Connector enrollment nears finish line

Enrollment in the OPERS Medicare Connector is in the final few weeks of 2015, and Ohio Public Employees Retirement System representatives are focusing on helping those who want to sign up to do so by the end of the month.

As of Dec. 10, 83 percent of our eligible participants had signed up for their health care coverage through OneExchange. That’s more than 120,000 out of our Connector-eligible population.

So far the top three medical insurance carriers are Medigap plans offered by AARP/UnitedHealthcare, Humana and Medical Mutual of Ohio. The top plans our members have chosen are Plan F, Plan N and Plan G. Humana tops the list of prescription insurers.

A fraction of our membership has told us they are frustrated with long hold times, varying degrees of expertise from advisors, and other issues. While it’s a small number relative to the large eligible population, we realize that this may be a challenging time for many of our members as they transition from our sponsored group plan, which required little action on their parts, to one in which they must select their own coverage. Making this choice is a slam dunk for some, but it’s not that way for everyone.

OPERS will do the best we can to solve your problems if you contact us. We take customer service very seriously.

One thing we ask: If you have specific questions about a plan you already have chosen, please contact the plan provider, or call OneExchange at 844-287-9945. Please do not refer these questions to OPERS. We can’t tell you what you have chosen or comment on your plan. This type of call does tend to back up our phone lines, making it more difficult for us to reach people who we can help.

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

  • My wife and I spent over 3 hours on the phone with one exchange.. At no time were we offered the AARP insurance plan.. Friends we have talked to said they had asked and were told it was available at quite a cost savings over Medical mutual.. Why was this plan not offered? The reimbursement methods are about as clear as mud. How do we get clarification? Awaiting your reply. Thanks in advance, Joe.

    • Joe,

      We are not sure why that plan was not offered. Plans vary by region, but you certainly can ask for a specific plan if you know about one.

      Regarding reimbursement through the HRA, OneExchange has a detailed description on the OneExchange/OPERS website. Scroll down to “HRA Information.” You should be receiving an HRA kit in the mail, as well.

      –Ohio PERS

    • My husband and I have had the same experience with OneExchange. They are either very inept or they are dishonest; either one is unsettling. Since OPERS would not talk to me about this, I sent my concerns to my state rep. along with the link to thses posts.
      Marirae

  • Only a fraction of the members have told of their frustration–the majority are too exasperated to make any comment let alone be comfortable with the decisions they’ve made.

    • You are spot on suzyQ. It was like rolling the dice and hoping one made the right decision. When the time comes for me to use my hospitalization on major medical needs , it’s going to be expensive.

      By the way ; after trying time and time again to get through, I was on hold for a half hour and after getting through it took over an hour to complete my sign up. This was after my initial call to get registered. Add on the time it took to study the options ect. It was not a pleasant experience.

    • I agree 100%, Susie. I was so frustrated I told the person at One Exchange I am going to contact our Congress Reps. to tell them exactly what they have done to the seniors of this State. No one told me I had to pay the total of 3 months of Medicare upfront and will not be reimbursed for 2 months because my HRA will not pay for one month of Medigap, one month of Silver Script and 3 months of Medicare part B. Why wasn’t I told? Also, no one told me I would be penalized because I did not have social security time in so my Medicare that I was told would cost me $104 and change is now costing me $121.60!! Why wasn’t I told the truth in the first place? I will not in any way shape for form let these people have free access to my checkings account so I will be paying them monthly, and submitting 3 claim forms each month to get my money back. I have more than enough to cover all my insurances but since I have to pay Medicare quarterly, it will not cover it all-till the second month.

  • I contacted the Connector several times. Unfortunately for me, when I was finally ready to complete my enrollment, I didn’t get the one person I had a very good experience with. However, in defense of the last person I spoke to, he wasn’t nearly as bad as an earlier woman who did nothing more than read everything to me, line for line, without any explanations. Then, after I complained that I would no longer be able to afford my medication, she had the nerve to tell me how much I would be getting every month, which also wasn’t correct! In fact, I got a lot of incorrect/inadequate information. But, I guess I’ll know just how bad this all is after the first of the new year. Let’s hope it is a Happy New Year!

