Answers about spousal health care coverage

Rising costs, increased longevity and an increasing number of retirees have made it necessary to consider changes to the health care program available to Ohio Public Employees Retirement System members.

The latest update to the program is under way, and one of the biggest changes being contemplated by the OPERS Board of Trustees is whether to eliminate access to coverage for spouses of current and future retirees. The result of this cost-control measure would be to preserve access to health care coverage for members who have contributed to the system.

And as we have mentioned before, OPERS is not required by law to provide health care coverage for its retirees and can only do so after it funds the pension benefit.

Statewide member and stakeholder meetings regarding all of the proposed health care plan changes began in June, and we are soliciting member feedback before the Board makes a final decision this fall. Please visit our website to see the presentations and take our health care survey.

Here are answers to many of the questions we’ve heard most often on spousal health care coverage:

Q: Why is OPERS considering eliminating health care coverage for spouses?

A: Because of rising costs and the increased number of retirees projected over the next 30 years, OPERS must consider significant health care plan changes. At the current rate of spending with no changes to the plan, the OPERS health care fund is predicted to run out of money in 8-14 years. The OPERS Board has been reviewing many options over the past three years and believes that it was important to cover career employees who paid into the system.

The Board is considering providing spouses over the age of 65 with access through a personalized model to select a Medicare Supplement or Medicare Advantage plan, but current and future spouses of retirees would not have access to OPERS health care coverage. A transition period is being considered that would extend access to current spouses for approximately three years with a reduction in the allowance provided by OPERS each year until allowances and access are no longer available.

Q: If spousal health care is eliminated, when will that happen?

A: The earliest it would go into effect would be Jan. 1, 2014. That’s the earliest that the transition period mentioned above would begin. As soon as the Board makes its decision, OPERS will communicate the information to our members.

Q: How many OPERS members carry health insurance on their spouses?

A: About 50,000.

Q: What are the costs to members, and how much does OPERS pay out for this coverage?

A: The full monthly premium for retiree health care coverage for those under 65 is $814; for those over 65 and enrolled in Medicare, our cost is $358 a month. In 2011, OPERS paid out $1.58 billion in health care benefits.

Q: Why not provide access to health care for spouses under the condition that they pay the full premium? That wouldn’t cost OPERS anything.

A: Providing this access actually could cost OPERS more, because it would invite “adverse selection.”

Currently, the full premium cost for OPERS retiree health coverage is $814 per month. Generally, only those people who have medical costs higher than that premium would opt for coverage. Their very high medical claims would drive up cost for the entire plan.

Eventually, the plan would have more high-risk participants, and OPERS would be forced to raise premiums. That would make the plan even less attractive than before. The continual devaluing of the plan eventually would make the plan unsustainable.

Q: Are any other options being considered to keep spousal coverage? What about insuring them separately?

A: Throughout the review process, OPERS has been exploring all options to create the most effective plan for our members. Because spouses would have to pay the entire premium, these plans may be cost prohibitive and won’t have the subsidies that could be available on the health care exchanges that are part of the Affordable Care Act, or national health care reform.

We are working on a way to help spouses navigate toward these exchanges, which are scheduled to be available in 2014. The exchanges are expected to connect people to a variety of plan options, and there should be federal subsidies available for premium payments – those earning up to 400 percent of the poverty level will be eligible for assistance. That means in today’s dollars even couples earning $60,000 a year would get some assistance from the federal government to pay their health care premium, assuming the provisions are implemented.

Q: What about spouses who are over 65 and use the OPERS health care as supplemental coverage?

A: The Board is considering a personalized health care model for Medicare-eligible participants. It would discontinue the current group Humana Medicare Advantage Plan in favor of a personalized model with a monthly allowance to be used to purchase a Medicare plan of the retiree’s choice. Spouses who are over 65 would have access, but no allowance, to this model. Please see the OPERS Health Care Preservation Plan Proposed Changes document in the Special Coverage section of for more information.

Q: Is OPERS self-funded? How does that impact premium rates?

A: OPERS is a self-insured plan, which means we set a self-supporting rate that our actuaries determine is necessary to pay the anticipated claims. The self-supporting rate is like a monthly premium and OPERS and most retirees pay a portion of it. If claims are higher than this self-supporting rate, it costs the plan money.

Typically, we would make up those costs in setting premium rates the following year. We also have to increase rates annually to mirror medical cost trends. This increase has been in the double-digit percentages for many years, although recently has decreased to about 8 percent as the recent recession has prompted Americans to reduce their use of health care services.

Q: Then why haven’t premiums changed in the past two years?

A: Over the past two years OPERS has secured funding from the Early Retirement Reinsurance Program made possible through the national health care reform. During 2011 and 2012 the OPERS Board of Trustees approved using part of the $180 million dollars we received to keep rates steady in 2012 and 2013.

Q: Couldn’t you just adjust rates to cover your costs? Or purchase stop-loss insurance?

A: We are trying to protect the ability to provide coverage for career employees, and keep rates affordable. Continuing to allow spousal coverage, for individuals who have not paid into the system, would push rates up. Stop loss insurance is not recommended for a group as large as we are and would just add more expense.

Our biggest issue is that OPERS pays a portion of the premiums. Most current retirees pay either no premium or only $15-30 a month. Premium payments will need to be adjusted in the health care program as retirees’ health care allowances will be based on age and service. A chart has been developed to help members understand what they will be responsible to pay if the Board adopts all the proposed changes.

Q: What about coverage of spouses for survivors of retirees? Shouldn’t they at least consider the age and income of the survivor?

A: The OPERS Board is reviewing our policy in that regard.

Q: What efforts have been made to work with other retirement systems to share health care costs?

A: Since 2007, OPERS has participated in the Rx Ohio Collaborative, an effort with other Ohio pension funds, The Ohio State University and about 80 other employers to help manage retiree prescription drug benefits. It leverages collective purchasing power for the benefit of current and future health care program participants. For many years the pension systems have worked together on procuring medical vendors as well.

Q: Will my premiums decrease if my spouse is no longer covered?

A: No, because the premiums that retired members pay cover their claims. Spousal premiums cover spousal claims.

Q: Under the proposed personalized model for those in Medicare, if I do not need insurance coverage at all, can I use remaining allowance dollars to pay for my spousal coverage?

A: The board will have to examine this situation as final decisions are made.

Q: Why are these changes to the OPERS Health Care Plan really necessary?

A: To answer that question, it is important to review how the health care fund receives an inflow of dollars.

Health care funding has only two major sources: employer contributions, if available, and investment income. Member contributions can go only into the pension trust fund. However, employer contributions can be used to fund both pension and health care. How much we allocate to each trust fund depends on how well funded we are.

We must use the employer contribution to fund pensions up to the point at which we are able to pay off any unfunded liabilities within 30 years. If we have sufficient funding to reach the 30-year requirement, then we can use a portion of the employer contribution for health care.

The pension trust fund can be used only to pay pension benefits, and the health care trust fund can be used only to pay health care benefits.

As part of our plan to keep the pension fund within the 30-year requirement, OPERS adopted a schedule of declining contributions to health care – ultimately down to zero by 2014. This is why it is so important to pass the legislation in 2012 – so we can restore the health care funding to 4 percent annually.

OPERS’ experience estimates that our health care expenditures will exceed $2 billion within the next 10 years. OPERS expenditures have increased from about $7.6 million per year in 1974 to $1.6 billion in 2011. The combination of these factors creates an ever-increasing gap between revenue sources (investments and employer contributions) and health care expenses. Recovery from this trend means changes must be considered soon.

Health care plan options become very limited without the passage of pension legislation. With the passage of pension legislation, OPERS will be able to re-allocate 4 percent of the employer contribution to help fund health care, as long as our current plan is modified.

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319 Responses to Answers about spousal health care coverage

  1. Theodore Williams says:

    What is going to happen when a 55 year old spouse with pre-existing conditions is dropped. WHO will ever pick up someone like that. $800.00 plus p/month cost. That is one third of my retirement. Do I live in a tent. This really leaves alot of people up a creek.

    • L says:

      I agree! Do they think spouses with pre-existing conditions will have insurance companies beating their doors down to insure us? This is devastating. I don’t know what I will do!

      • Sam says:

        Well, you are both talking about me here… I have no insurance at my work and have several pre-existing conditions. I am 54 yo and will have to either find a new job or get fired, so I can go on unemployment and join the system..

        • diane says:

          Your talking about me too!!! I have had to go 2 yrs with no ins. and pay out of pocket because we could not afford the ins. Now when I am about to turn 55 they are saying I might not have ins. again. I have worked 2 part time jobs and cleaned 2 offices to keep our head above water!!! That’s what 32 yrs. of service gets you

          • Michelle Brown says:

            I agree! I, too, have 2 pre-existing conditions (diabetes and heart) and ironically my husband has the same. Both of us are on insulin (I’m on a pump and supplies are extremely expensive). I have a pacemaker and he just recently had 3 stents put into his arteries from a heart attack. I cannot possibly afford private insurance for him even if we woud be lucky enough to get it. I retired with 33 years of service as a Secretary so you know I’m not drawing a huge retirement! I still can’t believe that raising premiums to continue spousal coverage is not an option. My guess is that whoever is sitting on these panels and making these solutions have never endured the hardships of diseases. Wait until they have to deal with it someday and see if they still look at things the way they are!

    • Robin Barto says:

      My family is in the same situation…This really worries me…I wonder how much of this is politically driven given the current republican governor who didn’t get SB5 passed…It seems a nationwide trend for republicans to take from government employees. Also, if Romney gets elected then Obamacare he said will be eliminated..If that happens then insurance co’s will be able to discriminate and not cover those with pre-existing conditions who are looking for individual plans…

      • Michael Pramik says:


        We should point out that the OPERS Board of Trustees proposed this pension legislation before the current governor was elected.

        –Ohio PERS

    • shawn says:

      I hope President Obama quits helping us soon. I am not sure how much more we can take. I will be 58 years old with a pacemaker and preexisting condition and NO INSURANCE…. Why doesn’t everyone go after wall street and the bankers who caused this problem and leave us alone.

      • Michelle Brown says:

        I’m with you Shawn – I, too, have a pacemaker as well as an insulin pump. Doctoring and supplies are not cheap! Add to it, my husband is on insulin and suffered a heart attack having 3 stents put in. Who in their right mind would insure him? I do not understand why premiums can’t be increased and leave spouses under the plan!

    • JK says:

      My wife was dropped from my health care also…two years after my retirement. This happened two years ago…not about to happen in 2014 as referred to in the article. No mention was made of this being in the works when I went to any of the pre-retirement seminars from PERS. If it was I would not have retired. She also has a pre-existing condition and when I went to get insurance at least 5 companies refused to cover which I thought was illegal because she had previous coverage under my OPERS plan. The unions won’t help..surprise!!! Why doesn’t PERS push to make your former employer rehire you into your previous position to get coverage. Paying $800 per month is something you can’t count on doing. My agent said he would love to get the list of members needing coverage and offer a better rate.

  2. Julietta Toedtman says:

    I am a current employee with over 20 more years to pay into the system. I would gladly pay double now so that my spouse can have health insurance when I retire. What about those that are new starting out? Can you create a plan so spouses can pay in to secure now so that eventually this will no longer be an issue for those that in?

    • Michael Pramik says:


      It’s difficult to predict the future of health care 20 years from now, but as a public employee in Ohio you certainly can contribute to Ohio Deferred Compensation and use those funds at a later date for any reason you choose.

      –Ohio PERS

      • Frank says:

        This is wrong on so many levels that it is beyond belief. 37 years ago we made far less than the general public but had our benefits and retirement to look forward to, now because of bad investment choices they want to take away what we all earned that includes hospitalization for members and SPOUSES.

  3. Mark parsons says:

    Why does elected officials, who contribute nothing, get their insurance locked in after 10 years?

    • Michael Pramik says:


      All of our members are required to contribute 10 percent or more of their wages to their pensions. Some employers agree to “pick up” part of that contribution, but that is a local employment decision.

      Under the terms of the OPERS Board of Trustees’ current health care proposal, no future retirees will be “locked in” to health care coverage after only 10 years of service time. Our proposal is for health care at any age with 30 years of service, or after age 60 with at least 20 years of service.

      –Ohio PERS

      • dave says:

        your proposal is unfair to those who will retire in 2014 with more than 10 years of service but less than 20 years of service.

  4. Robert R. Williams says:

    This would be a hardship on our family. My Wife has not worked in 12 years , she is 55 years old , where am I suppose to get healthcare insurance for her ? What effect will the new federal health care laws have on the situation? I know things are tough , I worked in the system for 30 years , with expectations that things would be sound at my retirement , if these types of cuts were evident , I would have continued working for several more years. This decision would put me in a bad position.

  5. B. A. says:

    You said, pertaining to those over ae 65:
    It (Opers) would discontinue the current group Humana Medicare Advantage Plan in favor of a personalized model with a monthly allowance to be used to purchase a Medicare plan of the retiree’s choice.

    I just can’t help but wonder what sort of co-pays for doctor’s visits, tests, other procedures, etc we will be forced to pay as we use our monthly allowance to purchase a “Medicare plan of the retiree’s choice?”

    Humana is good coverage, but it is a group coverage. When we fly solo, we will never get anything comparable….to the Humana coverage we have now. Is this one of the sacrifices we have to make?

    And you talk about helping the retirees find coverage for their spouses through exchanges and also have the govenment subsidize the health care coverage — up to an income of $60,000…..I wonder
    what sort of co-pays will these exchanges offer?

    What about our meds? Doughnut hole or no?

    Bottom line: you are forcing us to make oh, so many sacrifices — not the least of which is turning over an element of control over our own health care to the government (not between us and our doctors) and at the end of the day you are still asking us to fight your battle over pension “reform.” Which will eliminate COLA for some of us and definitely eliminate reimbursementr for Medicare for all of us.

    Why do I want to do this for you?

    Sorry. I just don’t see you as a “friend” any longer. You are on the other side of the table now. Sorry to say.

    • weg says:

      i agree 100% couldn/t have said it any better. thank you, also, a proud Vietnam Veteran

    • Sue says:

      As a nearing 65 year old retiree, I feel like I was just kicked off the bus (or thrown under it).

      • Charlene Antalek says:

        I am an OPERS 2009 retiree who has not yet used OPERS health insurance because I purchase coverage from my spouse’s employer. Now that I have covered this cost for OPERS for 4 years (5 years by age 65) and will be eligible for Medicare in Jan. 2014, there will be no health care subsidy for me or my spouse, no Humana Medicare plan, nor the $96.50 Medicare subsidy .We were planning on all of these benefits, based upon the last round (2007?) of health care changes. I have given up the OPERS subsidy ($444/ month ) for 4 years and shouldered medical costs myself, so effectively by Jan 2014 I will have saved OPERS $26640 that I did not use and will never receive in the form of future health care. This is not fair or just by any means. OPERS is pulling the rug out from under the baby boomers just when they need help the most. Phasing this new system in over a 5 to 10 year period would be much more fair!

        • Tom Severns says:

          Actually Charlene, since OPERS self-insures, what you “saved” the system is the medical expenses you would have incurred during that period, less any premiums, co-pays and out of pocket minimums you would have paid yourself.

  6. Tom Severns says:

    I totally disagree with your conclusion that “only those people who have medical costs higher than that premium would opt for coverage. Their very high medical claims would drive up cost for the entire plan.” We don’t carry medical insurance (or any other kind of insurance) based on our current medical costs – it’s based on our concerns about what MIGHT happen in the future! Throughout my working lifetime I always paid more for my healthcare insurance than what the insurance company paid in claims, because I’ve been fortunate enough to enjoy good health – just as I’ve paid far more for auto insurance than the insurance companies have paid on my claims. In 40+ years of home ownership I’ve had exactly one claim, for about $200, yet I’ve always insured my home. The whole idea of carrying insurance is to pay for the unexpected, and to believe that retirees will opt not to ensure their spouses because their current medical bills are under $814 per month is in my opinion an unwarranted assumption.

    Incidentally, are you at all concerned that these spouses who currently have such high medical expenses may not be able to afford insurance at all once you drop them – if they can get coverage at all. Heaven help them if the Republicans are able to repeal the Affordable Care Act – if that happens I foresee many bankruptcies on the horizon for my fellow retirees!

    • Sam says:

      I am the spouse of which you speak… no insurance at my job. several pre-exisiting conditions…. My husband worked MANY years for this coverage so that we would both be safe. under the bus……………..

  7. Kenny says:

    I don’t understand why OPERS and the state legislators are so reluctant to increase our contribution percentage to keep spousal health coverage. Regardless of how the statutes, laws and rules are written now…change the way you do contributions from members in order to increase the member retirement contribution so that this increase will go towards funding healthcare…including spouses….it’s a no brainer OPERS…members are willing to contribute more of their pay to keep spousal and retiree benefits. Why hasn’t this solution been discussed?
    As an additional question – your number of 50,000 insured spouses seems kind of small. Are you saying that of the several hundred thousand OPERS current retirees and members now working….only 50,000 spouses are being insured? just seems low to me.

