Comparing UnitedHealthcare, Other Medicare Advantage Carriers

Navigating the world of retiree health care can be a challenge with countless carriers and plans available. Carriers can differ widely, not just in the kinds of benefits they offer, but also how they operate and process claims.

Recently, there has been news coverage of Medicare Advantage plans—comprehensive plans from private insurers that combine Medicare Part A and Part B with Part D prescription coverage—and their use of prior authorization to approve or deny certain types of care.

Insurance companies sometimes require prior authorization before a doctor can provide treatment to a patient, often for very expensive or complicated procedures. A common complaint about the prior authorization process is that it can lead to delays in care. Insurance carriers, on the other hand, argue it’s an important part of making sure patients are receiving appropriate treatment.

In a recently released report, KFF (formerly the Kaiser Family Foundation) analyzed Medicare Advantage data from the Centers for Medicare & Medicaid Services for the year 2023 and compared insurance carriers on their use of prior authorizations. That analysis included UnitedHealthcare and Kaiser Permanente, both of which provide PERACare Medicare Advantage plans.

The KFF analysis found that while UnitedHealthcare’s prior authorization denial rate was in the middle of the pack (9.1%), the company averaged just one prior authorization request per member for the year, which was the second-lowest among all carriers. Kaiser Permanente had a denial rate of 10% and averaged 0.5 prior authorization requests per member.

It’s important to note that medical providers initiate prior authorization requests, not patients. Patients with questions about prior authorizations should first reach out to their doctor and then the insurance carrier if any questions remain. For PERACare questions that remain unanswered, PERA may be able to further research the issue with the carrier.

Selecting a health care plan is a complex decision with many important factors to consider, including provider networks, premiums, deductibles, out-of-pocket maximums, and more. At Colorado PERA, we strive to select PERACare carriers that provide a high level of coverage and large provider networks while balancing cost. We encourage our members to examine all options available to them before choosing a plan that fits their needs.

Learn more about PERACare plans at copera.org/peracare.

Learn more about prior authorization on UnitedHealthcare’s website or Kaiser Permanente’s website.

Social Security Administration Expediting Benefit Processing for Those Affected by WEP/GPO

The Social Security Administration says it is speeding up implementation of the Social Security Fairness Act, issuing back payments and recalculating benefits for those previously affected by the Windfall Elimination Provision (WEP) and Government Pension Offset (GPO) sooner than initially announced.

After President Joe Biden signed the Social Security Fairness Act into law, the Social Security Administration (SSA) said it was facing a shortage of staff and funding as it worked to recalculate benefits for the millions of Americans whose benefits had been reduced by WEP and GPO. At that time, SSA said implementation could take a year or more due to manual processing of accounts.

In late February, SSA said it had set up an automated process to handle most accounts, allowing the agency to speed up processing. The agency said it was “immediately” beginning to issue retroactive payments to reflect higher benefit amounts going back to January 2024.

Retirees and other beneficiaries can expect to see a lump sum payment deposited directly into the bank account on file with SSA by the end of March, SSA said. New monthly benefit amounts will go into effect with benefits paid in April.

It’s important to note the Social Security Fairness Act does not affect Colorado PERA retirement benefits. PERA members or retirees with questions about how the law affects them should contact the Social Security Administration directly.

LEARN MORE: PERA and Social Security

Affected beneficiaries will receive a letter from SSA explaining any change in benefits, but that letter may arrive after the lump sum for back payments, according to SSA.

The agency said it would have to manually process accounts that have a high level of complexity and those without a bank account on file, which will take additional time. That means not everyone will see their retroactive payments or new benefit amounts right away.

In addition to recalculating benefits, SSA is encouraging anyone who never applied for Social Security benefits due to WEP or GPO reductions to go ahead and apply now.

For more information, visit ssa.gov.

Social Security Fairness Act Rollout Could Take A Year or More

Editor’s note (Feb. 27, 2025): Since this article was published, the Social Security Administration announced it is expediting processing for many cases and sending out retroactive benefit payments. View our updated article or visit ssa.gov for the latest information.


Public employees hoping to see larger Social Security benefit payments following the repeal of the federal Windfall Elimination Provision (WEP) and Government Pension Offset (GPO) may have a long wait.

