Filed Under:Health Insurance, Individual Health

Understanding METs and TEFRA

Americans are living longer than ever these days -- and some are working later in life than ever, too. This has consequences for employers of all sizes, especially those with fewer than 20 employees, in their group health benefit costs. And the news is not all bad, either.

According to the U.S. Census Bureau's recent population reports (December 2005), 35 million people in the United States today are age 65 plus; in 2030, the bureau projects the older population will double to 72 million. Out of that population, those who choose to continue to work past the age of 65 create unique health care plan obstacles for both the employer and employee. As an agent, if you have small group clients with fewer than 20 employees, and some of the employees are seniors, you have the opportunity to present new strategies to reduce their group health plan costs.

Senior employees on small group health plans tend to disproportionately increase the overall morbidity risk and subsequently may generate higher premium rates for the whole group in states where small group medical underwriting and modified community rating is permitted. Thousands of small employer groups are experiencing this rating action and are searching for effective solutions to reduce the high cost of their health insurance premiums with minimal impact on benefits.

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Nichole Morford

Nichole Morford
Managing Editor

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