    • Michael Pramik says:


      We have no data that suggest active members would support a pay cut to finance a non-vested benefit for non-contributors to the system.

      –Ohio PERS

      • Joh says:

        Asking survey participants if they would pay more contributions to ensure health care for spouses would have been a good question to ask on your survey instead of asking the questions and answers in such a way that the answers could only support OPERS stated changes to the plan.

        • Carrie Rose says:

          I agree, I have several years experience building e-surveys, but this OPERS healthcare coverage survey does not permit the respondent to craft individual or meaningful comments and phrases questions so the responses will support OPERS decisions. They are subjective rather than objective.

          • Virginia says:

            This has been stated by others on this blog, but OPERS has not responded or changed the healthcare survey. I don’t think the Board wants meaningful data from its stakeholders, only skewed statistical responses that will be interepreted in a manner that supports their decisions for retiree future healthcare. I have contacted PERI, and my Ohio representative but in the end I think retirees and future retirees will end up “under the bus” as many have said.

        • my wife a heart attack last year and the cost was over 1oo,000 dollars
          how can we survive such a catastropic illness without healthcare coverage ?
          thank you

      • Linda says:

        OPERS needs to get data then, I’m sure they chose to be in the pension for the benefits that they think they are working for and would like to keep the security that the pension is known for.

      • Alexander says:

        Why doesn’t Opers GET some data? No one even ASKED us. I don’t think you really want to ask us because you know we’d say YES! We’ll gladly pay to keep our spouses covered. Why do the kids get an allowance? The law said kids had to be allowed to remain on a parents plan; it doesn’t say they had to get an allowance. Why can’t the spouse have some percentage of allowance? Children are cheaper to cover than an adult. Why can’t the spouse have the allowance and we pay full price for the kids? Opers, you are NOT looking out for us, if you’re not looking out for ours.

        • Michael Pramik says:


          To say that OPERS didn’t ask its members for feedback on health care is incorrect. In the months leading up to the decision by OPERS to finalize the changes to the health care program, OPERS staff received 26,937 responses to a survey of members and retirees on health care. Further, as a member and/or retiree, you were free to attend the monthly public board meetings and the monthly public Health Care Committee meetings that were held for more than two years leading up to the health care program changes.

          These public board meeting discussions on the health care program began in July 2010, when we entered into negotiations with Towers Watson for consultation on the plan’s future design. The plans were discussed in length at every monthly meeting from then until final decisions were made in September 2012.

          From August 2010 through September 2012, OPERS conducted 217 educational sessions across the state on the subject of the new health care plan. These sessions included webinars, meetings with stakeholders and “town hall” meetings with members and retirees.

          –Ohio PERS


    I am in the same position as Theodore Williams . I stopped pleading with OPERS & writing to congressman Steve Stivers & my both senators why the affordable healthcare for the spouses with the preexisting condition is an absolute must ,unless within couple of years we in that position will either be bankrupt .This means will end up on SSI & medicare !. ELECTIONS DO HAVE COSQUENCES !!

  9. Sharon L. McClain says:

    I am the OPERS retiree and my spouse and I both are on the Humana Medicare Advantage plan. If these health care changes are implemented and I am given a monthly benefit to purchase a health care plan, and with whatever amount is left of my benefits being used to purchase some form of health care for my spouse, what happens to his health care after I am deceased if he survives me?
    Does he lose his health care because I am deceased and there would be no health care benefit issued or will you have some kind of stipulation that says a spouses health care will contiue? I am sure other retirees are wondering about this same circumstance for their spouses health care. I feel strongly this is something that OPERS needs to have a plan for so our spouses are not left without any health care. Please repond to this issue.
    Thank you.

    • Michael Pramik says:


      The current plan under consideration would not allow a spouse to assume the coverage, or to “step into the shoes” of the member in such a manner.

      –Ohio PERS

  10. jim duggan says:

    The Ohio Public Employees Retirement System has decided that spouses of current and future retirees will no longer have access to OPERS health care coverage.

    The reason given by the OPERS Board is that it “believes that it was important to cover career employees who paid into the system” and since only the employee paid into the system and not the spouse, only the employee should be provided health care on retirement.

    I thought this type of thinking went out in the ’60s, when it was assumed that contributions from the earnings of the working spouse were in no way attributable to the support and efforts of the non-working spouse. There are other ways to solve the Board’s economic problems without this type of discrimination.

  11. Barbara Losie says:

    I like to say that you have no idea how these changes would effect people. But I know you do. I have been with the systems for 23 yrs. In this ‘wonderful’ insurance world, my husband is considered UN insurable. It’s very scary to think of how this will play out. We have many that are ‘double-dipping’ in our system with the county. Although I don’t think this effects insuarance…they might have a hard time sleeping. Seems that there isn’t much that is fair in the system any longer. As a county employee, I haven’t had a raise in FIVE years. Amazing. Please do everything you can. God Bless.

  12. Frank says:

    I just want notified of follow-up comments and new posts by email.

    • Michael Pramik says:


      We’d suggest signing up for an RSS feed for PERSpective. You can do so from the PERSpective home page. Click on the RSS icon next to the command “Get the blog via RSS feed,” and follow the instructions.

      –Ohio PERS

    • Ed Bell says:

      Make a comment and check the box labeled: ” Notify me of follow-up comments by email” under the “Post Comment” button.

  13. Rich Cates says:

    Adverse selection? Gimme a break… mean my wife is too old and sick for you to have to worry about her dragging down the rates of the group policy!

    $800.00 a month X 12 equals $9,600 a year out of our pension…..Wow nobody saw that coming when I retired just 3 years ago? I worked 30 years in enforcement with my wifes support…we worked as a family, we saved as a family, we retired as a family, we took reduced monthly pension as a family, and now she is being cast aside.

    You need to rethink what this does to those of us who are already out….we have no other options

    • tom says:


      Its $9600 plus $750 deductible plus $2000 out of pocket before it kicks in at 100%. These numbers dont reflect the services that dont go against your deductible or out of pocket.

      I tried to change plans last year because enhanced and intermediate were almost identical. When i called i was told that i had to wait until open enrollment for 2013 to change and now recently there have been posting that these no longer exist. I could have saved myself $2500 last year and i feel that this was known about during open enrollment and it was known about when i posted the question in april of this year. I read a response in one of these articles that these current changes have been discussed since 2010.

      This whole thing is very frustrating and i hope the members keep calling to voice there frustration, because in this article it states that spouses “COULD COST OPERS MORE”.

      If opers charged 50,000 spouses $400 a month, that would generate $240 million

  14. Beth says:

    Another reason I won’t be retireing…EVER, I simply will not be able to aford it.

    • don wonnell says:

      Tell everybody to keep working. Appears for equivalent coverage with a spouse in OPERS it will cost the $188 a month in the OPERS Health Care “Preservation” Plan, plus about $130 a month for dental and vision, plus $100 more for spouse’s Medicare, plus $358 for spouse’s health coverage, total around $780 a month. The “Preservation” plan doesn’t show what the costs are for equivalent coverage including a spouse. OPERS – like to hear whether you confirm the $780 or not.

      That’s $9300 a year, and with all kinds of taxes it takes about $11,000 a year to get the $9300.

      If you don’t have equiivalent coverage, you obviously have less coverage meaning higher
      copays and uncovered costs which can be huge, which means substandard coverage.
      Encourage OPERS to try to group medical coverage costs into some kind of a plan administered by other than OPERS, which could lower costs.

      This will cause a lot of 80 year old state and local workers, a lot of people on welfare and food stamps, and as somebody said many bankruptcies. How many Walmart greeters do they need? Don’t know why this couldn’t be addressed 3 years ago – $700,000 a day could have gone a long way to minimize this disaster.

      Then there’s the spikers. Aren’t there 700 people who have done things like work for 20 years or so at low annual pay, work 3 at $100,000 a year or so, and drawn about $30,000 on up OPERS pensions?

      Believe our only hope is to go to PERI and OPERS meetings, read all we can about this, contact legislators with such things as passing pension legislation in September 2012, and contact legislators with our opinions of what’s going on.

  15. Duane Piert says:

    Why are state officials, Fireman, and policeman excempt from these changes in health care it seems to me you are only doing this to the blue collar workers. What ever happen to all men and women are equal. This seems to me this could turn into a lawsuit

    • Michael Pramik says:


      No group in OPERS is exempt. If you’re referring to other pension systems, they are run separately from OPERS.

      –Ohio PERS

      • Barb P says:

        I too would like to know if the Ohio State Representatives, local city governments under the OPERS system and Ohio State Senators not under the same situation as to not being able to continue to receive health care benefits (or Medicare Advantage) if their spouses who worked under the OPERS system have passed away.

  16. Fellow Retiree says:

    My spouse is 58 and has worked for 40 years at a job with no health care coverage. There is no way we are going to be able to afford buying insurance privately. I think the State of Ohio is going to see a lot of unpaid medical bills and a lot of health providers, hospitals, medical facilities, etc. will be hurting trying to get people who can’t afford it to pay their bills. Also, the health of the people of Ohio is going to diminish as well since they will only seek help once a situation has turned into a true life threatening emergency. I’m also concerned about whether they will ever drop retirees as well. I was a life time state employee who began straight from high school so I have never contributed to social security. Therefore, I do not qualify for Medicare. I really think this is all a scam to unload insured people so once Obama Care takes affect, OPERS will not have to continue offering coverage to those people.

    • NickP says:

      I am assuming your wife is not a public employee, or she would already be eligible for her own medical coverage under a retirement plan such as OPERS, If she is in the private sector she has been paying Medicare taxes her entire career . Therefore, YOU are eligible for Medicare as her SPOUSE. You will both be covered by Medicare when you each reach 65..

    • ki says:

      You will be on your knees thanking the universe that there is an Affordable Health Care Plan.

  17. Mike says:

    The problem that I have is for over 30 years (not retired yet) OPERS has always taken part of my employer
    contribution to fund other members employee and spousal health insurance.

    If health insurance is not mandated who gave OPERS the right to use my money to fund other members
    insurance? Why did some members for years receive spousal coverage and all others will now be cut off?
    OPERS is solvent for another 30 years. New members should have to contribute more to pay for the
    people that have already contributed and who are retired or about to retire.

    If OPERS had not used or mandated a part of my employer contribution to fund other spouses health
    insurance the employer contribution rate would have been less and I could have received bigger raises?
    Or the money that was used by OPERS to fund insurance could have gone into my pension thus allowing
    me to have a bigger monthly pension.

    And I agree with Tom what do we do if the Republicans do repeal the ACA?

    • David says:

      That is the way insurance works. A large group of people pay to be covered against a calamity that may or may not happen. They are distributing the cost of that calamity among themselves. If they never need to use the insurance, they haven’t lost – they’ve gained peace of mind and the knowledge that a disaster won’t ruin them financially.

      Suppose you pay your homeowner’s insurance for 20 years and never have a claim. Your neighbor pays into the same policy, and during that time he has 3 house fires and a burglary. Are you going to complain that you don’t want your premiums to pay for his misfortune? What if it were YOU who had the 3 fires and a burglary?

      OPERS uses funds collected from your employer to pay for a portion of current retirees’ health care. When YOU retire, people still working will be helping to pay for YOUR health care. That seems fair to me. What am I missing?

      • Greg says:

        What you are missing is that Mike’s neighbor may have only paid 8.5% (of his pay) for only 10 years for his insurance, while Mike pays 10% for 30 plus years, and now that he has a fire, they only want to repair part (71% or so) of the half of the house that Mike lives in. The half that his wife lives in is suddenly not covered at all. If you were in his situation, you would want a refund of a portion (at the very least, the extra 1.5% they required you to pay) of your premiums as well. This refund could be used to help repair some of the damage to the other half of Mike’s home.

    • David says:

      Despite all the political rhetoric, I think it’s unlikely that the ACA will be repealed. It may be changed in some ways, however.

      If it’s repealed or crippled by defunding, you still have some options. One is to relocate to a place that has lower-cost health care and/or publicly funded health care. Much as I hate to say it, that’s literally every other nation on earth! The US has the world’s highest health care costs, bar none. It’s also the only major industrialized democracy that doesn’t have some kind of national health insurance system.

      Some other nations allow foreigners living there to buy into their national health insurance plans. Some others limit or don’t allow participation by foreigners. But even if you have to buy an international or local private insurance plan, these are often far less expensive than US private health insurance. Why? Because the cost of health care in other nations is so much lower. In many cases, you can buy an *entire year* of coverage overseas for the cost of one or two months of a US private health policy.

      Don’t want to leave the US and move far away from friends and family? I don’t blame you. The good news is that a few US states have, or are considering, ways to cover their uninsured residents. Massachusetts, for all the flaws its program has, is the “poster child” here. Also, Vermont voters recently approved Green Mountain Care, a more comprehensive public health insurance plan for their state. Look it up on the web for more information.

      I think that the US will eventually fall into line behind the rest of the world, and simply extend Medicare and/or Medicaid to all Americans. However, that’s likely to take many years. Many of us, especially those close to or already in retirement, may run out of time before it happens.

  18. Ed Bell says:

    “Health care funding has only two sources: employer contributions, if available, and investment income.” I have read this statement many times. but, isn’t it true that the healthcare fund benefits from Medicare Part D, the Affordable Care Act (Obamacare), and other federal programs. Earlier in the article you mentioned 180 million dollars. Was that temporary money from the Stimulus Act or permanent money from the Affordable Care Act?

    • Michael Pramik says:


      Thanks for the observation. The blog has been updated to “two major sources.”

      –Ohio PERS

      • Ed Bell says:

        Where did the 180 million dollars come from, and how much is the federal contribution? It irks me to read disparaging comments about the federal government and know that the poster is not considering all the facts.

        • Michael Pramik says:


          OPERS has received $180.1 million in money from the federal Early Retiree Reinsurance Program. We plan to use $82.3 million of these funds to keep our health care self-supporting rate flat in 2012 and 2013.

          –Ohio PERS

          • Ed Bell says:

            After a little research I found that the Early Retiree Program is part of the Affordable Care Act and started on June 1, 2010. It provides $5 billion in financial assistance to employers to help them maintain coverage for early retirees age 55 and older, who are not yet eligible for Medicare. It ends on June 21, the start date required by the Affordable Care Act.

  19. William Dodson says:

    I am a dependent on my wife’s PERS Plan. however, I retired under PERS two years ago, but did not elect for coverage (redundant) and remain on her plan. She is also on Medicare. How will I be affected?

    • Michael Pramik says:


      If you never elected coverage in the past, you would be able to join the plan in the future.

      –Ohio PERS

      • hoping to retire soon says:

        Can members opt in or opt out as they please during each enrollment period ? Or do you mean that someone who has never opted in before will be able to join the plan only one time “in the future” when the new changes take effect ?

        • Michael Pramik says:


          Current rules allow members to disenroll at any time and then re-enroll during the next open enrollment periood. Proposed changes to the health care plan include a provision that would allow retirees to enroll during open enrollment and disenroll only once during retirement. Similarly, a retiree who originally waived medical coverage would have one opportunity to enroll during open enrollment.

          –Ohio PERS

          • tom says:

            Explain how this is fair since their contributions came in for all those years. Opers needs to post all of the proposed changes.

  20. Jamie Bell says:

    I agree with Tom Severns. Those are my feelings exactly.

  21. JamesD says:

    Loss of health issuance for anyone has a serious impact. For non-medicare eligible persons it can be catastrophic. Has OPERS considered “grandfathering” non-medicare eligible spouses of current retirees until she (or he) becomes medicare eligible?

    • Michael Pramik says:


      The OPERS Board of Trustees has a working plan but has not made a final determination of future health care changes.

      –Ohio PERS

    • Freelon Alexander says:

      I agree. Current retirees are on a fixed income. We wil not be able to re-budget to pay for our spouses. Some will go bankrupt; some will die. It seems OPERS doesn’t care about that. There is no more overtime or bonus coming, just a COLA that will probably not be able to keep up with everyday needs, let alone a spouse’s health ins. premium. Current retirees should not be made to suffer that way after working all thier lives. It’s supposed to be time for us to RELAX, right?

      • Linda says:

        I agree. I just retired with 30 years of service last September. I did attend healthcare seminars, which, at the time, led us to believe that OPERS was in fairly good shape for the future. I made my decision to retire based on that. Now, only one year later, they want to cut out healthcare for my spouse. This is crazy.

        If I was warned about this a year ago, I wouldn’t have retired! Current retirees should be exempt from all these changes! We have no options to be able to pay for a spouse’s healthcare now.