While the Social Security Administration (SSA) hasn’t provided a timeline for when changes will take effect, officials are warning the process of recalculating and paying benefits for millions of beneficiaries will likely take a significant amount of time to complete—potentially a year or more.

What we know so far

Congress passed H.R. 82, the Social Security Fairness Act, in late December and President Joe Biden signed the bill in early January. The bill repeals WEP and GPO, which for decades had reduced Social Security benefits for retirees who also received a pension for work not covered by Social Security.

As enacted, the bill applies to benefits payable after December 2023, meaning affected retirees who were already receiving Social Security benefits in 2024 will be owed back payments once their benefit is recalculated. So far, SSA hasn’t said whether those back payments for 2024 will come as a lump sum or be included in future benefit payments.

Why the long timeline?

There are a couple reasons why implementation of the Social Security Fairness Act could have an extended timeline, with staffing and funding being two of the biggest challenges.

According to SSA, the agency is understaffed and has been under a hiring freeze since November 2024, meaning it is unable to bring on any additional staff to help with implementation or answering the phones. In addition, the Social Security Fairness Act did not include any funding to pay for any of the administrative costs associated with this significant change in federal law, SSA said.

Unless SSA receives additional funds or the staffing freeze is lifted, the agency will have to work within its current budget and staffing levels to complete all the changes required under the law.

How to stay in the loop

The Social Security Administration will continue to provide updates on its website, and more information should be available in the weeks and months ahead.

We will be closely monitoring this issue and will post updates on PERA On The Issues when available. To stay in the know, be sure to subscribe to the biweekly newsletter.

Year in Review: Our Top Articles of 2024

As 2024 comes to a close, we’re taking a look back at the articles that resonated most with PERA On The Issues readers. Here are our most-read articles of the year.

2024 Proposed Legislation Status

Legislation is always a popular topic on PERA On The Issues, and 2024 was no exception—our article tracking PERA-related bills throughout the session was our most-visited page of the year. State lawmakers introduced nine PERA-related bills during the legislative session, ultimately passing six of them, though one was amended to remove the provision related to PERA.

Continue reading to find out what we expect to see in the 2025 legislative session.

What to Expect for Medicare Advantage in 2025

The open enrollment period for PERACare—PERA’s health benefits program—happens every fall for coverage beginning the following January. While premiums for PERACare’s Medicare Advantage plans had been stable for three years, that rate freeze expired and various regulatory changes led to carriers announcing this fall that Medicare Advantage premiums would be higher for plan year 2025.

Updated Tax Brackets, Contribution Limits and More to Know for 2025

If you’re already thinking about your tax situation for 2025, you’re not alone. Our roundup of various tax-related inflation adjustments was one of our most-read articles of the year. The article includes details on updated retirement plan contribution limits, HSA/FSA contribution limits, new marginal tax brackets, and more.

U.S. House Passes WEP/GPO Bill, Heads to Senate

We frequently hear from PERA members who are frustrated with the way the Windfall Elimination Provision (WEP) and/or Government Pension Offset (GPO) reduce their Social Security benefit, so it was no surprise to see a high level of interest in the topic again this year.

Lawmakers have been introducing bills to modify or repeal WEP and/or GPO for years, and in 2024 the House of Representatives brought one such bill, the Social Security Fairness Act, up for a vote and passed it. With the bill awaiting action in the Senate, PERA and the Fire & Police Pension Association of Colorado teamed up to send a letter to Colorado’s senators encouraging them to support the bill. The bill has since passed the Senate and is awaiting President Biden’s signature.

State Lawmakers Pursuing Two PERA-Related Bills in 2025

Back here in Colorado, state lawmakers are getting ready for the start of another legislative session in January. We expect to see some PERA-related legislation introduced in the new session, including two bills that lawmakers on the Pension Review Commission drafted during this year’s interim period between sessions.


We want to thank everyone who subscribes and reads PERA On The Issues. We appreciate your readership and we look forward to helping you stay informed in the new year.

Make sure you’re subscribed to our biweekly newsletter to stay up-to-date on all the latest news, and join the conversation on Facebook and LinkedIn.

Survey Finds Strong Support for Public Pensions

The American public continues to hold positive opinions of defined benefit pension plans, according to the latest survey data from the National Institute on Retirement Security (NIRS).

