The $5 billion subsidy in the healthcare reform legislation for companies that provide medical coverage to pre-65 retirees may prove the last hurrah for such benefits. Although the subsidy was intended to bolster companies' coverage for earlier retirees until insurance exchanges begin in 2014, analysts say the $5 billion will run out in half that time. And a recent survey by HR consultancy Towers Watson shows many employers are moving away from providing retiree health benefits.

Of course, the ranks of companies that provide such benefits has been eroding for some time. Mercer data show just 28% of companies with 400 or more workers provided health insurance to pre-65 retirees last year, down from 46% in 1993. And according to the Towers Watson survey, which was conducted after the Patient Protection and Afford Care Act (PPACA) became law, 43% of companies that currently provide retiree medical plan to reduce or eliminate those benefits. Among companies that would be subject to the excise tax on costly health benefits that goes into effect in 2018, the portion that say they're likely to cut back or eliminate retiree medical rises to 55%.

Until 2014, companies have good reason to continue sponsoring their own coverage for pre-65 retirees, says Dave Ostendorf, chief health actuary at Towers Watson. People in that age range are not yet eligible for Medicare and they often have medical problems that make it hard for them to get coverage in the individual market.

“Once you get to 2014 the exchanges start up and there's guaranteed coverage for everybody,” Ostendorf says. “At that point it may make a lot less sense for employers to sponsor their own [retiree medical] plan.”

When the exchanges are in place, he says, “if an employer provides coverage to pre-Medicare retirees, it looks as if they won't have access to the government subsidies for the exchanges.” By contrast, if a company provides financial support so that early retirees can buy their own coverage, it seems they will be eligible for the government subsidies, he says.

“The thing to keep your eye on is how employers are going to look at the intermediate-term availability of the exchange and how they're going to slowly transform their programs to accommodate that,” Ostendorf adds. “I think you will see a lot of migration from traditional programs to providing subsidies for these benefits.”

The healthcare reform measure's program to subsidize health coverage for retirees who are not yet 65, the Early Retiree Reinsurance Program (ERRP), took effect June 1. It provides an 80% subsidy for retiree medical claims between $15,000 and $90,000.

According to a survey by HR consultancy Hewitt Associates, 76% of companies that offer retiree medical benefits intend to apply for ERRP. But a report from the Employee Benefit Research Institute estimates that the $5 billion could be used up by the end of 2011.

The perception that the subsidy will be used up fairly quickly, along with interim regulations from the Department of Health and Human Services suggesting applications would be accepted on a first come, first serve basis, has left companies anxious that they could miss out on the subsidy. Organizations representing employers have submitted comment letters asking that the process for reimbursement be amended to extend the time frame for filing.

“I think virtually all employers who have a correctly completed application will be accepted,” Ostendorf says, but adds, “There's a real incentive for employers to be ready to go right away once the application window does open.”

For a look at what concerns companies most about the healthcare reform measure, see 2018 Healthcare Tax Fuels Worry Now.

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Susan Kelly

Susan Kelly is a business journalist who has written for Treasury & Risk, FierceCFO, Global Finance, Financial Week, Bridge News and The Bond Buyer.