Welcome packet details HRA reimbursement
Participants in the OPERS Medicare Connector will be reimbursed for qualifying medical expenses through a Health Reimbursement Arrangement upon enrolling in a medical plan through OneExchange.
OneExchange, the Connector administrator, will send participants an HRA welcome packet about two weeks after they complete their enrollment process. Be sure to review all the materials within the packet, which includes a quick-reference guide, claim form, list of eligible expenses and a “Getting Reimbursed Guide.”
The HRA is effective Jan. 1. Participants who must pay their January premiums upfront can submit a claim for reimbursement against their January allowance amount. This is the only type of expense that can be reimbursed during 2015.
The packet will cover many other topics of interest to Connector participants, such as:
- How the reimbursement process will work
- Important terms
- Information on who to pay
- Frequently asked questions
You can track your HRA allowance and status of reimbursements, as well as set up automatic reimbursements, either by logging into your OneExchange online account or by calling OneExchange at 844-287-9945.
You also can submit requests manually online, by fax or by mail. This process, too, is explained step-by-step in the Getting Reimbursed Guide.
OneExchange recommends saving the documentation you receive from your health care providers, including premium statements, explanation of benefits statements and monthly prescription plan summaries. Also retain documents sent to you by OneExchange.
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.
135 thoughts on “Welcome packet details HRA reimbursement”
Why can’t the packets be sent out now? I couldn’t schedule my enrollment call until December 15th, sooner times were not available. If it takes two weeks for the packet to be sent, it will be 2016 before I receive mine.
The packets are being sent only to people who enroll through OneExchange, so naturally it has to take place after the signup. If you’d like to sign up before your enrollment call, you can call OneExchange. You really don’t need an appointment.
A lot of the information, including the Getting Reimbursed Guide, is already posted at the OneExchange OPERS portal.
Will we be reimbursed for eye care bills, dentist bills, etc. We need to know what items will be eligible now as we are currently making dental and vision plan purchases for next years. It is totally unfair to withhold this information.
Yes, it would be unfair to withhold that information. That’s why it’s posted on the OneExchange/OPERS website.
Please send me these things via email.
We send these through the mail after participants choose a plan.
Why can’t the reimbursement packet be sent now? If the procedure is the same no matter what plan is selected, it would be useful to have this sooner rather than later. All of this takes time to absorb. We need the time to ask questions and not more time to worry over unknowns.
The HRA packet is sent only to individuals who actually enroll through OneExchange. It’s very specific to just enrolled participants. Remember that you don’t have to wait until your appointed time to enroll. You can call OneExchange any time.
Also, you can read the Getting Reimbursed Guide on the OneExchange/OPERS website.
why couldn’t they send this out ahead of time? If the procedure is the same no matter what plan is selected, it would be useful to have this ASAP so we can see if we have questions.
It shouldn’t be a deep dark secret.
The HRA packet is sent only to individuals who actually enroll through OneExchange. It’s very specific to just enrolled participants. Remember that you don’t have to wait until your appointed time to enroll. You can call OneExchange any time.
Also, you can read the Getting Reimbursed Guide on the OneExchange/OPERS website.
Are they doing an deposit in our HRA account before the first of the year. I thought I read that on one of the blogs or listened to a web messages that was given out in the last few month. Thank Loretta Blankenship
Your first deposit will be two weeks after you sign up for a plan.
I have two separate bank accounts, one for my OPERS pension deposit and the other which will be used for the HRA (to pay premiums and to get the HRA monthly deposits). Does OPERS need to be informed of the separate bank account as well as One Exchange? Also, will the $300 paid by OPERS at the beginning of the year go into the pension account or the HRA account?
The $300 will be credited to your HRA. The bank account that you will have linked to the HRA is preset as the account to which we deposit pension benefits. But you can change it through your OneExchange online account. Details are on page 7 of the Getting Reimbursed Guide, which is sent as part of the HRA welcome packet. You also can view this guide on the OneExchange OPERS portal.
can we have two direct deposit accounts? my monthly pension amt is now deposited into my main account. I have another account that I’d like to use for the HRA deposits rather than having them go into my main account. I downloaded the guide and it does explain how to set up a direct deposit account but not about having two. I do want to keep my monthly pension amt to continue going into the main account. Thanks!
You certainly can have two accounts. We recommend calling OneExchange to provide the banking information for your HRA account.
I still have not received any info about what I am supposed to do. When do I contact one exchange etc.. I am one of the people who worked for State only and don’t have part A medicare. Yes I realize part A will be paid for, but that’s about all. I have received nothing since the packet Opers 2016 Connector Readiness Kit, that was sent to all retirees. I keep watching the Connector readiness videos, but nothing ever mentioned about the rest of us. Kind of disappointing.
