OPERS health care director discusses HRA
The Ohio Public Employees Retirement System has released the latest monthly health care chat with OPERS Health Care Director Marianne Steger.
In the February video, Steger talks about questions our members have about the OPERS Medicare Connector HRA process.
We’ve posted the video on our YouTube channel.
Michael Pramik
Michael Pramik is communication strategist for the Ohio Public Employees Retirement System and editor of the PERSpective blog. As an experienced business journalist, he clarifies complex pension policies and helps members make smart choices to secure their retirement.
I watched the video and thought it did a good job explaining the HRA process. That was until Ms. Steger got to the part about recurring reimbursement of Med B premiums. She failed to note what we’ve been told by OPERS regarding reimbursements for those of us who do NOT have the Med B premium deducted from a Social Security benefit payment but instead pay SS directly, i.e. that we cannot use the recurring reimbursement process. Her comments certainly imply that the recurring reimbursement process applies to ALL participants.This would have been a great time to clarify the matter, but instead I suspect it will continue or even add to the confusion.
Tom,
Here is how OneExchange has explained this situation to us:
Connector participants who have their Medicare Part B premium deducted from their Social Security check receive an award letter. It states the amount that is deducted on a monthly basis, and it serves as both proof of coverage and proof of payment; no further documentation is needed. These participants may use the recurring reimbursement form for their Medicare Part B premiums. They will need to resubmit a recurring reimbursement form on a yearly basis.
Connector participants who pay Medicare premiums on a monthly or quarterly basis need to provide proof of coverage and proof of payment, and submit both using a standard form from OneExchange. The reason is that the statement they receive from the Centers for Medicare & Medicaid Services does not indicate coverage for an entire year — only for the relevant month or quarter.
Several options are available for proof of payment for these participants. They include canceled checks, copies of bank statements showing payment of the named premium, credit card statements indicating payment of the named premium, or a statement from CMS showing they have provided payment for the months in which they are seeking reimbursement.
–Ohio PERS
My Recurring Premium Request Form for Medicare premiums was submitted in January and was rejected by One Exchange (I too do not receive a social security check) – they did not like the proof of enrollment and proof of payment documentation I submitted. They did not tell me which part of my submission was lacking; but, this is what I did before I resubmitted a new request form with new documentation on February 4th. The new documentation is what I got from Social Security. Social Security issued me a letter stating what my premium for 2016 is and that I am enrolled in CMS EasyPay which is used by CMS to electronically withdraw from my checking account my monthly premiums. That I am current and that the Easy Pay is current and ongoing. Before submission of this new documentation, I called One Exchange, read the letter from Social Security to the representative asked if that was sufficient to support Recurring Reimbursement claim and was told yes. Now, whether or not the person who will review my submission agrees is a different story. I will just have to wait for the Explanation of Payment. Could be approved, could be denied by that representative. I just checked yesterday with One Exchange on where it was in the process. Told 2 – 3 weeks backlog so they did not know where it was in the system. Felt it worth a try.
Thank you OPERS. One Exchange called me, researched my two Medicare Part B submissions, told me exactly what documents were required by me to submit to One Exchange (e.g. letter social security, bank statement showing payment etc) and the proper form for submission. January and February reimbursements have been paid. Problem resolved. Thanks again.
Viewed your UTube of February 11, 2016, and you still are putting frosting on an unsavory situation. One Exchange and its subcontractor Pay Flex is totally without the means to process timely reimbursement claims. They have have no idea when or if they received them, whether they are processing them or if they have been approved. Some of us have been waiting two weeks. Please don’t fall back on the One Exchange party line of we are experiencing a larger than normal volume. Pay Flex’s claim to fame is that their system is down for maintenance every three days. What you think was going to happen when OPERS said submit your claims manually for the first two two months or so. DUH! And as for recurring claims good luck. Here is the thing, OPERS entered into a contract with these people and they are not performing. Hence breech of contract. Pay Flex maybe a contractee of One Exchange. Both can’t get the job done. There should be remedies for the lack of performance.Time to get out the old legal books. OPERS really needs to step up and protect people who are at this point out of pocket hundreds of dollars.
For the most part, OPERS Medicare Connector has worked well for me. I am very pleased to have
the HRA Reimbursement, and understand with the change we all have to have a little patience, and with time it will all work out smoothly.
