
Give your Medicare primary members and retirees access to trusted care from respected doctors, hospitals and other healthcare professionals.
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