Researchers contacted more than 1,200 adults aged 25 and older across the country to understand public opinion about defined benefit plans like what Colorado PERA offers. They found 86% of survey respondents think all workers should have access to a defined benefit pension, and not just public employees.

In addition, while Americans may be divided politically, the NIRS survey found strong agreement on the value of pensions. More than 80 percent of each political group—Democrats, Republicans, and Independents—voiced their support for pensions.

Unlike a defined contribution plan such as a 401(k), a defined benefit plan like the PERA Defined Benefit Plan provides retirement income a person cannot outlive. That makes for a valuable benefit that can be a powerful tool in maintaining a qualified workforce.

Two pie charts showing results of a survey of Americans' attitudes toward pensions. The left chart shows 82% of Americans agree that pensions are a good way to recruit and retain qualified teachers. The right chart shows 84% of Americans agree that pensions are a good way to recruit and retain qualified public safety employees.
Image courtesy: National Institute on Retirement Security

Defined benefit plans are most common in the public sector today, and the NIRS survey asked respondents whether they agreed that pensions are a valuable tool to recruit and retain workers who provide important public services, such as teachers and public safety workers. The survey found 82% agree that pensions help recruit and retain teachers and 84% agree that they help recruit and retain public safety workers.

Since 1931, Colorado PERA has been helping support Colorado’s public workforce by providing lifetime retirement and other benefits. In addition to the PERA Defined Benefit Plan, PERA members have access to defined contribution plans, health care benefits, and more, ensuring the state’s public workers have the tools they need for a secure retirement.

Updated Tax Brackets, Contribution Limits and More to Know for 2025

The new year is mere weeks away. To make sure taxpayers are informed and prepared, the IRS announced inflation adjustments for many tax provisions in 2025, including marginal tax brackets and retirement account contributions.

Retirement plan contribution limits

The IRS announced higher contribution limits for 401(k), 403(b) and 457 plans next year.

The maximum amount a worker can contribute to those plans is $23,500 in tax year 2025, an increase of $500. The catch-up contribution limit for most plan participants age 50 and older remains unchanged at $7,500.

Beginning in 2025, some older workers can make additional catch-up contributions. As part of the SECURE 2.0 Act, plan participants who are between the ages of 60 and 63 can make catch-up contributions totaling up to $11,250 in tax year 2025.

Learn more about PERAPlus 401(k)/457 Plans

HSA/FSA contribution limits

The amount of money workers can contribute to medical savings accounts also will increase in 2025.

  • HSA: Individuals enrolled in a high deductible health plan (HDHP) with a health savings account (HSA) will be able to contribute up to $4,300, and those with family coverage will be able to save a maximum of $8,550.
  • FSA: For workers who don’t have an HDHP with an HSA and instead use a flexible spending account (FSA), the maximum contribution for 2025 is $3,300. For plans that allow unused balances to roll over, the maximum amount that can be rolled over will increase to $660.

2025 tax rates

Below are updated marginal tax rates for single taxpayers and married couples filing jointly. Visit the IRS website for more tax tables and additional details.

Note that since these changes are for tax year 2025, they will generally apply to tax returns filed in 2026; 2024 tax rates will apply to returns filed in 2025.

  • 37% for incomes over $626,350 ($751,600 for married couples filing jointly)
  • 35% for incomes over $250,525 ($501,050 for married couples filing jointly)
  • 32% for incomes over $197,300 ($394,600 for married couples filing jointly)
  • 24% for incomes over $103,350 ($206,700 for married couples filing jointly)
  • 22% for incomes over $48,475 ($96,950 for married couples filing jointly)
  • 12% for incomes over $11,925 ($23,850 for married couples filing jointly)
  • 10% for incomes $11,925 or less ($23,850 or less for married couples filing jointly)

Standard deduction

In addition to updated tax rates, the IRS announced increases to the standard deduction for tax year 2025:

  • Single taxpayers and married couples filing separately: $15,000 ($400 increase)
  • Heads of household: $22,500 ($600 increase)
  • Married couples filing jointly: $30,000 ($800 increase)

Taxpayers who are 65 or older can take an additional standard deduction, which is also adjusted for inflation. For tax year 2025, that amount is $2,000 for single filers and $1,600 for others.