  • If a fraction of the members reported problems what fraction reported they did not have a problem? We can only hope that the top administrative officials and the Board of Trustees of OPERS have been reading these blogs to get an idea of the difficulties the members are having with this process. We can also only hope that the same people will learn from this experience and will take steps to see that the experience next year will not be nearly as difficult.

  • I used the OneExchange “process” for my spouse, myself and 3 other family members who are members of OPERS. I’ll keep the rant to a minimum, as I do not wish to be patronized.

    All told, I spoke to at least 8 One Exchange representatives. Only one, the last one I spoke with while signing up the final of the 5 members, knew what community based rates were and which insurer (AARP) offered it. After explaining what community based rates where to one representative he directed me to a plan that was attained aged based.

    Half of the representatives were unintelligible for various reasons.

    Fortunately all but my spouse and I have received confirmation of insurance.

    My spouse and I signed up on 11/3 and when we had received nothing regarding our insurance after the others who had signed up days later had received theirs, I contacted OneExchange. I was told I had to call back after 21 days had passed as it had only been 20 days. As it was the Wednesday before Thanksgiving, I needed to wait until the following Monday to call. I was told the issue would be looked into by a special unit and someone would call me in a week. When I heard nothing from OneExchange, I contacted the insurer I had selected (no easy feat) and they informed me that they had no application for me. I called One Exchange back and the representative said she was very familiar with the system and would correct it. I contacted the insurer again after one week had passed and was told they now have my application and it was being processed. When pressed, he very reluctantly told me that there had been a number of problems with OneExchange. Tonight, I received a phone call from One exchange to tell me that there had been a delay in my application and if I had any questions I could/should call them, not the insurer or OPERS. She couldn’t answer any of my questions about the reasons for the delay or how long the delay would be (other than a “few weeks.” I was told if I needed medical care and I didn’t have my medical card by 1/1/16, that I should keep my receipts for reimbursement. Gee, thanks.

    OPERS, I am very disappointed in your lack of due diligence (if there was any) in selecting. OneExchange. I would ask that you not act as a referral for OneExchange so that a future group of retirees can avoid suffering their ineptitude.

    Thank you

  • OPERS members in northwest Ohio need to be aware Promedica physicians and hospitals won’t accept any plan provided by Humana.

  • Our 2.5 hour enrollment call was not a great experience. First, we could barely understand the representative due to his heavy accent. Second, we had trouble hearing him due to the background noise. We were hurried through the process, having to repeat the same information, and having to listen to the same lengthy disclaimer speech three times. Hopefully this call is not a sample of things to come in 2016.

    OPERS, how about doing a survey of all your retirees to see if they were frustrated with enrollment?

    • Steve,

      We’re sorry that you felt that your experience with OneExchange was not what you expected. We typically survey our membership every year after the open enrollment period has ended.

      –Ohio PERS

      • I agree that the call was hurried and specifically agree that the background noise was so significant it was very difficult to understand the person I spoke with. I know there is a way to block background noise and this should have been addressed right away. I would like to request a survey of OneExchange and the service we expected but did not receive.

    • Excellent point! I am having a terrible problem with this Connector which I have written about on this blog. I called OPERS today. They are going to send an email to OneExchange. Customer service seems to be one big circuitous route to nowhere.

  • i am totally livid!!! My insurance request were forwarded by One Exchange on November 17. I have heard nothing regarding the Health Insurance so decided to follow up with the company. Apparently it is in underwriting due to One Exchange’s error. Had I not followed up I would have been without insurance next year! I am told that the insurance company sent my “agent” Joslyn an email on November 19. The email said that they received my application but that the person signing the application was my daughter Jessica rather than myself.. Well apparently this employee is not doing a good job as she never replied. I am putting a lot more work into this than Towers Watson is! I tried to contact Towers Watson personally but no supervisor was available so I was told to send an email.