  22. Arnold Frye says:

    As the old saying goes, “Where there is a will, there is a way.” However, it doesn’t seem that the OPERS Board of Trustees have the will or the desire to avoid eliminating spousal health care coverage for OPERS members. I rather give my OPERS health care benefits to my wife than to keep them for myself. Why can’t OPERS allow this to be done?

  23. Mike McCullough says:

    I have many of the same concerns regarding proposed changes in health care coverage expressed by other people in previous comments shown here. I am quite sure that the vast majority of OPERS retirees have expected changes in health care, given the dismal condition of the economy over the past 3 to 4 years. However, the drastic impact of some of these changes is what dismays and angers me, more specifically, the proposal to drop spouses from coverage. There will be options for retirees affected by this change, but none of them are desirable: 1) forego health insurance for a spouse; 2) change lifestyles (i.e., spend less money in some other category); or 3) bring in more income by going back to work.

    Option #1 is not acceptable in my view, especially as one gets older and will likely require more health services. While option #2 may be a limited possibility for some couples, rearranging expenses to the tune of $8,000 to $12,000 per year in order to buy health insurance is just not practical…certainly not for my wife and I. So this leaves option #3 – going back to work, also not a good option in the current job market. And getting a job will be even harder for those retirees which have been out of the workforce for a number of years. Just exactly what do you expect us to do?

    Clearly, the options available to OPERS are difficult, since no one likes having benefits cut. What I object to is the magnitude of the impact associated with dropping coverage for spouses. Health care for spouses was provided for years with no hint that it might be taken away, and couples such as my wife and I made plans based upon that knowledge. I made the decision to retire with the belief that health care for my wife would be covered. To now take away that coverage when it was probably a very important factor for thousands of retirees is simply wrong and very unfair.

    I encourage OPERS to look other alternatives to make the health care system solvent. For example, please consider less drastic options such as perhaps requiring higher premiums for spouses. There are surely better and more fair alternatives than simply dropping coverage entirely. Thank you.

  24. Tom Severns says:

    It’s worth noting that STRS provides spousal coverage with very high monthly premiums: $543 for Medical Mutual Basic and $1,032 for Plus, with NO subsidization. Has anyone at PERS discussed with STRS whether their experience has been that “only those people who have medical costs higher than that premium would opt for coverage” as PERS believes will occur should PERS offer an un-subsidized plan? If that’s the case then there’s a good argument for not offering spousal coverage. But until I hear that the STRS program doesn’t work I’ll continue to believe that PERS management is not doing all it can to help its married retirees.

  25. Virgil Arrington says:

    Typically, when changes are made to retiree benefits, every effort is made to avoid harming those who have already made decisions to retire. I retired two years ago, and my spouse is under 55. At the time I decided to retire, the plan allowed spouses’ premiums to be subsidized at age 55. My decision to retire was based, in part, on the anticipation that in just a few years, I would receive some subsidy for my wife’s premiums. Had I known that, now OPERS would drop spouses completely, I might have delayed my retirement. Those who have not yet retired can adjust their retirement decisions based on changes to the system. However, those of us who have already retired are stuck with the decisions we already made with the information we had at the time. I would implore OPERS to maintain its previous practices of not adversely affecting those who cannot go back and undo past retirement decisions.

    I know your task is difficult, and I wouldn’t want to be in your shoes, but I’ve not understood the current system. Right now, OPERS pays me to use the Base MMO plan. I would gladly pay an increased premium for myself if I could also obtain a subsidized premium for my spouse.

    Thank you for soliciting our input. I pray that a solution can be found that doesn’t leave spouses in health care limbo.

  26. Donna says:

    If health for our spouses are cut, are we (OPERS members) going to have better health care, such as a choice of carrier? Aetna , etc??

  27. michael p mathes says:

    thanks opers these are great changes. I dindt want to pay for otheres heath care.

    • Mike says:

      michael p mathes;
      I assume that your parents or grandparents or other family members have not retired from the State of Ohio with spousal coverage or that no one in your family is getting Medicaid or Medicare. Otherwise, we are all paying for health care for those in your family who never paid into the system. Even Obamacare requires that we all pay for everyone else’s health care, especially those who pay no taxes at all, 47% of the population in America. All of our parents paid for our health care growing up and I believe that it is our responsiblity to pay for theirs as elderly retirees. If we don’t want to pay for other people’s health care, then our system should go back to each of us paying our own costs from our own incomes and do away with an insurance system, which is by definition, a system that pays for those who need it by those who don’t.

      • Ed Bell says:

        47% of taxpayers pay no income taxes. Everybody who works pays Medicare and FICA taxes. Many more pay real estate, sales, and local income taxes. Over 1,400 people with incomes over a million dollars paid no federal income taxes last year. Romney has denied the rumor that he paid no income taxes for 10 years. I am sure that he paid lots of other taxes.

    • david says:

      From what’s been said on other forums dealing with this topic. You have not paid a penny for the spouses coverage, because the employees don’t pay nothing for the medical part only the employer and returns on investments. Here’s a though for you, do you also think that the Miliatry sould drop the dependents coverage also, because your taxes help with that to.

  28. Gary Schaal says:

    One of the questions asks:
    What about spouses who are over 65 and use the OPERS health care as supplemental coverage?

    A: The Board is considering a personalized health care model for Medicare-eligible participants. It would discontinue the current group Humana Medicare Advantage Plan in favor of a personalized model with a monthly allowance to be used to purchase a Medicare plan of the retiree’s choice. Spouses who are over 65 would have access, but no allowance, to this model.

    My comment:
    In one breath you say the Board is considering a model WITH monthly alowance. In the next breath you say Spouses over 65 would have NO allowance. Isn’t this entire question and answer about spouses over 65? I am confused.

    • Michael Pramik says:


      In the personalized model, which is only for those over 65, the model under consideration would provide members with access and an allowance but would provide spouses with access only.

      –Ohio PERS

      • Paula Michael says:

        Attended a town hall meeting in Lima today. If the proposed changes are adopted…my monthly allowance for age and years of service (27 years of service and 66 years old in 2014 when I want to retire) would be $286. OPERS says they “will not sponsor a plan for over 65 retirees, but will provide assistance and allowance to select a plan on the individual market.” My question is… Why would we be forced to go through the “connector” to find our Medicare supplemental insurance. If we have earned an allowance, give it to us and we will get our own supplemental insurance. Thousands of people do it every year… Who will pay the “Connector”? It seems to me someone is going to get very rich doing something that is FREE by contacting an insurance agency, Humana, AAPR. Give the allowances through an HSA.

        • Greg says:

          At least you got into the Lima meeting. A gentleman from our office called to find out where the “town hall meeting” was and was told he couldn’t go, nor was he allowed to know where the meeting was to be held. Apparently, this was due to potential overcrowding and fire code occupancy limits. I understand safety issues, but if the meetings are that full, hold more meetings in the area.

  29. Daisy Carter says:

    Why isn’t OPERS looking into health care options? Why keep Medical Mutual? I know there are cheaper insurance companies out there-even private health care providers do not pay this much-I have been checking with family members that are insured thru their companies. Also my father is a retired union worker and he pays nowhere near what you are asking retirees to pay and he does have coverage taken out for my mom. What is up with this? You need to dump Medical Mutual and open up the options for state employees for a cheaper insurance company.

  30. Dennis Kelly says:

    OPERS needs to make changes to the law to make health care part of it. Has this been considered at all by the OPERS board?? If it has why has it not been properly delt with?? If it has not, lets get moving. The way I see it, first it is the spouses, next it will be the members. Then where will we all be?? What is the current average monthly benefit (cash only) paid to OPERS members?? Thank You

    • Michael Pramik says:


      As stated in our Summary Annual Financial Report (available on the OPERS website), the average monthly benefit paid to OPERS retirees as of Dec. 31, 2011, was $1,906.50.

      –Ohio PERS

      • Tom Severns says:

        Actually Charlene, since OPERS self-insures, what you “saved” the system is the medical expenses you would have incurred during that period, less any premiums, co-pays and out of pocket minimums you would have paid yourself. But I agree with the rest of your comments.

      • Alexander says:

        Hello. Then how in the world can OPERS expect retirees making less than 2k to pay future premiums of 800$ and up if you have a kid too? 1,172$ eventually for me–1 wife and 1 child. The math here does not work. This does not compute to someone on an ALREADY FIXED INCOME!

  31. Robert Disch says:

    I agree that those of us who have already retired can’t go back in time. We will have to live with the decissions we made some years ago, before anyone would have beleived PERS would suggest that spousal coverage should be dropped.

    I also hope that some way can be found to put this proposal where it belongs, in the trash can!

    • Tom Severns says:

      As the saying goes, “you can’t get blood from a turnip!” There is a limited amount of funding available for health care benefits, so unless the legislature raises the employer contribution rates (extremely unlikely with the GOP in control), costs must be cut somewhere. It may seem unfair, but it would be even more unfair to cut the benefits of the retirees whose payroll deductions and employer contributions actually funded those benefits in order to provide benefits to spouses, who contributed nothing. That said, I continue to believe that OPERS should seek ways to provide unsubsidized health care benefits to spouses.

      • Alexander says:

        Spouses contribute their LIVES; maybe their dreams and aspirations too, sir. They pay in kind, not cash.

        • Michael Pramik says:


          Unfortunately, OPERS cannot pay its health care bills using in-kind donations. In order to preserve meaningful health care for decades going forward, we were forced to make some difficult decisions. One was the eventual elimination of subsidized health care for spouses.

          –Ohio PERS

          • VAJ says:

            Not to speak for Alexander, but I think his point is that today’s retirees made economic decisions many many years ago based on the representation that health care was available. I chose to be a career public servant in part because of the retirement benefits. My wife and I decided she would be a stay-at-home mom, again in part because she would always be supported by my income and retirement benefits. Perhaps some farsighted administrators at the time shouldn’t have offered such a rich package, but they did and we made decisions based on their offer. Now that we are, in fact, retired, the benefits that we bargained for in our job decisions are being taken from us. I agree that changes needed to be made, but fairness only dictates that those who have already made irrevocable employment and retirement decisions should get the benefit of the compensation offered at the time those decisions were made.

  32. S says:

    I think PERS is on the right track…protecting the career WORKER. PERS has no obligation to a non-worker (spouse) who did not pay into PERS. Keep it up!

    • copswife says:

      You must be single? Us wives pay in. It isn’t the spouse’s money it is the families money that provides for us daily. We pay a HUGE price as the spouse/family. Doesn’t always mean with $$$.

    • Free Alexanderlon says:

      Sorry, but my wife got up every morning before me to help get me ready for work. Took care of EVERYTHING so I could go to work with a clear and sound mind and body. Offered me comfort and solace on “bad” workdays. Made my lunch, washed my clothes, and made sure all bills were paid. Gave up her dreams to help me fulfill mine. I feel she most certainly paid into the system, as it made it easy for me to do a good job for OPERS. You talk about spouses like they are of no value. Maybe yours is valueless, but not mine. I worked for the two of us, not just myself, and I don’t appreciate OPERS (or anyone else) relegating my spouse to a nobody.

  33. Jim says:

    I made my decision to retire and take a plan based on the information they gave me at the time. There was no mention of “you might want to take the lump sum because we plan on cutting your wife’s health care soon”.

    To get her a plan will take 50% of my pension.

    If this isn’t illegal it should be!

  34. Susan S. says:

    What effect will these changes have on an adult dependent child (handicapped) who is currently covered under their parent who is a retiree?

  35. Kenny says:

    has OPERS ever bothered to ask the membership if they would be willing to pay a higher percentage from their paychecks (change the rules and laws to accomodate this percentage increase) to keep current healthcare benefits, to include spouses?

    • Greg says:

      With the growing number of retirees, the percentage that current employees would have to pay would have to go up significantly, and would have to continue to go up as more and more of us retire. You also have to consider that most Public Employees are no longer getting raises. State employees will go at least 6 years without any sort of COLA. This means that our contributions to OPERS are frozen as well. Obviously, health care costs will continue to climb, so the only way that the OPERS fund would be able to keep pace would be to keep raising the retirement withholding % even higher. Families that are not getting raises won’t be able to afford to keep paying more and more into the system. OPERS simply waited too long to address this issue, and now the changes are catastrophic. OPERS continues to blame the legislature for inaction and a 2-year delay. Truth is, OPERS could have, and should have made changes long ago.

      • LInda says:

        The growing # of retirees is basically because opers is changing everyones pension and employees are retiring to try and lock in their pension. Some of the previous replies that they dont want to pay for someone who did not contribute to opers (spouses). Well, if thats the case, why does opers allow dependents under 26 on the retirees medical insurance. Did they work for the pension? Why should opers pay for their access for medical? Most people who retire should be close to being done raising their children. I’m not saying to eliminate dependents at all, They too need to be covered. This comment is for the people who do not want access for spousal coverage. They are probably not married, divorced, widowed or their spouse has medical insurance. I’m just saying that a spouse should be covered at a REASONABLE COST. Retirees should be grandfathered for spouses insurance. We accepted to work for alot less pay and be in the opers reirement system for the benefits. If opers needs to change things up, it should only be newly hired. I took a lesser pension to keep spousal coverage and I know opers wont give me this money back.

  36. copswife says:

    I find it all incredibly sad to be honest. The sacrifices the wives and children go through so our spouses can serve the community are huge and in the end we have nothing. I have not given up 20 years of my life watching my husband walk out the door to protect others to end up broke and homeless. It is hard enough to make ends meet from day to day with him working. I get cuts need to be made but the system needs an entire overhaul.

    • SG says:

      You say that the system needs an entire overhaul. Let’s start by going back and re-adjusting the pensions of the SPIKERS (past and present) who received huge salaries for a few years and hardly paid anything into the system.

      • Geg says:

        That makes perfect sense and would be fair; unfortunately, OPERS can’t do that because those benefits were “guaranteed”, and OPERS only figured out a couple of years ago that we can’t afford to continue to offer these types of crazy benefit calculations. Now the rest of us must pay through the loss of our “unguaranteed” benefits – our health care benefits.

  37. Fred says:

    64 years old, 19.52 years total credit, purchased 1.853 military no longer working.

    1st ?. I have to go back to work for 1.48 years or 2.333 years?

    2nd? Wife now 47 any options for health care at 65 if I don’t retire before enactment of legislation.

    All of the videos I have watch give many excuses why the board has to cut our pensions/health care.

    3rd?. Can someone explain since PERS creation, 1939 I believe, no one recognized people live longer with each passing year until the year 2009?

    • Michael Pramik says:


      According to the latest proposal, purchased military time will not count toward health care eligibility.

      –Ohio PERS

  38. Steve Ford says:

    OPERS needs to standardize the proposed requirements for retiring. Currently, I am in Group A as I am eligible to retire within 5 years. However, by not allowing purchased military service credit to count as “years of service” for health care, I will be required to work an additional 4 years in order to qualify for health care. OPERS should have one set of criteria for retiring, not two. The purchase of service time was made in good faith at the rules at that time. OPERS has a morale obligation to honor the transactions intent. To say I am not a “career” OPERS person because of my military time is wrong.

  39. Mary Apicella says:

    I sure don’t know what surviving spouses will do without insurance. There must be some way to
    take care of them.

  40. Dillon says:

    I see this is all about your spouse but what about if you still have children in your household. Can you keep the insurance on them?????????

    • Michael Pramik says:


      The board’s preference for current and future retirees is that children up to age 26 will have access to coverage if the retiree has at least 20 years of service and is enrolled in the health care plan. Children would receive half of the retiree’s allowance percentage.

      –Ohio PERS

      • Sharon says:

        Aren’t there currently Federal and State laws mandating coverage for dependent children up to ages 26 and 28, respectively?

        What has research shown regarding how other states handle health insurance coverage for their public retirees and spouses?

  41. Madeline says:

    My husband is 78 and I will soon be 75. I am the OPERS retiree and my retirement was May 1, 2005 (25 years service). I have Medicare A and B by virtue of my husband participation in Social Security. Thus, as an OPERS retiree with Medicare, approximately 80% of my annual medical expenses are covered by Medicare. The same situation exists for my husband (with an OPERS supplemental plan). I selected a reduced benefit in order for him to have access to an OPERS supplemental insurance plan to Medicare. At that time that OPERS denies spouses a supplemental insurance plan, will my benefit increase by the monthly amount I deferred? I believe I am entitled to that addition to my monthly benefit. All this aside, it is absolutely unconscionable to take this path of no medical coverage for spouses for those of us who have passed the point of time in our lives to be able to change our financial future in any substantial way. Further, using the analogy above in the mail with regard to purchasing home insurance but not having any crisis such as a fire but the neighbor having three house fires – thus the home owner who has not had a crisis is essentially supporting the repair of the neighbor’s home – why not increase the amount current working members of OPERS contribute to the system especially if it might “save” their own retirement health plan. With reference to what STRS members are paying in retirement, I’m betting the average benefit of members of STRS is a great deal more than that of OPERS retirees.

