Healthcare Provider Update: Healthcare Provider for Merck Merck & Co., Inc., commonly known as Merck, is a global leader in the healthcare sector, renowned for its innovative pharmaceuticals, vaccines, and biologic therapies. As a prominent healthcare provider, Merck delivers a wide array of health solutions targeting various health conditions, particularly in areas such as immunology, oncology, and infectious diseases. Potential Healthcare Cost Increases in 2026 In 2026, healthcare costs are projected to rise significantly, primarily driven by the anticipated expiration of enhanced federal premium subsidies associated with the Affordable Care Act (ACA) and growing medical expenses. Faced with an average premium increase of 18%, healthcare consumers may experience out-of-pocket costs climbing by over 75%. This situation is exacerbated by surging medical care prices, as hospitals and providers seek to balance inflationary pressures while maintaining profitability. As a result, many individuals may find themselves priced out of adequate health coverage, prompting essential discussions on the need for policy interventions. Click here to learn more
Merck employees considering a special needs trust for a relative should consider the tradeoff between preserving government benefits and covering supplementary needs, 'says (Advisor Name), of the Retirement Group at Wealth Enhancement Group. Working with professionals who understand these trusts is important so your loved ones are properly protected without compromising their benefits,' she said.
The Retirement Group, a division of Wealth Enhancement Group, reminds Merck employees that setting up a special needs trust is about more than financial security - it's about peace of mind. Engaging skilled advisors may help structure the trust to meet immediate and long-term care needs while preserving eligibility for key government programs.
In this article we will discuss:
1. How to Form a Special Needs Trust: How to start a special needs trust for people with disabilities so they can continue to receive government benefits such as Medicaid and SSI.
2. Types of Special Needs Trusts (SN Trusts): Exploring different types of special needs trusts including third party and self-settled trusts and how they can be adapted to meet the needs of disabled people.
3. Funding & Managing a Special Needs Trust: A Practical Guide. Guidelines for funding and managing a special needs trust so it can meet its intended goals without compromising eligibility for government programs.
How Much Does A Special Needs Trust Cost?
For Merck customers with a child or other relative with special needs, a special needs trust may be appropriate. An estate plan that accommodates the needs of disabled people without compromising eligibility for government benefits is called a special needs trust or supplemental needs trust. An attorney can help you form and manage such a trust.
Tip: Our Merck clients should know that the term special needs is used herein to describe any trust established to fund the supplemental needs of a person with a disability while maintaining eligibility for government benefits. It includes trusts funded by the individual (as defined by the Omnibus Budget Reconciliation Act of 1993 (OBRA' 93), as well as trusts funded by assets received from a third party (a parent or grandparent).
But Why Set Up A Special Needs Trust?
Some Merck employees wonder why a special needs trust should exist. Unlike other types of trust used in estate planning, the purpose of a special needs trust is to meet the life expectancy of a disabled individual. In general, children and people with special needs are eligible for federal and state benefits. And if your child is eligible for government benefits, one of your goals may be to keep him or her eligible indefinitely. A special needs trust may help you with that goal. And this type of trust can offer more services for your loved one.
Tip: We also want these Merck employees to know that although this discussion is about using a special needs trust to benefit a child with disabilities, some special needs trusts may be established for a parent or other older adult who wishes to keep eligibility for nursing home benefits under Medicaid.
Preserve Eligibility for Medicaid.
Medicaid eligibility is a pro for Merck clients contemplating a special needs trust. The joint federal-state Medicaid program helps disabled people who have financial need. For children and adults, Medicaid eligibility is determined only if their monthly income and other assets are below state-specific limits. (Most states set a USD 2,000 asset limit.) A state may look only at legally available income and assets to determine Medicaid eligibility. The beneficiary is denied direct access to the assets of the trust to the point where they are not legally accessible through a special needs trust. So a special needs trust can protect Medicaid eligibility because its assets are not countable.
Preserve Eligibility for Supplemental Security Income (SSI)
Many children and adults with limited Income and resources receive monthly Supplemental Security income (SSI) benefits. These monetary benefits may be used for housing or food. Since SSI benefits are determined by need, a child with special needs who inherits money could lose eligibility. Rather than their child, these Merck customers can put their assets toward taking care of a special needs trust. Since SSI recipients typically automatically qualify for Medicaid, preserving your child's SSI eligibility may also preserve his or her Medicaid eligibility.
Provide Other Care and Services.
A special needs trust may be especially useful to Merck clients who want to protect their child without cutting into Medicaid benefits. Medicaid covers hospital bills, physician services and long-term care but not non-essential items and services. Those may include health-related costs like eyeglasses, dental care, rehabilitation and home health help services, and personal costs like transport, computer equipment and vacations.
Caution: To prevent trust assets from reaching the beneficiary, the trustee must have sole discretion over trust income and principal distribution. No beneficiary may control the trust or demand distributions from the trust. The trustee should buy goods and services for the beneficiary directly rather than give the beneficiary money from the trust to buy items needed.
What Requirements Must A Special Needs Trust Meet?