I would like to comment on the service from One Exchange. Their website is excellent! However,
for members who are not computer literate, it is a bit overwhelming. For me, I had a little problem, but eventually figured how to navigate the site easily.
As far as contacting the Company directly via a phone call, the wait times are very long, and when I am finally connected, I have to go through about 3 reps before I get my answer. Specifically, I am having
difficulty with receiving information on recurring Medicare payments. My paperwork cannot be located, and probably will have to resubmit. I will wait a little longer to see if any information is available before
the month ends.
I am overall pleased with the transition, and would like to thank OPERS for the HRA reimbursement.
I appreciate the updates. Is it possible to get a nuts and bolts info sheet as opposed to watching a video?
Sheri,
The videos we produce regarding health care are designed to complement the wealth of information on our website and the OneExchange/OPERS website. For instance, some of the information in this video was taken from the list of questions and answers regarding the HRA process that is on our website.
–Ohio PERS
Why does it take One Exchange so long to get forms sent to you? I called a month ago for them and still have not received them. I tried to get them from their web site and it does not come up anywhere on my computer where you can click to get them. I called them and they gave me the same instructions that was in the booklet and it still did not work, then I sent them an e-mail about it and they sent back the same thing and it still did not work so I called and ask for them to be mailed to me and still do not have them. How are we suppose to send in for our money when we can not get the forms to do it with??????
Ida,
You do not state what forms you’re looking for. There are several forms on the OneExchange/OPERS website that might be what you need (under HRA Information).
–Ohio PERS
I am still waiting for One Exchange to send me the paper work to set up a bank account for medical reimbursements. I talked with them in mid-January. I think Monday, 2/15, it will be a month.
Not sure what you are talking about. How do I know if I should be getting a refund? Please advise.
Thank you.
Kay
Kay,
We’re not sure what type of refund you’re talking about. We recommend calling Member Services at 800-222-7377.
–Ohio PERS
Well Well Well, what has One Exchange done now. I sent in recurring claim forms for my wife and I, hers was accepted, they paid her for January and February for her Medicare B Premium.. They denied her rest of the year payments but it is a recurring form so I am thinking as each month comes up then I guess they will reimburse and thought i’d just have to stick it out to find out. Finally today they approve my Medicare B premiums I sent in on the recurring form and they paid me for the whole year., drained my account, didn’t have quite enough to cover it all, so it shows my account with a zero balance ??? Been sitting on the phone for over an hour and of course no answer yet. Other claims sent in for my vision/dental will not have funds to cover now. Whoops One Exchange just answered , she is telling me that when I send in a recurring form they pay me for the entire year not month to month as it occurs. I will ask for a supervisor, OMG, please give me somebody that knows something!!!!
In regards to my last comment Supervisor wouldn’t talk to me, said they were to busy, told her she was wrong, but she would give me correct information now. Nope. Telling me to submit forms again later when I have more funds available.. I told them I want to speak to the supervisor, she said she would be me on hold but the wait time could be a long time. That is how it is left..Ridculous! How do we get answers to our questions?
Here is a “new one” for you. I sent in a reimbursement standard form to One Exchange for 6 months of medicare part B that I paid. I later discovered by reading your comments that we should deduct the portion that OPERS pays us in our pension check ($31.81), which I omitted to do.. I contacted One Exchange and advised them of this error on my part. They advised me that they would deny my claim and that I should re-submit a new one with the OPERS portion deducted. I did as they said to do. Guess what,, they ended up paying me for both claims. Now I have to try and straighten up this mess. Soo much for their sophisticated computer program that Ms Steger stated that they have to eliminate the possibility of a double payment.
After watching the video, my comment is in regard to Ms. Steger’s advice for receiving a more timely reimbursement. That is, she states to do a manual reimbursement procedure, even though you may be set up for auto. Unfortunately, according to One Exchange, she is wrong. I was told specifically by One Exchange NOT to send the form for manual reimbursement as that would cause me to be reimbursed TWICE..(exactly what Ms. Steger said would NOT happen), and that I would then have to reimburse them. Consequently, I have not yet been reimbursed even once.
Here is the One Exchange employee comment about OPERS: “They’re crazy!” This does not sound like good business to me.
To continue, I have had numerous phone conversations with One Exchange and am told something different each time I call. It is completely exasperating and impossible to rectify because no one seems to know why I was given one answer when it really is something different. Some employees appear to be poorly trained.