We have a schedule for those who did not qualify for premium-free Medicare Part A coverage. Please watch our latest video on this subject for more information.
Unless I missed something in the packet HRA reimb I noticed a link on the One Exchange cite for reimbursement electronically thru Pay Flex according to their disclaimer looks like if you sign up and agree to the disclaimer you then become a member, also looks like there will be a charge for this and also a charge for submitting claim on your HRA acct, since I did not sign up because I have no idea what the charge will be and also if there is a charge for each additional claim.
It’s a $2.33 per-month administrative fee. Not per transaction, but per month.
Why is the Retiree’s being charged we were never told why?
We’re telling you why right now, before the fee is even collected. It’s for administrative expenses, the costs to operate the HRA.
I thought I’d asked about this but can’t find it now. I’ve tried to find the link on the one exch site about administrative charges, amts, etc but cannot find it. How will this be charged/debited? where is the link? TIA.
We’re not sure there is a link. It’s going to be $2.33 per month, not per transaction, charged to the HRA.
Please send one of the packets with the calendar and the selection process. I don’t recall seeing this packet.
We sent the packets only to members going through the initial transition to the connector in January 2016, which means they were to turn 65 before Feb. 1, 2016. The readiness packets are available online.
People who turn 65 after that date will receive Medicare “age-in” materials. Call us at 800-222-7377 if you have questions.
Will our current HRA account balance become part of the HRA account through OneSource?
There is no past HRA. You might be referring to the Retiree Medical Account, or RMA. Our current plan is not to combine the two.
Michael, are you going to address the fact that our HRA will lose any additional money left in 2017 and start over ? I was under the impression it woiuld carry over month to month, year to year. I think with the Medicare premium allowance, would keep it wiped out anyways, right ?
There is no truth to what you are saying, and we’re sorry if you have misunderstood. The money in your HRA will continue to grow if you don’t use it. It will roll over to the next year, and you will never lose any additional money that you have built up in your HRA.
The annual $300 deposit will be placed into your account for three years, in January of 2016, 2017 and 2018. The monthly HRA deposit will go into the account within two weeks of your signing up for a medical plan.
Thanks Michael. I revisited The Connector with a different agent and told her what I had been told by Femi ! She says the only explanation, he was confused by another company .
The people at One Exchange could not give me a answer what counts in the Drug Donut Hole
We address the donut hole in this video about pharmacy coverage.
I watched the Video it didn’t say whaqt counted
That information is available from Medicare.
When asked about when they would deposit the HRA funds. Med-Gap Plans you are required to pay up front. They would only say it could take up to 90 Days for the Reimbursement the first time. But it might take 3 to 6 weeks for paper claim. I asked about the 300.00 HRA dposit that your office said was given to them on Oct 1. They said they did not know anything about that. Question does anybody know?
For auto-reimbursement it could take 2-3 cycles
We recommend that Connector participants plan to request a manual reimbursement for at least the first premium and that it could take a few weeks to get it. Regarding the $300 HRA deposit, that will be made in January to your HRA account. I don’t know you mean by “they,” but we’re not sending that money to an outside party.
I’ve called OPERS several times and the line automatically disconnected each time. The call goes directly to voicemail and the call disconnects. I did not received the HRA packet mentioned above.
YOUR VIDEO ON THE DRUG GAP DOESN’T EXPLAIN WHAT COUNTS WHEN YOU GET IN THE GAP. I HAD TWO DIFFERENT ANSWER FROM ONE EXCHANGE. TALKED TO THE DRUG STORES THEY WILL NOT GIVE YOU ANSWER BECAUSE OF THE OBAMACARE LAW. WHO WOULD YOU CALL TO GET AND CORRECT ANSWER.
You’re correct. We didn’t go into that amount of detail. Here is a link to a Medicare website page that describes what counts for the donut hole. Your best resource for this information is Medicare.
Besides being able to set up an auto-reimbursement for the supplemental plan that I choose, will I be able to also set up auto-reimbursement for all or any of the following? 1) my part “B” medicare monthly premium 2) my monthly premium for my chosen part “D” plan, and 3) my wife’s monthly Medical Mutual premium that is withheld from my OPERS pension.
All of the expenses I have listed above will remain consistent and if I’m able to set up auto-reimbursement for them, it will greatly simply the work I must do each month in order to get re-imbursed for these eligible expenses. Thanks.
Auto reimbursement is available for most plans offered through OneExchange. But something like your wife’s premium withheld from your pension may require monthly filing. Please contact OneExchange, or for more information, refer to the HRA section on the OneExchange/OPERS portal.
