What Makes Medicare Different for Everyone?
June 1, 2022
What Makes Medicare Different for Everyone?

One of the ways that Medicare can be different for some is with the cost of the Medicare Part B premium. The Part B premium has a standard rate. If you have a higher income, you will pay an Income Related Monthly Adjusted Amount, also known as an IRMAA. Most people will pay the standard rate. However, if your modified adjusted gross income that was reported on your tax return from two years ago is above a certain amount, you will pay the standard rate plus the IRMAA. If you do not pay your IRMAA you could lose your Medicare coverage.


This amount generally changes every year. You can find the current IRMAA amounts on the Social Security website.


Medicare Part D and IRMAA

Medicare Part D is also subject to the IRMAA depending on your income, again from your reported income from two years ago. You will pay the IRMAA in addition to your Medicare Part D premium, whether you have a stand-alone Part D or a Medicare Advantage Plan with Part D.


The Part D IRMAA is paid directly to Medicare and not to your plan or employer. If you do not pay the Part D IRMAA, you will lose your Part D prescription coverage.


If your income has gone down, depending on specific circumstances, you may be able to get a new decision about your IRMAA.


If you are subject to an IRMAA, you will receive a notice from Social Security.


Medicare Late Enrollment Penalty (LEP)

Another way Medicare can be different for some is if they have a Late Enrollment Penalty (LEP) on their Medicare Part B premium. In most cases, this penalty will be for the rest of the time that you have Medicare. This is not a one-time penalty. If you have Medicare due to disability, your penalty will go away when you turn 65.


How is the Part B penalty calculated? For each 12-month period that you delay Part B enrollment you will have to pay a 10% premium penalty unless you are eligible for the Medicare Savings Program (MSP) or you have active job-based insurance through yourself or your spouse with more than 20 employees.


There is also a penalty for a late enrollment in a Medicare Part D plan. If you delay enrollment, you will pay a LEP of 1%, of the national base premium, in addition to your Part D plan premium. The national base premium changes every year and currently for 2021, it is $33.06. This penalty is assessed for every month that you went without a Medicare Part D or creditable coverage. Creditable coverage is coverage that is as good as or better than the Medicare Part D coverage. If you receive assistance through Social Security’s Extra Help Program, also known as LIS (Low Income Subsidy), have creditable drug coverage or prove that you received inadequate information about your drug coverage being creditable, you may not have to pay the LEP.


Like the Part B LEP, this is not a one-time penalty. The LEP for Part D, is also a penalty that you will have for as long as you have Medicare. If you are under 65 and have Medicare due to disability your LEP will go away when you turn 65.


Medicare for Those Under 65 with Disability

How does Medicare coverage for those under 65 with a disability work? Like the Initial Enrollment for a person eligible due to turning 65, there is a seven-month period to enroll in Medicare. The difference is that the enrollment period for those on disability surrounds the 25th month of disability. You will automatically receive your Medicare card and packet three months before your 25th month of disability. Your effective date will be the 1st of the month, that is your 25th month of disability. Generally, you should not delay Medicare Part B unless you have job-based insurance that pays secondary to Medicare (employer insurance with more than 20 employees). If you delay without job-based insurance as previously mentioned, you may incur a penalty. If you do not receive your card and packet, contact Social Security.


Railroad Retirement

Another scenario where Medicare will be different for some is those with Railroad Retirement.  When a person who is receiving Railroad Retirement benefits becomes eligible for Medicare, instead of enrolling in Medicare through Social Security their enrollment will be processed through the Railroad Retirement Board (RRB). They would be automatically enrolled in Medicare Parts A & B.


If the person is not collecting Railroad Retirement benefits when turning 65, they should contact the Railroad Retirement Board (RRB) to enroll. The RRB will collect the Medicare premiums and the Medicare Part B premium should be automatically deducted from their monthly check. Additionally, the doctor’s and providers will send claims to the Railroad Medicare Part B Claims Contractor selected by the RRB. It is important to make providers aware that the Medicare is Railroad Medicare. The Medicare card will look different. It will have RAILROAD RETIRMENT BOARD labeled at the bottom of the card and an insignia at the top left, for the RRB. Finally, if you are under 65 and disabled, you will have different eligibility criteria depending on how the RRB classifies your disability.