Recently, One Exchange told me on Jan. 31 that my husband (I pay his premium directly from my checking account, like mine) could NOT be auto reimbursed at all as was initially allowed and set up for way back in Oct. 2015 (Everything sounded so simple then!). OPERS told One Exchange they could NOT do auto reimbursement for spouses as of the last week in Jan. Why was I not informed of this by OPERS? I was told it was their decision by One Exchange. Why did this happen?
I did prepare and send the correct forms to One Exchange for manual reimbursement for my husband’s premium. Of course, we have not been reimbursed for that, either. I do know that Humana (my provider) sends all premium payment information to One Exchange on the 10th of each month.
Also, in case this may help any others out there with similar problems, when doing manual reimbursement, you must send proof of payment of your premium to One Exchange in a letter, from your insurance provider, stating the word “premium” paid, due to IRS audit requirements. They will not accept bank statements, cancelled checks, (as I was told) etc. as proof of payment. If you have auto reimbursement, you do not need to provide this
Cynthia,
We have never told anyone that spousal premiums can’t be auto-reimbursed. They can be, as long as the insurance provider allows it.
You only have to read the OneExchange Getting Reimbursed Guide (page 9) to see this for yourself.
We are looking into your other comments.
–Ohio PERS https://perspective.opers.org/wordpress/wp-admin/edit-comments.php?comment_status=moderated#comments-form
Yes, Mr. Pramik, I have read OneExchange Getting Reimbursed Guide. Your comment suggests I have not and that this is my fault. I resent that comment! My husband and I were both set up for auto reimbursement last October when seeking new insurance through OneExchange. We were then assured by OneExchange we would be reimbursed automatically. And yet, on Jan. 30 (when calling them to inquire about reimbursement) I was specifically told my husband could not be reimbursed automatically and that I must complete the Recurring Premium Reimbursement Form for him regarding Humana premium, Silverscript premium, and Medicare B, as well as for myself regarding OPERS Vision and Dental and Medicare B.
This person, Regina in funding (I keep a record of names of every person I have spoken with) told me exactly how to do this, including additional notes to put on the form, and what documentation to include, and then to fax all to OneExchange.
The consequence of this procedure has caused them to send me 5 pages of denial of all, causing me great confusion. As well, they have told me I must return a reimbursement I received for my Silverscript premium! (I did receive that automatically toward the end of January.) Of course, all I did following Regina’s specific instruction was WRONG, yet I was told it was right by her(including all the other information in my post of Feb. 17).
I am telling you this in detail (and there is more) so that you can understand people are being told the completely wrong information by OneExchange. I have been led by OPERS to trust these people, regardless of what is printed on a page! You cannot argue with them. I was told the previous (printed) information was wrong regarding reimbursement for spouses! And furthermore, that OPERS made that decision.
I called them again on Feb. 18 to see what progress had been made regarding my fax, and then told everything I did was WRONG!
I would like to know what you, personally, would do in such a situation. Have you ever called to speak with any customer service rep at OneExchange? No, I doubt that, since you are not retired….but why not take a go at it and put some fun in your day!
Cynthia,
Thanks for your comment. You asked what we would do in your situation, and I probably would post a comment like yours. We are investigating why some OneExchange reps are saying different things to our members than are others.
–Ohio PERS
Wow , what a mess! I am in the same boat as you. Trouble is I have yet to try to get any reimbursement . OPERS should be ashamed .
I plan on writing each director a letter explaining this issue of having to buy insurance through One Exchange when we don’t need that insurance. If I owned a company or was a CEO and found out that my directors or staff was waisting my money (OPERS) money to reimburse employees for buying insurance they didn’t need or want I would get rid of the entire staff.
First, I want to say I appreciate getting some reimbursement. I realize you are trying to continue with covering our healthcare and wouldn’t have to do this.
I have found the reimbursement process to be a bit frustrating. Having to send info each month will add up with postage costs. I will have to figure out how to use the fax, but I am wondering how many retired people have a fax at home. Going to the library or elsewhere to fax also adds to the cost of things.
I realize you can send a few things at at time, but the monthly medicare amount would add up quickly. (I am one of the people that does not get a SS check so I have my payments auto deducted each month. ) I don’t see how that differs from the auto deductions we are doing for our premiums each month, and those can be done as a recurring reimbursement item. The amount does not change month to month.