Is it going to be possible to be reimbursed for Medicare Part B Premiums from the HRA account?
Yes, you can submit Med B premium payments for reimbursement.
have a question about this. the premium is $104 a month and is deducted from my monthly Social Security pmt. We’re then reimbursed for part of this by OPERS….next year it will go down to 1/3 so we would be eligible to be reimbursed through the HRA for the other 2/3. I know that part of the documentation for this would be a copy of the SSA benefit letter we get. Would we submit a copy of the OPERS Benefit Change Notice to document the 1/3 we still get from OPERS? Will the poor souls who have to validate reimbursements figure this out?
Just use the documentation from Medicare that shows you paid the premium and request the smaller amount.
Will the RMA be gone with these new changes?
No, your RMA will not be gone with the change to the Connector.
Should we be setting up a new separate account for deposit of HRA allowances at a bank or credit union???
You can, but you don’t have to. This will be explained in the HRA welcome kit you will receive after you choose a plan. You can view some of this material now at the OneExchange/OPERS portal. (Scroll down to “HRA Information.”)
I have Medicare Part A and have just signed up for Medicare Part B which will begin on 1-1-16 (I have had medical coverage through my husband’s company and he is retiring 12-31-15). We are in the process of choosing a medigap plan. Am I able to choose a plan through AARP or Aetna through the
Connector? I am not sure what this means. Who am I able to get coverage from?
The licensed benefit advisor will help you with that. You also can go to the OneExchange OPERS portal and do your own research before your call.
Is there a document that has to be provided to prove that your Medicare Part B Premium is deducted from your SS check so that I can request reimbursement for that from the HRA account?
How do I prove that my wife’s insurance is deducted from my monthly benefit check so that I can request reimbursement for that from the HRA account?
You can use the Award of Notice or your Social Security statement as documentation for reimbursement.
For your wife’s insurance, beginning in January you can call us to request a receipt for a non-Medicare recipient’s premium amount.
You said “For your wife’s insurance, beginning in January you can call us to request a receipt for a non-Medicare recipient’s premium amount.”
Will I have to request a receipt every month?
There is a Recurring Premium Reimbursement form on the OneExchange website.
Will we still receive a partial Medicare B Reimbursement or is that included in the monthly OPERS allowance deposited into our HRA account?
The Part B reimbursement will continue to be added to your pension benefit.
I was told by a One Exchange staff member and a One Exchange supervisor that I could not use HRA funds for a spouse who was under the age of 65. I have looked at the IRS rules: https://www.irs.gov/pub/irs-pdf/p969.pdf and it appears that the IRS does not have this rule. Can we use our HRA funds for the qualified expenses of spouses under the age of 65?
Our understanding is that premiums and out-of-pocket expenses for any eligible dependent’s health plan is eligible for reimbursement through the HRA. But we are double checking it.
The reason that I was asking One Exchange this question was to see if we needed to make changes during open enrollment. My wife and I are both retired under OPERS. I wondered if we could be reimbursed out of my HRA, if she continued to pay for her dental insurance out of her pension. We were considering switching her coverage to my account. Before today, I had accepted the answer that One Exchange gave us.
The premiums and out-of-pocket expense for any eligible dependent’s health plan is eligible for reimbursement through the HRA.
If I purchase the OPERS dental for $19, can I get that $19 back by submitting HRA claim? If not, what is the benefit to OPERS dental vs dental thru my OneExchange/MedMutual Medicare supplemental plan? I believe I can purchase that using HRA funds rather than my own money (and save $228 annually). Thanks and you do a great job communicating very complex information thru website and print.
Yes, that qualifies as an expense you can submit for reimbursement through the HRA.
do we have to use one exchange or can i use my own insurance agent?
In order to receive an allowance you need to use the Connector and thus purchase coverage through OneExchange.
Yesterday, my husband signed up for AARP Medigap. We had to pay a “binder fee” that will be withdrawn from our account within 48 to 72 hours. Do we get reimbursed for this or only for the actual payment that will begin in December?
The binder fee is the first premium payment. It can be reimbursed.
My wife and I are both retirees over the age of 65. I am set up to receive from the Health Reimbursement Account for 2016 $396 per month and my spouse receives $254 per month for a total of $650 a month. Can I only apply the $396. to my premium alone or can I use some of it toward my spouse’s premium? My spouse’s HRA ends in January 2018, Can I use some of my account to pay for her health insurance premiums?
You can use what is in your account for any qualifying medical expenses. One of those would be your wife’s premiums.
