Healthcare Cost Strategy:
Turn One of Your Biggest Expenses Into Significant Savings
Strategic financial planning for business leaders who are facing the challenge of an aging workforce and rising healthcare costs
The Challenge:
Surging Healthcare Inflation
Healthcare costs are the fastest-growing expense in most corporate budgets, with employees 65+ driving disproportionate cost increases that traditional group plans struggle to manage
Current Reality:
Healthcare costs are expected to rise 8.5 - 9.5% in 2026 (Source: PwC & Aon)
Employees 65+ cost 2.44x more than the younger workforce (Source: CMS)
By 2030, the 65+ segment of the workforce will be 9.5% (Source: US Department of Labor) and will consume up to 20% of the healthcare budget
The Unique Medicare Opportunity:
An Alternative Healthcare Funding Source
Medicare offers 65+ employees an additional healthcare option that features coverage designed specifically for the 65+ population. And when employees decide to move to Medicare, high-cost claims leave your group plan risk pool.
9.5%
Expected Annual Healthcare Cost Increase for Employers in 2026
(Source: Aon)
$16,082
2026 Projected Average Employer Healthcare Costs for Employees 65+
(Source: CMS & Kaiser)
42%
Increase in the Portion of the Workforce That is 65+ Between 2023 and 2030 (Source: US Dept of Labor)
50%
Members Who Rated Medicare as Excellent (Source: 2023 Kaiser Family Foundation Survey)
Financial Impact Opportunities
Cost Elimination/Reduction
Removes high-cost 65+ claims from group plan, with average savings in 2026 of $16,082 per transitioned employee.
Lowers healthcare coverage headcount and therefore associated administrative expenses
Impact increases over time as the percentage transitioning to Medicare increases
Rapid Savings
65+ employees can choose to transition to Medicare at any time of the year and when that happens, the employer realizes savings immediately while retaining valuable employees
Fast ROI
Program costs are primarily via shared savings. Therefore, there are minimal fees at risk, a low break-even point and high ROI that is realized quickly.
Reduced Premiums
Lower group plan premiums as average age and risk profile improve when the 65+ population transitions. Plan administrative costs are lower as the group plan population decreases.
Our Shared Success Financial Model
We've structured our fees to align with your results—minimizing risk while maximizing financial impact
Phase 1: Complimentary Assessment
Assessment to determine program fit for your organization
High-level workforce demographic overview
Preliminary cost impact estimate
Go/No-Go recommendation with estimated savings potential
Phase 2: Program Management Fee (Fixed*)
Your annual investment covers:
Corporate Medicare Gameplan development and annual updates
Employee education programs and materials
Personal advisory services via licensed Medicare advisors
Annual Benefits cycle integration
Quarterly reporting and continuous optimization
*Fixed fee based on employer size
Phase 3: Shared Savings - 90% Retained by Employer
You keep 90% of all documented savings
We share 10% only when you realize actual cost reductions
Compounding returns as participation grows over time
3-year partnership minimum ensures sustained results
How It Works: Your Implementation Roadmap
Now that you understand the financial model, here's the operational process—what actually happens month-by-month to deliver your results.