    • Steve says:

      I believe OPERS is planning to eliminate all Health Care benefits in the near future. Even the ORSC actuarial study stated Ohio is one of the few States to offer health care to retirees. Frequently citing the fact they are not required to offer health insurance and constantly referencing the Affordable Care Act is just laying the foundation for the future.

    • Tom B says:

      You brought up a great point, Madeline. I mentioned this on anther blog, but haven’t seen anyone else bring it up since. When we retired, to receive our full pension amount, we had to select option B. But option B carried no provisions for the spouse upon the retiree’s death . . no pension and no health care. Option D, which most of us chose, reduced our monthly pension benefit amount so that, upon our death, our pension AND HEALTH CARE would continue uninterrupted to our spouse for the remainder of their life. Since OPERS is now going to eliminate spousal coverage upon the death of the retiree, those of us who chose option D should see an increase in our pension payment . . . the reduction from option B should be recalculated since OPERS will no longer carry that liability.

  42. Sharon says:

    To suddenly dump spouses from health care is soooo detrimental to the families. Most spouses won’t be able to get care, due to their ages and/or pre-existing conditions (even minor ones). Therefore ultimately many won’t seek healthcare or families will lose everything trying to fund health care expenses!

    What is so frustrating about this is that when my husband retired, we made choices based on choices that OPERS had made. Now OPERS is drastically changing their choices and we can’t! It was unheard of to have absolutely $0 monthly premium for coverage — yet that is what OPERS chose to do. Imagine if they had the foresight to even charge a monthly premium of as little as $30. Over the years, across all the retirees, think of the money that would have brought in. Now they are trying to recoup all that lost money at once — and make us feel bad that spouses even have access to healthcare.

    We need to get media involved, imagine what a shock this is going to be to those who don’t have internet access or didn’t get/read the specific part of the newsletter. So many of us have so much to lose due to bad decisions by OPERS.

  43. Mary K. says:

    Healthcare Savings Accounts are the way to go. Pay into it now, let it accrue, and don’t touch it. You’d be surprised how quickly the account will grow.

    • Madeline Huffnagle says:

      Healthcare Savings Accounts may be the way to go but at ages 78 and 75 there may not be much time before some crisis hits and the account won’t have time to grow.

  44. Amy Kale says:

    It appears that we have made several wrong decisions. First, we made the decision for me to work in a government job, taking less pay then I could have received in a public sector job with the same skill set. Secondly, at my retirement, we deferred compensation so that my spouse could have access to insurance from PERS in the event of my death. Lastly, we placed trust in the people that administered, legislated and directed the PERS program believing they had the skills, knowledge and foresight to maintain and lead the PERS system.

    While I would not change the first decision, because I am proud of my service to my community, I would like to ask if it is possible to change my second decision? The money that has been deferred could be used to purchase insurance for my spouse.

    As for the third decision, I say shame on those elected official and administrators that have jeopardize the dreams of so many families.

  45. Tonya Brooks says:

    Since when is a spouse who is home taking care of children or elderly parents a non-contributor? Yes, I do pay. The money my husband earns is OUR money. It is the FAMILY’S money. That is the definition of family. Our family has paid into your system and now you save money by throwing husbands and wives under the bus? And you try to justify yourselves by calling us non-contributors and saying we didn’t pay into the system. Thirty-five years ago when we started working for the the State of Ohio, raising your children was an honorable profession.Now you are trying to convince the public that we are bums.

    I was a PERS employee and when I left my full time job to take care of my children, I was vested in health care. Guess what? You have now raised the time needed to be vested and I am no longer vested. This is the most cynical move I could imagine. I get it that the New American Credo is “If I can’t have it, you can’t have it,” and plenty of people will be happy to see me suffer because They don’t have family health care. The PERS Board is banking on this kind of selfishness.

    Just tell me. At 61, where will I get a job with benefits? What if I am diagnosed with cancer or heart disease next year? Oh, I’m just a mom and I don’t deserve health care. I’m a non-producer in your new world order. Death Panels? YOU are the death panels.

  46. Helen Kleinman says:

    I am a retiree age 68 who retired with the less than 15 years of service I had 11 years with PERS and 25 with SS. If the new rule is 15 years to be eligable for the Health insurance coverage will I be losing my health care coverage?

    • Michael Pramik says:


      If you are already retired and in the health care program, you won’t lose access to coverage.

      –Ohio PERS

      • Dee says:

        I am just disgusted by all of this. It is a shame that OPERS is so heartless to their employees and spouses. These men and women have given many years of service to you and you cant come up with a better plan than, “Hey, I know so that we can stay rich we will cut out the little man’s benefits, kick the spouse to the curb and have a martini.” REALLY? This is so immoral and unethical it makes me ill just thinking about it. I wonder how you people sleep at night? It used to be an honor to work for you and now YOU have made it death sentence a paved way to the poor house. Shame on you all!!

  47. Tom Severns says:

    I suspect that when OPERS calculated the benefit reduction for retirees electing the “joint and survivor” option they failed to factor in the cost of continuing health care benefits to a surviving spouse, and considered only the cost of continuing the pension benefit. However, if retirees and their spouses were told that health care benefits would continue for the surviving spouse it would appear that under contract law OPERS would have a legal obligation to provide access to health care for the survivor. I took the reduced benefit when I retired, and it reduced my my benefit by about 8%; whether I was told that if my wife survived me she would be allowed to continue to receive my health care benefit I can’t say. Perhaps someone out there still has the informational material they received when choosing a retirement option that would settle the issue.

    • Tom Severns says:

      An addendum to the above comment: I went through my OPERS files and found an OPERS “Retirant Handbook” dated 9/98; on page 14 under Health Care Benefits – Eligibility it states “If you selected a joint and survivor annuity plan of payment (Plan A, C, or D), at your death your beneficiary will be entitled to health care coverage if you were eligible for health care coverage.”

      This would seem to preclude OPERS from denying coverage to a surviving spouse if the joint and survivor plan had been elected, as clearly the retiree “paid” for this feature by electing a reduced pension benefit. On the other hand, it might NOT preclude OPERS from denying coverage to a spouse while the retiree is still living, as it does not mention any right to coverage before the retiree’s death.

      • Sharon says:

        Thanks, Tom, for posting this! I recall having a sense of security at the time we made all the decisions about being a surviving spouse (never thought there would be an issue with being a living spouse…)

      • Arnold Frye says:

        On Section III (Health Care Coverage) on my OPERS Application for Retirement (OPERS Form SR-1), it states: “Health care coverage is provided to a qualified retirant who also may elect coverage for a spouse and/or dependent child(ren), there is a premium charge for dependent coverage. The effective date of health care coverage is the first of the month following PERS receipt of your completed application or the effective date of your retirement, whichever is later.” I, like many other OPERS retirees, do not agree to OPERS’ proposed unilateral change of its spousal health care benefits. I believe that OPERS is legally required to honor the contracts that were formed when it accepted my and other OPERS retirees’ application for retirement. Nowhere on my OPERS application for retirement form does it state that OPERS has the right to eliminate the health care benefits that I elected for my wife. However, Ohio Revised Code, Section 145.561 (Acquiring vested right in pension when granted) states, “Except as provided in section 145.573 of the Revised Code, the granting of a retirement allowance, annuity, pension, or OTHER BENEFIT to any person pursuant to action of the public employees retirement board vests a right in such person, so long as the person remains the recipient of any benefit of the funds established by section 145.23 of the Revised Code, to receive such retirement allowance, annuity, pension, or other benefit at the rate fixed at the time of granting such retirement allowance, annuity, pension, or other benefit. Such right shall also be vested with equal effect in the recipient of a grant heretofore made from any of the funds named in section 145.23 of the Revised Code.” The language I quoted from Section III indicates that OPERS can charge a premium for dependent coverage, but not to eliminate dependent coverage entirely.

        • Michael Pramik says:


          Health care coverage is not a vested benefit and may be reduced or eliminated altogether based on available funding. Thus, the statue you reference is applicable only to pension benefits (e.g. COLAs and ad-hoc increases). Health care coverage is not an “other benefit” within the meaning of the provision you cited.

          –Ohio PERS

          • Arnold Frye says:

            This is a legal issue that should be resolved by the courts.

          • Kay says:

            Since this has never been tested in court, I am wondering if in fact, a court would interpret the statute in the same way. The legal agreement in the retirement contract, signed by all parties, does not refer to Health Care as “vested”, but in fact states that Health Care and Retirement benefits will be provided to the spouse in return for a reduced retirement benefit on the part of the contributing employee. Likewise, those same employees have paid for other people’s spouses, establishing an historical precedent that may need to be tested in the courts to sort out the language, as well as the benefits.

        • JM says:

          All current retired spouse shoul be grand fathered , can you say class action lawsuit

  48. says:

    Employment income and retirement benefits are shared property per court rulings. To eliminate spousal medical coverage reduces retirement benefits since retirement income has to be used to secure medical coverage for a spouse without coverage. Eliminating the option of spousal medical coverage is a disservice to retirees and spouses
    Treating spouses as unwanted baggage may be legal but is morally wrong.
    Most disappointing in this scenario is OPERS retreating into a position that spouses are not their concern. It’s a non responsible easy way out.
    It is understood this is a financial issue and adjustments need to be made but throwing peoples lives into crisis is not a solution. OPERS has the opportunity to assist retirees in securing spousal medical coverage with it’s group buying power via a self funded program or outside provider. The statement that people with medical costs less than a monthly premium would opt out is unjustified.
    Nobody knows what their medical costs will be especially at retirement age.
    The issue is ACCESS to AFFORDABLE medical insurance for BOTH retiree and spouse. OPERS needs to make that a PRIORITY.

    • Kay says:

      I believe that the OPERS Board is taking the opportunity to dump spouses into the hypothetical, as of yet non-existent , health care exchanges proposed under Obamacare. These exchanges, already rejected by 26 states, propose to throw everyone who is “uninsurable” by other means into a pool run by the state. Since these exchanges will, by definition, be made up of those that the OPERS Board has already said will “use more than they contribute in monthly premium payments”, the payments to doctors, hospitals, and other health care providers will be less than they receive from Medicaid, Medicare, and/or Insurance,. So IF there is a health care exchange, which most states cannot afford due to the requirement that they expand Medicaid Coverage, and IF doctors/hospitals accept what the state Obamacare Exchange can afford to pay for an office visit or surgery, or medication, and IF there are enough doctors/providers to see all the new people thrown into the system (same # of docs + 20 million new patients), then maybe spouses or disabled dependents can get coverage. Otherwise, I cannot imagine what will happen to someone who has life threatening, chronic illness who cannot get insurance, find a doctor who will take a State of Ohio Obamacare Exchange rate of payment, or who has care severely limited due to budget constraints, e.g., dialysis, chemotherapy, radiation treatments, diabetes, transplant recipients, or babies in the neonatal intensive care unit. We all know that Providers will take Cash patients first, Insurance second, Medicaid third, Medicare fourth, and the Obamacare Exchange folks will be the last priority to health care providers and may not be able to find care.

      • Bill says:

        Well said. Obamacare is a pipr dream that may not even exist.

      • Ed Bell says:

        Can you empathize with the 20 million people who don’t have health care now? They are all working or they would have medicaid. I am sad every time I hear about a person, who does not witness the pain of another, because they are blinded by their own self interest.

  49. Greg says:

    Many public employers are using the retire/rehire loophole to have OPERS pay an employee’s health care and/or provide employees with significant raises (66% or more). Can you provide an estimate of the number of double dippers out there? Also, future retirees are having their retirement percentages for more than 30 years cut from 2.5% to 2.2%. How does OPERS intend to have these double dippers share in the sacrifices necessary to keep OPERS solvent? Finally, is there any way OPERS can make the retire / rehire option available for all of us or none of us?

    • Michael Pramik says:


      OPERS does not provide health care coverage to full-time, rehired retirees. Further, Ohio law allows a retired public employee to return to work in a public sector position while receiving a pension, and it is up to the individual employer to rehire that person.

      Once the retiree is rehired, he or she no longer contributes to the pension already accrued and does not accrue additional service credit. Again, the employer provides health care coverage for the individual if it was offered before retirement.

      In 2009 OPERS had 166,516 retirees and beneficiaries, 12,549 of whom were rehired retirees. OPERS paid retirement benefits to 8,261 of them, which is about 5 percent of the total retirees and beneficiaries.

      –Ohio PERS

      • Greg says:

        Thanks for your response. It doesn’t seem fair that one member can retire, grandfather in all the current benefits, and then rehire back into the same position; while others are left with no choice other than to retire and look for employment elsewhere, or to continue to work several years and accept reduced benefits. It seems that since we all pay into the same system, we should all have the same options. Anyway, what happens to the 14% the employer is supposed to pay on the double dipper, and the 10% the employee is supposed to pay? I heard that the employee receives a full refund plus an attractive return. I also heard that if the employee rehires for slightly less than full time, the employer doesn’t have to offer health insurance, thus placing the burden on OPERS. Are these assertions correct? Thanks again.

        • Michael Pramik says:


          Yes, there are situations in which the rehired retiree takes a part-time job and uses OPERS’ health care coverage.

          –Ohio PERS

  50. Chris Clark says:

    I retired May 31st of this year with 30 years of service. Under the current rules, my wife won’t be eligible for healthcare under OPERS until she reaches 55. I acknowledge that when my wife reached 55 that I would still have to pay the OPERS preimium to have her covered which was acceptable to me.

    I had a backup plan and was planning on working an additional couple of years with a new employer until she reaches 55. Now with OPERS changing the game plan and now not going to provide spousal coverage – everything in my life changes. If I had known about OPERS’s intentions back in April, I would NOT have retired. Rather I would have worked an additional 5-6 years to raise my monthly retirement stipend to cover paying for health insurance for my wife through an exchange.

    While this is bad for me – I cannot imagine how this affects all of the existing retirees who have been retired for many years that have spouses. To retire knowing that your spouse is covered with health insurance and now being told “Sorry” we are not going to cover your spouse anymore! The only way for these people to survive is to get re-employed to get health insurance. Yeah right! Who is going to hire a person in their 60’s or 70’s?

    Lets face it, the true reason for this is because of stock market crashes, bad economy, and bad investments. I understand that OPERS must make changes but not on the backs of those already retired!!!!!!!!! The current state legislature has already made numerous changes to state laws that adversely affect local governments. They won’t think twice about jamming the retirees. I have lost faith in our state and federal government.

  51. PH says:

    I am one of the spouses that will be dumped. I am 57 with pre-existing conditions. I have already checked into the costs of private insurance and I have had quotes in the $1,200 a month range. I seriously think a whole lot of us will lose everything over this. I am also an OPERS employee who has 17 years in. I was recently laid off due to a lack of funding for my organization. How in the heck am I supposed to find another job in OPERS for the next 3 years?

  52. Paul Albert says:

    Find another way to save money. I did not see any mention in the Pention Trustee Advisors report that any of the other ohio public pensions are dropping spousal coverage.

    The Trustees Report supported the School Employee Retirement System approach to health care that does not drop spouses:

    The State Teachers Retirement System is not dropping spouses though they are not subsidized.

    Ohio Police and Fire Pension fund is not dropping spouses.

    The Highway Patrol retirement not dropping spouses.

    Pretending that people can retire when they cannot be certain their spouse can get health insurance is bad, dropping spouses after the person has retire is just mean.

    Given the current political realities, assuming health care exchanges will even be available is just wishful thinking.

    Basically you are just forcing people to keep working until their spouse is 65. If not most likely their spouse will have no helath care coverage.

  53. Sharon says:

    Hmm, well, I seem to remember that in our situation, it was necessary for my husband to return (briefly!) p/t after being forced into retirement.. but anyway, the only health care coverage stipulation was for him to not return to work during the first 60 days.

  54. Ed says:

    Will 35% purchased elected time count toward health insurance coverage?


    • Michael Pramik says:


      The current proposal would limit the types of service credit counting toward health care eligibility to contributing service, service transfers from other Ohio retirement systems, service purchased under USERRA and restored service credit. For more information contact our Member Services department at 800-222-7377.

      –Ohio PERS

  55. michael p mathes says:

    PERS you are doing wonderful changes on this. I’m suprised spousal heathcare went on so long. If they want health care go work for it, we did-I didnt want to pay for somebody else’s heath care.

