Navigating Medicare can be tricky for anyone, but for California employers, it’s especially important to help team members understand how Medicare Part B premiums affect their CA employee coverage, compliance obligations, and retirement planning.
With more employees delaying retirement and working well into their 60s and 70s, many find themselves needing both employer-sponsored health insurance and Medicare. Knowing how Medicare Part B interacts with your existing California insurance plans isn’t just good HR—it’s key to staying in step with California compliance rules while supporting your workforce’s wellness and financial clarity.
In this blog, we’ll unpack the essentials of Medicare Part B, how premiums are calculated, who needs to enroll (and when), and how it all ties into MEC (Minimum Essential Coverage) and wellness-driven benefits.
What Is Medicare Part B?
Medicare Part B is one of the key components of Medicare, covering outpatient care, preventive services, doctor visits, and some home health care. Unlike Medicare Part A (usually premium-free for those who paid into Medicare taxes), Part B carries a monthly premium based on the individual’s income level.
While most people get Part A for free, Part B requires a monthly premium. In 2024, the standard premium is $174.70 per month, but individuals with higher incomes may pay more due to Income-Related Monthly Adjustment Amounts (IRMAA).
24 Medicare Part B Monthly Premiums by Income Level
| Income (Individual) | Income (Joint Filers) | Monthly Premium |
| $103,000 or less | $206,000 or less | $174.70 |
| $103,001 – $129,000 | $206,001 – $258,000 | $244.60 |
| $129,001 – $161,000 | $258,001 – $322,000 | $349.40 |
| $161,001 – $193,000 | $322,001 – $386,000 | $454.20 |
| Above $193,000 | Above $386,000 | $559.00 |
When Should Employees Enroll in Medicare Part B?
The timing of enrollment is crucial. If your company offers a California insurance plan that qualifies as Minimum Essential Coverage (MEC) and you’re an Applicable Large Employer (ALE), employees can typically delay Part B enrollment without penalty. However, if your plan does not meet MEC—or if the employer has fewer than 20 employees—employees may be required to enroll when first eligible to avoid costly late enrollment penalties.
Remember that Medicare Part B alone does not qualify as MEC—but if paired with Medicare Part A or a group health plan that does, employees will meet the requirement under the ACA.
📝 Tip: Encourage employees to check with HR (or your insurance advisor) before making any decisions about enrolling or delaying Medicare Part B. A wrong move could cost them hundreds of dollars in late penalties over their lifetime.
California Compliance: What Employers Need to Know
Helping your employees understand how Medicare fits with your CA employee coverage isn’t just thoughtful—it’s necessary for staying compliant.
California residents are required to maintain MEC to avoid state-level penalties. While employer-sponsored California insurance plans typically satisfy MEC, it’s essential that older employees don’t unknowingly drop MEC by relying on Part B alone.
As an employer, you should:
- Know if your plan is considered primary or secondary when an employee is Medicare-eligible
- Offer guidance (without giving personal financial advice) on when Medicare coordination makes sense
- Report MEC to the California Franchise Tax Board (FTB) when required (especially if self-insured)
| Employer Size | Who Pays First? | Employee Must Enroll in Part B? |
| Fewer than 20 employees | Medicare | Yes, to avoid coverage gaps |
| 20+ employees | Group Plan | No, can delay Part B without penalty |
If you’re offering California insurance plans businesses use to comply with MEC, it’s essential to know if you’re the primary or secondary payer. This affects whether delaying Part B will cause late penalties for employees.
How Medicare Fits into Wellness-Focused Group Benefits
We often think of Medicare and wellness programs as two separate ideas. But in truth, understanding Medicare empowers employees to make proactive healthcare decisions—which is at the core of any solid wellness initiative.
Employees who understand their benefits:
- Are more likely to schedule preventive screenings
- Can avoid duplicate coverage (and unnecessary costs)
- Experience less stress when transitioning to retirement
Incorporating Medicare education into your wellness or benefits outreach is one way to align California insurance plans with holistic employee care. It builds trust, increases participation, and reduces long-term administrative burden.