    • Well I just finished trying to send an email but they only allow 500 characters and that is not enough so there seems to not even be a vehicle to complain.

    • Sheri, I am so sympathetic…..I am not yet retired, but I do read through these blogs regarding One Exchange (which sounds like a disaster), and how OPERS apparently won’t help or isn’t much help with this process. Frightening to those of us who will be facing this same scenario in the near future!

    • Sure wish OPERS would reply to my comments and let me know that they know about my problem. Signed Soon to be Uninsured

  • The following was stated in a previous post:
    Plans vary by region, but you certainly can ask for a specific plan if you know about one.

    It was my understanding that we could only choose the from the plans selected by OneExchange. The only choice in my area was among two companies. One of the companies has a limited network and not a very good reputation among providers. That gave me one remaining choice that I selected. I gathered all of the information that I needed on my own. The statement in a previous post suggests that I could have selected a company/plan that was not listed by OneExchange. If that is correct, we should have had that information at the outset before making our choices.

    I found the OneExchange rep to be pleasant and I had no trouble getting through for my appointment. However, the representative knew no more about the plans than that which was presented online by OneExchange.

    Millions of people make their own choices for medicare supplement/advantage plans each year. I, and many other retirees, are comfortable in making a choice on our own. It would increase our choice in plans and save a lot of money that is being paid to OneExchange.

    I appreciate the fact that we are getting a good allowance for our medicare supplemental coverage. OPERS staff have worked very hard to ensure a smooth transition.

    • What we stated is that you can ask for a specific plan, but if it’s not one that OneExchange offers in your area you can’t select it and also receive HRA contributions.

      –Ohio PERS

      • I also was under the impression that we could only pick from the providers shown on the OneExchange web site. If I had known otherwise I would have done more comparison of other providers in this area. I suggest that this is a point that needs to be stressed more next year.

        • Michael, i assumed based on this ” What we stated is that you can ask for a specific plan, but if it’s not one that OneExchange offers in your area you can’t select it and also receive HRA contributions. –Ohio PERS”
          that I could not buy a plan outside of the connector and be reimbursed ?

          • Dorothea,

            No, that’s not what that comment meant. You cannot buy a plan outside of the Connector and be reimbursed through the HRA.

            –Ohio PERS

  • I look at this as training so when the feds decide to privatize Medicare we will have already been through it. You may argue that it will never happen, I say 10 years ago did you think OPERS would have done this. My question is, has OPERS discussed this possibility and what if any action will they take?

  • This
    is a follow-up to an e-mail last week regarding Re-occurring funding
    pay payments for reimbursement of OPERS Dental and Vision from the HRA.
    I submitted the form to One Exchange along with your open enrollment
    statement. Today I received denial of the claims for next year.
    Calling the number provide they indiciated that I would need to submit
    the monthly bills. I told them that the monthly premiums were taken
    right out of the Pension amount direct deposited into my checking
    account. I receive no bill from OPERS! I was transferred from HRA
    claims to Customer Service and was told I’d have to deal with Claims.
    Third call and was told they’d have to send the request back for review,
    although they thought the Open Enrollment Statement was clear and
    should have been sufficient. I’m sure I’m not the only one experiencing
    this. Is there something you can do to help!!

    • Bill,

      The solution is to call us in January and ask for a receipt that documents the dental/vision premium that you paid.

      –Ohio PERS

      • You mean I will need to get receipts every month for the dental and vision premiums I pay?? Can’t you share this information for reimbursement? This seems like more work than necessary on everyone’s part.

        • Linda,

          You do need to request a premium receipt letter, but you don’t have to do it every month. You can wait for a few months, for instance, until a few premiums accumulate. The premium receipt letter is available only for premiums for the current month or prior months.

