Answers to OPERS member questions

This month: Learn about health care open enrollment for 2025

By Michael Pramik, Ohio Public Employees Retirement System

Nov. 22, 2024 – Members and retirees often ask us questions through our social media channels that others could benefit from. Periodically we post these questions and answers in our PERSpective blog.

Because we’re in the midst of open enrollment for 2025, this month we’re answering questions about health care for next year.

Q: I’m Pre-Medicare, and I didn’t opt in to the HRA last year. What do I need to do to opt in during open enrollment?

A: You can change your funding decision through your Via Benefits online account each open enrollment period and your new election will take effect January 1 of the following year. Sign into your online profile and select Your Funding Decision to make changes between now and Dec. 15.

Remember, though, that opting in to the HRA is not the same as having medical insurance. While you’re free to secure coverage on your own, we recommend scheduling an appointment with a Via Benefits licensed benefit advisor to review your options and then enroll in a plan.

Q: I’m a Medicare retiree, and I’d like to keep things the same next year. Do I need to do anything?

A: We encourage you to review the 2025 medical and prescription drug plan details provided by your plan administrator. Look for changes in premiums, plan design and prescription drug formulary. If you’re unsure of any changes to your medical plan for 2025 or have questions, reach out to Via Benefits.

If then you discover you’d like to make any changes, contact Via Benefits by Dec. 7 at 1-844-287-9945. An appointment is not required. 

Q: Am I able to get health care outside of Via Benefits and still receive contributions to my HRA from OPERS?

A: If you are Pre-Medicare, you can secure coverage anywhere you’d like and still receive money from OPERS after you opt in to your Health Reimbursement Arrangement. We do, however, encourage you to review all of your options with Via Benefits.

If you’re a Medicare retiree, you must choose a medical plan through Via Benefits in order to receive the HRA contribution.

Q: I’m over 65. Can I purchase a medical plan through Via Benefits then go on my own for prescription drug coverage?

A: Yes. You can secure Medicare Part D coverage on your own, but you do have to sign up for a Medigap or Medicare Advantage plan through Via Benefits in order to receive HRA contributions.

Q: How does the HRA work if I return to employment?

A: A re-employed retiree is one who is receiving an OPERS pension benefit and is also employed in an OPERS-covered position. This includes re-employment in a full-time, part-time or seasonal/occasional OPERS position. Classification of a re-employed retiree is not dependent upon contribution or earnings.

In the event you become re-employed by an OPERS-covered employer, you must inform the employer that you are receiving an OPERS benefit. If you know of your intention to become re-employed when you apply for retirement, you can provide that information within your retirement application.

Potential re-employment plans should be discussed with the employer to determine whether there are any restrictions or policies on re-employment. Contributions to OPERS must begin from the first day of re-employment.

There are additional implications if you are re-employed in an OPERS-covered positions. We recommend reading the section on Re-employment and the HRA on the OPERS website if that applies to you.

Q: I’m an OPERS retiree who’s under 65, and I’m covered by my spouse’s medical insurance. Do I still receive HRA deposits?

A: Yes. The Pre-Medicare HRA is an “open” HRA, meaning you receive contributions as long as you meet eligibility requirements. You can use the funds within your HRA to be reimbursed for qualified out-of-pocket medical expenses such as deductibles and copays. You also can be reimbursed for premiums, but the premiums have to be paid on a post-tax basis.

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.

Michael Pramik

Communication Strategist

3 thoughts on “Answers to OPERS member questions

  • November 22, 2024 at 1:25 pm
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    Medicare Supplemental plans can either be community-rated (everyone is charged the same price regardless of age, and age-issued plans that increase by age. My concern is whether OPERS will keep up with rate increases for the age-issued plans. It seems that the community-rated plans may not increase as often. Also, VIA benefit plans don’t tell us whether plan pricing is community rated or age-issued.
    Some discussion of this can educate pre and retired OPERS individuals.

    Reply
  • December 2, 2024 at 12:06 pm
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    If I’m not making any changes to my Health, Vision and Dental plans for 2025 do I need to do anything!

    Reply
    • December 4, 2024 at 4:19 pm
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      No action is needed if you’re satisfied with your dental and vision coverage, it will automatically continue for 2025. Unless your insurance carrier advises you otherwise, your current health care coverage should automatically be renewed for 2025. For questions pertaining to your health care supplemental plans, please contact Via Benefits directly. Thank you, OPERS

      Reply

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