The trust must be drafted correctly if it is meant to supplement rather than replace government benefits. While specific requirements depend on state law and the kind of special needs trust being established, we recommend our Merck clients understand the following general rules about special needs trusts in general:
So the beneficiary of the special needs trust might not have access to the trust's assets. No such beneficiary can end the trust. This individual must meet SSI requirements. Kids and adults have different laws. Provisions of the trust may bar the trustee from making payments or distributions that would affect the beneficiary's eligibility for government benefits (e.g., distributions can not be made directly to the beneficiary). Special needs trusts may exist in a will as a testamentary trust or during the creator's lifetime as a living or inter vivos trust. Special needs trusts can hold unlimited assets and can be augmented at will.
What Types of Special Needs Trusts Are Available?
The many varieties of special needs trusts fall broadly into two broad categories: a third-party special needs trust funded by assets not owned by the beneficiary and a self-settled trust funded by assets owned by the beneficiary.
Third-Party Special Needs Trust
The assets paid into the third-party special needs trust are not assets of the beneficiary. A parent or grandparent, for example, could fund a testamentary trust with cash, life insurance or another asset. If the third-party trust is properly drafted, the state will not be required to pay for long-term care services when the beneficiary dies.
Self-Settled Trust
The disabled person sets up a self-settled special needs trust out of their own funds. For example, a self-settled trust could be created using a personal injury award or inheritance. One type of self-established trust is the qualified self-funded special needs trust. This type of trust is created for the benefit of only one disabled person under age 65 at the time of its establishment. All long-term care after the beneficiary dies must be paid for out of trust assets. Such a trust is also called a (d) (4) (A) trust.
Other common types of self-settled trusts are qualified pooled trusts, also called (d) (4) (C) trusts. A nonprofit organization establishes and manages such a trust. Each trust beneficiary has a separate account but funds are pooled for investment and management. Any remaining trust assets are given to the charitable organization upon the death of the beneficiary and the charitable organization reimburses Medicaid for benefits paid to the beneficiary. Some survivors may even receive a share or all of the remaining funds.
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Caution: Self-settled trusts are complex and must conform to OBRA' 93.
Caution: One parent may preserve eligibility for nursing home benefits under Medicaid by placing money in a special needs trust for a child with disabilities that has a Medicaid payback provision.
What Does A Special Needs Trust Usually Get Funded For?
Many Merck employees wonder how often such trusts are funded. Many times a special needs trust is created but not funded while the parent or other creator is alive. A parent dies leaving the special child's share of an inheritance to the special needs trust. Also, the trust can be named the beneficiary of assets other than the child - such as employee benefits and life insurance policies.
A special needs trust is funded typically by:
1. Life insurance Cash (including relatives' gifts). Stocks, bonds, investments - etc. Pension benefits / IRA funds / 401 (k) assets - Retirement plan benefits. Real and personal property Personal injury settlement proceeds (for self-settled trusts).
2. Though life insurance is among the most common ways of funding - particularly low-cost survivorship life insurance - each method has advantages and disadvantages. And these Merck employees will need to project how much lifetime income their child will likely need to fund the trust.
Still Other Things to Consider?
A few other things to consider for Merck customers considering a special needs trust.
Selecting a Trustee
Trustees are people or institutions that administer the assets of a trust. The trustee is liable for following the terms of the trust document and meeting its objectives. You may designate yourself, another family member, an attorney, a bank or another professional as trustee of the special needs trust. All have benefits and drawbacks. Such Merck employees may also name a relative and a professional trustee as co-trustees.
Providing a Letter of Intent.
For our Merck clients who establish a special needs trust through a will, you may also want to write a letter of intent setting out your wishes for your child's future care. Although not a legal document, it may be useful to guardians, trustees, family members and anyone else caring for your child. This letter could discuss your child's medical needs, daily routine, interests / likes / dislikes, religion, living situation, social activities / behaviour management and independence. A letter like this might help your child's attendants and may help the child adjust to a new living situation.
Informing Family Members
Tell siblings or other relatives why these Merck employees are starting a special needs trust. Siblings should expect equal inheritances but you will likely have to save more for your child with special needs. Clarifications & explicit instructions may prevent.
Sources:
1. Special Needs Alliance . 'SNA 2022 Handbook.' Special Needs Alliance , 2022. www.specialneedsalliance.org .
2. CPT Institute . 'What is a Special Needs Trust? [The Complete Guide].' CPT Institute: Protecting Government Benefits for the Injured and At Risk , www.cptinstitute.org .
3. Medicaid Planning Assistance . 'Special / Supplemental Needs Trusts & Medicaid Eligibility for Seniors.' Medicaid Planning Assistance , www.medicaidplanningassistance.org .
4. The Autism Community in Action (TACA) . 'Special Needs Trusts.' TACA , www.tacanow.org .
5. NeuroNav . 'A Special Needs Trust Deep Dive: What to Know.' NeuroNav , 15 Oct. 2024, www.neuronav.org .
How does Merck's new retirement benefits program support long-term financial security for employees, particularly regarding the changes to the pension and savings plans introduced in 2013? Can you elaborate on how Merck's commitment to these plans is designed to help employees plan for retirement effectively?
