Provides relative to Medicare as the secondary payer for retirees with employer-sponsored health insurance (OR NO IMPACT See Note)

House Bill 771 enacts a new section of the Louisiana Insurance Code establishing rules for benefit coordination when Medicare-eligible retirees return to employment and obtain employer-sponsored health coverage. The statute creates a new R.S. 22:1113 that mandates health insurers treat Medicare as the primary payer for individuals who are eligible for Medicare benefits, previously retired from employment, and subsequently return to active employment while becoming covered by an employer health plan, health maintenance organization, or equivalent health coverage subject to Louisiana state regulation. The law prohibits health insurance issuers from designating Medicare as a secondary payer except where federal law expressly requires otherwise, thereby reversing the default arrangement and requiring coordination of benefits with Medicare in the primary position and the employer-sponsored plan in the secondary position.

The practical effect of this legislation falls primarily on health insurance issuers operating in Louisiana, including traditional insurers, health maintenance organizations, and entities administering employer health plans and the Office of Group Benefits. These entities must modify their benefit coordination procedures and claims processing systems to ensure that when a Medicare-eligible retiree returns to work and enrolls in their health plan, Medicare is treated as the primary payer responsible for its share of covered services before the employer plan pays its portion. Individuals who fit the specified categories—those who are Medicare-eligible, previously retired, and now re-employed with new health coverage—will experience a change in how their multiple insurance sources coordinate, potentially resulting in different out-of-pocket costs and claim processing sequences depending on how Medicare and the employer plan's coordination of benefits actually functions in practice.

The statute operates within the federal framework governing Medicare as a secondary payer, particularly the regulations found in 42 CFR Section 411.32, which establish conditions under which Medicare can be designated as secondary coverage. Louisiana's coordination of benefits rules traditionally interact with federal Medicare law under the Social Security Act, and this statute explicitly preserves the supremacy of federal law by including a savings clause stating that nothing in the section requires actions conflicting with or preempted by federal regulations. The legislation thus functions as a state insurance regulation that respects federal limitations while establishing Louisiana's policy preference that employer-sponsored plans serve as secondary payers when Medicare-eligible retirees return to employment, a framework consistent with federal incentives to reduce Medicare's costs through coordination with other available coverage sources.