From uncertainty to security: Rethinking retiree health plans with the individual marketplace

As healthcare costs continue to rise, plan sponsors are searching for cost-effective, flexible solutions to provide retirees with quality coverage while maintaining financial sustainability. The individual marketplace offers a modern alternative to traditional group health plans, enabling plan sponsors to reduce costs, mitigate risk, and enhance choice.

What is the Individual Marketplace?

The individual marketplace, often referred to as an “exchange,” is a platform where retirees have expert guidance and decision support to shop for and enroll in personalized health insurance plans that best fit their needs. Unlike traditional group plans, which offer limited options, the individual marketplace delivers greater flexibility and personalization, ensuring that each participant finds a plan tailored to their unique healthcare and financial situation. Because health insurers are competing for enrollments in a large and growing risk pool, the individual marketplace drives maximum efficiency and value for retirees.

Plan sponsors can continue to provide financial support to retirees in the marketplace delivery model – the subsidy is provided through a Health Reimbursement Arrangement (HRA). The HRA is a tax-free account that reimburses retirees for qualified expenses, and plan sponsors define the annual contribution amount.

Empowering informed decisions with Via Benefits

Via Benefits has helped millions of retirees successfully transition from group coverage to the individual marketplace, offering:

• Expert benefit advisors to guide participants through plan selection

• Comprehensive decision-support tools for easy comparison of coverage options

• Ongoing advocacy services to ensure continued healthcare access and financial security

What advantages will plan sponsors see moving to the individual marketplace?

• Cost control & predictability
  Plan sponsors can reduce long-term liabilities by shifting from group plans to the efficiency of the individual marketplace with a defined contribution model, allowing them to control their subsidy level rather than managing the volatility of unpredictable premium increases.

• Employee choice & satisfaction
  Retirees gain access to a broader selection of plans and expert support, enabling them to choose coverage that aligns with their specific healthcare needs and budget.

• Risk mitigation & financial sustainability
  Transitioning to the individual marketplace helps organizations de-risk their healthcare commitments, ensuring long-term financial stability while maintaining competitive benefits.

• Simplified administration
  All enrollment, interaction with insurers, and ongoing service to retirees is supported by the retiree exchange. This reduces the administrative responsibilities of plan sponsors. Via Benefits streamlines the transition process, providing expert guidance, enrollment support, and ongoing advocacy to ensure a seamless experience for both plan sponsors and employees.

• Maximize federal health insurance subsidies
  For Medicare retirees, plans available on the individual market incorporate the maximum federal subsidies that reduce participants’ premiums and out-of-pocket costs. For Pre-Medicare retirees, Premium Tax Credits can reduce costs for eligible participants, making healthcare more affordable while lessening the financial burden on plan sponsors.

Organizations that embrace the individual marketplace are future-proofing their benefits strategy, ensuring cost efficiency, participant satisfaction, and financial sustainability. As healthcare costs continue to rise, Via Benefits provides the expertise and solution needed to optimize benefits while honoring commitments to retirees.