    • Marilyn G says:

      While I understand and sympathize with employee’s spouses who might find themselves without healthcare coverage in 2014, I too am surprised that gradual changes were not made sooner by OPERS. I retired with over 30 yrs in STRS over 10 years ago. I did not elect medical coverage at that time because I was covered through my husband’s public employer.
      When he retired in June with over 29 yrs I was shocked that as his spouse MY premiums under OPERS would be LESS than under my plan in STRS where I contributed over 30 yrs.
      Of course, I signed up for STRS healthcare as required ( OPERS requires spouses covered by another public pension to sign up with that plan). It is obvious that something has to give, and I am afraid that in oder to make the actual retiree who has paid into the system a priority,
      spouses may have to work through the ACA exchanges in order to have coverage–especially those with pre-existing conditions. Those who are adamantly against Obamacare and want it overturned may not realize until it is too late they are not only voting against their own self
      interest, but cutting the lifeline to their own affordable healthcare insurance.

  56. Brian says:

    Correct me then if I am wrong, but OPERS does pay the health care for retire/rehire as long as they work under 34 hrs a week.

    • Michael Pramik says:


      The public employer, not OPERS, determines what is called part-time work. In some cases a rehired retiree can work and belong to the OPERS Health Care Plan.

      –Ohio PERS

  57. Sharon says:

    The sad truth is that we planned given the information we were given. It is far from being a given that spouses in their late 50s and 60s and beyond would be able to find a job that will offer health insurance. So you know, I have worked our entire marriage, however I am currently in a job that will likely not be arond later, at the time OPERS makes change, due to owner retirements. I made my decision to stay employed there based on OPERS’ earlier decisions…

  58. kirk Hoffman says:

    Will this have to be redone if “obama care” is modified. The exchanges may be eliminated.

    I would like to plan now for additional cost increases. So do you believe medical costs for PERS for those with Medicare coverage will increase with Pres. Obama’s cut in the present medicare coverage and the additional cuts sheduled in the future yet to be implemented by “obama care” (thus our rates for the suplimental coverage will rise) or will our coverage reduce as does Medicare?

  59. Jessica says:

    I have almost 30 years in and not retired yet. My husband is self employed and relies on my health insurance. Part of our future retirement plan is me providing our health insurance from the years I worked in public service. I have gone years without a raise…but am working and counting on the future benefits I will receive including coverage for my spouse. I would think there would be other ways to make the program financial strong in the future. For example…why does someone receiving $300 a month in pay, attending one meeting a month, receiving the same benefits as a full-time employee? Seems a part-time employee should receive pro-rated time credited. Keep these benefits for full-time employees. Just a thought….sad you work all these years and we are at a point of having to explore these possibilites of reduced benefits.

    • Michael Pramik says:


      OPERS’ pension redesign proposal does include raising the minimum earnable salary. You can find details on our website.

      –Ohio PERS

      • Jessica says:

        Is the minimum earnable salary part of the current legislation?

        • Michael Pramik says:


          Yes, it is. It would require a minimum monthly salary of $1,000 for full service credit after a brief transition period. Partial credit would be available to those making less than the minimum earnable salary.

          –Ohio PERS

  60. Elaine says:

    I agree with Madeline and many of the others who have commented on taking a reduced monthly
    benefit in order for our spouses to have access to supplemental medical benefits – in my case a medicare supplement plan. I retired in my late sixties with 32 yrs of service – working longer to increase my monthly pension a little more. I also obtained medicare through my husband as do not have social security time. I know times are getting worse for healthcare benefits, but my thoughts are although I pay a small fee per month for my medicare spouse I would gladly have paid that for myself also instead of getting “free” healthcare. There are those I have heard about who came to work for the state just to be vested in the free heathcare plan ( which I know as been changed to some extent).

    I imagine most of the married retired folks choose option B, C or D when they retired – if we didn’t – we would not be eligible for a supplemental insurance plan for our spouse. Here we are, in our 60s, ’70’s and up not able to work or get jobs w/insurance and not only having to pay for our spouse, we may lose or medicare allowance and some folks thrown into not “non insurable state”. I think OPERS messed up all those years giving “free healthcare” to the retirees when they could have been charging say $20 or so a month for the members. Unfortunately the heathcare changes are going to be a hardship on a lot of folks. It looks like we will be are in plan A with the money of plan B,C, or D.

  61. dan young says:

    Seniors plan for retirement and family benefits are a crucial part of these plans. My wife has retired without an income, but my current income allowed for this. The additional cost for insurance, as projected, will force us to sale our home.
    I paid a considerable sum into the fund for thirty years with the understanding that the system would be their to cover insurance for us under current requirements. Those making recommendations for change are in positions that these changes will have little to no impact on there finicial position.

  62. j.a. says:

    I have read Paul Albert’s submission and I would like to say that I certainly understand why he wants his spouse to be covered/all spouses to be covered.

    I would like to know how I would benefit if the spouses weren’t covered? I think that is a fair question. Maybe my coverage would be just as bad if spouses were covered. But maybe I would get covered at 100% of spouses were dropped.

    Sorry — in these terrible economic times, as we face the possibility of having to surrender much of our medical coverage to governmental control, i.e. Obama Care (instead of having our treatments for whatever ails us be between doctors and patients….think about that!!!) — I absolutely owe it to myself to ask questions to see how various aspects of the OPERS changes will be best for me. And all of you who participate in the blog (and those who do not) you owe yourself the same due dilligance. We all do.

  63. Sharon says:

    J.A, Yes, yours is a valid question. If spouses were younger and insurable, I’m sure there would be less ‘lively’ discussion. Unfortunately, however, that is not the case for most and the fear is not just having to pay more towards care when led to believe at initial planning that would never be the case, but also if coverage would even be available.

    Any projected savings to OPERS will come as a cost to our state and us somewhere else. Whether more financial strain and drain on Medicaid, whether lower patient care ratios when hospitals aren’t getting paid and cut staffing, etc. Somewhere down the line, everyone will be paying some sort of price — with affected retirees and spouses paying the highest price of course.

  64. John Bay says:

    I am still stunned by the decision to terminate health care coverage for spouses. At a minimum, there should be at least a three year transition period to allow families an opportunity to ease into what otherwise could be a devastating situation. Anyone with a spouse with a pre-existing condition and no other health insurance will be faced with a life changing insurance premium. Imagine the heart wrenching choices for someone who would have great financial difficulty managing life’s other expenses compounded by crushing health care premiums. Please show some compassion and consider a transition period.

    • Michael Pramik says:


      Two things: A transition period already is under consideration, and the final decision on spousal health care has not yet been made.

      –Ohio PERS

  65. Tom Severns says:

    I find it hard to believe that the Board cannot find some way that spouses can continue to be covered, even if it means that the full cost is borne by the insured. To force spouses, a large number of whom undoubtedly have pre-existing conditions, to seek private insurance on their own is unconscionable and will destroy the financial security retirees thought they had achieved when they retired. STRS found a way, and their health care fund was in far worse condition than was ours.

    • ohio says:

      I would like to know this, too. How has STRS managed to deal with this without breaking the promise of providing spousal coverage? How come they seem able to manage the financial considerations without such drastic measures? STRS has been in terrible shape. I must be missing something.

      I should have stayed within the education system…beginning to regret the years I gave to public service for measly pay but the satisfaction of helping many people. Guess I should have spent my time helping only young students instead of the general public.

  66. Madeline says:

    I don’t believe we received any answers on whether or not (if spousal health care is eliminated) the amount we had withheld from our monthly benefit in order to enable OPERS health care for our spouses will be restored to the monthly benefit. I believe we are entitled to the full monthly benefit under those circumstances. Has this matter been discussed by the Board?

    In revisiting the requirements to be eligible for health care upon retirement, why would the Board keep the current policy of an individual being eligible for health care at age 50 if that individual had 30 years in the system? The length of time that the individual might draw health care benefits could possibly exceed the length of time that individual worked in the system.

  67. Jeanne says:

    Spouses of retirees are being thrown off the OPERS medical plan. I believe, at one point, OPERS said that they only wanted to provide medical coverage the retirees who contributed to the OPERS system.

    Could you tell me what these 22-26 years have contributed to the system? Why cant spouses of retirees have the same access as these young adults?

  68. William Trubee says:

    Most organizations provide health insurance by sharing the premium requiring the employee to pay 20% to 25%, with different rates, i.e. single plan, employee & spouse, and family plan. Could this be an option to keep health insurance for our spouses? Otherwise, if the only choice is to eliminate our spouses altogether, would OPERS give me the premium dollars in my pension, which I could then find health insurance through another provider, tailored to meet my needs?

  69. Elaine says:

    One of the issues also mentioned from several of the post was coverage for a surviving spouse and Opers has indicated they will not subsidize or place them in a group plan – in otherwise they are done! I am not familiar with a lot of companies, etc, but I am glad that my parents did not have that problem. When my father retired at 62 in the 1980’s he was able to get insurance with his company and when he turned 65 and went on medicare they only had to pay two dollars a month EACH for their supplemental plan. When he passed away in the late 90’s my mom’s insurance went on as usual. except her two dollar per month went to “zero”. She passed away a few years ago with great coverage at no charge to her and the company was so respectfull. This is also a feature that the retirees need to be addressed by OPERS.

    Healthcare may not be guarenteed by OPERS for any of the retirees and many folks are retiring in their early to mid 50’s and able to have healthcare benefits which is great, but the seniors need security. Plus if the PERS retiree passes away – that’s so UNFAIR not to include anymore.

  70. Pam says:

    My husband is retired with 30 years of service. My husband has never paid into Medicare yet you expect him to sign up under me as I have the necessary credits. A couple of years ago I took a job under OPERS, but went with the Member Directed Plan as I will never be able to work the number of years need to obtain health care coverage from OPERS under my own years of service. We went to all of the pre-retirement meetings for my husband. We were under the impression that healthcare would be available to spouses, at a cost, based upon years of service. Now that is all changing. I am too young for Medicare, where does that leave me.

  71. Linda says:

    Well, how are we to make an informed decision for open enrollment when these changes won’t be decided on until after that closes???? I turn 55 this year, so am eligible to be back on the health plan under my husband’s retirement, he retired 3 yrs ago, but now don’t know what to do.

    • Michael Pramik says:


      The changes to the 2013 Health Care Plan have been decided. Open enrollment considers only those changes, not the long-term planning being discussed by the OPERS Board of Trustees. Further, the long-term changes will not go into effect until 2014 at the earliest and will take years to fully implement.

      –Ohio PERS

  72. James says:

    I worked hard in my job for 36 years to provide my wife and me with a secure retirement. Now your telling me she will a have no health insurance? This will put us in terrible financial shape and put much stress in our retitrement years. I’ve been retired since 2004, and certainly did not plan for this disaster. The board needs to look at other options for current and future retirees. I think this was poor planning on OPERS.

  73. Linda says:

    Guys do not take your eyes off of pension legislation. If this doesn’t happen in 2012 things are going to get a lot worse across the board. Again I say what is left to cut once health care disappears, pensions? Yes this can happen, we brought up the possibilty of health care disappearing at one of the retirement meetings when pension reform was first brought up, and were told no way, well people this is happening What has waiting gotten us thus far, We must redouble our efforts to get pension legislation done now. We can not wait this must be done now before the election, I ask you do you think they will have any reason to act once the election is over, based on their curret record, I think not! What do you think?

  74. Christine says:

    My husband currently receives a pension and health care coverage because his late wife was a member of OPERS. Would he be considered a surviving spouse, and thus lose health care coverage, or is there some type of grandfathering for a spouse that is already receiving benefits?

  75. Connie says:

    My concern is spousal insurance I will be 58 years old when I can retire with 30 years in ( this is 5 1/2 years away).
    Will my spouse be covered under my insurance? is my insurance locked in or is this something that will change to all? what will the estimation cost for me and him to be covered on my insurance if and when I decide to retire?

  76. Sharon says:

    I’m sorry but I did not see a response to my question, so forgive me for asking again. Could you refresh my mind on what Option A was, it’s been a while since we made those decisions. I believe that may have been the increased pension monthly benefit, but no pension benefit to spouse after retiree’s death? Whatever we chose was the one that if I (as spouse) die before my husband, then his monthly benefit increases. Can’t remember which option that was. And, to get back to subject at hand, how any of these affected health care coverage, thanks for clarifying / confirming.

    • Michael Pramik says:


      You really need to contact our Member Services department at 800-222-7377. They will be able to help you with that information.

      –Ohio PERS

      • Ken says:

        I retired 6 yrs ago from law enforcement after 33 yrs, my spouse is 60 and covered under my plan through OPERS, is law enforcement included in this? We have no options for her if she is dropped. She supported me while I worked and this is what she gets in return? If you have been retired OPERS should grandfather this in, very stressful for alot of us.

  77. Dee says:

    Don’t remove health care for spouses of those who have already retired, we have been blindsided with this. This will be a hardship felt through the state of Ohio if this happens to good people who planned their retirements and now they are being told your spouse means nothing. Getting health insurance for people in their late 50s early 60’s is impossible, please grandfather this in.

    • Cherie James says:

      I agree, those of us that have already retired should be permitted to have our spouses grandfathered in. I retired with 30 years of service. It’s devastating to be told that my husband will no longer have insurance. He does not qualify for medicare, he has not physically been able to be employed for over 30 years and did not fit into the “box” to qualify for disability SS.He is 62 and has diabetes. I have supported us and we have lived meagerly all of our lives. This would be devastating. My retirement still keeps us in the low income bracket. I can understand that if a spouse is employed, that they would need to acquire their own insurance from their place of employment in order to save Opers funds but a spouse that is not employed or not eligible for medicare should be able to stay with opers if you do not grandfather them in.

  78. Madeline says:

    The Health Care Bulletin I received online a couple days ago provided what I think is a new portential change in Medicare eligible retirees and spouses. “No longer feature an OPERS-sponsored plan for Medicare-eligible participants but introduce a Personalized Model allowing participants more choices and greater flexibility”. It is also a possibility (Personalized Model) for spouses eligible for Medicare parts A & B. This is pretty vague information without knowing the choices and the cost.

    Why not set an age qualification, such as age 60, even for those individuals with 30 years in the system?

  79. Greg Warren says:

    Like many others, I was certainly blindsided by this! Having said that, I cannot believe that those of us that worked for over 30 years for the state of Ohio are going to be treated like this. Making this change will dramatically alter our lives financially. My spouse is 60, meaning for the next 5 years we are going to have to either see our lives go down hill rapidly or one of us try to find some type of employment that will allow us some type of health care coverage (good luck with that). There surely could be some other options that would not be quite this devastating ( increased premiums for retirees, increased premiums for spouses ). Does anyone out there really think that the entire health care package is safe? If this can be done so callously, they can do anything.

  80. Katherine says:

    I hope members will be allowed to make a plan change if spousal coverage is eliminated? I retired 6/30/11 and was told that the only way my spouse could receive health coverage is if I would take a lesser monthly payment and had a survivor benefit for my husband. I would NEVER have chosen a survivor benefit if I had any idea that spousal health coverage was not going to be an option. We will need every penny in order to try and pay for coverage for health coverage for my spouse if it is taken away.

    • Karen says:

      Same goes for me. I also picked that plan because I was told it was the only way for my husband to get insurance thru OPERS after I die.

      • Linda says:

        And the same for me. Are the retirees going to be compensated for chosing a retirement plan option that we were told would guarantee spousal coverge?

        • Froggy says:

          Well said. Ditto from the rest of us.
          If OPERS can make these changes, we should be able to make the change in choices we made in our original plans! Maybe we should be reimbursed for the difference in the two plans that had influenced our decisions at that time. We gave up $500 per month for the last 3 years to make sure I would have insurance if something happened to my spouse. Grandfather the already retired!

  81. Steven Halsey says:

    The company which supplied my insurance (for 41 years) moved it’s operations to China, I am paying a premium to be on my wife’s policy. If this goes into affect at the time they state, I will not be old enough to go on Medicare. I have had 4 insurance companies tell me I am un-insurable because of pre-existing conditions[ that condition is high blood pressure, which has been under control. I guess I should hope to die before OPER’s changes go into effect.

  82. Jim says:

    Why wasn’t the issue of health insurance for spouses addressed in the current pension legislation that is pending before the Ohio General Assembly. If OPERS Trustees & staff did address this issue, it shows they didn’t do their homework. This very important issue should have been addressed for the security of current retirees and their spouses. Because of poor planning from past & present OPERS Board of Trustees and staff these people did a terrible injustice to the current retirees. Trustees & staff must not have to worry about their spouses security. When my wife and I went to Columbus to sign up for retirement in 2003, I wanted to make sure my wife had security so I took Plan D (which reduced monthly benefits). We were told that my wife would have the security of my pension and health benefits while I was alive or when I died if that was our desire. No one ever told us that there was a possibility that my wife might not have health insurance. SHAME ON YOU!!!!!! What do our elected officials in our state government say about this injustice that places many current retirees in financial ruins.

