Health care open enrollment

Subsidy changes will be in effect for retirees next year

By Heather Drago, Ohio Public Employees Retirement System

Sept. 18, 2018 – OPERS’ health care open enrollment season kicks off on Oct. 15. With open enrollment materials hitting the mail at the end of the month, here’s what you should expect to read:

Subsidy changes for Medicare-eligible and pre-Medicare plan participants

  • OPERS will not extend the annual $300 deposit for Medicare-eligible retirees into 2019. The subsidy was provided for three years (2016-2018) to help offset out-of-pocket costs due to the Medicare prescription drug coverage gap.
  • Pre-Medicare participants will receive a $49 premium reduction to help offset costs, $25 less than in previous years.

OPERS pre-Medicare plan participants

  • While OPERS continues to pay the majority of the cost for coverage, pre-Medicare plan participants will pay more for monthly premiums.
  • An increase in medical claim costs, prescription drug use and price resulted in the premium increases for 2019. Changes to deductibles, co-insurance, copays and out-of-pocket maximums helped offset some of this premium change.
  • Spouses under age 65 can enroll in the OPERS Retiree Health Plan administered by Medical Mutual as long as the retiree is enrolled or receiving a Health Reimbursement Arrangement allowance. Pre-Medicare spouses must pay the full monthly premium of $1,305.95.
  • Enrolling, making changes or canceling coverage? Fill out the Health Care form included in your open enrollment packet, or call OPERS between Oct. 15 and Dec. 7. If you choose to discontinue coverage, you may do so over the phone.
  • No changes? No problem. No action is needed by you, as your current plan will automatically continue in 2019.

OPERS Medicare Connector plan participants

If you are enrolled in a plan through the Connector, review your current medical and prescription drug plan to see if it still meets your needs for the upcoming year. Additionally, spouses will continue to have access to health care plans through Via Benefits and will remain enrolled in their selected plan unless coverage is cancelled.

  • If there are changes to your current plans, your insurance carriers will notify you. Look for adjustments in plan design, premium cost and the prescription drug list.
  • If you decide to keep your current plan, you do not need to re-enroll. Your current plan(s) will automatically continue in 2019.
  • If you’d like to explore new coverage options, call Via Benefits at 1-844-287-9945 between Oct. 15 and Dec. 7. Selecting a Medigap plan may require medical underwriting.

You may receive calls and mail from other insurance agents and/or brokers offering medical and prescription drug plans. Remember, to remain eligible for your health reimbursement arrangement allowance, you must enroll in a medical plan through Via Benefits.

The 2019 OPERS health care open enrollment runs Oct. 15 through Dec. 7.

 

 

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

30 thoughts on “Health care open enrollment

  • September 18, 2018 at 10:49 am
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    For Pre-Medicare retirees, are all the details, such as what our new monthly premium will be, and deductibles, available now to view online?

    Reply
    • September 18, 2018 at 10:58 am
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      Your personalized information will be mailed in early October in the 2019 Health Care Open Enrollment packet.

      Reply
  • September 18, 2018 at 10:53 am
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    Hi, thank you for allowing comment/feedback. Why is it necessary for the $300.00 annual subsidy deposit to be dropped when we still need help to offset out-of-pocket costs due to the Medicare prescription drug coverage gap. Our supplement insurance and part D insurance premiums keep going up to for several reasons, including discounts given for enrollment fall off gradually.

    Reply
    • September 19, 2018 at 11:11 am
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      The subsidy was provided for three years, 2016-2018, to help offset out-of-pocket costs due to the Medicare prescription drug coverage gap also known as the doughnut hole. This is a coverage gap that about 25 percent of OPERS health care participants experience after they’ve reached a defined, out-of-pocket cost threshold.

      Reply
  • September 18, 2018 at 10:55 am
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    Although disappointing that retirees will no longer receive the $300 buffer payment in January of each new year, it is understandable with health care costs rising rather uncontrollably. However, something I would really appreciate is that Authorized Providers through VIA not be able to increase the costs of premiums during the calendar year as many do due to enrollment dates, etc., which makes budgeting on this restricted allowance difficult. If retirees no longer receive the $300 payment in January, then providers should hold off any premium increases until January of each year so that consumers are truly comparing apples to apples when looking at costs and planning budgets for the year. Consumers never have the intended increases available at the January enrollment that occurs during the year based on enrollment dates, etc.. Please make this a consideration when considering further changes to the allowance amounts. Thank you for providing excellent options for retirees and excellent options for great health care providers. These efforts are very much appreciated!

    Reply
  • September 18, 2018 at 11:00 am
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    Will i still receive my 3% increase on January 1st 2019?

    Reply
    • September 18, 2018 at 11:58 am
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      Retirees receive their COLA on the anniversary of their retirement date. If you received your COLA on Jan. 1 in the past, you will receive it on Jan. 1 in 2019.