Michael, you stated “It will roll over to the next year, and you will never lose any additional money that you have built up in your HRA.” Additionally that RMA will also remain intact – forever. Both of these “forever” statements scare me. Is there a contract you and I sign that will assure me that both account balances will remain forever (“never lose any additional money…built up in account”)? Not clear what is meant by “additional”. There are several connector advantage plans with zero premiums therefore the HRA money will go unused; which is fine because I’d like to save and accumulate it for when a catastrophic medical event happens – possibly ten years from now. But I need your assurance or else I could select a plan with a $2000 premium…which would not be the most effective use of anyone’s money.
By “additional,” we meant that any extra money you have left over one month stays in your account, and you can use it later. And no, I’m not going to sign a contract with you. However, rest assured that we have no intention of taking anyone’s allowance funds.
Ken, I am 81 and paying $224 a month for Plan F. You are right as far as age related, but I wouldn’t worry that the premium will exceed $ 337. I have had many claims over the past 20 years. I went on disability in 1992.
I just discovered this site and find the comments very interesting! I have my phone appt this Saturday and am in no way ready to make a decision. I feel sick to my stomach! At this point I can’t get past worrying about paying the premiums. The information I received clearly said that we have to pay the premiums first and THEN get reimbursed. If I get a medigap plan with rx plan, it looks like my premiums may well be from $250-300. I DON’T HAVE that much extra each month to pay the premiums and wait to be reimbursed! And I doubt that many do! I don’t understand why they couldn’t have set it up so that once we’re signed up for a plan and OPERS knows what our monthly premium will be, that amount couldn’t be direct deposited into our bank account so we would have it to pay the premium when due. WHAT are we supposed to do!! The info received said that for some plans we will have to pay the premium when we sign up……with what?
The initial deposit of $300…..will we get that before we have to pay the first ins premium and will it be direct deposited or do we have to request it as a reimbursement? I don’t understand how this will work!
We will use a Health Reimbursement Arrangement to provide funds to Connector participants. The first regular allowance deposit should arrive in participants’ accounts within a few weeks of their initial sign-up. This deposit can be used only for reimbursement of expenses incurred in 2016 or later, including January 2016 plan premium payments.
The additional, $300 deposit will arrive no later than Jan. 8. Regular monthly allowance deposits for the remainder of the year should arrive at the beginning of each month.
Michael, I clearly do not understand how the HRA will work! I thought that we had to pay the premium first ourselves and THEN submit a claim for reimbursement for it. Therefore having to use our own money for the premium payment and then get reimbursed. What you’re saying sounds like they will regularly deposit our monthly amount into MY bank account and I can then use it to pay the premium. Which is it?
I am totally exhausted by this whole process. I have gone over ALL the plans on the exchange site. Logically it looks like a medigap plus rx plan would give me the best benefits. BUT I’m 82 and the F and G plans run from about $222 a month plus a rx plan. I don’t HAVE $222-275 extra money every month to pay the premiums up front and wait to get reimbursement!
The advantage plans are less, e.g. a good Med Mutual plan for about $109 a month which I might be able to pay and wait for reimbursement. But the coverage scares me to death! E.G. last year I was in the hospital 3 times and our current coverage was wonderful, I had very little to pay. But now the advantage plans say co-pay is e.g. $195-200 PER DAY for the first 6 days….that’s $1200 I would have to pay!! Don’t have the extra money to do that either!
so WHAT can I/we do??? Eagerly awaiting your solution!
As in any reimbursement-type plan, you would be paying upfront only for the first premium. And, we’re giving you an extra $300 toward that in early January.
Polly, that quote for $ 222 a month is great. My husband has had a Medigap Policy since 1992. He is 81 and pays $224 a month.
I am concerned about what will be needed to be reimbursed for my Medicare Part B premiums. Since I have a small Social Security benefit of $79.00 per month, it all goes toward my monthly premium. I am left with a balance of $25.90 which I should be billed for. However, because I had to pay my entire Medicare premiums prior to be awarded Social Security retroactively for 7 months, I now have a credit of over $500.00 that SS will not refund nor give me any documentation for. I will not be billed for my monthly portion of $25.90 until September 2017, after my credit has been depleted. I will have nothing to supply to anyone as documentation for monthly reimbursement of Medicare premiums. Do I have to wait until the end of 2016 when SS mails out 1099s in order to be reimbursed, which in my case will only show a partial payment?
Please direct your questions to Medicare: 1-800-MEDICARE, or give us a call at 800-222-7377.