    • Michael Pramik says:


      It wasn’t addressed in pension legislation because health care is not a vested benefit according to Ohio law. You might note that the major changes in pension legislation affect current members only, and not retirees. For instance, retirees will not have their COLAs tied to the Consumer Price Index. They will not have their pension benefits reduced because of age-and-service factors, and they will not have their final average salaries recalculated to account for their five highest-earning years instead of their three highest-earning years.

      –Ohio PERS

      • VAJ says:

        Even though health care is not a vested right, it was quite possible to have included it in the current pension legislation to make it a vested right. As it is, we have two different decision making bodies wrestling with different parts of our retirement benefits. If health care had been included in the legislation, the Board wouldn’t find itself trying to react on the health care side to whatever the legislature does on the monetary benefit side. Then OPERS members could retire with greater faith that their benefits would not change after retirement. Currently, OPERS retirees are at the Board’s mercy when it comes to health care. As you constantly remind us, health care is discretionary. Trust me, we get it, and it scares us.

        • Tom Severns says:

          VAJ – Where do you think the money would come from to pay for such a vested benefit? If the money was there I don’t think there’s any doubt that OPERS would continue providing health care benefits at current levels, but it’s not, and there is no way the legislature is going to increase employer contribution rates to pay for such a vested benefit.

          • VAJ says:

            I realize these are extremely hard financial times and I don’t envy the OPERS leaders. However, my only point was that all OPERS benefits should be governed by the same legislation and decision-making body. As it stands, the legislature controls the financial benefits by LAW and the OPERS board controls health care by GRACE. The law requires 30 years of funding for the monetary benefits–giving members some level of comfort–but it requires no long term security for health care benefits. The benefits would be better coordinated if they were governed by a single body and all subject to the same 30 year funding requirement. Members would then have greater security knowing what would be available when they decide to retire. Over the years, OPERS members have made many decisions based on the promise of future benefits. We took public sector jobs 30 years ago at lower pay, in part, for the retirement benefits. We retired and chose lower monthly pension payments on the promise of spousal health care WITH subsidized premiums. Now, after having made these decisions, we’re told that OPERS can and may unilaterally remove the benefits we were promised, all because there’s no law keeping them from doing so. I feel more secure about benefits provided by LAW that can only be changed by LAW. We can’t have a system where decades of public service are solicited with a carrot of benefits that can be easily removed after the Board decides it no longer wants to give what it previously promised.

  83. Retired City Worker says:

    As most of us who worked 30 or more years in the public sector, I see there is no actuary representing our future with the OPERS proposed changes. The actuary proposing OPERS changes represents only OPERS and not us. I spoke to an actuary who said these are the facts: for me, paying 8 1/2% of my wages for 30 years to OPERS and NOT into social security/medicare leaves me and my spouse with only OPERS healthcare and my pension for retirement. OPERS drops my spouse’s healthcare and I must pay for Medicare Part A( 0-29 credits) at $451.00 per month. Also I will need Medicare Part B $115.40 per month. These A and B costs will be $700.00 per month very soon. Now, Medicare doesn’t cover everything, so I now need another $800.00 per month for a secondary supplemental insurance. That’s $1,500.00 per month just for my spouse who OPERS is dumping. That is not even my own healthcare cost. My pension is not much more than this healthcare cost per month just for my spouse.
    Is this legal? Healthcare is not in the Constitution, so OPERS is using this with their spin on it. However, contracts are in the Constitution, and no one would ever work in the public sector for such average wages without this one important benefit of healthcare. Taking away our spouses healthcare coverage is quite a direct hit on women, as most of the retirees spouses are women.
    What can we do? Write your Legislature and Senator. For those of us that were kept from paying into social security and medicare, being lead to believe OPERS provided our security for ourselves and our spouses in our senior years, this is not legal. It needs a class action lawsuit and for those who suffer ill health from stress over this, even a private lawsuit. I cannot sleep thinking I can afford to pay all over again for what I paid 30 years for, with the new Obamacare. I don’t have another life to give to the public. It is illegal and immoral, as we were all duped into believing OPERS would take better care of us than social security and medicare, For those of us who gave our lives of 30 years or more to the public sector, should OPERS even think we can afford Medicare Part A and B for our spouses or ourselves, they had better take a closer look with an actuary looking at the affects these OPERS proposals will have on us. OPERS should look into lowering healthcare costs, as we pay the highest cost for healthcare in the world! Lower healthcare costs and don’t take away what we paid for with our lives OPERS!

    • Anita Caldwell says:

      “I don’t have another life to give to the public.”

      This says it all. We don’t have another 30 plus years to do it all again. If we did my husband wouldn’t have worked as a state attorney regardless of the great schedule for an active and involved family life…that and the end benefits. We always laughed and said if the benefits go the end of the world will have arrived. Apparently my husband should have taken that higher private sector law firm salary rather than enjoy and LOVE the public work he did. He gave that higher salary up for the pleasure of making Ohio citizens comfortable with the system when they came before him. He was patient and kind and explained the options and decisions and the ramifications to the citizens…too bad no one did the same for him.

  84. Chuck Reese says:

    After working in the system for 30 years and my wife working 27 years at a factory we decided to retire and enjoy life. She had no health insurance after leaving her job. We understood her health care as mine would continue, with no reason to believe things would change. Now with this impending change we have no idea what we will until she reaches 65, she now is 57. We will properly have to find part time jobs again to pay her insurance costs. She never would have left her job if we would have known this was going to happen.

  85. Tom says:

    First, keep in mind that the people making all these decisions on health care make far more money then the majority of retired people. I don’t believe they really have any concept of the financial and immotional impact these changes are going to have on us commoners.

  86. Tom R says:

    For those of us who have retired will have a difficult time finding the additional monies needed to cover the health insurance cost for our spouses. Those who are still employed may have the chances to continue working until they are at a point where they can account for the additional cost for health insurance. By leaving the retired spouse covered as they currently are would be a great help to all those currently retired.
    Unknown to us is and I hate bringing this up but how many current retired spouse will still be living ???
    This in itself would be reducing the number of covered spouses.

    • kay says:

      Tom R.
      Actually Tom, that is a good point from an actuarial standpoint. If all spouses who are currently covered were allowed to remain on the plan, grandfathered in, there would be a diminishing number of spouses to be covered each year, eventually 0, as the Board wants. Surely the State of Ohio is large enough and has enough income, given recent changes, to cover these folks who were promised coverage.

  87. James says:

    Even many of us who DO qualify for Medicare are still under the gun. With the Windfall Reduction Act in force, my SS payment is so small that it won’t cover the entire cost of Part B. And what about the states like Ohio that may opt not to participate in the ACA exchanges. Where do we go for insurance then?

    • Tom Severns says:

      James, many of us get NO Social Security because we don’t have 40 quarters of contributing service. We get a quarterly bill for Med B and send them our payment.

      • JA says:

        Hi Tom. Sorry, but I don’t get what you are saying. So you have NO Social Security, then you still have Medicare but have to pay for it out of your own pocket? I always thought that if you had no SS, you had no Medicare and that was that. I further thought that OPERS was considering Medical Mutual coverage for those who did not qualify for Medicare?

        I think what James is alluding to is that many of the OPERS pensioners are harmed by the WIndfall Reduction act — it is called by several names and I don’t know which is correct. I am one of those who is subject to it, too.

        IMHO the time might be now for State pensioners to attempt to eliminate Windfall especially if we are going to be asked to sacrifice so much from our OPERS pensions.

        I don’t know where to begin, though…Is OPERS allowed to explain how this might be done if anyone is interested?

        When we were working in the private sector — we did indeed contribute to Social Security and Medicare. One retired Sheriff’s Deputy has posted on another of these blogs that he worked a second job and is having great amounts (sorry, I don’t remember the figures) taken from his social security benefits because he has a State pension in OPERS. I personally know of another man (who has not posted, as he is in OP&F) who worked seasonal jobs in private industry for — 25 or so years — who will probably face a similar fate when he retires. He contributed to SS & Medicare too.

        I hope you will be able to comment on this — perhaps more than what you commented to James, please?

        Many of us are affected. And we feel really ripped off because of this.

        • Michael Pramik says:


          We suggest that you contact your congressional representatives about the Windfall Elimination Provision and the Goverment Pension Offset. Both are Social Security Administration rules and thus are subject to federal legislation. For your information, SERS Ohio offers a web link regarding these provisions through its website.

          –Ohio PERS

        • Tom Severns says:

          JA – I did not contribute to either SS or Medicare until 1992, when I changed employers (still under OPERS). At that point contributing to Medicare became mandatory, and I contributed until I retired. Combined with my post-retirement Medicare contributions I had over 40 quarters of Medicare contributions so when I turned 65 I was eligible for coverage. And as I noted, because I have no SS benefits from which the Med B premium can be deducted I’m billed quarterly.

  88. Linda says:

    What happens if I decide to go back on spousal coverage for 2013 and then they phase it out over several years. When it is completely phased out, am I eligible for COBRA coverage? I’m sorry if this has already been covered.

    • Michael Pramik says:


      Please contact our Member Services department at 800-222-7377 for answers to those questions.

      –Ohio PERS

  89. Robert Carr says:

    I’m 76, my spouse is 71. I retired in 1998 with 31+ years of service. We made my retirement decisions based on Opers’ then-current pension and health care plans of which spousal health care coverage was an integral part. In fact, my spouse had to give up permanently her (inferior) private-industry-provided health care in order to be covered under Opers’ better and broader health care coverage. – Dropping coverage now for over-age-65-spouses of retired long-tenured employees creates a real hardship for us, including having to deal with at least two different health care plans’ rules and regulations. We’re not getting any smarter with old age and have enough trouble navigating and coordinating current Humana Medical Advantage Plan documents and statement with incoming medical bills. – Although my spouse did not directly pay into the Opers system, my spouse’s income from a job in private industry made it possible for me as the Opers employee to contribute to the Opers pension and health care system during my long working career. – We understand the need for change and are willing to pay toward my spouse’s Opers-provided health care, if needed. But, please don’t make changes retroactive.

  90. In making changes to your coverage for 2012 you stated (If you choose to change your plan level Enhanced, Intermediate, Basic) under Medical Mutual Plan for 2012, you will be required to remain at that plan level for a two-year period. The way I read it you are not honoring your agreement with your members. Am I correct or not?

    • Michael Pramik says:


      Each year OPERS reviews the health care plan to provide the best coverage for members while preserving the plan for the long term. The two-year commitment was required every year, not only in 2012, pending future changes. As you observed, it no longer applies.

      –Ohio PERS

  91. spouse of retired employee says:

    Since OPERS says “health care” is not a benefit. How is it possible they could use the term “health care benefit” when we went to the pre-retirement meeting in Columbus and learned about the Plan D option?

    • Alexander's wife says:

      Yes, YEs, YES! My hubby worked for OPERS for over 37 yrs. The term “health benefit” was the ONLY way health-care coverage was described in every OPERS benefit guide book we ever got. OPERS themselves insinuated the IMPORTANTNESS of the health benefits, and how employees had to work x amount of years “in order for your spouses and dependents to be covered”. If it wasn’t a real promise, why did OPERS stipulate the VESTING time?

      • Michael Pramik says:

        Alexander’s wife,

        The vesting time is stated in Ohio law, and you’re probably aware that we’ve changed it. However, health care is not now, nor has it been, a vested benefit like pensions are.

        –Ohio PERS

  92. Dave says:

    I have a wife who needs medical care and don’t understand how you can just take away what I worked for …I am on disability so therefore my helping her to get medical care would be impossible. Did any of you think about how it will throw families into bankruptcy and devastation….I am at a loss of words as to what to do….You mismanaged our money now we are the ones to pay for it….I am just sick at the prospect of my future and my wifes…shame on you….

    • Michael Pramik says:


      OPERS is making changes in the health care program, as it periodically must, to preserve health care for longterm, contributing members of the system.

      –Ohio PERS

      • VAJ says:

        I just want to commend you for your professional and patient responses to the comments on this blog. I know we’re not making your job easier, but I hope you are hearing the personal pain and feelings of betrayal many of us have. For many, many years, OPERS officials have repeatedly reassured us that OPERS is healthy. And, when we planned our retirement, we relied upon those reassurances. From your responses, you are obviously concerned about the health of the overall system, but the system affects individuals, each with a story about how they retired and selected monthly benefits based on the promised health of the system. Now that we hear that the system isn’t healthy, we are painfully reminded that you don’t have to give us health insurance at all. I hope you can understand how that doesn’t set very well with those of us who dedicated 30+ years in public service in exchange for an overall compensation package (that we justifiably believed included promised pension benefits)

      • PH says:

        We understand the need for making changes to “preserve health care” but what we don’t understand is how OPERS can make these changes to people who are already retired. “Dave” is right when he said it will cause bankruptcy and devastation for many OPERS retired people. Where is the grandfathering clause for retired people? What happened to OPERS being a “partner in our future”?

  93. GP Gilmore says:

    It is fascinating to hear the current political discourse at the conventions…”we’ve got your back…”, etc. It is also sadly amusing to were OPERS “explain” that they have no obligation to cover… The fact is that past employees felt there was a contract; they got benefits both current and future. Among those was the benefit of health insurance for the employee and spouse. It was really the failure of the OPERS system administrators who did not account for the growing costs for both employee and spouse throughout the past years. This is a sickening disgrace!

  94. Greg Warren says:

    I can only add my name and anger to the others who are going to have spouses without health care coverage. Saying this is unbelievable and cold is an understatement. The impact this will have on the lives of many of us is something none of us ever could have imagined. Those of us who put in our 30 years plus have a right to feel abandoned and hung out to dry. There are many areas where changes and cost saving measures could be enacted, but to attack this one group with what could very well be a death sentence is mind boggling. Others areas are “tweeked” while spouses of career public servants are sacrificed to protect other groups.

  95. Linda says:

    I thought I read in a blog that board members are not salaried by OPERS. Well if they are not and are not in the pension I can see why they don’t have our back on spousal insurance. IT DOES NOT EFFECT THEM. They need to be voted out. OPERS board members need to realize what a hardship it will bring to current retirees not allowing coverage for spouse. I’m sorry that I feel this way but for some reason the board does not have any smypathy at what it will do to retirees who have already made their decisions to retire thinking their spouses would have healthcare benefits. I AM SCARED TO DEATH!! I don’t know how we will survive. Please help us retirees by saving spousal insurance.

    • Retiree says:

      I agree with Linda, the Board members are clearly not on our side. If we want to save spouse healthcare or even have a last chance, we must all write letters to the Board. I believe you can use the opers address. It’s our last chance to try to save spouse healthcare, especially for the ones that chose option D for our pension and healthcare benefits so our spouses could continue in the future with these benefits. They keep saying that The Board will decide in the fall to year end, so let’s all do this as soon as possible. PLEASE SAVE SPOUSE HEALTHCARE FOR CURRENT RETIREES.

  96. JK says:

    Michael: My husband has been covered under my health care for 30+ years. In 2011, he was diagnosed with cancer. He has 8 years in OPERS himself, but had to go on disability soon after his cancer diagnosis because he is unable to work. With his OPERS disability he now has 10 years in, but is continuing under my health care coverage. Knowing that I was about to retire, I asked this question of OPERS: “I am currently employed, and my husband is under my insurance plan. If I retire, will he still be included under my OPERS health care insurance plan?” I received this answer from OPERS: “You can carry your spouse on the coverage at retirement.” So I made the decision to retire in July. Now I find that he is going to be dropped from my insurance?? My question is: Since he is on disability and has 10 years in OPERS, will he be eligible for his own coverage after the health care changes?

  97. VAJ says:

    I just watched the interview between Michael Pramik and Marianne Steger at (thank you to OPERS for posting this to Facebook). Several things stood out in the interview.

    First, Ms. Steger says that the reason for the changes is because the baby boomers have reached retirement age and health care costs are rising. Surely, these events could have been foreseen long before 2012. Indeed, anyone in the 1960s, when the benefit was first offered, could have figured that the baby boomers who were already born by then would someday retire. The reason this is important is that, while OPERS has been struggling with these issues, many people have been retiring in reliance upon current benefits. Having retired, they are now told that OPERS can’t afford the benefits that have been offered for over four decades.

    Second, Ms. Steger says that the Board has been considering these changes for two years. Well, it was only two years ago that the change was made to not subsidize health coverage for spouses under 55. Those who retired in 2010 reasonably believed that that small change to the system would have kept the system solvent. So, they retired, believing that, when their spouses turned 55, they would be covered. Now, they hear that, as they were making that decision, the Board was already considering the current changes. I don’t recall anyone telling us that two years ago. When people are making retirement decisions, they need the best information they can get about what may happen to their benefits in future years.