          –Ohio PERS

  • This was forced on 2 OPERS by the Republicans in the State House
    if I have 1 more Republican tell me that this is much better then what we had before I am going 2 go vote against every Republican running 4 office.

    • Phil,

      Thanks for your comment, but OPERS made this decision to preserve health care coverage into the future for our retirees. The decision was not “forced” upon us by politicians of any party.

      –Ohio PERS

      • I think the necessary preservation of any Heath Care being provided by OPERS has been missed by many . The day it would have to end because of the decline of funds would have been a bigger disaster. I know how disastrous it was when I found I lost 66 % of my SS I had depended on. No one bothered to tell me,when I went to work for the county.

  • I would have to sum up the overall experience as very successful. With the number of people having to enroll, it had to be a nightmare. My only concern was the limit of insurance Companies involved. My husband has had Medigap Policies for 20 years and gets competitive quotes from many each year. None of the connectors choices were any of them. AARP has always been the highest price..

  • I would like to thank OPERS for following up and and getting back to me with an answer on my issue.
    It is greatly appreciated.

      • I am POA for a retiree. He will get no HRA because he is on Medicaid. And probably no $300. either. It took me five long phone calls to find that out. No adviser knew Pierce could not get insurance through the connecter. Hold time and help time from an adviser each time was close to four hours, of wasted time. I did receive help in enrolling in a plane for myself, but I can get no HRA because he the retiree did not enroll in a plan with ONEEXCHANGE. Also I was told not to worry about cancelling my dental and vision plans by their date, I could cancel at anytime. When I found a new dental and vision plan. That is not true and I am stuck with paying for him and I for 2016. He doesn’t have any teeth and does not even open eyes any more.
        Not enough room for what I need to say. Noon of this is right.

        • Ron,

          It is to make the reimbursement process flow more smoothly. There will be this additional deposit also in 2017 and 2018 during January.

          –Ohio PERS

          • My automatic reimbursement is going well. It’s getting reimbursed for the dental & vision that OPERS is taking from my pension check that is taking too long. Why can’t that be set up for automatic reimbursement too?

          • Ron,

            The reason is that coverage can be terminated throughout the year for different reasons, and creating a receipt for future coverage when a retiree or dependent becomes termed would have been problematic.

            –Ohio PERS

          • i applied for those premiums and they show up in my history for the year. I applied just as i did for Medicare Premium from 1-1-16 thru 12-31-16 .Both were paid automatically.

  • This is in response to “Phil 102” commenting that this connector debacle was caused “….by the Republicans in the Ohio Statehouse….” The Republicans?? Really?? And what does this man think about upcoming changes to our (OPERS) healthcare plans DIRECTLY brought on by the forced implementation of Obamacare, like the so-called “Cadillac Tax”?? I suppose Phil 102 thinks that the Republicans are responsible for Obamacare as well. Wow……

  • Well I called Towers Watson again, They have sent a note to the specialist asking for a status of my healthcare application. The status in the computer if that is the answer is that it was sent to the carrier in November but the problem is that Towers Watson filled out the application wrong and the insurance company sent them an email about that also in November which no one is addressing. So they are going around in circles ignoring the fact that I have gotten them the answer. In about one week I will have NO INSURANCE!!!!

  • Envisioning the mass of people that would have to be processed by One
    Exchange, I signed up for an appointment the second week of October. I had to wait a whole 10 minutes before the first person answered. The time between each of the 3 sections was never longer than 15 minutes. The trained advisor I talked with gave me her assessment of the plan I should choose. I complied and I proceeded to the 3rd person. There I chose my health care company, my Rx service and was good to go. Having gone through the process, I knew what to look for and felt more knowledgeable to choose a plan. I spent the next two days researching (what I should have done in the first place).. I called back after those two days (same short wait times) and easily changed my plan . I stayed with Humana as I had been satisfied with their service before. I received my cards from them and Silver Scripts the next week The only glitch I have run into is I have not received my HRA Kit …. AND that is something I do not understand. (By the way, we WERE told there would be delays in getting our reimbursement until it was all set up. ) I need a step by step explanation (like when I try to set up a new program) Overall, I had a good experience initially, because I signed up early. I did experience the long hour wait when I called the beginning of December to ask a question. I just put them on speaker and played solitaire. I did come to hate the music they played though. :o( thank you OPERS. After you taking care of me for 25 years, I think I can take it from here!