Having more than 3 lines on a page would also be helpful , especially for prescription items.
Also, I am surprised that reimbursement for our dental and vision payments can’t be done as a recurring reimbursement since OPERS is the one who hired One Exchange.
I understand how the process works, but still don’t really like all of the papers required for the recurring things.
Thanks for taking time to read my comments.
looks like opers tossed their members under the bus when it came to the health care change over.
Problems i have experienced:
i have called one exchange and they could not find my account.
the phone wait time is horrible, always at least 20 min. or more and then you are passed from one person to another
i received a letter from CMS that cigna health spring had received sanctions against them..one exchange knew nothing about this
when given the list of choices of health care plan, the list was not complete, there were more choices on the internet. what about those who do not have internet?
forms are not clearly available on the one exchange site
one exchange employees can not find forms or know which ones are needed for specific purposes
reimbursement (yearly) form for monthly premium is not on site (i talked with 5 different people and no one knew where this form was and i was told my one person “just use the medicare form)
according to the latest video, the medicare reinbursement form must also show opers reinbursement amount also…where on the form is that stated or where on the form is a place to put that amount
monthly premium reinbursements (yearly) are not coming back in a timely manner and the video said to fill out the out of pocket form to get a premium payback…why is there such a delay?
who is helping the blind or elderly members with this mess? A blind member called one exchange and requested assistance and was told to get a family member or a neighbor to help. With ID thief so common and people taking advantage of the elderly, is that a good answer?
what happens to members who do not have computer access or internet service or a printer or a fax machine? All that cost a lot of money which most do not have. what are they to do? call each month and get 1 form for each reinbursement area and then call again next month for the same? go to the library and make copies x10 at their expense then mail their original records to one exchange (at their expense) only to find out that their records are now lost.
And those pie in the sky videos on you tube, give me a break. If i were to do an instructional video i would make sure i had all my ducks in order first, instead of causing more confusion.
I wish to add another comment in regard to my posting of Feb. 17. In my post I state, “I am told something different each time I call” One Exchange. My call to them yesterday, Feb 18 proves this point. I spoke with three different people, and am finally told that all the information given to me on Jan. 30 was INACCURATE. (Two people actually gave me that information on Jan. 30, plus telling me exactly how to fill out the forms….which proved to be unnecessary.)
Therefore, I am posting this to ask anyone reading my post of Feb. 17 to please disregard all of that. Even though I was assured at the time I was following the correct procedures….I was NOT. NONE of it is correct!
I will not get reiterate the incorrect information from my last post, and all of the changes I have had to make including resubmitting of paperwork for reimbursement. My point here is that you cannot trust One Exchange for telling you the right thing to do when you call. I wonder now if I was told the correct procedure yesterday?! Who is right?
This is not a discussion about the necessity of OPERS having to do this in order to preserve funds. However, OPERS’ selection of One Exchange as the intermediary to carry out this reimbursement program is questionable. The inaccuracy of information, poor training of employees, and incredible general poor handling of customers is beyond the pale. If I ran a business doing these things I would quickly be out of business! Is Tower Watson One Exchange the low bidder, I wonder?
To top off the whole conversation with them yesterday, I was also told that all of the funds placed in my HRA account had been removed, as of a particular date ! As you can imagine, I asked “why?” They said, “We don’t know”. Another individual then said the funds had been replaced at a later date. “Why?”……”We don’t know”…..and so forth….
Good Luck folks! If you can handle the stress of dealing with One Exchange, you can do anything!!
Cynthia,
One thing we know for sure: Connector participants can set up automatic reimbursements for spouses.
–Ohio PERS
The video was informative. For that I thank you.
