Health care details for spouses

Coverage will not automatically end in 2018

By Heather Drago, Ohio Public Employees Retirement System

Nov. 7, 2017 — Although OPERS no longer will provide allowances for spousal health insurance in 2018, current coverage for spouses won’t automatically end next year.

If your spouse is enrolled in pre-Medicare health care coverage, you’ll be charged the full premium amount in 2018 unless you contact OPERS to cancel the spousal coverage. Details can be found in your Open Enrollment kit.

Regarding spousal health insurance coverage for those in the OPERS Medicare Connector, we’ve received questions from retirees regarding spousal access to health care coverage in 2018. To be clear, spouses, including surviving spouses, will not lose their existing medical, pharmacy, vision or dental coverage in 2018.

The facts:

  1. While all spouses will continue to have access to OPERS health care, they will no longer receive a monthly Health Reimbursement Arrangement allowance effective Jan. 1.
  2. Retirees can still seek reimbursements from their HRA for any qualified medical expenses incurred by their spouse.
  3. Surviving spouses can continue to access the HRA balance for qualified medical expenses.
  4. All spouses will remain enrolled in their selected plan(s) until the individual cancels the coverage. If a spouse is enrolled in a Medicare plan through the OPERS Medicare Connector administered by OneExchange, that coverage will continue into 2018.

Prior to open enrollment, OneExchange attempted to contact spouses in an effort to reinforce these messages. If you or your spouse missed the call and have enrollment questions, please contact OneExchange at 844-287-9945.

Retirees: Remember, in order for OPERS to provide you with an HRA allowance, your agent of record must be OneExchange. If you enroll in a medical plan through a broker or insurance carrier, you will not receive future HRA allowance deposits from OPERS.

Often during this time of year, you will receive information from many sources outside OPERS. Please remember that OPERS is your source for health care coverage information. Call us at 800-222-7377 with any questions or concerns regarding spousal access to 2018 health care coverage.

Heather Drago

Heather Drago is a health care communications specialist with the Ohio Public Employees Retirement System. She breaks down health care topics into clear, concise, consumable messaging for our retirees. When she’s not blogging, Heather composes content for OPERS print publications, the OPERS website and internal employee communications.

Heather Drago

Health Care Communication Specialist

6 thoughts on “Health care details for spouses

  • November 7, 2017 at 2:56 pm
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    With the new COLA changes, how does one determine if one qualifies whether I qualify for the below market purchase power? This is the third time I have asked without a reply. Please explain.

    Reply
    • November 7, 2017 at 4:01 pm
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      One of the changes the OPERS Board of Trustees has approved for the cost-of-living adjustment is a one-time benefit increase for retirees whose purchasing power is less than 85 percent of what it was when they retired. This increase will affect only a small percentage of our retirees who have been retired for more than three decades. Because of several factors, most notably the historically high levels of inflation through the 1970s, their current pensions have a value of less than 85 percent of the original benefit.
      OPERS is still working out final details of what groups the increase will apply to, the increase amounts and how we will administer them. But again, it is likely to affect only longtime retirees – a small percentage of our overall retiree population.

      Julie, OPERS

      Reply
  • November 9, 2017 at 9:03 am
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    Will the 85 % only be one time or will it occur whenever a retiree goes below the percent. Based on CPI being similar to the last 27 years, all retirees will be below 85% in 22 years using the new rules. This does not seem to be addressed in the changes.

    Reply
    • November 9, 2017 at 9:07 am
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      Mark,

      This is a one-time adjustment.

      Julie, OPERS

      Reply
  • November 9, 2017 at 12:48 pm
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    The majority of us are already painfully aware of this cut.

    But of course the important thing is that you mentioned it in the Blog…

    Reply
  • November 14, 2017 at 12:14 pm
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    Why are people discussing cost of living cuts in this blog for health care?

    Reply

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