    Third, Ms. Steger states that our health benefits are unusual and that other pensions systems don’t offer spousal coverage or premium subsidies. That may be true, but it is also true that many of us chose public service precisely because of these “unusual” benefits. It was a part of the total compensation package that was offered to us in exchange for our service. It’s not right to induce service by way of an “unusual” form of compensation and, then, after the service has been rendered, take the compensation away because it’s “unusual.” It would have been appropriate in the 1960s for OPERS to consider how common the benefit was when it decided to offer it. For whatever reason, the Board offered the benefit in the ’60s (despite it being unusual) and the state and local governments have enjoyed the benefit of good employees who were induced to work in exchange for that benefit.

    Finally, Ms. Steger always speaks about the Board’s decision as if it were already made. She talks about the Board having “wrestled” with these questions as it made its decision. Yes, she says it is a “tentative decision” subject to finality by the end of the year. But, it appears as if the Board made a tentative decision and only then asked for member input. To me, that seems to be putting the cart before the horse and it certainly makes one wonder what effect our input will have. If you want to inspire member confidence in Board decisions, it’s important to solicit member input before a decision (tentative or otherwise) is made.

    • Terry says:

      VAJ: You are so right about this! I feel as though I’ve just been caught up in a bait and switch carnival game!

      How do the BOARD members sleep at night? And how could they have been so short sighted? Sounds to me as though these Board members have done a very, very poor job in protecting our members, indeed.

    • Katherine says:

      Great comments! I retired July 1, 2011 and the upcoming spousal changes were never mentioned. The only reason I selected a survivor benefit was so that my husband would have medical coverage. I would have never selected a survivor benefit. I think members should be allowed to change their plan selections in the light of all of the devastating changes. We will need the extra money monthly to pay for health insurance.

    • Virginia says:

      It is very disconcerting that the OPERS Board with guidance from the healthcare committee has been discussing and making important decisions, even tentative ones, regarding retiree and spousal healthcare for two years without informing members of possible changes. Health preservation is clearly a priority for all OPERS members. Planning and living in retirement requires up to date information on pension benefits and healthcare.

      • Michael Pramik says:


        We have had the following publication on the home page of our website for more than two months, and this summer we solicited input from all of our members. Far more than 20,000 replied.

        –Ohio PERS

        • Shar K says:

          Two months notice is hardly enough for changes of this magnitude. Even though the ‘yet to be named’ changes will be ‘phased in’, the phase-in will immediately cost more than had been planned for or anticipated for current retirees and spouses. And, 2 months notice on the internet did not give the vast majority of retirees without internet access or knowledge of how to use the internet fair notice. The fact that you have heard from 20,000 when there are at least 4 times that amount of retirees, not to mention 50,000 spouses who are currently covered, leads me to believe that many truly have no knowledge of this or know how to voice their concern (or, like my parents would have been, are too ‘shy’ to voice an opinion because their generation was raised to not question authority…). And, even though 50,000 of spouses are currently covered, that does not mean that many more would be affected at later stages of their lives — perhaps they have access to employer coverage now but are still counting on relying on OPERS spouse (or surviving spouse) coverage later.

          OPERS really does need to re-think how this will affect all, including considering grandfathering those already retired as they are stuck.

        • Virginia says:

          I did read the OPERS publication you reference when it was issued and gave my input. My point is, if there was discussion of eliminating spousal healthcare as early as two years ago, it would have been helpful information in determining when and if to retiree.

          • Katherine says:

            YES, I agree. I would have never retired last year had I known of the spousal health care changes or minimally would not have selected a lesser pension with a survivor benefit for spousal insurance.

        • VAJ says:

          Having the publication on the website for the past two months does nothing for the many members who retired in the past two years while the Board has been considering eliminating spousal coverage. When we retired, the Board had just instituted the new rule eliminating subsidies for spouses under 55. We decided we could live with such a limitation so we retired, knowing our spouses would get subsidized health insurance once they reached 55. Now, we hear, just two months ago, that when we made the retirement decision, the Board was already considering eliminating spousal coverage completely. I hope you and the Board can understand the depth of our frustration with this state of affairs.

          That said, I’m encouraged that so many members have responded to your request for input. I just hope our input is not too late for the Board to reverse course on its “tentative” decision.

  98. Shar K says:

    VAJ, this is a great comment. OPERS should feel some shame in doing what it is doing. It is because of THEIR poor planning that now many of us will be suffering, both financially and medically. Yet somehow they continue to twist things around and blame us, the retirees and families, making us sound greedy. I have yet to read even one post from them making them sound a little more human, acknowledging that they should have done things differently years ago. Yet they now expect us to suddenly do things different in our lives, like we can just snap our fingers and will have affordable healthcare, etc. There is just no way they can rationalize what devastation they intend to bring upon us — you look to fix things when the shingles start to look bad, not when you are getting buckets of water into your home every time it rains.

  99. Brenda says:

    The assumption that OPERS has made for the spouses under SS eligible age is incorrect. Many members chose to stay employed and paying into the OPERS system when private industry would have paid them a greater wage because of the retirement benefits. Many spouses do not have insurance and planned on the purchasing of healthcare under OPERS. They do not have health issues currently, but plan for the future as responsible employees. Yes, a change to healthcare should take place, but to remove the option to pay for a spouse plan is unethical on OPERS part since those already in the system planned on this option. If OPERS could show research that it is indeed costing the system extra money, then phase in the removal of spouse benefits for those just coming into the system so they have can chose if this system fits their future planning. SHAME on OPERS for lack of management and future foresight that would honor the promises to its members!

  100. spouse of retired employee says:

    For years our medical cards have been in OPERS employee’s name. Recently I was sent a health card with my name and a different number. Now it all becomes very clear what the real intent behind this change. When the “drop spouse- health coverage” phase goes into effect the transition will be easy, because the spouse will no longer be identified with the OPERS employee group health number. That was a slick move on OPERS part. Have other members gone thru the same change with their health coverage cards? It’s kind of like “handwriting on the wall” for thousands and thousands of us older folks that OPERS has placed us in.

    • Dede says:

      You are sooo right about getting the new medical card in your own name, the writing was on the wall then, they had every intention of dropping spouses then and only put it out there for input after the fact. These board members need to be replaced, who elected them, how did they get their jobs, they do not represent US.

  101. The board has stated that a spouse has’nt contributed to the system, thus does not deserve health care coverage. However, a child can be covered until age 26. This “child” can be married with a family and not even living at home. Believe it or not any one 18 and older is an adult. Ask any one in that age group in the military. At 26 years old, that is approx. a third of ones life. This “child” has’nt contributed any monies to the fund. I can even live with coverage if that “child” was in school. Any one of the out of touch board embers must realize that that spouse is and should be first when considering health care. There’s probably not much many of us can do now….maybe 12/21/2012 will really happen.

  102. Garlene says:

    I am 71, my husband is 59. I have the health insurance and retirement, he does not, nor does he have a job at this time. He will be eligible for his retirement under the railroads at age 62, but not medicare for health situations. I have minimal health problems, he has two chronic conditions that make him not eligible for most work and no health insurance plans that I know of. Out of our retirement we pay for his insurance, OPERS no longer covers me as a secondary even…I just discovered that when I had to change doctors. If this no access plan goes into effect, we will have to choose between housing, utilities and food or medical care…it’s that simple. Current retirees and their spouses should be grandfathered in, plain and simple. We would have made different choices if we knew when I retired 8 years ago that you were going to remove this.

  103. One of the 99% says:

    I was forced into retiring before I was finacially ready, but I knew at the time my spouse’s healthcare was available. I chose the benefit that reduced my monthly benefit but provided survivor healthcare for her. We are not medicare age and due to my $1600 montly pension we chose the $400 a month basic healthcare coverage. Not because it provided much coverage because it didn’t. But it provided coverage for large medical expenses so a hospital or nursing home would not be placing a lien on my home in time of medical emergencys. I was given very little notice that my $400 a month premium is now going to be $800, leaving me $800 a month to pay my house payment and all other monthly expenses. I can’t do it. I think the rate medical mutual is charging is not in line with what other groups are paying….I think OPERS can do better. We are too old to find work now and there are no jobs in our rural area. How can my spouse participate in the new healthcare Affordable Care Act (Obamacare) in 2014 when our Ohio governor, John Kasick has refused to allow Ohio to be a part of it? I feel like OPERS sold us out… Senate bill 5.

  104. Charlie says:

    What happens to me since I am 70 years of age and my husband has a pre-existing serious health condition, I get 1200.00/mo. in OPERS and because I was a public employee and even though I had full service quarters for full social security benefit I now only get 400.00/mo. That leaves me 1600.00 a month to live on and my husband will have no health insurance although we have always relied on the fact that I earned that benefit will working for a modest wage. Even more unfortunately for my husband his employer stole the pension he and his co-workers paid into and now he gets $146.00/mo after over thirty years of service, no health insurance at all and he is not eligible for social security. Must we rely on welfare benefits after working hard and being productive citizens our whole life.

    • SuzyQ says:

      I understand your frustration. I too worked under Social Security for almost 15 years, mostly with General Motors and we all know how that went. I took what was considered a “good government job” that assured great benefits. I am 63 and when I retire I will have no General Motors pension and greatly reduced Social Security benefits due to working under OPERS. Now it appears the great benefits OPERS offered are also disappearing.

  105. Ron says:

    I got into a public sector job because of the retirement benefits. Now OPERS is beginning to eat away at those benefits…If you are going to take benefits away, what the heck do we need OPERS for…We might as well all go to a 401K for retirement and get rid of the of the whole plan…That’s what it coming to…good grief what is this country coming to. I’m sick of it…

  106. Holly says:

    Is there anyway to find out what our total health care premiums are? When I look at my account, I see my health care deductions, but that does not tell me what the total health care premium is. If I need to plan on paying much more for my spouses health care coverage in the future, it would be nice to see the total premium on my account and then a break down of my percentage and the percentage that OPERS is paying.

    I also chose my plan based on health care coverage for my spouse, but fortunately, sought the advice of a financial planner first- so I chose plan E which was only a difference of about $30 per month over plan B which is the highest, and then got a large term life insurance policy to cover my spouse in case something happens to me and he is no longer covered. So I feel fortunate that I am at least getting close to the highest amount and not over $300 less per month if I had chosen plan D! Guess I will put a call into my financial advisor and give her a thank you. That being said, we still have to worry until he turns 65, which is 8 years away! And if the $800 per month figure that I see being tossed around in the blog is accurate, it will certainly be a struggle.

    By the way, his company (after 24 years with the company) out-sourced his job when he was 2 months and 11 days away from qualifying for retirement health care, so although he thought he was taking care of his future, he had the rug pulled out from under him. When he found a subsequent job with OPERS benefits, we had hope that he would have coverage through OPERS as well. Unfortunately, that job was phased out after only 18 months, so once again the rug pulling routine, Now it appears it will be happening again in the near future.

    If the changes to the OPERS health care forces current employees who are the health care providers to work until their spouses are 65, and thus causes less drain on the health care system, will they look at this again before any changes are made? I know if I was still working, and not yet retired, I would have had to rethink my decision and would probably still be working!

    • Michael Pramik says:


      The current non-Medicare premium for the OPERS health care plan is $814 per month. The Medicare premium is $358 monthly.

      –Ohio PERS

  107. Dan Mc says:

    30years of service in juvenile prison system. stayed in that hole because of the unusual benefits. that was the only way they could keep people or hire people for that hole was to give them the unusual benefits. I’ve retired on those unusual benefits that Gov. Rhodes and the rest of those rep.s promised me if i stayed in that hole. been retired for many years now. they kicked my wife off of health care rolls for 2 years now with the promise that at 55 she can go back on, she is now 55, but quess what? the devastation has arrived. she can’t get insurance with her pre-existing conditions. I’m 62 and haven’t quit working yet. intend to work til 70 to get some soc. sec. if anyone has the answer please tell me. why has OPERS done this to us? it was their job to watch out for us and not to let this happen. God help them.

  108. Holly says:

    I listened to the Youtube video interview again, and I am confused as to the math equation for the “tentative” plan for spousal coverage phase out.

    Marianne says that in 2015 they will reduce OPERS premium coverage by 1/3, which would leave the spouse responsible for that 1/3. then in 2016, they will again reduce OPERS premium coverage by 1/3, which would now leave the spouse responsible for 2/3 of the total premium. Then in 2017, they are again reducing OPERS premium coverage by 1/3 – which according to my math leaves the spouse responsible for 3/3 or 100%. She then says that the next two years – 2018 and 2019, the spouse would be responsible for 100%.

    The way she presents the phase out, she implies that the full amount will not be required until 2018, but it seems to me that it will be 2017. Is my math wrong?

    • Michael Pramik says:


      This is a case of semantics. It depends on when you perceive the phase out to begin and how long it is.

      You could look at it this way: It’s a three-year phase out beginning in 2014, with the regular allowance still being granted in 2014, and some allowance the next two years. Or, the phase out begins in 2015, when the initial lower allowance takes place, with no allowance granted in the third year of the phase out in 2017.

      Either way, you are correct. There will be no spousal allowance in 2017, although spouses will be able to access the plan that year and the two following years.

      –Ohio PERS

  109. Kathy says:

    Isn’t there some way the phase-out of spousal coverage could include continuing spousal coverage for those spouses who have no other options in a longer phase-out period? In other words, many spouses can work somewhere and get their own health care coverage, but some can’t due to health problems. Those same people will have trouble even getting any health insurance on their own and if they can get coverage, I would think it would be at a much greater cost – likely unaffordable for someone in my payrange. How do we know what will be offered under the health care exchanges when they don’t even exist yet? I fully realize that changes have to be made, but it feels like the rug is being pulled out from under me at the last minute. Again, I ask: Isn’t there some way the phase-out of spousal coverage could include continuing spousal coverage for those spouses who have no other options in a longer phase-out period? Thank you for exploring all options carefully!

    • Michael Pramik says:


      We will be communicating the upcoming changes to the OPERS health care plan beginning this week.

      –Ohio PERS

  110. ron says:

    i found health coverage for my wife similar to the coverage i would have to pay for her through OPERS for about $444.00 per month…If things were to change would i be able to place my wife back on the OPERS plan at a later date….When i say things changing i mean if some of the health care changes OPERS is wanting to make regarding spouses, lessens or not changed at all….

    • Michelle Brown says:

      I have to assume your wife must be in good health to get a health insurance plan for $444.00 per month. My husband has 2 pre-existing conditions so I am petrified to think what insuring him through a private plan will cost (if we are even lucky enough to get it).

  111. Faye says:

    I retired after 13 years at age 65. I choose a traditional plan that paid about $200 less than the top plan so that I could have insurance for my husband as well as myself. This was promised to me by both OPERS and my employer because I had worked the required 10 years. I do not see how OPERS can now change the rules and not offer me or my spouse group insurance. I remember my husband telling me to forget about him and take the money. I should have listened to him. How sad is that.

    Seems to me this should be against the law. If you are now changing the rules and taking away the insurance do I get that extra money the other option would have given me??? If not, why not?

    • Michael Pramik says:


      Regarding your statement that OPERS will “not offer me or my spouse group insurance,” as a retiree you are still going to be eligible for insurance coverage after the health care plan changes are implemented. Your spouse will continue to receive access through 2019, with some form of allowance through 2016.

      –Ohio PERS

  112. Mary M says:

    I retired 12/31/11. I chose option C @ 10% for the sole purpose of assuring access to healthcare for my spouse should I die first. I always believed we would have to cover the cost but never dreamed his access would be eliminated. I never would have chosen that plan if I had known eliminating access was being considered as the “under consideration for 2 years ” would lead me to believe. This means a reduced pension for my entire retirement with no recourse. We should be given the option of reverting to Plan B. I definitely see a class action suit in the making if peole were not advised of what was under discussion when they retired.

    • Retiree says:

      I agree with Mary, I was promised spouse insurance at the time I retired from OPERS and my employer too. If PERS takes away spouse insurance with these new rules now, then PERS should change the old rules and let us change our option D for a higher pension payout so we can help pay for our spouse healthcare.Its the only fair thing to do. Current retirees should be able to keep their spouse insurance period.

  113. Mary says:

    I retired 12/31/11 and was told the only way my husband would have access to healthcare if I predeceased him was to elect Plan C with 10%survivor benefits. Now a few months later you say you are taking away that access and you have been thinking about this for 2 years, So I have a reduced pension for life without recourse and with no chance to make a knowledgeable decision. We should be given a window to revert back to Plan B.

    • Frank says:

      Other posters on these blogs have implied that they should be allowed to change to another Plan of Payment since they chose a particular Plan in the past to obtain healthcare coverage for their spouse and that has resulted in a reduced monthly payment and now their spouse is going to lose their coverage.

      I understand the plan to phase out the allowance beginning in 2015, etc..

      I have been informed that my spouse would be eligible for healthcare with allowance if I choose Plan B when I convert from disability to an age and service pension in the future. Is that correct? And, other than our share of the premium, will my monthly benefit be reduced?