Visit the IRS website for more adjustments to tax provisions in 2025.

PERA benefits and taxes

Colorado PERA benefits are subject to federal income tax, as well as applicable state and local taxes. PERA retirees who would like to update their tax withholding can do so by logging in to their secure member account or completing a paper Form W-4P.

Retirees and benefit recipients can expect to receive their 1099-R tax forms for tax year 2024 in January 2025.

Learn more at copera.org/taxes-on-benefits.

Why the State is Commissioning a Study on PERA’s Plan Design

Since 1931, Colorado PERA has been providing retirement and other benefits to the public employees who keep our state running. As the workforce and retirement landscape have changed, PERA also has adapted and grown; Colorado’s largest public retirement plan now covers nearly 700,000 current and former public workers.

PERA benefits, including the hybrid defined benefit plan and the option for some members to choose a defined contribution plan, have been valuable in helping public agencies recruit and retain employees for decades. Critics of defined benefit pensions, however, argue that today’s workers would be better served by other types of plans. An upcoming study will help shed light on that debate.

Purpose and scope

During the 2024 legislative session, state lawmakers passed House Bill 1427, which calls for the State Auditor, in cooperation with PERA, to enlist an independent actuarial firm experienced with public pensions to conduct a comprehensive study comparing the cost and effectiveness of the PERA Defined Benefit (DB) Plan to alternative plan designs, as well as providing an analysis of certain aspects of PERA’s current defined benefit and defined contribution plans.

The study will be similar in scope and purpose to a study that took place following similar legislation in 2014. That study compared various facets of the PERA DB Plan—such as cost per member, contribution rates, income replacement ratio, and portability—to other public and private sector plan types, including Social Security. The study is available online here.

Why refresh the study after a decade? In part, things have changed, and state leaders see value in having updated data. Since the last study, Colorado has seen tremendous growth, the public workforce has changed, and various reforms have put PERA on a path to full funding. This new study will incorporate all those changes to provide a more accurate assessment of PERA’s value to employers and the state as a whole.

While a lot has changed in the past 10 years, one thing that hasn’t is PERA’s commitment to providing retirement security to our members. The previous study concluded that PERA’s plan provides a better benefit at a lower cost than other plans, making it the best option for providing retirement benefits to the state’s public employees. We believe an updated study will show the same results.

What’s next?

The State Auditor and PERA have until the end of October to select an actuarial firm to conduct the study. Once a firm is selected, the study is likely to take several months to complete.

When the study is complete, PERA and the State Auditor will provide a report of the study’s findings to the governor, the Joint Budget Committee, the Legislative Audit Committee, and the House and Senate Finance Committees.

We’ll also provide a summary of the study’s findings here on PERA On The Issues. Make sure you’re subscribed to our biweekly newsletter to receive all the latest updates.

What to Expect for Medicare Advantage in 2025

Recent changes to Medicare Advantage (MA) and Medicare Part D prescription drug coverage will affect the cost of PERACare health benefits in 2025.

What’s changing

The Centers for Medicare & Medicaid Services (CMS) pays MA insurers a base payment for every enrollee in their plan, as well as additional money for enrollees that have more health issues. CMS will be reducing the base payment amount for 2025. In addition, in 2024 CMS started phasing in changes to how it calculates the additional health status payments. These actions are expected to reduce the amount CMS reimburses insurers.

For 2025, the Inflation Reduction Act adds an out-of-pocket maximum of $2,000 to costs MA enrollees pay for their Part D prescriptions. This means after that first $2,000, enrollees will not have to pay anything for their prescriptions. While this is a positive change for those who take multiple medications, this means more costs for the insurance companies.

While final rates and plan benefits for 2025 are not yet available, MA and Part D carriers have already noted that in response to these changes they are likely to increase MA premiums more significantly than in recent years and may also make benefit reductions. This will impact individual Medicare Advantage plans, individual Medicare Part D plans, and the Medicare plans offered by PERACare.

Other factors affecting cost

PERA’s insurance team uses a competitive bid process to identify carriers and plans that provide valuable health benefits to PERA retirees, and we negotiate the best rates we can. PERACare was able to negotiate a rate guarantee keeping MA premiums unchanged for several years, but that guarantee is now expiring.