      • My husband and I had the same good experience. We chose Humana and One Exchange told us our doctors were covered under the plan. Then in early December we discovered that in northwest Ohio no Promedica facilities and doctors will accept Humana. We had to change our plan to Medical Mutual of Ohio. One exchange was not aware of the Humana – Promedica problem. I am happy we discovered this before the cut off date to change our coverage.

        • Cathy, I called Humana just now. I was told that any medical facilities that accept medicare do not require networks etc. for Medigap Policies.

          • Our Promedica doctors, plus the Promedica main office told us that they are no longer accepting any Humana coverage, including medigap policies.

          • Thanks Cathy. I am glad you got that straightened out in time. I guess i am not familiar with Promedica . Happy New Year !

  • I have read the OPERS blog for quite a while. I was really concerned about my call .With that said, my wife and I had our appointment on Oct.26 other than the half hour on hold the call went better then I expected. The caller was was very helpful the call took about 2 hours. The only thing I don’t like about this is that I have to pay for it myself because I am a reemployed retire and cannot get my HRA thanks to Obama. I went on OneExchange to compare and will pay more than the retire plan OPERS offers but I have no deductibles,so either pay now or pay later. I know OPERS is trying to save our healthcare,but I wish they could keep the spouses on after 2017 .

  • I called OPERS on Dec. 22 to complain about Towers Watson. They referred my complaint to Towers Watson. As a State of Ohio employee I would never have been allowed to provide such poor customer service as Towers Watson provides. I got a call from Towers Watson this afternoon (2 days after calling OPERS) in reference to my call to OPERS. Apparently next week someone is going to look into my problem. I told them again that I KNOW what the problem is. The worker at Towers Watson signed my daughter’s name on the app instead of mine so it is stuck in underwriting. I may as well be talking to myself. I first advised Towers Watson of this problem on December 16 and they still have done nothing to resolve the issue!! Looks like I may uninsured as of January 1 and powerless to do anything about it!!!

  • The person whom I spoke with did not tell me about any of the insurance programs, she simply took the information and told me Plan F would be best for me. She did not tell me about any companies, but I was put on Cigna. I can only hope this company is accepted by Marietta Memorial Hospital (Marietta Health Systems) and the doctors I see. I was of the impression that I would be offered a few companies and make a choice, but that did not happen. Secondly, I had entered my information before the call on the connector thinking I would get to review some of the companies, but that did not happen. Now when I look at my information it has what I entered, but says I have not selected a plan, then it goes to what the person who spoke with me entered and indicates I have be approved for Silver Script and an a medgap Plan F, but no other information. What happens if the local Hospital and doctors don’t accept Cigna?

  • No receipt for my $301.20!

    One Exchange demands a receipt for my entire 2016 drug coverage payment. I paid it that way yesterday because it looked easier than dickering with money in, money out every month. Now the drug company says it doesn’t know if it sends them.

    Kind of unbelievable, but I would rather eat the $301.20 than begin anew here.

    On the tele with One Exchange for 15 minutes the first time trying to get basic reimbursement questions answered (yes, I read the pamphlet, but I still had a question); 35 minutes after being transferred.

    On the phone on hold with the drug company until my phone battery signaled it was almost out and 5 minutes with the new phone.

    That lady never came back to the phone so I called again and have now been on hold 13 minutes and 20 seconds waiting for a supervisor because this lady didn’t know either, if I would get a receipt.