Unfortunately, my personal experience with signing up for auto reimbursement and also filing manual reimbursement has turned into a nightmare – still unresolved. Unlike the video stating that One Exchange has sophisticated software and never by signing up for auto reimbursement and also signing up for manual reimbursement would that result in a duplicate reimbursement to the retiree from their HSA account. To the contrary, my mother and I did the duplication and it did result in a duplicate reimbursement. We both were paid twice in January because we signed up for auto and also filed manual reimbursement forms. I caught the duplicate, called One Exchange and the representative in Reimbursements said no that can could not ever happen – I must be mistaken. In the second call to a representative in Funding, I was greeted with OMG you should never have done that (I did it on the form One Exchange mailed to me and sent it in December because a One Exchange representative told me to do it). Unfortunately, because of what I did, I was told that the only way to stop the duplication from recurring in both my mother’s account and my account was to send them a cancellation form and send a check (in the full amount of the overpayment) to FlexPay and that the money would be returned to our accounts. I did just that on 1/22/16 (overnight Express for a cost of $29.95 each) and mother’s account appears to have been manually corrected by One Exchange, the overpayment money returned to her HSA account and no further duplications have occurred. However, mine is still not corrected as of this date, even though I have called and talked with them multiple times. Finally, a One Exchange supervisor found the check I mailed them on 1/22/16 for my account and they returned the funds to my HSA on 2/11/16. But, my HSA still shows that I am in overpayment status (which means the other manual premium reimbursement form I had sent for my Medicare Premium can not be processed – according to One Exchange until this is resolved). My bank says no duplicate payment was made to me from my HSA for February. One Exchange says that there is an overpayment for February. The amount of the overpayment is fluid to say the least. I have gotten two statements with two different amounts of overpayments and was told not to write anymore checks until this gets resolved. In my last conversation the other day with a One Exchange representative in Funding, I agreed with them not to follow-up with them until after March 1st in hopes that the computer might right itself. But, if the computer does not right itself, I was told that I would need to ask One Exchange to assign me to someone in Research and Resolution in order to have One Exchange be able to correct my account because the other representatives I have talked to can not resolve the issue. And, unfortunately the one supervisor at One Exchange that I talked to and that found my personal check and got it deposited on 2/11/16 (for which I am grateful), promised to get to the bottom this and call me back but never has. Not even a call to say, hold tight we are working one this. No follow-up whatsoever. Leaving me to just hang in wind.
So, my experience shows that a computer program is only as good as the HSA account holders accurate document submission and One Exchange representatives ability to accurately review, approve. code and upload documents so that the computer can read them and make its sophisticated decisions.
If this ever resolved, you can bet I will never, ever file a manual form on an premium that has auto reimbursement.
I was told by OneExchange never to file a manual reimbursement for myself (that it would cause dual reimbursement as you experienced). Then told that my husband was “ineligible” for auto reimbursement, which is untrue. And at a later date that I should file for manual reimbursement to expedite reimbursement, which I did. This is also advised by OPERS as we see in the video! Now I see what a mess that will become from your post! (Please check out my posts for my nightmares…stay tuned for more).
OneExchange employees are at best incompetent! I feel your pain.
I have a comment about submitting multiple claims for reimbursement. I mailed a claim for Part B reimbursement to Nebraska, the address on the original forms, which was the wrong address. I then mailed the claim again to the correct address in Texas. I had heard nothing and got worried because they had no record of receiving either of my mail claims, so I resubmitted the same claim by fax. Eventually, I got reimbursed for the Part B reimbursement based on one of the claims. The other two were denied. It must have created a headache for One Exchange, and my HRA account shows a bunch of denied claims, but I did not get duplicate reimbursements. If I had it to do over again, I would not have submitted the same claim multiple times, but it was new and I was worried about the reimbursement process and got impatient.
Have contacted one exchange 3 times now and we are more confused than ever. You get different answers each time and are different then on the OPERS vidio. I am told my dental & eye care can now be done on reacuring reimbursement form but I have to have more proof of payment than the OPERS health care premium receipt we can get online that show deductions made. On Medicare B for us who do not get SS check I don’t know what to do there as I have nothing that shows how much PERS is paying even though I know it’s $31.80 and what form to use now. On paying some of my wife’s under 65 health care they didn’t know what I was talking about. I think you should put proper sample filled in forms on line with what you need to send in as proof of payment that they will accept. Where can I get the information they say I need. I have never been at such a loss of what to do now.
Chuck,
You can’t use the recurring reimbursement form for dental or vision coverage purchased through OPERS. We are working to change this, so in the future you might be able to do so.
Regarding the Medicare Part B reimbursement, you can set up a recurring reimbursement for that. Your proof of payment does not have to indicate the amount we are refunding. You can just request reimbursement for your premium less that refunded amount.
–Ohio PERS
Same thing happened to me! Unacceptable is correct!
For all experiencing the pain of dealing with OneExchange incompetency:
Here is a 2015 post on the Glassdoor website,, a recruiting firm, which includes company reviews by employees:
A OneExchange former employee in West Jordan, UT states:
“Good job for students to have when not in school”…
“This company is extremely unethical when it comes to helping retirees with their insurance. Mistakes made by ill-trained employees make retirees lose coverage….”