PERACare plans offer generous benefits and broad networks of providers across the United States. The plans also cover only retirees, who tend to have more medical needs and use more services than the general population, resulting in higher plan costs. PERA offers a subsidy, based on years of service, to help offset some of the cost of PERACare premiums.

Everyone’s health care needs are different, and we encourage retirees to take a look at all their health insurance options to choose a plan that best fits their budget and needs.

What to know about open enrollment

PERACare staff are working to finalize plans and premiums for 2025, and we’ll be mailing information out in the coming months.

Here are some important dates to keep in mind:

  • October 1: 2025 PERACare information available online
  • Mid-October: PERACare open enrollment materials mailed to current PERACare enrollees
  • October 21 to November 21: PERACare open enrollment
  • October 15 to December 7: Medicare open enrollment
  • December 15: Last day for PERA to receive cancellation requests for January 1

For more information, visit copera.org/peracare.

The Latest on Federal WEP/GPO Legislation

Update: In November 2024, the House passed H.R. 82, the Social Security Fairness Act. Please visit this page for the latest.


We often hear from Colorado PERA members who want to know if legislators have made any progress in their efforts to change two provisions of federal law that can reduce retirees’ Social Security benefits.

Because most PERA members do not participate in Social Security while working for a PERA employer, any Social Security benefit they earned from private-sector work may be affected by the Windfall Elimination Provision (WEP) or the Government Pension Offset (GPO).

Those provisions have been part of federal law since the 1980s, but lawmakers in recent years have repeatedly sought to modify or repeal them without success.

Why WEP and GPO exist

Social Security benefits are designed to replace only some of a worker’s pre-retirement earnings, and lower-paid workers receive a larger replacement percentage than higher-paid workers. Prior to the WEP being enacted in 1983, non-Social Security government workers like PERA members would receive a larger-than-intended Social Security benefit because of those years in their earning record when they weren’t contributing to Social Security. The WEP was meant to remove that advantage.

The GPO applies to PERA retirees who also receive a Social Security spousal or widow(er) benefit and reduces the Social Security benefit by two-thirds of the PERA benefit. That’s because spousal and widow(er) benefits are considered “dependent” benefits and were meant to help spouses who stayed at home and depended on their working partner for financial support. According to the Social Security Administration, now that it is common for both spouses to work, the GPO requires the “dependent” benefit to be offset by the dollar amount of their own retirement benefit.

It’s important to note that a retiree’s PERA benefit will never be reduced to Social Security or other benefits. Learn more about PERA and Social Security.

Where things stand

While federal lawmakers have introduced about a half-dozen bills this Congress that touch on the WEP and GPO issue, the one that has received the most attention and support is H.R. 82, the Social Security Fairness Act of 2023. Its counterpart in the Senate is S. 597. Both bills were introduced in early 2023.

Other bills that seek to modify or repeal WEP and/or GPO include H.R. 4583 and S. 2280—both known as the Social Security 2100 Act—which propose a number of changes to Social Security, including temporarily eliminating WEP and GPO. Those bills were introduced in July 2023.

In April 2024, the House Ways and Means Committee convened for an informational hearing on the topic of WEP and GPO. The meeting didn’t result in any action on the above bills, but lawmakers heard from a panel of experts on the effects the two provisions have on retired public employees and the potential impacts of any changes to Social Security. Testimony largely centered around the fact that the Social Security Administration now has better worker data and WEP/GPO formulas could potentially be updated, but the cost to make any changes would amount to billions of dollars over the next decade.

Neither Social Security Fairness Act bill has made forward progress in Congress, but they continue to gather support—H.R. 82 in particular has gained more than 300 cosponsors in the House. And in May, the bipartisan Problem Solvers Caucus threw its support behind the Social Security Fairness Act with its 62 members endorsing the legislation.

In September, bill sponsors Reps. Abigail Spanberger (D-VA) and Garret Graves (R-LA) filed what’s known as a discharge petition, seeking to move H.R. 82 out of committee and force a floor vote. That petition reached the required threshold of 218 signatures, allowing the sponsors to request a vote in the House of Representatives. With Congress in recess for the month of October, a vote could happen as soon as November, but even if it passes the House, the bill faces an uncertain future in Senate.

What’s next?