I currently work part time. My last day of work will be prior to December 18th. I will ask my City to formally notify OPERS of my status at that time. Can you estimate how long it would take for my January HRA deposits to be done? I signed up through the Connector 2 weeks ago but I have not received the HRA packet. Is this something I won’t get because I am presently working?
Thank you for all of the information found here.
The first regular allowance deposit should arrive in participants’ accounts within a few weeks of their initial sign-up. This deposit can be used only for reimbursement of expenses incurred in 2016 or later, including January 2016 plan premium payments.
The additional, $300 deposit will arrive no later than Jan. 8.
Michael, What happens to the HRA funds when the pensioner dies. I realize no new deposits would be made, but would the spouse still be able to draw on the balance for qualifying expenses until the balance is depleted?
When the pensioner dies, no new deposits will be made through the HRA. However the remaining balance is available to an OPERS dependent, who could be a spouse or underage child. A claim must be made within 24 months of the retiree’s death. If no claim is made during that 24 months, the money will be forfeited.
Does the spouse need to be getting their insurance through OneExchange to qualify to get the remaining funds? When I asked this question to a benefit advisor, I was told any remaining money in the deceaseds HRA account would not be accessible to a beneficiary and OneExchange would keep the money.
No, the spouse would not have to do that. And as we said, in the case of the death of the member, beneficiaries would have 24 months to use the funds remaining in the HRA.
Michael,My retirement date is 12-01-2015. OPERS was very helpful explaining what was happening in December with our health care. My wife is not 65 yet. OPERS has signed her up for a Medical Mutual plan for 2016. My wife has had a Med. Mutual plan that we have paid for with a government subsity for the last 2 years. I have asked a few of OPERS phone operators this question. “Is my wife entitled to, or going to be receiving the subsity through the 2016 OPERS plan?” Please help
There will be a subsidy, but it will be one-third of what it was this year. The spousal allowance is being reduced by a third next year another third in 2017, then will be zero in 2018.
Do the HRA funds earn interest?
The actual HRA “funds” are released to members only as a reimbursement of qualifying health care expenses, so no, they do not accumulate interest for participants.
Mr Pramik, do I have to call my old health care insurance companies, Humana and Express Scripts,
to cancel those policies once I have signed up through One Exchange?
No, you don’t. Those plans will be automatically cancelled for you. You should have received letters a few weeks ago stating the OPERS Humana and Express Scripts plans were terminating on Dec. 31. Sorry if we didn’t get them to you.
I understand there is a $2.33 per month administration fee for each account. Is this correct?
Is there also a fee for each reimbursement from the account?
If there is, how much is it?
Are there any other charges by anyone else or for anything else to our account?
The $2.33 fee is a monthly administrative fee, not a reimbursement fee. That is the only charge to administer your HRA.
If submitting an on-line HRA reimbursement request for dental and vision premiums which are deducted from my pension monthly, what “documentation” needs to be provided? What about the unreimbursed portion (1/3 this year) of my medicare part B premium. What “documentation” is required? Really seems like these could be automated.
OPERS retirees will be able to call us in January to request a receipt, or you may be able to print one from your online account. This information is not automatically transferred to OneExchange because some retirees may choose not to seek reimbursement for dental and vision premiums.
Regarding Medicare Part B, the award notice from Medicare will serve as documentation; however, you can seek reimbursement only for the portion that you have paid.
Well, Michael, we’ve been told from early on that the award notice that we get at the first of the year for the SSA pmt and cost of Pt B premium would be enough documentation for reimbursement. Now, on another forum posting on Jan. 22, you said:
“Here’s the answer to that question: First, pay your Medicare part B premium to Social Security. Once your premium is paid, you will receive or you can request (either by phone or online) a proof of payment letter. Once you have your proof of payment from Social Security, request a Recurring Reimbursement Claim Form from OneExchange. Submit this form along with your proof of payment letter from Social Security. If you receive the $31.81 premium reimbursement from OPERS, please be sure to subtract this amount from the total premium. You can request reimbursement only for the amount you paid, not for the portion reimbursed by OPERS or another source. You do not need to send proof of the portion you are being reimbursed by OPERS; just indicate it on the form.”
I submitted a claim for the Med Pt B premium on 1/18, including that SSA award letter, and so far haven’t heard ANYTHING one way or the other, but I now expect that it will be denied because there was no SSA proof of pmt letter included. And that video opers posted with the One Exch woman giving information was not helpful either! I’ve been so stressed out by this whole debacle for months.
And more…..how will I be notified if claiims have been approved or denied? I assume if approved, I will see the deposit in my bank account. If denied, will they let me know? and will they tell me WHY they were denied? I really feel sorry for those who are paying premiums from their bank accounts….at least one man has said it’s causing them to not have the money to pay bills, waiting for reimbursements.