For additional information go to www.rrb.gov or reach out to Simco.


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The Employer's Guide to 2026 Minimum Wage Updates

November 5, 2025
As we move into 2026, employers across many states and localities are preparing for significant minimum wage increases. Nearly 20 states and more than 40 local jurisdictions will raise their wage thresholds effective January 1, 2026. This poses important planning, budgeting, and compliance considerations, especially for mid-sized employers like those that partner with Simco, where payroll, HR, benefits and advisory services intersect. Below we’ve summarized key state and local minimum wage updates and outlined the steps you should take now to stay ahead of the changes and mitigate risk. State-Level Minimum Wage Increases (January 1, 2026) The table below highlights selected state increases scheduled for January 1, 2026.

The Benefits of Outsourcing HR: Save Time, Cut Costs, and Boost Engagement

October 24, 2025
When HR Is Overloaded, Your Business Feels It For many small to mid-sized businesses, HR is one of the most critical (and most overextended) functions. From payroll and benefits to onboarding and compliance reporting, administrative tasks can quickly consume your team’s time, leaving little room for strategic work that actually moves the business forward. Sound familiar? You’re not alone. A recent survey from Champions of Change: isolved’s Fourth-Annual HR Leaders’ Research Study found that 51% of HR leaders spend four or more hours a day answering repetitive questions. This time could be better spent on employee engagement, culture, and growth initiatives. When HR teams are pulled in too many directions, the consequences ripple across the entire organization, resulting in missed deadlines, frustrated staff, compliance risks, and ultimately, higher turnover. Why HR Leaders Consider Outsourcing Outsourcing HR isn’t just for businesses without dedicated HR teams. In fact, a survey of 1,000 HR decision-makers found that 76% could benefit from outsourcing certain tasks, even though only 54% currently have plans to do so. HR outsourcing allows organizations to offload both core and strategic tasks, including payroll, benefits administration, recruitment, onboarding, compliance support, performance management, employee relations, and workforce analytics, without adding headcount. This augmentation provides a multiplier effect: a small HR team can function like a much larger one, accomplishing more in less time. By leveraging experienced HR professionals through outsourcing, organizations can free up internal HR teams to focus on initiatives that directly impact business growth, such as talent development, employee engagement, and culture-building. Routine administrative tasks, when handled externally, no longer distract from these high-value priorities. The True Cost of Administrative Overload Overburdened HR teams don’t just affect your internal operations; they impact your employees’ experience. Inconsistent onboarding can create a rocky first impression for new hires. Delayed payroll or benefits questions lead to frustration and decreased trust. Compliance oversights expose your business to fines and legal risk. Even small inefficiencies add up. According to the National Association of Professional Employer Organizations (NAPEO), organizations that leverage an outsourced HR model achieve an average ROI of 27.2% per year, saving around $1,775 per employee while paying $1,395 per employee for outsourced services. That’s not just cost savings, it’s a reinvestment in your team and your business. The Power of Strategic HR Outsourcing Outsourcing doesn’t mean giving up control or handing HR off to a faceless provider. Done strategically, it’s about extending your team. Administrative tasks like payroll, benefits, onboarding, and reporting can be handled efficiently by experts, while HR teams gain confidence that compliance requirements are being met. Most importantly, it frees internal HR to pivot from reactive, day-to-day tasks toward engagement, culture-building, and retention strategies. Outsourced HR support can scale with your business, providing additional expertise during busy periods, leaves of absence, or rapid growth phases. The impact is clear. Teams feel supported, employees feel heard, and the organization operates smarter, not harder. With the right outsourcing partner, a small HR team can act like a team of 10, and a team of five can perform like a team of 25, all while maintaining compliance and efficiency. Retention Starts With the Right Employee Experience When administrative burdens are reduced, HR teams can focus on creating meaningful experiences for employees. Transparent processes around pay, benefits, and policies build trust. Faster, more organized onboarding leaves a strong first impression. Access to modern self-service HCM tools empowers employees to manage their own information, reducing repetitive questions and improving engagement. By leveraging experienced HR professionals to handle gaps in internal processes, organizations can enhance overall employee satisfaction, ensuring every interaction, from onboarding to open enrollment, feels seamless and supportive. A Smarter Approach to HR Means a Stronger Business Across industries, companies are recognizing that HR outsourcing is no longer a luxury. It’s a strategic advantage. Organizations that adopt a blended model of technology and advisory support report measurable reductions in administrative workload, cost savings compared to maintaining fully in-house HR teams, and improved engagement for employees. Strategic HR outsourcing allows internal teams to shift from transactional tasks to big-picture initiatives, creating a more resilient, efficient, and high-performing workforce. At the end of the day, HR isn’t just a function; it’s the backbone of your organization. When it’s overextended, the entire business suffers. But with the right support, HR teams can focus on meaningful initiatives, employees feel more valued, and the business benefits from measurable ROI. Strategic HR outsourcing isn’t about replacing your team, it’s about empowering it. Your people, your culture, and your bottom line all benefit. Curious how Simco's HR Advisory services can help your business? Let's talk today.

