Healthcare

White Paper: Changes to Group Medicare Advantage & Part D Explained

August 19, 2024

White Paper: Changes to Group Medicare Advantage & Part D Explained

by Sheela Andrews, Pharm D.

To access the article: https://retireefirst.com/blog/white-paper-changes-to-group-medicare-advantage-and-part-d-explained/

White paper front cover with access now button

RetireeFirst and BluePeak Advisors have co-authored a white paper for employer plan sponsors and their consultants on Medicare regulatory changes taking effect in 2025 with recommended steps to limit financial impact.

In an industry undergoing significant changes, RetireeFirst has emerged as an educator. In order to continue our award-winning services to 375 group plan sponsors with 325,000 retiree members, we had to rapidly digest all the regulatory changes to Medicare Advantage and Part D taking effect January 1, 2025 along with additional clarifications and updates from the CMS Final Notice.

We first shared this acquired knowledge in a webinar series that was well received by the retiree health benefits community—so well received that our clients and their broker and consultant partners requested additional resources. Given the complexity of Medicare regulations and payment methodologies, we were asked to write a white paper providing detailed, actionable information without burying a reader in minutiae and jargon.

RetireeFirst took on the challenge.

To expand our areas of expertise, we reached out to BluePeak Advisors, a division of Gallagher Benefit Services that leads the nation in healthcare compliance consulting that focuses on government programs. BluePeak consultants specialize in PBM and Medicare Advantage (MA) and Medicare Advantage Prescription Drug Plan (MA-PD) health plan operations, Medicare compliance, STAR rating improvements, and operational and clinical program strategies. In a collaborative effort, we could address the content scope our audience requested.

The Evolution of Employer Retiree Plans

  • Timeline & Key Dates in 2024
  • 2025 Rate Announcement
  • Medicare Part D Redesign/Inflation Reduction Act (IRA)
    • 2025 IRA Contribution Changes to Part D
    • The Medicare Prescription Payment Plan (M3P)
    • Retiree Drug Subsidy (RDS) & Employer Group Waiver Plans (EGWPs)
  • 2025 MA/Part D Final Rule Updates
    • Behavioral Health
    • Mid-Year Notification of Unused Supplemental Benefits
    • Medication Therapy Management Program Updates
    • Formulary Management Strategies
  • Recommendations for Employer Group Plan Sponsors

Sheela Andrews headshot
About the Author

Sheela Andrews, Pharm D.

Chief Product Officer

As Chief Product Officer, Sheela’s primary focus is to strengthen and build out the current Medicare products we offer while focused on the strategic direction of the organization. She is responsible for owning and overseeing the strategy, planning, development, and implementation of all of Retiree First’s Medicare products, carrier relationships and collaboration, strengthening compliance, data integration improvements, and product service enhancements.

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