Premiums, Penalties & Planning
If an employee delays enrollment in Part B and doesn’t have creditable coverage, they could face a lifetime late enrollment penalty of 10% for every 12-month period they didn’t sign up.
Here’s a quick look at how this can impact costs:
| Scenario | Monthly Premium | Impact |
| Standard Enrollment (2024) | $174.70 | No penalty |
| Delayed by 2 years without creditable coverage | $209.64 | 20% penalty added |
| High-income filer (>$103,000 individual) | Up to $560.50+ | Subject to IRMAA |
Encouraging timely Medicare education is a form of preventive support—just like encouraging health screenings or wellness checkups. It’s one more way to embed wellness into your company culture.
Coordinating Employer Health Plans with Medicare Part B
| Employer Plan Size | Plan Status | Medicare Enrollment Timing |
| <20 Employees | Medicare is primary | Enroll in Part B at age 65 |
| ≥20 Employees (MEC) | Employer plan is primary | Can delay Part B without penalty |
| Non-MEC plan offered | Insufficient for MEC | Must enroll in Medicare |
Supporting Aging Workers in California
The demographic shift toward an older workforce is already happening. According to the California Employment Development Department, workers aged 65+ represent one of the fastest-growing employment groups in the state.
Employers who embrace this shift—and adapt their CA compliance accordingly—are more likely to retain experienced talent. Here’s how to do it:
- Offer Medicare planning sessions during open enrollment
- Coordinate benefits with Medicare Part A and B
- Provide written comparisons between group coverage and Medicare
- Maintain compliance with MEC standards and properly advise workers about primary vs. secondary payer rules
Not only does this keep employees informed, but it also builds trust and avoids costly missteps.
Combining Group Plans with Medicare: What’s Allowed?
Employees eligible for Medicare can remain on employer plans as long as your policy allows it. However, some plans may require employees to transition off once they’re Medicare-eligible—especially in smaller businesses.
That said, combining Medicare with employer insurance can offer expanded protection. For example:
- An employee might use Medicare Part A while keeping your company’s California insurance plans for outpatient care.
- Some choose to enroll in Part B while also maintaining group coverage to limit out-of-pocket costs.
The key is flexibility and proper coordination—especially when designing group plans California workers can rely on.
Wellness and Medicare
Helping employees navigate Medicare doesn’t stop at premiums and enrollment—it’s also a chance to promote wellness through health benefits. Consider:
- Hosting Medicare Q&A sessions as part of a workplace wellness series
- Integrating Medicare education into financial literacy or retirement planning events
- Offering coverage reviews for employees nearing 65
This kind of wraparound support improves mental well-being, reduces stress, and encourages informed decisions—all pillars of a healthy workplace culture.
Empowering Your Team with the Right Information
Here’s a quick recap of how California employers can support Medicare-eligible employees effectively:
| Action Step | Why It Matters |
| Confirm MEC status of group plan | Avoid Medicare late penalties |
| Educate employees on primary vs. secondary coverage | Prevent unexpected medical bills |
| Discuss Medicare enrollment timing during onboarding and offboarding | Protect retirement transitions |
| Monitor Part B premium changes annually | Keep benefits conversations current |
Simplify Medicare for Your Team
For employees nearing Medicare eligibility, clear communication is key. Helping them understand Medicare Part B premiums, enrollment timing, and how it interacts with their existing group coverage creates trust—and keeps your organization California compliant.
At Regency West Insurance, we make it easy for employers to integrate Medicare guidance into their benefits planning. If you’re updating California insurance plans, offering Medicare transition support, or just want to be sure your group coverage aligns with wellness goals and compliance standards, we’ve got you covered.
Let’s simplify Medicare and support your employees with the right tools, the right timing, and the right coverage.
Schedule your consultation with Regency West Insurance today