We can expect congressional lawmakers to continue discussing this issue. Even if none of the above bills see any meaningful action before the current Congress ends, legislators are likely to introduce new bills in the next Congress.

As we’ve seen repeatedly over the years, bills that seek to modify or repeal WEP and/or GPO face a steep uphill battle, with lawmakers often citing the cost of increased Social Security benefits as a significant hurdle to overcome. That’s especially true in the face of pessimistic forecasts of Social Security’s finances.

While the most recent projections are somewhat better than expected, Social Security’s cash reserves are still expected to be depleted in about a decade. If that happens and Congress hasn’t taken any action, Social Security will be forced to begin reducing benefits, but experts expect lawmakers will take action to shore up the system’s finances before any benefit reductions are necessary. It’s possible that a package of reforms for Social Security could also include some changes to the WEP and GPO, but only time will tell.

One of the most effective forms of advocacy is for PERA members and retirees to contact their senators and representatives in Congress to let them know how the WEP and GPO affect them, as this issue is will be decided at the federal level.

We’ll continue to monitor this issue and post any updates on PERA On The Issues when we can. To stay in the loop, be sure to subscribe to our biweekly newsletter.

Measuring the Impact of $4.5B+ in Annual Retirement Benefits in Colorado

Every month retired public employees across the state receive their benefit payments from Colorado PERA. Retirees then spend their income in their communities, supporting local economies and jobs and providing an important stabilizing economic force.

In 2023, PERA paid $4.56 billion in benefits to 114,432 retirees living in Colorado, resulting in $7.1 billion in total economic output and supporting 28,525 jobs in the state, according to a newly released report from Boulder-based Pacey Nehls Economic Consulting. The Economic and Fiscal Impacts report also found PERA retirees paid nearly $382 million in state and local taxes on those benefits, supporting schools, roads, and other vital services.

The multiplier effect

When retirees spend their pension income, it sets off a multiplier effect as businesses then spend money to stock more inventory and hire staff, employees of those businesses spend their own income, and governments collect taxes on all that spending. The result is every dollar in PERA benefits grows as it cascades through the economy.

This cycle of spending illustrates the economic measure of “value-added,” which counts only the additional production of goods and services resulting from PERA distributions rather than total output.

Pacey Nehls estimates a PERA retiree’s economic output multiplier at 1.56, meaning an extra 56 cents are generated in the economy for every dollar a retiree spends. In total, PERA retiree spending resulted in $3.39 billion in added economic value statewide last year.

The stabilizing effect

A chart showing annual PERA retirement distributions per capita for various regions in 2009 and 2023. Colorado statewide: $480 per capita in 2009, $780 per capita in 2023. Metro Denver: $412 per capita in 2009, $708 per capita in 2023. Colorado Springs: $491 per capita in 2009, $735 per capita in 2023. Pueblo-Southern Mountains: $1,007 per capita in 2009, $1,555 per capita in 2023. San Luis Valley: $647 per capita in 2009, $1,155 per capita in 2023. Southwest Mountain: $496 per capita in 2009, $775 per capita in 2023. Western: $507 per capita in 2009, $879 per capita in 2023. Mountain: $363 per capita in 2009, $654 per capita in 2023. Northern: $567 per capita in 2009, $809 per capita in 2023. Eastern: $531 per capita in 2009, $996 per capita in 2023.
Regional per capita annual PERA retirement distributions in 2009 and 2023

The consistent flow of billions of dollars in PERA retirement benefits into communities across the state every year helps add stability to the state and local economies. This stabilizing effect is especially strong in some of Colorado’s rural areas, where public employees make up a larger portion of county payroll and their retirement benefits are higher per capita.

For example, the Denver metro area has the most overall PERA distributions in Colorado at more than $2.3 billion last year, which equates to $708 per person. Meanwhile, the Pueblo-Southern Mountain region’s $382 million in PERA benefits comes out to $1,555 per person.

The stabilizing effect of PERA benefits was especially helpful during the COVID-19 pandemic. When businesses, schools, governments, and other entities shut down or greatly reduced staff due to the health emergency, PERA continued to pay benefits to retirees across the state, providing consistent, reliable money to local economies when other economic activity was lower than usual.

For more information, including detailed breakdowns by region and county, download the Economic and Fiscal Impacts report here.