      Reply
  • September 18, 2018 at 12:28 pm
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    OPERS not extending the annual $300 deposit for Medicare eligible retirees into 2019 is a huge disappointment and problem for retirees! Only providing the subsidy for three years (2016-2018) to help offset out-of-pocket costs due to the Medicare prescription drug coverage gap was not a long enough time for it to be provided. The subsidy should have been continued on an annual basis until the United States government devises a comprehensive plan to lower drug costs commensurate with the lower costs in many other countries.

    Reply
  • September 18, 2018 at 4:09 pm
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    Your message of September 18 said Mcare eligible retirees will not receive the $300 allowance for 2019. At the end of the message it says that we’ll remain eligible for the health reimbursement arrangement allowance we must still be in rolled through Via benefits . Will you explain this? On the one hand it seems we will not receive reimbursement and on the other hand seems we will. Thanks.

    Reply
    • September 19, 2018 at 11:06 am
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      The $300 subsidy was a one-time payment provided once a year for three years, 2016-2018, to help offset out-of-pocket costs due to the Medicare prescription drug coverage gap. This is different from the Health Reimbursement Arrangement allowance that you receive each month.

      Reply
      • September 19, 2018 at 9:13 pm
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        Is the HRA monthly deposit subject to ending as well?

        Reply
        • September 21, 2018 at 2:34 pm
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          The $300 subsidy was a one-time payment provided once a year for three years, 2016-2018, to help offset out-of-pocket costs due to the Medicare prescription drug coverage gap. This is different from the Health Reimbursement Arrangement allowance that you receive each month. The HRA allowance will continue.

          Reply
  • September 18, 2018 at 4:34 pm
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    I am re-employed part-time for an OPERS employer and have to pay my own premiums, so I have never received the $300 that others received for three years. Am I eligible to receive it for three years after I quit the OPERS job?

    Reply
    • September 19, 2018 at 11:05 am
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      The $300 subsidy was a one-time payment provided once a year for only three years, 2016-2018, to help offset out-of-pocket costs due to the Medicare prescription drug coverage gap.

      Reply
  • September 18, 2018 at 5:05 pm
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    Is the $300 deposit still in effect for someone already retired?

    Reply
    • September 19, 2018 at 11:04 am
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      The $300 subsidy was a one-time payment provided once a year for three years, 2016-2018, to help offset out-of-pocket costs due to the Medicare prescription drug coverage gap.

      Reply
  • September 19, 2018 at 3:13 am
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    When will the schedule for the “Education Seminars” regarding OPERS plans to change healthcare options for under 65 and over 65 be available in your web site? Is OPERS planning to offer stipends, leaving recepients to fend for themselves? One last question: why did an OPERS representative tell the Dayton Daily News in 2017 that OPERS had made enough changes to healthcare that will allow them the ability to provide it indefinitely? Apparently that is not true, since major changes need to be implemented by 2020.

    Reply
    • September 26, 2018 at 9:51 am
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      Your HRA will remain the same.

      Reply
  • September 27, 2018 at 9:35 am
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    Christine Gregory’s post about premiums being increased during the calendar year was spot on. While it’s true that an increase in the middle of year means an individual pays a lower premium for the first half of the year and a higher premium for the second half. But it’s difficult to budget for the entire year when there is no information available at enrollment what the increase will be.
    Also, given the continual rise in premiums, health insurance premiums may soon exceed HRA allowances by quite a bit for many people. Changing to a plan with a lower premium is of little help, as those plans have deductibles and coinsurance–and it would take only one serious illness or accident requiring multiple tests and treatment to devastate someone financially.

    Reply
  • October 6, 2018 at 4:55 pm
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    What determines the amount of the HRA each month? I am pre Medicare retiree and won’t be eligible for Medicare until May 2019.

    Reply
  • October 16, 2018 at 3:36 pm
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    Why can’t OPERS find a better company than ViaBenefits to administer our health plan enrollment? Their website gets overloaded and you just watch the little circle go round and round! I tried today to find a plan and just gave up. This is just making this harder than it needs to be. There has to be a company out there that provides better service that we are paying for. Please go find it.

    Reply
  • October 24, 2018 at 4:04 am
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    I have to change my insurance policy, because my provider no longer excepts United Health Care. Do I have to go through VIA Benefits or the Marketplace to find a new provider to keep my HRA Aacount.

    Reply
    • October 24, 2018 at 8:57 am
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      Please call Via Benefits at 1-844-287-9945. They can help you find a new provider.

      Julie, OPERS

      Reply
  • October 24, 2018 at 9:50 am
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    Those of us who have been retired for a number of years are up to speed on OPERS’s program and appreciate it very much. Only one question referring to the presentations being scheduled at various sites around Ohio: Regarding the mention of the “future” for HRA’s, will something be discussed that we don’t already know about? If so, should we sign up for and drive 30-40 miles to attend the presentation just to get information on that subject, thinking that this benefit might be reduced or eliminated down the road? Thank you.

    Reply
    • October 24, 2018 at 12:45 pm
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      Thank you for asking. The presentation addresses how OPERS funds both pensions and health care and the challenges we face for the future. No specific changes to the current HRA program will be discussed.

      Julie, OPERS

      Reply

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