“Trainings aren’t long enough, because of the seasonal nature of the positions.”
What I can draw from this and verify is that OneExchange employees are very ill-trained and incompetent! They are students or recently graduated with BA degrees and little, if any, experience!
Could it be, OneExchange was THE low bidder for OPERS? I am all for preserving funds, but should it be at the expense of retirees?
I forgot something…..to add further to my post above:
The former OneExchange employee also states in a comment to OneExchange:
“Look at doing a complete overhaul before Medicare or the AG comes knocking on your door.”
Would this give you pause to reflect…?
I received on Feb. 19 a letter from OneExchange containing 5 pages of denial of reimbursements, which was caused by them, by requiring me to submit recurring reimbursement forms, etc. All of this, as stated in previous posts, was NOT required and inaccurately generated by OneExchange. Basically, it was an exercise in futility on my part because I actually believed what they were telling me.
Beyond that, the envelope also contained a request for me to RETURN my Jan reimbursement for my Silverscript premium payment. Since my husband and I are supposed to be auto-reimbursed, we did both receive reimbursement for these payments, which were deposited into our respective checking accounts. Now they want one of these back. I am truly mystified by this! And, I had been thinking they got this particular reimbursement right and in a timely fashion! Nope!
Now starts another round of phone calls to OneExchange, which takes at least up to three hours ( to speak with someone who may know something? )
Can we get reimbursed for “waste of my time spent with incompetent persons employed by OneExchange”?
I too have had a number of problems with Oneexchange. When you call, the agents seem to “kick the can down the road” by telling you to wait and the reimbursement may come. I cannot understand why the auto reimbursement is such a problem. Oneexchange had from October 2014 until 1/2016 to develop, test, and deploy automated systems for reimbursement. Why was not the auto reimbursement ready to go when the connector HRA started.
I have had all the same problems as others, you get different answers from each person you talk to. I have contacted them three times now and am more confused than I was when this mess started. They tell that OPERS dental and eye care can be put on reacuring forms but I must contact the provider and get a letter stating amount and coverage dates ? On the Medicare part B I have to have something from OPERS stating they pay $31.81 that I can’t find or print out. On paying a part of my wife’s under 65 insurance they didn’t know anything about this. PERS should show filled out forms along with what type of proof of coverage or payment is needed. At least I know I have $700.00 in my account, I just can’t use it.
When I sent my claim for Part B reimbursement, I included my “Benefit Change Notice Statement” that I received from OPERS the first of the year. It comes out once a year to tell us our new monthly benefit for the year. It shows the $31.81 reimbursement from OPERS for medicare. This letter is not available on line. I don’t know why. If you can’t find yours, maybe OPERS will send you a duplicate.
Reading these comments is terrifying. I won’t be on one exchange until July 1st.,2016 but I am so afraid of all of this. I don’t have a computer, only a tablet. Dont own a fax or a printer and can’t afford these things so I am not buying them. I don’t have anyone close by to help me out either. Is this mess going to be like this when I get enrolled???? Somebody better be checking this out. My stress level will never be able to handle this.
Nancy, by the time you start doing this, most of the bugs will probably be worked out. When you sign up for insurance through One Exchange, ask for automatic reimbursement of any premiums. Then, once the insurance company tells One Exchange that you have paid your premium, your reimbursement will be automatically deposited into your checking account. You can submit claims for other reimbursements (doctors visits, drugs, etc.) by mail. You can download the forms or ask One Exchange to send you the forms by mail. Once you get one, take it to Fed Ex or the library or somewhere with a printer and copy several. I send all of my claims by mail and it has worked. Might be slower than via fax or on line, but it does work. Once you are ready to submit a claim, I also copy everything before I mail it. Don’t stress too much about this. For many people, things have worked smoothly without any problems, and most of the bugs will be worked out by the time you are doing this.
Nancy,
I would suggest that you go to Medicare.gov and find the Medigap and Advantage plans available in your area. Also, if you are taking any medication, there is a Part D (prescription) plan finder available where you can enter your medication to find the best plan for you. One Exchange may not offer all of the plans available to you, but you can always ask them. I know when my husband signed up, we asked about United Healthcare, even though they were not listed on the OE website, but the plan was available to us. I would do this before contacting OE so you have an idea of which plans and companies you may be interested in. Plus, it’s good to know the differences between an Advantage plan and a Medigap plan, so that you can make a good decision.