The information that vision and dental could not be recurring reimbursements could and should have been explained at the beginning, instead everything we got indicated that they could be recurring. Indicates to me that OPERS did not know how the HRA was going to work themselves.
Is it possible to set automatic payments out of my HRA account to cover my Medicare monthly payments? Also my monthly drug premium payments?
What is the quickest way to be reimbursed? And can the reimbursement go directly to my bank account?
How will this HRA allowance be noted on my monthly pension allowance?
As I get older I find bookkeeping is seemingly more complicated. I hope this new experience will not be too daunting! But I do appreciate all the work you have done to continue our health care coverage.
You can set up automatic reimbursements of your monthly Medicare payments, but you can’t set up automatic payment of the premiums. Please read the Getting Reimbursed Guide on the OneExchange/OPERS portal.
Your HRA is separate from your monthly pension allowance.
It is virtually impossible to get through to OPERS and ONE EXCHANGE. I prefer to set up a separate bank account for our health care. If I set up a direct deposit to a new account with One Exchange, can I be assured that my OPERS benefit direct deposit account will not be impacted in anyway.
Yes, you can use a different bank account for your reimbursements than for your pension benefit. There is a form that is easily accessible on the OneExchange/OPERS website.
I will file for reimbursement of medicare B premiums for me and my wife.Since I will be reimbursed by PERS $33 a month for all of next year do I have to subtract this amount from my monthly premiums I pay.
No. Part B premiums are separate from medical premiums that are paid to the insurance carrier. Also, you will be able to seek reimbursement only for the portion of the Part B premium that you actually pay.
Michael, I’m one of those retirees that need to purchase Medicare Part A before I can talk with OneExchange. Have already talked with Social Security and found out I can not go before Jan. 01,2016 to apply for Part A. Also in the past couple of days I’ve received two mailers regarding ending the Humana Medicare Advantage and Express Scripts Medicare PDP to be terminated as of Dec. 31,2015 and both to be replaced with a so-called creditable replacement by both Companies. With all this info I’m facing I have a looming question, SSA says Part A will cost approximately $447.70 per month and the cost of Humana and Express Scripts is right now unknown, but I believe I will be paying out first and it looks like I’ll be doing this according to the mailer sent to me on Sept. 01,2015 for at least six months until I can apply with the Connector. So do I get reimbursed for all of these expenses and couldn’t this expense have lessened by better management? It seems like six months is to long of a time period to take when our retirement monies are involved. Thank You.
You do not say whether you need to purchase Medicare Part A because you didn’t qualify for premium-free Medicare Part A coverage, so it’s not clear how to answer your question. But if that’s the case, please watch this video about how non-qualifiers will gain coverage on the Connector. It will help you with your questions. Or, call us at 800-222-7377.
I’m wondering how this will work? I looked at the hra info online prior to getting the paper copies. They mention submitting a copy of the SS letter we get at the beginning of the year that shows what the Pt B premium will be, e.g. $104 per month. OPERS has been reimbursing us for that (or most of it) but it’s being cut back 1/3 each year. This year we were reimbursed 2/3 and next year will be down to 1/3. So does that mean we submit a copy of the SS letter and a copy of the OPERS benefit change notice from Jan ’16? Are the folks who are figuring out our premium reimbursement going to compute what we should get for the Pt B premium?
Also, don’t know yet what evidence I’ll get from the medigap co re their premium…may only be the entry on my credit card statement (since that’s the only way I can pay it up front). I’m not crazy about submitting a copy of my credit card statement with all the other info on it, e.g. my card limit and other purchases! Maybe I’ll just have to take a black marker and redact everything but the premium deduction!!??? Sound like a lot of fun!
Regarding the Part B question, the retiree is responsible only for requesting the allowable amount (the amount you were not reimbursed for). The retiree signs the form attesting that he or she is seeking the correct amount.
Regarding Medigap documentation, insurance carriers will send a confirmation statement, as well as premium statements, once the policy has been issued. And yes, you should never provide any documentation that includes your credit card number.
I, too, would like to know how the HRA is going to work as the plan I am contemplating getting is with an insurance carrier that does NOT support auto-reimbursement. When I asked the benefit advisor how the reimbursement would be handled, she was clueless. Am I going to have to fill out paperwork each and every month for a recurring bill that has the same cost each month? If that is the case, I will likely change carriers–forcing me to change plans.
My experience when calling OneExchange has been very disappointing. These ‘seasoned’ benefit advisors that we were told would be speaking to us are, I’m afraid, SEASONAL advisors and don’t have much expertise.
