Do you have an employee ready for Medicare? Did they postpone signing up because they continued on an employer group plan while working past age 65, and now they’re ready to retire?

To make the jump to Medicare, they will need a form from you to help them transition to Medicare under a special enrollment period. The employee has a specific period of time to enroll, so your help in facilitating this document is critical to helping them meet that transition deadline.

Employment Verification Form

As long as the employee was covered continuously by a creditable group plan (and the employer had 20 or more employees covered on the group plan), they will need an employer verification (EFV) form. Or, as Medicare calls it, a “REQUEST FOR EMPLOYMENT INFORMATION” Form CMS–L564 to be supplied with their Medicare plan enrollment forms. https://www.cms.gov/medicare/CMS-Forms/CMS-Forms/Downloads/CMS-L564E.pdf 

An EVF provides proof of group coverage for employees over 65 and outside their Medicare initial enrollment period. This form is submitted with their Medicare Part B enrollment form. They need to prove they qualify for a Special Enrollment Period (SEP) to sign up for their Medicare upon retirement and avoid penalties. 

Proof of Employer Continuous Coverage

For an employee to qualify for a SEP, they must meet two criteria:

1. They must have group health insurance while ACTIVELY employed (from their job or spouse’s job) or have had such insurance within the past eight months. AND
2. They must have been CONTINUOUSLY covered by job-based insurance since becoming eligible for Medicare (including the month they turned 65.)

A SEP grants the employee the opportunity to enroll in Medicare with the same eligibility benefits as though he was enrolling when he was 65. He avoids any lifelong penalties for deferring initial enrollment and still enjoys guaranteed issue if he selects a Medicare supplement. 

The EVF will ask when the employee first went on a group plan and left the plan. The starting date is the very first date they enrolled with your employer plan. The end date is the date he left the group plan. It’s essential that the employee’s employment show he has been on continuous group plan coverage past the date he was first eligible for Medicare.

It will also ask the period of time when the employee was actively employed. If the employee went on Cobra benefits after age 65, there is a coverage gap upon leaving the company –they do not have continuous coverage or work history. Cobra is not considered creditable coverage after age 65. So they would not qualify for a SEP to enroll in Medicare.

By providing this form for your Medicare transitioning employee, you give him peace of mind and a smoother enrollment process.

If you need any help with completing the details of the form or helping your retirees plan their transition to Medicare, our Certified Medicare Planners® are here to help.

If Medicare feels a bit confusing, we get it! 

That’s why we are here – to help make Medicare@Work easier! An employee can find greater confidence about when to enroll in Medicare by consulting with a Medicare expert like a Certified Medicare Planner®… or whether they should wait and keep their employer group plan.

Every situation is different.

Medicare guidance for your employees in 2021.

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Your Medicare Transition Partner
– Lora