You don’t have to sign up for any of the plans on the first conversation with OE. You can gather the information and call them back several times before making a decision. Some of the employees there are much more knowledgeable than others, and I just would not depend on any of them for much direction in choosing a plan.
Expect to wait a month or two before receiving reimbursement. Since you will be signing up at a slower time, you may receive the first reimbursement the following month. After the first reimbursement is received, it generally occurs on a regular basis each month.
Just make sure you provide the correct documentation along with any forms (that seems to vary from person to person, though – I guess depending on the OE employee who receives the form.)
Mary
Nancy Hoffman, that is a good suggestion to look on medicare.gov for medical and drug plans. I knew I wanted a medigap plan and a prescription drug plan, so I did not look at advantage plans. I don’t know if they are rated by medicare. The drug plans are. You can put in a list of your drugs and then medicare will list which plans you can purchase. You can ask for the list according to price–the cheapest plans to the most expensive based on your drugs. The plans are also rated by medicare from 5 stars (the best) to one star (the worst). 3 stars is average. You can read about the ratings per plan–what the plans were good at and/or why they were bad. The two plans that were the cheapest for me were rated 2.5 stars (below average). Those two plans were not offered by One Exchange. I didn’t want them anyway and I was glad One Exchange was not offering plans that were rated below average by medicare. All of the plans listed by One Exchange were 3 stars or better. So when you check on medicare, in addition to price, look at the plans ratings.
Thought I did every thing I was told to do to sign up with One Exchange in December and that I would have a HRA available for reimbursement. Called OE yesterday and was told I had no HRA account. Called OPERs today and told my HRA was “deferred”. OE now tells me ” a ticket” has been summitted and I must wait 4-6 weeks to be able to receive any money while they process the”ticket”. When I ask to speak to a supervisor I am told they are in a meeting . I am put on hold and am never connected to a supervisor. Same thing happened yesterday. Maybe if the supervisors had less meetings and actually supervised they might do something right.
They are keepin the money in their bank account as long as possible to earn interest and will all go to jail eventually…
C,
We’re not sure what you’re talking about. If you are implying that OneExchange is hesitating to pay premium reimbursements to make interest on the funds, that is a false assumption. OneExchange never has OPERS health care funds in its possession.
–Ohio PERS
I truly feel bad for the 50 or so retirees that have posted here their nightmarish experiences with this transition to the open market. And I do agree that when OneExchange ramped up their staff to handle the OPERS retirees, that many, many representatives were ill-trained and unprepared to help us. I found some to be extremely knowledgeable and some to be “lost in space”.
On the other hand, so many have commented that OneExchange has been incompetent since they had months to prepare for this enrollment. Well, SO DID WE!! I don’t understand the mind-set of those who sat back and waited for their enrollment call without doing as much research as possible beforehand, either on the web at medicare.gov or sites like ehealth.com, or by calling medicare, or going to the library, or talking to friends and family already on medicare . . . the sources of information are plentiful. Why would anyone put all their trust in a company we’ve never heard of to guide us to make such important decisions without having enough knowledge ahead of time to be comfortable that they were making decisions in our best interest?
And lastly, since we had months to prepare for this reimbursement arrangement, why wouldn’t we think to set a little money aside to cover expenses until the bugs were worked out of the process. I can’t even imagine the chaos at OneExchange when thousands of reimbursement requests came pouring in in the first few weeks of January. The first reimbursements were very slow, but my March reimbursements are coming in on time and without a hitch. We were never reimbursed for our vision and dental coverage premiums, but suddenly it seems to have become a major financial factor for many.
I think the transition to the open market and the function of our HRA has happened without major incidents for the vast majority of our members and I applaud OPERS for again showing why they are one of the best Public Retirement Systems in the country.
Tom,
Thanks for your comments. We are not seeing anywhere near the volume of member comments about the HRA process now that March is here and we believe the automatic reimbursements are starting to be paid regularly.
–Ohio PERS
How do you KNOW people were not prepared? Or, that they thought they were? Regardless, they had great difficulties dealing with employees at OneExchange who did not have the correct information.
