FOR BREAKING NEWS VISIT WWW.QNS.COM AUGUST 10, 2017 • QUEENS BUSINESS • THE QUEENS COURIER 33
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The Interplay Between Medicare and
Employer- Sponsored Health Coverage
BY RONALD A. FATOULLAH, ESQ.
AND STACEY MESHNICK, ESQ.
Medicare benefi ts start at age 65, but
many people continue working past
that age, either by choice or by necessity.
It is important to understand how
Medicare and employer health coverage
work together. Depending upon one’s
circumstances, Medicare is either the primary
or secondary insurer. Th e primary
insurer pays any medical bills fi rst, up
to the limits of its coverage. Th e secondary
payer covers costs which the primary
insurer does not cover (although it may
not cover all costs).
Knowing whether Medicare is primary
or secondary to your current coverage
is crucial because it determines whether
you need to sign up for Medicare
part B when you fi rst become eligible.
If Medicare is the primary insurer and
you fail to enroll for Part B, your eventual
Medicare Part B premium could
start going up by ten percent for each
12 month period that you were eligible
for Medicare Part B, but did not sign
up for it.
If your employer or spouse’s employer
has 20 or more employees, your employer’s
ELDER LAW
insurance will be the primary insurer
and Medicare will be the secondary
payer. If your employer or your spouse’s
employer has fewer than 20 employees,
Medicare will be the primary insurer and
your employer’s insurance will be the
secondary insurer. If you are retired and
still covered by your employer’s group
health insurance plan, Medicare pays
fi rst and your former employer’s plan
pays second.
If you receive both Social Security
Disability Insurance and Medicare and
your employer has 100 or more employees,
your employer’s insurance is the primary
insurer. Some employers are part
of a multi-employer plan and if at least
one employer in that plan has 20 employees
or more, the employer’s insurance
pays fi rst. If you receive Social Security
Disability and Medicare and your
employer has fewer than 100 employees,
Medicare will pay fi rst.
If you have end stage renal disease
(ESRD) and are in the fi rst 30 months
of Medicare coverage of ESRD, your
employer’s plan pays fi rst. Aft er the fi rst
30 months, Medicare becomes the primary
insurer. It does not matter how
many employees your employer has.
If you are self-employed and have a
group health plan that covers yourself and
at least one other person, Medicare pays
fi rst. Note that if you are self-employed,
you may be able to deduct Medicare
premiums from your income taxes by
including the premiums in the self-employed
health insurance deduction.
If your employer’s insurance is the primary
insurer, the employer must off er
you and your spouse the same coverage
that it off ers to younger employees.
It also cannot deny you coverage, cancel
your coverage once you become eligible
for Medicare, or charge you higher premiums,
deductibles or copays.
Th e rules relating to the interplay
between Medicare and employer-sponsored
health insurance programs are complex.
It is important to know the rules that
apply to your particular situation.
Ronald A. Fatoullah, Esq. is the principal
of Ronald Fatoullah & Associates, a law
fi rm that concentrates in elder law, estate
planning, Medicaid planning, guardianships,
estate administration, trusts, wills,
and real estate. Stacey Meshnick, Esq. is
a senior staff attorney at the fi rm who
has chaired the fi rm’s Medicaid department
for over 15 years. Th e law fi rm can
be reached at 718-261-1700, 516-466-
4422, or toll free at 1-877-ELDER-LAW
or 1-877-ESTATES. Mr. Fatoullah is also
a partner with Advice Period, a wealth
management fi rm, and he can be reached
at 424-256-7273.
Ronald A. Fatoullah, Esq. is the principal
of Ronald Fatoullah & Associates,
a law fi rm that concentrates in elder
law, estate planning, Medicaid planning,
guardianships, estate administration,
trusts, wills, and real estate.
Stacey Meshnick, Esq. is a senior staff
attorney at the fi rm who has chaired
the fi rm’s Medicaid department for
over 15 years. Th e law fi rm can be
reached at 718-261-1700, 516-466-
4422, or toll free at 1-877-ELDER-LAW
or 1-877-ESTATES. Mr. Fatoullah is
also a partner with Advice Period, a
wealth management fi rm, and he can
be reached at 424-256-7273.
RONALD FATOULLAH
ESQ, CELA*
editorial
MAGNIFICENT MANAGERS
Dear Mindy, I want to
be a manager who is a role
model to my team. What are
the most important things I
need to do to inspire others?
Manager in Queens
Dear Manager, Eff ective
managers have great communication
skills and show
their team trust and respect.
Here are some guidelines to
follow:
Get to Know Your Team:
Effective managers know
that they will only be as successful as
their individual team members. Th at
begins with listening to your employees
and building trust. Let your employees
know that you are there to support
them individually and
as a team. Recognize that
each member of your team
has individual strengths,
unique personal motivators
and their own communication
style.
Communicate Eff ectively:
Great managers really listen
to their employees. Let your
employees know that you care
about their opinions and look
for opportunities to implement
their ideas. Regularly
scheduled team meetings are
an eff ective way to build strong teams
and inspire team members to creatively
solve problems together.
Set Clear Goals and Expectations:
Employees need to know what is expected
of them. Meet with each employee
to establish realistic individual goals
and make sure that both you and the
employee understand the necessary
steps to accomplish the goals. Clearly
communicate your expectations for the
team and help them understand what
success means in your organization.
Meet regularly to ensure that you are
holding your team accountable for their
goals and take corrective actions quickly.
Encourage Creativity and
Innovation: Eff ective leaders know that
one of their most important jobs is to
develop their people. Invest in classes
that will encourage your team members
to strive for ongoing professional development.
Challenge your team members
to fi nd creative ways to solve problems
and actively encourage innovation. Find
ways to recognize and appreciate those
who step up to the challenge.
Employees want their managers to be
open to new ideas, show integrity and
be responsive to their needs. Th ey like
to feel valued and be recognized when
they have achieved success. If you focus
on your employees you will gain their
respect and be able to build long lasting
trusting relationships.
For more tips to communicate eff ectively
at work, contact Mindy for a free
strategy session. Mindy Stern, SPHR,
SHRM-SCP, ACC is a trusted HR advisor,
leadership coach, author, speaker
and president of AIM Resource Group
Inc. Visit the website at www.aimresourcegroup.
com or call 718-217-1074
to get RESULTS!
EMPLOYMENT
MATTERS
MINDY STERN
SPHR, SHRM-SCP,