Health care open enrollment is under way

Separate dates are set up for Pre-Medicare and Medicare retirees

By Michael Pramik, Ohio Public Employees Retirement System

Oct. 10, 2024 – Open enrollment season 2025 is here for the OPERS health care program. OPERS has begun mailing enrollment materials, and all eligible benefit recipients will receive an open enrollment packet.

We’ve updated our website with the latest information about this year’s open enrollment period. Pre-Medicare open enrollment runs from Nov. 1-Dec. 15, while Medicare open enrollment is from Oct. 15-Dec. 7. OPERS vision and dental open enrollment runs from Oct. 15-Dec. 15.

For those eligible for the OPERS Health Reimbursement Arrangement, the open enrollment statement will provide the monthly HRA deposit you will receive in 2025. The OPERS Board of Trustees approved an increase in the HRA base allowance for Medicare retirees and voted to maintain the Pre-Medicare allowance at the current level.

The current base allowance of $350 per month for Medicare retirees will increase to $400 beginning in January and is expected to remain at that level through 2030. The base allowance for Pre-Medicare retirees is currently $1,200 per month and was scheduled to reduce to $1,000 per month in January. Instead, it’s expected to remain at $1,200 per month through 2030.

“Base allowance amount” refers to the maximum amount on which an individual’s monthly HRA allowance is based. Depending on their age and years of service at retirement, benefit recipients receive between 51% and 90% of the base allowance amount.

Those who are opted in to the HRA will receive the following open enrollment materials:

• Personalized statement which features your 2025 monthly HRA deposit amount and premiums for the OPERS vision and dental plans
• 2025 OPERS Health Care Program Guide, which provides information about eligibility for the health care program, the OPERS HRA, Medicare requirements and the OPERS vision and dental plans.
• Vision/Dental Open Enrollment Change Form to submit if you wish to enroll, make changes to or cancel your OPERS vision and/or dental coverage

Pre-Medicare benefit recipients

• Review the 2025 medical and prescription drug plan details provided by your plan administrator or insurance carrier. Depending on the administrator/carrier, you may receive this information in the mail. If not, visit the plan administrator’s and/or carrier’s website. Look for changes in premiums, plan design and prescription drug formulary.
• Enrolled in a plan through Via Benefits and have questions about your coverage in 2025? Contact Via Benefits between Nov. 1 and Dec. 15. You can opt to schedule a phone appointment with a Benefits Advisor to review your medical plan details for 2025 during this time period, but an appointment is not required.
• Review your funding situation. You can change your funding decision each Open Enrollment period, and your new election will take effect January 1 of the following year. Sign in to your online profile and select Your Funding Decision to make changes between Nov. 1 and Dec. 15. Remember, opting in to the HRA is not the same as having medical insurance. If you are eligible for the OPERS HRA and you choose not to opt in, you are essentially turning down funds that you could use to be reimbursed for qualified medical expenses. This is not something that is deducted from your monthly pension benefit.

Medicare benefit recipients

• 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 are unsure of any changes to your medical plan for 2025 or have questions, reach out to Via Benefits.
• Enrolling, making changes or canceling coverage? Contact Via Benefits between Oct. 15 and Dec. 7. You can call Via Benefits and schedule a phone appointment with a Benefits Advisor to discuss your 2025 medical plan, but an appointment is not required. Selecting a Medigap plan may require medical underwriting.
• Remember, you must enroll in or remain enrolled in a Medicare medical plan through Via Benefits to continue receiving HRA deposits.

OPERS vision and dental plans

Open enrollment is your opportunity to enroll in, cancel or change OPERS vision and/or dental coverage for yourself and any eligible dependents for 2025.

• Not making changes to your OPERS vision and dental coverage? No problem. Your enrollment will automatically continue in 2025.
• Enrolling in, making changes to, or canceling vision or dental coverage? Fill out the form provided in your open enrollment packet. You also can call OPERS between Oct. 15 and Dec. 15 to change your plan level or cancel coverage. If you decide that you don’t want OPERS vision and/or dental coverage in 2025, enrollment for you and your dependents will NOT automatically terminate.
• If you’re enrolled in a vision and/or dental plan with both OPERS and Via Benefits (or another third-party provider), take some time to review your coverage needs to determine if both plans are needed. Enrollment in the OPERS plan(s) is for the entire calendar year and cannot be changed until next year’s open enrollment.
• If you have specific questions about how much the plans pay for certain services, please visit metlife.com/opers, or call 1-888-262-4874.

For your convenience, OPERS sends a notice of your paid premiums for all those enrolled in the vision and/or dental plan(s) to the OPERS Connector for automatic reimbursement from your HRA. To view and/or update your automatic reimbursement preference, log into your account and select View Accounts under the Funds & Reimbursement section, or contact Via Benefits at 1-844-287-9945.

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.