    We only thought we were retired. We have retirement gigs now, that we didn’t want.

    I used to write, but I can see now where I will have a lot less time to do this and a lot more time spent on hold listening to tinny music and talking to customer service reps who don’t know what they are doing.

    No more coffees at Paneras with my friends. I have clerical tasks to do to get my reimbursement money from One Exchange. And dotting all the i’s and crossing all the t’s and doing a lot of telephone work.

    Lots to look forward to.

    I would have rather been taxed for the benefits than waste my valuable-to-me time on all this stuff.

    • JA,

      Sorry it’s been so difficult. It is indeed a rare thing that someone can’t provide a receipt for something you’ve paid for. We hope you get that straightened out.

      –Ohio PERS

  • This is my first time having to be involved in the process of selecting a health care plan. Medicare is a very complicated plan which most people can nevr understand the least of it. I on the other hand is a licensed l insurance agent with Medicare training and I still don’t understand it enough to advise others or myself to
    choose a plan. I feel that OPERS let us down. My experience with One Exchange Connector was all but favorable. The first Rep was not very knowledgeable to plans that fit my needs. I chose to end the conference without choosing. The next Rep was very impatient because I could not understand his accent and had to keep asking him to repeat the information. He wasn’t making any sense to me, he ignored my questions and continued to explain whatever he was talking about. Finally I got a Rep that Iwas able to complete the process. But. then I was told that I had to contact OPERS to keep the Vision & Dental plan. I called you all and was could not get through because high volume of calls, okay, it is now Dec 30, 2015 and its not done yet. this process was not very good for Retirees,

    • I completely agree!!! This process has taken 10 years off my life as well as using up many of my hours of life this month due to One Exchange’s lack of intelligence or customer service. I have put my story on here before. Basically the first person to sign me up did it wrong on November and ignored the email about the error from the insurance company. I kept telling One Exchange exactly what the problem was and who did it. Instead of helping me they had to refer it to an investigation committee so it was not until yesterday that they called back to address the issue and yes the issue was exactly what I had said it was so a new application needed to be done. Well I was on a train trip and the connection was too poor so I was asked to call back later. I did that and the poorly speaking man would not put me through to the woman . I told him how upset I was and that I realized it was not his fault but that I had not been having a good experience. So — he hung up on me! I called back even more unhappy and frustrating. Then before I reached a real person I got disconnected. I tried a third time and was able to speak to the person I requested. I also reported that I had been hung up on. She finished the application process and turned me over to the second person in the process where the call is recorded. That second person seemed to know what she was doing and did and said things that I don’t think the first person had done. So a second app was supposedly sent in on December 30 and I need to simply hope that I will really have insurance if I get deathly ill on January 1′ etc. This has been the most frustrating and arduous experience of my life. I have spent the last 2 1/2 weeks of my life focused on this issue. I should have been enrolled in November and they should have been able to take care of it when I first called on Dec 16!

  • What is OPERS doing to correct some of the problems members are having with One Exchange? You chose them and next to except responsible for there actions.

    • Robert,

      We’re responding to many individuals in various ways — over the phone, through email and through this blog. We realize that not everyone is receiving the same level of customer service. In some cases, OneExchange reviews phone calls, and if their employees are giving out incorrect advice, the employees are retrained.

      While repeated errors need to be fixed, please realize that as of the end of 2015, more than 132,000 of our members successfully completed enrollments through OneExchange.

      –Ohio PERS

    • What did you people do, wait until the last day ? i have never heard such whining and bellyaching in my life.

      • No John, I did not wait until the last day. I did mine on November 27. It was One Exchange who waited until the last day to fix my error!! Glad you apparently didn’t have problems but some of us did and ONe Exchange was very unhelpful and unresponsive.

        • I am sorry to hear that ! My wife’s went so smoothly. I did have one agent I could not understand and asked for another ! Hope all goes well; for you from now on !