We’re sorry that the advisor didn’t meet your expectations. That has not been the norm.
If your health care provider does not support auto-reimbursement, you can fill out a recurring reimbursement claim form that is good for one year. You’d then fill out that form at the beginning of the following year. That form is on the OneExchange/OPERS portal.
It’s my understanding, through-I think-a response on this forum, that for premiums fr companies who do not have the AR listed, we can use the Recurring Premium form that’s in the HRA packet. I plan to ask more about this because I’ll need to use it also, not just for a company on the exchange but for things like the dental premium, the Pt B premium, etc. Can you clarify this?
Not all carriers offer automatic reimbursement. If a carrier you choose does not, you can submit a recurring claim for expenses that are paid regularly. Work with OneExchange to establish this claim, or use the form that’s available on the OneExchange/OPERS Web portal.
From reading this forum and my experience it is the norm that the advisors are poorly trained and give bad information.
According to my calculations I will have spent enough on premiums and drugs to have exhausted my full 2016 HRA allotment by July 1st. If I submit reimbursement requests to One Exchange equal to or greater than the total of my PERS deposit, will they issue refunds to my account monthly until the end of the year as deposited funds become available? I would otherwise be submitting the same documentation more than once – example: my January submission for reimbursement will be about $700 (the cost of my first month of drugs). My allowance is about half of that. Will they “let it ride” and reimburse me as the funds come in? I trust you have reviewed their general reimbursement practices.
You’ve got it right. Once you submit your reimbursement request, OneExchange will issue reimbursements up to the amount of your monthly HRA allowance. The balance of the claim will roll over month-to-month as a pending claim until deposited funds become available.
I assisted my parents with their enrollment call on November 11, 2016. They have received confirmation numbers for their acceptance in the Medigap and Plan D policies they chose. They have not received their Welcome Packet. We are concerned about the date their monthly HRA benefit will be direct deposited as their monthly premiums are scheduled for automatic payment beginning on or about 01-01-16 to 01-05-16. It is imperative that the HRA benefit be deposited and available prior to the premium payment transfer to avoid great financial hardship for them. Please advise when they can expect to receive the Welcome Packet and the HRA direct deposit.
The additional, $300 deposit will arrive no later than Jan. 8. Regular monthly allowance deposits should arrive at the beginning of each month.
The HRA guide should be sent soon after signup. We’re sorry that yours has not yet arrived. Much of the information is contained within the OneExchange/OPERS web portal. Scroll down to “HRA information.”
Kimberly, I hope you will see this note….We have to pay the premiums up front before we can be reimbursed for them….have to provide documentation that we’ve paid them. The How of this is explained in the packet Michael keeps talking about here. I haven’t received mine yet but downloaded it from the One Ex web site to read.
In the materials we received coming up to October, there was one sentence about the fact that we have to pay the premiums UP FRONT and THEN get reimbursed for them. Looking through this stuff I wasn’t able to find that sentence but did find a question in the FAQ section of the 2016 Enrollment Guide that related to this issue. When I realized this I was very upset because, as with your parents, I didn’t see how I was going to find the money to pay the monthly premiums before being reimbursed. I finally realized that the only way I could do it was to put the premiums on my credit card and then pay it off when I received the reimbursement. And I asked why they couldn’t just use the HRA money to pay the premiums for us. Michael explained that they had set it up this way so we would not have to pay taxes on that money.
Had I thought about it, the term “reimbursement” indicates that you’re being given money to cover expenses that you’re already incurred. But this in no way helps those of us elderly souls (I’m 82) who don’t have that extra cash each month to pay the premiums!
I was lucky enough to still have a credit card to use for this purpose. I don’t know how else I would have done it. I thought about all the other folks who are in the position your folks are in and have wondered what they will do. I hope there is some way you can help your folks with this. You see, in order to get the HRA money, we have to submit various documentation to prove that we have already paid the premiums. I think there will be and probably already are a LOT of questions about this whole process and I wish there was a direct forum someplace we could access to get answers. This thread is good but it gets buried on the Perspective site.
If you haven’t already, I suggest you go back to the beginning of this particular article/forum and read all of the questions and answers. There is a lot of confusion afoot and time is running out.
Also I hope everyone is checking the boxes to get email notification of replies and new posts so you can keep up with things. the url for the Perspective blog is: https://perspective.opers.org/healthcare ; this should take you to the web site and show the several articles that have info and discussions on them.
I was told during my signup for health coverage that our healthcare reimbursement money only lasts for 3 years and is discontinued at the end of 2018. I was also informed that any money left in the account after March 2019 will revert to OPERS and not available to the retiree. Is this true!
