Some changes are in the works in 2014 for participants in the Ohio Public Employees Retirement System Retiree Health Plan.
While coverage, co-insurance, out-of-pocket-costs and deductibles will remain constant, both Medicare-eligible and non-Medicare-eligible participants will see their premiums increase. On average, Medicare participants will see an average monthly increase of $10-$12, while non-Medicare participants will see a monthly increase of about $45.
We will begin mailing personalized cost statements and change forms within the next week. Open enrollment in the health care plan runs from Oct. 1-31.
Rising health care costs and increased participation in the plan are two reasons that premium prices are going up. Another is the expiration of money from the Early Retiree Reinsurance Program, a provision of the Affordable Care Act through which OPERS has secured more than $180 million.
We’ve used this “ERRP” money over the past few years to hold the participants’ share of the premium flat. Without the ERRP money, there would have been premium increases in 2012 and 2013.
The new premiums are not a result of the long-term changes to the health care plan that we announced last year. Provisions of the preservation plan include basing premiums on age and service, and eventual elimination of spousal coverage. That plan will continue as we seek to sustain health care for the long term for retirees who, along with their employer, paid into the system.
The cost statements that participants are about to receive will reflect the new premiums. They also contain detailed information about the plans, including in-network and out-of-network costs, value-based co-pays and lower out-of-pocket maximums for drug coverage.
For the first time in several years, OPERS will make changes to the optional dental coverage. For instance, the new plan adds coverage for implants and composite fillings, and increases the frequency of periodontal maintenance from twice a year to four times a year.
There will be no changes to the optional vision coverage.
We will be conducting several open enrollment seminars around the state beginning next month. The sessions will include representatives from Humana, Medical Mutual, Express Scripts, Kaiser, Aetna and MetLife. Registration is required, and space is limited. Members may register through their online accounts or by calling OPERS at 800-222-7377.
You can see a list of the seminar times and locations in a Special Open Enrollment Bulletin that we are mailing to retirees this week, preceding distribution of the open enrollment information.
For those who cannot attend the live seminars, we will conduct webinars twice a week from Sept. 17-Oct. 15. We will be posting signup links on Aug. 26. Go to www.opers.org and click on “Seminars” under the “Retirees” heading for more information.