Your Medicare Plan Is Discontinued: What’s Next?

October 14, 2025
If you recently received notice that your Medicare plan, or Medicare Advantage plan, is being discontinued, you’re not alone. Across the country (and right here in New York), insurers are scaling back or exiting less profitable markets ( Kiplinger ). While this can feel stressful, there are steps you can take to make sure your coverage doesn’t lapse and to find a better plan for your health and budget. Why Are Plans Being Discontinued? A mix of financial pressure, federal reimbursement changes, and rising health costs is driving insurers to reduce their Medicare Advantage footprints: Some major insurers are cutting back or exiting entire counties. For example, UnitedHealth announced it will discontinue its Medicare Advantage presence in 109 U.S. counties in 2026, according to Reuters . Local carriers in New York are also making changes: MVP is dropping several plans, and CDPHP is eliminating certain drug-coverage options, the Times Union explains . These shifts are happening alongside tighter government funding and increased regulatory strain. Because insurers must absorb the extra cost of covering benefits while meeting regulatory caps (for example, on prescription drug out-of-pocket limits), some plans become financially unsustainable and are discontinued ( the Kaiser Family Foundation ). Steps to Take if Your Plan Is Discontinued Here’s how to act so you don’t lose coverage: 1. Review the notice you received carefully Your insurer is required to send you a non-renewal or discontinuance notice. It often includes deadlines, whether you can enroll through a Special Enrollment Period (SEP), and what options you have. 2. Note the relevant enrollment period The Annual Enrollment Period (AEP) runs October 15 to December 7, 2025 , during which you can switch Medicare Advantage or Part D plans. If your plan was discontinued, some notices allow you to select a new plan until December 31 without penalty. In limited cases, you may qualify for a Special Enrollment Period (SEP) following the discontinuation. 3. Research your options early Don’t wait until the last minute. Compare plans available in your area. Key things to look at: Provider networks: Will your doctors still be covered? Drug formularies: Does the plan cover your medications and at what cost? Premiums, deductibles, and out-of-pocket max: These can vary significantly. Benefit trade-offs: Some plans reduce supplemental benefits (vision, dental, wellness perks) when trying to maintain financial viability. 4. Enroll in the new plan Submit your enrollment by the relevant deadline (typically December 7 for the Annual Enrollment Period (AEP). However, If your plan was discontinued, you may have until December 31 to choose a new one without penalty). Make sure the new plan starts January 1 to avoid coverage gaps. 5. If your plan wasn’t discontinued, still review Even if your current plan remains active, benefits, networks, and costs often change each year. It’s wise to compare alternatives anyway, especially after insurer shake-ups. Why Timing & Support Matter Delays cost you: Failing to enroll by deadlines could mean losing drug coverage or being locked into a less ideal plan. Support can ease the burden: Licensed agents can help you compare side-by-side, explain trade-offs, and guide you through enrollment. You deserve the best match: Everyone’s health and financial needs differ. Don’t settle for the first available option unless it truly fits. How Simco Can Help At Simco, we understand the stress of sudden plan changes. Our licensed insurance advisors are ready to: Help you interpret your discontinuance notice Compare plan options available in your area Assist with enrollment paperwork Explain benefit trade-offs and cost implications You don’t have to navigate this alone. Whether your Medicare Advantage plan was discontinued or you’re simply exploring your options, our team is here to support you. Contact us today to schedule a 1-on-1 consultation, and let us help you find the plan that keeps you covered and confident in 2026 and beyond.

Have a question? Get in touch.