We are providing an extra $300, once in January for three years, to Connector participants. That’s the amount that is ending in three years. Your monthly HRA allowance will continue. Money reverting to us after March 2019 is absolutely untrue, and we would be interested to find out who said that to you.
Michael, I was told by an agent called Femi, that it would end in July 1st 2017 and and revert back to Jan. 1st of $337. All the extra money would be removed if any..You responded tat was not true.
We’ve seen your comment many times on our blogs. Let me say for the final time that at no point in the future will any of your money in the HRA revert to OPERS. No “extra money” will ever be taken from your HRA. If that is the information that you received, it is incorrect.
I am an OPERS retiree enrolled in a 2016 Medicare supplement plan through One Exchange. My husband is not yet Medicare-eligible and is on the OPERS group plan. I was under the impression that eligible medical expenses incurred by my husband could be reimbursed by One Exchange from my HRA account. This was stated in all of your written material and at OPERS seminars I attended. But now One Exchange tells me I will not be able to do this because my husband is under 65 and still on the OPERS group health plan. So I cannot request reimbursement for his health insurance premiums that come out of my retirement check, nor for any of his co-pays or other medical expenses. One Exchange representatives tell me that any spousal reimbursements can only occur if the spouse also has an account at One Exchange and is Medicare eligible. They approved reimbursement for the 2016 Vision and Dental premiums I will be paying for myself through OPERS—but not those for my husband. Please clarify spousal eligibility for HRA reimbursement.
The information you received from OneExchange is incorrect. As long as spouses are eligible, meaning they meet the qualifications for OPERS coverage regardless of age or where they receive coverage, they can receive reimbursement for their qualified medical expenses through the HRA.
Does this mean that I can get reimbursement thru my OPERS HRA for the health care coverage premiums my spouse pays at his workplace? Or the copays he pays with his insurance? I am OPERS retired in 2016 and on Medicare. He is 64, working, with health care insurance through his employer.
Yes, you can be reimbursed through the HRA for your spouse’s premiums and other qualifying medical expenses, even if he is still employed.
I am signed up for automatic premium reimbursement deposits into my bank account.
I have paid both January and February premiums to the Insurance Company.
Still no deposits for my premium payments from opers. Is this hra system really going to work?
And what is going on?
It can take a couple of months for the first reimbursement to occur. Then, it will come at the same time every month.
My father did receive a direct deposit reimbursement for his insurance premium on 01-11-16. He has not yet been reimbursed for my mother’s insurance premium – they chose the same plan and the automatic payment was taken as a single transaction. The second month’s premium will be due in a few days… He has also not received reimbursement for either prescription premium. Are we to safely assume the direct deposit reimbursements are pending or is there someone I should contact to verify?
There was a programming delay that has affected some spousal reimbursements. That has been addressed, so the reimbursement process should be done on a more-regular basis in the near future.
I received my first re-occurring reimbursement on 1/22/16. Will I be receiving the reimbursement on the 22nd of each month for the rest of 2016 or will it be on some other day?
We can’t say. More than 100 insurers have taken part in the Connector, and the timing of their reimbursements is not uniform. However, it’s possible that the first one was delayed, as we have noted all along, and that in future months they will be made earlier.
Finally some relief! I got my REIMBURSEMENT (3 of them were due) and was very surprised of it finally coming through. I have to say that I had great concerns over the service and treatment we were getting (lip service) from One Exchange. The lack of confirmation paperwork made us think quite possibly they did not get or have our information or that my spouse was not going to be funded. The delay was frightening on reimbursement of the monthly co-pay. Am now so relieved that it is all working out as planned, so THANK YOU!! I believe we should give credit where credit is due …. and OPERS did all they could to find us a smooth health plan, rather than dumping all the retirees to fen for themselves…
For those of us not eligible for free Medicare Part A, what is the process for the Part A premium. My wife & I were both state employees & neither have qualifying work quarters for free Part A. We have separate OPERS accounts. In January, we each applied for Medicare Part A, & we have each been approved for Part A effective July 1 & will be billed for the Part A premiums beginning in June. I understood from one of the OPERS conference calls that in March, 2016 OPERS would mail out a form to each affected retiree to complete and submit, along with the award letter showing Medicare Part A enrollment. This would kick off the reimbursement process. This is April 4, & to date we have not received the request for Part A reimbursement form, nor have we received any further instruction as to where this documentation needs to be sent. We cannot find anything on the OPERS online site that answers these questions. Please help!
Our September Health Care chat addressed the process for those who do not qualify for premium-free Medicare Part A insurance. If you still have questions, give us a call at 800-222-7377.