Months 1-2: Medicare Gameplan Development
What We Do:
Analyze workforce demographics and 65+ population projections
Review claims data of 65+ population to identify cost drivers
Compare your group plan benefits against Medicare options in your markets
Build customized 5-year financial model
What You Get:
Detailed 5-year savings projection with conservative, moderate, and optimistic scenarios
Implementation timeline customized to your organization's benefits cycle
Executive presentation materials for leadership and board approval
Written strategic recommendations
Month 3+: Employee Education & Awareness Campaign
What We Do:
Design a year-round communication strategy
Create customized educational materials (webinars, guides, FAQs)
Launch Medicare 101 sessions for employees approaching 65
Establish ongoing touchpoints via email, intranet, and benefits portal
What You Get:
Informed employees who understand their options
Reduced HR burden from Medicare questions
Foundation for voluntary, confident employee decisions
Ongoing: Personal Medicare Advisory Services
What We Do:
Provide one-on-one consultations with licensed Medicare advisors
Advisors conduct personal needs assessment
Provide individual comparison between group plan and Medicare options
Coordinate enrollment and transition paperwork
Ongoing support for employees through the Medicare decision process and beyond
What You Get:
White-glove employee experience that builds trust
Higher participation rates from personalized guidance
Immediate cost savings as employees transition to Medicare
Annual: Benefits Cycle Integration
What We Do:
Integrate Medicare education into annual open enrollment
Conduct refresher sessions for the approaching 65 cohort
Coordinate with your benefits team and broker
What You Get:
Medicare becomes a normal part of your benefits offering
Consistent messaging across all benefits communications
Systematic process that scales with your workforce
Quarterly: Continuous Improvement & Reporting
What We Do:
Track participation rates and document savings
Analyze results and refine strategy
Coordinate with your benefits team and broker
What You Get:
Verified savings calculations for budget planning
Increasing ROI as program matures
Strategic insights for long-term workforce planning
What Your Employees Experience
Our white-glove approach ensures every employee feels supported throughout their Medicare journey:
1. Awareness
Company communications, webinars, and materials introduce Medicare as a viable option for those 65+
2. Education
Medicare 101 sessions, comparison guides, and the Medicare section of the Benefits Hub with information, FAQs, and videos available on demand
3. Request Help
Simple online scheduling to connect with a licensed Medicare advisor (no obligation)
4. Personal Consultation
One-on-one calls with a licensed Medicare Advisor to conduct a personal needs assessment
5. Informed Decision
Employee/dependent reviews options (Medicare and Group Plan) with the Medicare Advisor and chooses the best coverage option for their needs. If Medicare is selected, the Advisor assists with the enrollment process.
Employee Satisfaction:
50% of Medicare members rate their coverage as "Excellent" vs. 33% for employer group plans
Source: Kaiser Family Foundation, 2023
Sample Projection: 2,000 Employee Manufacturing Company
Medicare offers 65+ employees and dependents an additional healthcare option that features coverage specifically designed for the 65+ population. This coverage often provides better benefits at lower costs, removing high-cost claims from your group plan risk pool.
This illustrative example uses industry-average data to demonstrate typical program impact. Your actual results will depend on your workforce demographics, current plan costs, and claims experience.
Company Profile (2026):
2,000 Total Employees
158 Employees 65+ (7.9%) + 49 Dependents 65+ (31% of 65+ employees) = 207 total 65+ lives
10 - 16% of Healthcare Budget
Company Profile (2030)
2,000 Total Employees
190 Employees 65+ (9.5%) + 59 Dependents 65+ (31% of 65+ employees) = 249 total 65+ lives
14 - 20% of Healthcare Budget
Challenge: Healthcare costs consuming 14 - 20% of the benefits budget with unpredictable year-over-year increases driven by an aging workforce.
Solution: Medicare Gameplan implementation with employee education and individual advisory services. See projected 5 year cost savings and ROI for this organization immediately below.
Expected Results:
Ready to See Your Numbers?
Every organization's situation is unique. Use our Healthcare Cost Calculator to model your specific 5-year impact based on your workforce and current costs.
Schedule Your Financial Impact Assessment
What to Expect:
Answers to questions you have about Medicare for Employers
An employee demographic review to determine fit
A high level 5 year financial impact overview
Backed by Leading Industry Research
The 2026 Employer Health Care Strategy Survey from the Business Group on Health identifies older employees as being a major driver of employer healthcare costs today and even more so in the future. A Corporate Medicare Gameplan from Medicare for Employers is the answer.
And by Government Supplied Data
The Department of Labor predicts that the 65+ employee population will increase from 7.5% in 2025 to 9.5% in 2030
Bold Solutions Needed
This calls for "bold solutions" to address rising healthcare costs and innovative benefit models
Value-Driven Focus
Emphasis on value-driven strategies and trusted partnerships to improve quality while managing costs
Vendor Accountability
Employers are demanding measurable outcomes and performance-based partnerships from benefits providers
© 2025 Medicare for Employers. All rights reserved. | Licensed Medicare Advisor | Serving employers nationwide