The many (not just a handful here) people affected have every right to complain about these organizations that should have been better prepared. OPERS TRUSTED OneExchange and asked their retirees to do the same! They spent a lot of time and money through publication of slick, four-color publications, and mailing of same. I certainly was one who trusted OPERS and OneExchange and, btw, also spent much time researching options. In the end, OneExchange was still the only option.
Should OPERS NOT know of complaints? Should OneExchange NOT know about the incompetency of their newly hired employees? OPERS gave them over 140,000 retirees to deal with and OneExchange was not prepared. That is the simple story.
Did it ever occur to you that many people may have needed help, were ill, confused, did not know where to turn, did not have transportation, own a computer, have real financial problems, etc.? And, yet, did the best they could in their circumstance.
OPERS acknowledges that 85% of retirees are satisfied with their experience,
It seems as though they aren’t much concerned about the other 15% — some 21,000 retirees! 85% percent satisfaction rate doesn’t help the rest of us.
Tom B, not everyone has “a little extra” money to set aside. I applaud you if you are fortunate to be able to do that. I, for one, did not and do not, unfortunately. So being reimbursed for what I had to pay just before Christmas, was a matter of paying a light bill, gas bill or buying food to put on the table.
I am having problems dealing with one exchange and in calls to OPERS trying to solve problem my luck hasn’t gotten any better. I currently receive retirement through OPERS and I am also eligible for tri care due to being retired military. When I made my enrollment call in October 2016 I was told I was enrolled. Now today when I called the connector they stated I wasn’t enrolled because I didn’t enroll in a plan through them. Why doesn’t Tri Care qualify as an insurance co. They stated I must enroll in a plan through the exchange to get reimbursement for Medicare part B premium. This is a waste of OPERS funds in making this requirement. This is not even a good business decision. Why would I not enroll in the most expensive plan available instead of a cheap plan since OPERS is waisting money on this requirement.
Herbert,
As we answered you in your previous blog comment on this subject, in order for you to receive contributions to your HRA, you must be enrolled in a medical plan through OneExchange. There are plans that coordinate with TriCare, and that’s why we wanted those with TriCare to speak with OneExchange to try to find a plan for them.
So the OneExchange representative was correct in that you need to enroll in an insurance plan through the Connector in order to participate in the HRA.
–Ohio PERS
Received a deposit from PayFlex ?? 3/21/2016 for $274.12. I logged on to our OneExchange account but could not figure out how the finding department came up with this amount. Reimburements use the generic term ‘premium’ which is useless instead of entering the specific insurance company name. I called the funding department and the explanation of the payment follows…$25.10 x 2 = $50.20 for Aetna part D, March. Last week I faxed a quarterly Medicare premium reimbursement form to them for $269.97. They also paid 2 months of this premium at $89.99 and paid the 3rd month at $43.94…since that was all the money left in my account. So they owe me for a partial months payment of $46.05. I understand the reasoning for this but #1 how am I suppose to figure this out using the online information provided and #2 because of the partial payment, I now need to track that I’m owed a partial payment of $46.05 which will also make the following reimbursements confusing.
There needs to be a better way to track these reimbursements. Our online account should show the exact information that was just explained to me and state partial payment info, etc. We should not need to call these people for clarification.
Thank you.
I received a letter from OneExchange today apologizing for the difficulties that I have encountered. It states that they are working hard to improve my experience. To that end they will now be charging me $2.33 per month and making sure that I will not be getting my deposit into my account before it is due. So their improvement is simply collecting money from me, What a joke. When were we ever told that we were going to be charged to participate in OneExchange? OneExchange is collecting close to $250,000 per month from OPERS retirees to do nothing but be a clearing house for money that is due to the retiree. How long is the contract with OneExchange and what recourse does OPERS have against them for their poor customer service?
I just received a letter from OneExchange advising me that they had “inadvertently” neglected to charge retiree HRA accounts an “administrative fee” for the first three months of 2016. Those of us who have witnessed the abysmal performance of OneExchange in administering the HRA accounts were probably not surprised by this further example of their incompetence, and also believe it’s entirely appropriate that they will not receive those fees. To have retroactively applied the fees would have “added insult to injury” for thousands of retirees who have struggled with the process. It remains to be seen whether OneExchange deserves to receive the administrative fee in future months. Incidentally, this was the first time I heard of such a fee. I assumed that OPERS would pay any charges associated with HRA administration – I must have missed my notification of the fees by OPERS.