Merck's New Retirement Benefits Program: Starting in 2013, Merck introduced a comprehensive retirement benefits program aimed at providing all eligible employees, irrespective of their legacy company, uniform benefits. This initiative supports Merck's commitment to financial security by integrating pension plans, savings plans, and retiree medical coverage. This approach not only aims to help employees plan effectively for retirement but also aligns with Merck’s post-merger goal of standardizing benefits across the board.
What are the key differences between the legacy pension benefits offered by Merck before 2013 and the new cash balance formula implemented in the current retirement program? In what ways do these changes reflect Merck's broader goal of harmonizing benefits across various employee groups?
Differences in Pension Formulas: Before 2013, Merck calculated pensions using a final average pay formula which typically favored longer-term, older employees. The new scheme introduced a cash balance formula, reflecting a shift towards a more uniform accumulation of retirement benefits throughout an employee's career. This change was part of Merck's broader strategy to harmonize benefits across various employee groups, making it easier for employees to understand and track their pension growth.
In terms of eligibility, how have Merck's pension and savings plans adjusted for years of service and age of retirement since the introduction of the new program? Can you explain how these adjustments might affect employees nearing retirement age compared to newer employees at Merck?
Adjustments in Eligibility: The new retirement program revised eligibility criteria for pension and savings plans to accommodate a wider range of employees. Notably, the pension benefits under the new program are designed to be at least equal to the prior benefits for services rendered until the end of 2019, provided employees contribute a minimum of 6% to the savings plan. This adjustment aids both long-term employees and those newer to the company by offering equitable benefits.
Can you describe the transition provisions that apply to legacy Merck employees hired before January 1, 2013? How does Merck plan to ensure that these provisions protect employees from potential reductions in retirement benefits during the transition period?
Transition Provisions for Legacy Employees: For employees who were part of legacy Merck plans before January 1, 2013, Merck established transition provisions that allow them to earn retirement income benefits at least equal to their current pension and savings plan benefits through December 31, 2019. This ensures that these employees do not suffer a reduction in benefits during the transition period, offering a sense of security as they adapt to the new program.
How does employee contribution to the retirement savings plan affect the overall retirement benefits that Merck provides? Can you discuss the implications of Merck's matching contributions for employees who maximize their savings under the new retirement benefits structure?
Impact of Employee Contribution to Retirement Savings: In the new program, Merck encourages personal contributions to the retirement savings plan by matching up to 6% of employee contributions. This mutual contribution strategy enhances the overall retirement benefits, incentivizing employees to maximize their savings for a more robust financial future post-retirement.
What role does Merck's Financial Planning Benefit, offered through Ernst & Young, play in assisting employees with their retirement planning? Can you highlight how engaging with this benefit changes the financial landscapes for employees approaching retirement?
Role of Merck’s Financial Planning Benefit: Offered through Ernst & Young, this benefit plays a critical role in assisting Merck employees with retirement planning. It provides personalized financial planning services, helping employees understand and optimize their benefits under the new retirement framework. Engaging with this service can significantly alter an employee’s financial landscape by providing expert guidance tailored to individual retirement goals.
How should employees evaluate their options for retiree medical coverage under the new program compared to previous offerings? What considerations should be taken into account regarding the potential costs and benefits of the retiree medical plan provided by Merck?
Options for Retiree Medical Coverage: With the new program, employees must evaluate both subsidized and unsubsidized retiree medical coverage options based on their age, service length, and retirement needs. The program offers different levels of company support depending on these factors, making it crucial for employees to understand the potential costs and benefits to choose the best option for their circumstances.
In what ways does the introduction of voluntary, unsubsidized dental coverage through MetLife modify the previous dental benefits structure for Merck retirees? Can you detail how these changes promote cost efficiency while still providing valuable options for employees?
Introduction of Voluntary Dental Coverage: Starting January 2013, Merck shifted from sponsored to voluntary, unsubsidized dental coverage through MetLife for retirees. This change aligns with Merck’s strategy to promote cost efficiency while still providing valuable dental care options, allowing retirees to choose plans that best meet their needs without company subsidy.
How can employees actively engage with Merck's resources to maximize their retirement benefits? What specific tools or platforms are recommended for employees to track their savings and retirement progress effectively within the new benefits framework?
Engaging with Merck’s Retirement Resources: Merck provides various tools and platforms for employees to effectively manage and track their retirement savings and benefits. Employees are encouraged to utilize resources like the Merck Financial Planning Benefit and online benefit portals to make informed decisions and maximize their retirement outcomes.
For employees seeking additional information about the retirement benefits program, what are the best ways to contact Merck? Can you provide details on whom to reach out to, including any relevant phone numbers or online resources offered by Merck for inquiries related to the retirement plans?
Contacting Merck for Retirement Plan Information: Employees seeking more information about their retirement benefits can contact Merck through dedicated phone lines provided in the benefits documentation or by accessing detailed plan information online through Merck's official benefits portal. This ensures employees have ready access to assistance and comprehensive details regarding their retirement planning options.