      Thanks, its appreciated.

      • Michael Pramik says:


        Spouses of members who choose payment Plan B are eligible for health care until the member’s death. Recall that we are changing the plans of payment, sometime this year, to reduce the options from six to three. “Plan B” will continue to exist in what we are calling the “single-life plan.”

        Also, be sure to note that beginning in 2015 the spouse’s allowance percentage will be gradually reduced to zero by 2017.

        Your question about your monthly benefit is unclear. We’re not sure if you are referring to a reduction compared to your disability benefit or compared with the other optional plans of payment. For more information, contact one of our Member Services staff at 800-222-7377.

        –Ohio PERS

  114. ron houchins says:

    Michelle Yes my wife is in good health and we are very lucky in that regards so far..But do check other insurance companies and find out just how much it would cost..It may still be lower than the extreme rates OPERS is charging..It won’t hurt to check…There are several plans available and you may be able to find one that will fit your budget better….Good luck to you and God Bless…

  115. Ed Bell says:

    My last day of work was December 31, 2010 and I received my first pension check January 1, 2011. I retired with 20 years of paid service at age 60. I waived health care coverage, because my wife was retired with 30 years of service with OPERS and it was less expensive to purchase health care under her account. The September 27, 2012 healthcare policy statement for retires says, “Am I still eligible for coverage? Yes, if you are retired and participating in the OPERS health plan prior to January 1, 2014.” Does this mean that I have to enroll in the OPERS health plan in January of 2013 i.e. during this open enrollment period, to be eligible for coverage? Conversely, does this statement mean that if I don’t enroll during this open enrollment period, then I will forever waive my right to health care coverage?

    I am sure that my situation is shared by many retires. Please clarify our health care rights.

    • Michael Pramik says:


      Thanks for pointing that out. The answer was directed at retirees who do not yet qualify under the new criteria. Because you already have 20 years and are 60 years old, you do not have to enroll now. (You will not “forever waive” access to health care coverage by not enrolling now.)

      You may enroll in the future outside of open enrollment after a qualifying event, or during open enrollment whenever you choose.

      –Ohio PERS

  116. dave bailey says:

    I am aware that not all opers retirees pay income tax but most do. Our system could have made reductions much more cost effective and less painful for the members if they had reduced pension/cola benefits rather than slashing heath insurance benefits.Health benefits are not taxable but every pension dollar is for those , the majority, who pay federal,state and local income taxes. The board approved cuts were done in the most harmful and least cost effective manner. I am 70 and a diabetic. My spouse was a homemaker . We feel betrayed by opers.

  117. Pam says:

    My husband is retired with 30 years of service. My husband has never paid into Medicare yet you expect him to sign up under me as I have the necessary credits. A couple of years ago I took a job under OPERS, but went with the Member Directed Plan as I will never be able to work the number of years need to obtain health care coverage from OPERS under my own years of service. We went to all of the pre-retirement meetings for my husband. We were under the impression that healthcare would be available to spouses, at a cost, based upon years of service. Now that is all changing. I am too young for Medicare, where does that leave me.

  118. Dennis Miller says:

    My wife and I are both OPERS retirees the following pertains to her. When she retired effective February 1, 2004 she was 61 years of age and retired with a calculated service credit of 15.333 years. Having more than the required 10 years of service she has qualified for healthcare coverage and has been covered under Humana. Her current age is 69 and when eligible became covered under the Humana Medicare Advantage Plan.

    We are very much concerned as to how her healthcare coverage will be affected having less than 20 years of service when OPERS will introduse the “OPERS Medicare Connector” in 2015. Please address our concern, thank you.

    • Michael Pramik says:


      She will not lose her coverage if she is already retired.

      –Ohio PERS

      • Dennis Miller says:

        Mike, thank you for your reply of October 12th. Now I have another question pertaining to 2015 and the OPERS Medicare Connector that will be introduced. Hopefully your reply will be of a benefit to all retirees that will be affected by this future plan.
        The “Comprehensive Guide to Pension and Health Care Changes” pertaining to members already retired under coverage type points out that each year during open enrollment a personal licensed Medicare counselor will help to select the supplemental plan that is best for a retirees needs.
        Is this Medicare counselor to be an OPERS licensed Medicare staff member or an individual outside of OPERS? Also where will a retiree meet with their Medicare counselor, for example will a retiree need to schedule an apointment in Columbus? Hopefully appointments can be arranged close to where seminars currently are held.

        Thank you once again for your reply,

        • Michael Pramik says:


          The counselor will be employed by the company we hire to operate the connector, not an OPERS employee. We have not yet selected that company, so we can’t provide details. Our goal will be to have both telephone-based enrollment and in-person enrollment sessions throughout Ohio.

          –Ohio PERS

          • Dennis Miller says:

            Thanks once again for your reply, it’s obvious you are receiving many questions seeking quick answers and I am only one adding to this benefit.
            Its understandable 2015 is down the road. But, there are retirees currently 65 or older that will be covered under the Medicare Connector Plan, when it takes affect. These individuals, my wife and I a part, are wondering “now” how costs for this plan will affect them. Charts as seen cover twenty years of service, but don’t help to reflect anyone subject to the Medicare Connector Plan with less than twenty years. A person’s monthly pension is an individual’s livelihood in many cases. Not being able to compute in a “complete and easy format” how the Medicare Connector Plan will affect them is a serious change to ones life style. Once a company is selected I am sure OPERS will provide immediate details. When the plan goes into affect both my wife and I will be in our seventies. We both are OPERS retirees, she retired having 15.333 years of service and I having 32.423 years of service. With the financial change the Medicare Connector Plan will create to both our pensions, if it means anything, we, as were sure many in our category would personally lean more to in-person enrollment sessions throughout Ohio such as you stated rather than telephone-based enrollment as you also stated.

  119. Lonnie says:

    How many hundreds of thousands of dollars (Millions) is this “Medicare Connector” company going to cost over the next infinite number of years???? Would not that money be more and better suited to offset the cost of spousal Medicare insurance???? And as others have stated, what about the monies given up each month to ensure that our spouses would be covered in the event of our death?? Will that be pulled back into our monthly benefit?? With COLA?? And again we hear of the baby boomers. Did they and their employers not pay into the system??? We did our years and supported and paid for those ahead of us, now it’s our turn and all you can say is “Here’s the shaft, sorry you didn’t get the elevator ride”. Don’t get me wrong, the few years I’ve been retired you have treated us well, but this is a painful, uncalled for, kick out into the cold.

  120. Lonnie says:

    And another thought-will we retain our program with Express Scripts, or is that also going by the wayside?? That is also an important benefit for my wife and me. Just wondering.

  121. Lonnie says:

    And after December 31, 2013????

  122. Sharon says:

    Of course it was disheartening to read of the changes in the health care coverages that were approved last year. I will be without coverage and not eligible for Medicare for at least 4 years due to the change in coverage for spouses. And not to mention if I become a surviving spouse before then!

    In regards to my spouse’s coverage (he is the retiree), he will turn 65 in 2016. As I understand it, he can only get Medicare since I am under Social Security, correct? Do I already have to be Medicare-eligible?

    With the changes in Plan Choices offered for incoming retirees, will those already retired have a chance to switch in order to receive a higher benefit and therefore be able to afford health coverage that we are being forced to get outside of OPERS plans?

    • Michael Pramik says:


      There are too many unknowns in your questions to answer them here. Please contact Member Services at 800-222-7377.

      –Ohio PERS

  123. Marilyn Campbell says:

    I as a spouse of a deceased retiree receive 100% of his pension. How does this effect, if any, my health care benefits starting 2016? Will it remain as for living retiree’s?

    Thank you for your time and consideration.

    • Michael Pramik says:


      All surviving spouses’ allowances will phase out beginning in 2016, leading to a $0 allowance in 2018. Beginning in 2016 surviving spouses over age 65 and enrolled in Medicare Parts A and B can use the OPERS Medicare Connector and will receive an allowance in 2016 and 2017. By 2018, the allowance will be phased out to $0.

      –Ohio PERS

  124. marty says:

    I am the spouse of the retiree…..I think that I read that the ‘connector’ will assist me with finding insurance….will these plans from the ‘connector’ be the same plans that I can contact an agent about or will the ‘connector’ be able to offer plans at a more reasonable rate? If not , I can start looking now for a new insurance plan, correct?

    • Michael Pramik says:


      You can look up information about this year’s plans at the OneExchange OPERS portal if you click here. But you won’t be able to see what plans will cost for next year until Medicare releases those rates in early October.

      –Ohio PERS

      • marty says:

        Thanks but I am NOT RETIRED….my husband is the retiree using Medicare, I will need traditional health insurance.
        My question is: if the connector will have better pricing on health policies or will the prices be the same for policies if I would work with a local insurance agent? I know that I am being dropped but I also understand that the connector will assist spouses…the question is about cost. And yes, I know pricing is not published yet. Thank you, I look forward to your response.

        • Michael Pramik says:


          We can’t say because we don’t know what your local insurance agent offers. The only real way to know is to work with the Connector on pricing then call your local agent.

          –Ohio PERS

  125. Charles Reese says:

    So the connector will get ahold of my wife who is only 61 and help her get insurance. She turns 62 this December.

    • Michael Pramik says:


      The Connector applies only to those who are enrolled in Medicare Parts A and B.

      –Ohio PERS

    • marty says:

      I am the ‘spouse’ of the retiree and I am 60..I have posed this similar question 2 times and got 2 different answers, but today I called OPERS and asked the question….the repy is that ONLY those that are retired and on Humana need to speak with the connector, medical mutual coverage will continue as usual, the only change that I understand will happen is that OPERS will pay 1/3 less of the premium until they no longer cover any of the cost. If you need a better answer I suggest calling OPERS directly.

      • Michael Pramik says:

        That’s correct, and thanks for going more in depth to explain that the Connector is for those over 65.

        –Ohio PERS

        • Sharon K says:

          Am I the only one who has not been able to determine what actual premiums OPERS has been paying for medical coverage for my husband and myself? I know what we have been paying, but do not know what the total premiums have been.

          So when I keep hearing how subsidies, especially as they relate to spouses, are changing, and how spouses will have to pay 1/3, 2/3, whole amount of premium, I have absolutely no clue how to anticipate the actual numbers. Could you please point me to premium charts?

          And, are premiums for OPERS retirees/spouses determined based on age and/or gender? Or, same for all who are insured?

          Appreciate these answers :)

          • Michael Pramik says:


            We don’t post annual premium charts. Your allowance will be based on your service time and the age at which you began receiving OPERS health care coverage. Next month we’ll send you a personalized statement that will show your coverage premium share for 2016.

            –Ohio PERS

  126. Sharon K says:

    Although I keep hearing everyone will be paying a greater percentage of their health care premiums, I can’t seem to find what those premiums actually are… so I have no idea how to begin to anticipate what paying 1/3 or 2/3 etc amounts to. Could you please point me in the proper direction, even seeing past actual premium amounts would help. (non-Medicare eligible) Also are the premiums based on age and/or gender?

    • Michael Pramik says:


      The non-Medicare self-supporting rate for 2016 is $968 per month. That’s the full premium for all participants.

      –Ohio PERS

  127. marty says:

    I called OPERS again today….I was told that the cost of my health insurance (I am the spouse of a member, and not retired) will be $501.98 with a $1000.00 deductible. The price will be going up approx $250.00. I was also told I would not get an allowance for health care costs for 3 years, which I swear I was told in an earlier conversation that I would be getting that but it is for the member only.
    She also advised me to speak with the connector to find another policy if I wanted to…now just a few days ago the person I spoke with told me I did not have to do anything, just renew the policy when the renewal packet comes in October, so AGAIN I am confused as what to do.
    …do I need to speak with the connector or do I just renew the policy, can anyone answer this question??

    • Michael Pramik says:


      In a previous comment you said that you are 60 years old. If that is the case, and your spouse is over 65 and enrolled in the Connector, then you will be enrolled in the OPERS non-Medicare plan with Medical Mutual. You will not be eligible for the Connector, so there is no reason to contact the Connector administrator.

      Also, you mentioned that you were told you “would not get an allowance for health care costs for 3 years.” That is incorrect. The correct version of that sentence would be that in three years you no longer will receive an allowance as a spouse. You will receive an allowance in 2016 and in 2017 but not in 2018 or beyond. The allowances next year and in 2017 also will gradually decrease until the amount becomes zero in 2018.

      –Ohio PERS

      • marty says:

        Thank you….I was told, via telephone, that I, as a spouse under 65, would not receive an allowance….thank you for the clarification.

        • Michael Pramik says:


          Keep in mind that if there is money left over from your spouse’s Connector allowance, it can be used for part of your premium. We are working on the details, but that will be an option.

          –Ohio PERS

  128. Sharon K says:

    Thank you for that information. So, for spouses, will OPERS be paying 2/3 of that amount? I am a little confused as I’ve also seen the phrase “1/3 less”, not quite sure how to interpret that.

    • Michael Pramik says:


      The allowance is what we contribute toward the cost of the full monthly premium. OPERS will pay one-third less of an allowance to the spouse in 2016, whatever that allowance was scheduled to be. We’re also changing the way we calculate the allowances, so keep that in mind.

      You’ll know the exact amount in September, when we send out individualized open enrollment statements.

      –Ohio PERS

  129. Sharon C. says:

    My Dad retired from the state at age 65, when he set up his pension he took the option of less monthly income that allowed coverage for my Mom so that she would never have to worry about NOT having HIS pension. My Dad died at age 68 from ALS, and now what he did to have the piece of mind that she was covered was for nothing!! My Mom is 73 years old, so I don’t think she’s going to be able to work to have insurance in 2018.
    After working with the connector yesterday 10/16/2015 and choosing her new plan, we talked about her HRA, so my question is, will she still have an HRA in 2018? The connector was showing she does, but I think they are wrong according to what i can manage to understand of this mess.

    • Michael Pramik says:


      If a member selects the option of less monthly income so that a spouse can collect part of the pension, that pension is still being paid out. What is changing is the health care coverage so that it can be preserved in the future for contributing members.

      Regarding the HRA, it won’t go away in 2018, but for spouses we no longer will be contributing an allowance toward health care as of that date.

      –Ohio PERS

      • marty says:

        I understand that spousal assistance is being phased out over three years but how much will the retiree receive in their HRA each month?

        • Michael Pramik says:


          About 98 percent of retirees will receive $337 or more each month.

          –Ohio PERS

          • marty says:

            thanks for the answer….is that amount for the retiree’s lifetime?

          • Michael Pramik says:


            Maybe not that exact amount. It could be adjusted for inflation and remember that we are going through a transition to an allowance based on age and service.

            But if the question is whether a monthly allowance will continue into the future for the member, the answer is yes.

            –Ohio PERS

          • marty says:

            About 98 percent of retirees will receive $337 or more each month…..OK I understand that but then what is the money called that is being given for 3 years that is being reduced by 1/3 each year…..Sorry…I can’t seem to get this straight in my mind.

          • Michael Pramik says:


            When we passed pension legislation and made health care changes in 2012, you may recall that we did so in order to preserve our pension benefits and health care coverage for the future.

            One of the provisions of health care coverage that changed was the amount of allowance we provide to our health care participants. In the past, we were able to cover nearly all the premium, for example, for most of the participants. Going forward, that’s not going to be the case — health care costs are rising too quickly, there will be so many more people retiring from the baby boom generation, and life spans are increasing.

            So we adjusted the allowance we provide toward the premiums. The new allowances are based on the number of years the members worked and the age at which they initially elected our health care coverage (or coverage through the OPERS Medicare Connector).

            In order to lessen the severity of this change, we are transitioning over a period of three years to the new allowance. That is what is being reduced by one-third every year beginning in 2016. Our Comprehensive Guide to Pension and Health Care Changes explains this transition in detail.

            Regarding the money that is being given for three years, we believe you’re referring to an extra allowance of $300 that we are giving to Connector participants — each January for three years beginning in 2016 to reduce the impact of the health care changes. It is not being reduced. It will remain $300 for three years. The overall allowance is being changed and is being transitioned over a three-year period.

            –Ohio PERS

          • Tom Severns says:

            I think “the money called that is being given for 3 years that is being reduced by 1/3 each year” to which Marty referred is the Med B reimbursement, which has in fact been reduced by 1/3 each year (from $99.90 in 2013 to $66.60 in 2014 and $33.30 in 2015) and will be eliminated for 2016.

          • Michael Pramik says:


            If he was referring to the Medicare Part B reimbursement, you’re correct that it’s being reduced by one-third over a three-year period. But that reduction began this year, not in 2014.

            –Ohio PERS

          • marty says:

            YES!! That is correct, and today while discussing this with a friend, that is retired, we decided that this is what I have been asking and today the mystery is solved. Thank you!

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