The Ohio Public Employees Retirement System has created new, alternative health care plans for retirees who have returned to work with an OPERS-covered employer.
The Humana Interim Medicare Plan is for Medicare-eligible re-employed retirees, and the Medical Mutual Interim Plan is for those not eligible for Medicare. Both plans will be effective on Jan. 1.
The new plans are in response to federal rules that affect coverage, as we told you about them in a PERSpective blog posted in April.
Current Medicare-eligible re-employed retirees without employer coverage who will continue in employment have two options:
- Enroll in the Humana Interim Medicare Plan by completing and submitting a Health Care Open Enrollment Change Form no later than Dec. 31, 2015. Participants will not pay for the full cost of this plan as OPERS will provide an allowance toward the monthly premium. This deadline also applies to dental and vision coverage for 2016.
- Choose an individual Medicare plan through the OPERS Medicare Connector. Re-employed retirees will not receive or have access to allowance dollars while re-employed.
In 2016, Medicare-eligible retirees who selected an individual Medicare plan through the Connector and participate in the Health Reimbursement Arrangement when they become an OPERS re-employed retiree will have the following choices:
- Enroll in the employer’s coverage. If a re-employed retiree’s employer offers heath care coverage to other employees performing comparable work or in a comparable position, the employer must offer the coverage to the re-employed retiree. If the retiree waives the employer’s coverage, the retiree is not eligible for any coverage or HRA allowance from OPERS during re-employment.
- Remain enrolled in the individual Medicare plan selected through the Connector, but without receiving their HRA allowance or reimbursement for claims incurred while re-employed. (There are plans available that offer premiums as low as zero dollars per month that could make this option more attractive.)
- Disenroll in the individual Medicare plan they selected through the Connector and enroll in the Humana Interim Medicare Plan. OPERS will provide the appropriate allowance similar to our current health care plan, based on age and service. If the allowance doesn’t cover the full premium, we would deduct the remaining amount from retirees’ pension benefits.
Medicare-eligible and non-Medicare-eligible spouses may be enrolled in OPERS coverage if the retiree elects to participate in the Humana Interim Medicare Plan.
Re-employed retirees not yet eligible for Medicare will automatically be enrolled in the Medical Mutual Interim Plan in 2016. Coverage under this plan is the same as coverage for non-Medicare retirees who are not re-employed. Allowances will follow the same guidelines as those for participants in the general plan. However, premiums for re-employed retirees may be higher.
If you’d like to see how re-employment affects your health care costs, please log in to your account at www.opers.org and use the Health Care Calculator available in your online account.
If you do not choose one of these options, you will not have health care coverage through OPERS in 2016.