  • The cashiers at Walmart have better knowledge and customer service skills than OneExchange. When I signed up for my policies I was told that they would be direct bill from the start. Well apparently that is another error or lie from One Exchange as I got a bill today form my prescription plan. Those people do not know what they are doing! Maybe the worker did not set it up as direct bill even though she told me she did.

  • Correction:
    One Exchange’s bad advice on SilverScript for Rx coverage will cost me $648/year rather than $221/year. I have asked them for a check to cover their error which is costing me $492 extra.

  • I read through the printed information sent out ahead of time by OPERS and One Exchange regarding the process of signing up for health insurance and how the HRA would work. I also attended the information sessions, one with OPERS and one with ONE Exchange that answered a lot of questions for me. I also watched the videos regarding health insurance changes posted on the OPERS website. All of these helped me a lot. I was a little anxious about the initial phone call with One Exchange, but knew going in that it would take awhile, even though I had submitted information to them ahead of time using their website (this had been suggested by both One Exchange and OPERS as a way of reducing the amount of time to sign up). I too had some minor problems understanding at least one of the three people I talked to, but again, I knew ahead of time from reading the information pamphlets and attending the meetings that I would be talking to three people and that by law, they would each be reading several statements to me that I would have to respond to. I had done some research on my own ahead of time and was pretty sure that I wanted the Humana, age rated, F plan and after some discussion the specialist I spoke with agreed. I was on hold for about 15 or 20 minutes through the whole contact with One Exchange, but I knew this was a possibility ahead of time. I just looked at my One Exchange Account page today and my initial HRA deposit has been made and am expecting my additional $300.00 annual deposit from OPERS to arrive around the 8th of January. So, my experience, so far, has gone pretty well. I guess the proof will be in how well my health insurance and pharmacy choices work out.

  • I share the frustrations of the many OPERS members who spent long times on hold waiting to talk to the Connector. When I would call and the Connector would find out that I am eligible for TRICARE, I would be put on hold and forgotten. After 40-45 minutes I would hang up. I have forfeited OPERS health care in favor of straight Medicare and TRICARE. But I would have made a better informed decision had I been able to compare my choices with the Connector to straight Medicare and TRICARE. I kept trying to talk to the Connector about whether or not I can retain vision and dental coverage. I finally learned I could from a Connector employee who told me I could retain vision and dental. The only confirmation from OPERS I have is my revised pay statement for January 2016 showing deductions for those two coverages. I no longer live in Ohio, but I liked the Humana Medicare Advantage coverage.

  • Mr. Pramik,
    Could you please give us an update on the top 3 medical insurance Medigap Plans, top 3 Plans, and the top prescription insurer chosen by our retirees as of January 2016?
    Thanks very much!

    • Cheryl,

      As of Dec. 31, the top five Medigap carriers were Humana, AARP from UnitedHealthcare, Medical Mutual of Ohio, Humana Connect and The Health Plan.

      The top five Medicare Advantage Prescription Drug plans were AARP Medicare Advantage, Aetna, Anthem Blue Cross Blue Shield, Coventry Health Care and Humana.

      The top three Medigap plan types were Plans F, N and G.

      The top prescription carriers were Humana, Silver Script, Coventry Health Care, Aetna and Cigna Health Spring.

      –Ohio PERS

      • Thanks very much for your reply; I find this information very helpful. I’m not retired yet but don’t have too much longer to go. I feel it may be wise to go with the majority when selecting my health care.

  • Most interesting reading the comments here on Perspective. I concur with all complaints in all topics posted. Only one complement I can give is that Towers Watson personnel have been pleasant. Finally I must add that their web site is an abomination (For which they admitted to me numerous times). I was able to obtain all the information needed from a more intuitive site called “MEDICARE.GOV” which exasperated Towers Watson personnel suggested I use.

  • How much money is One Exchange making or being paid by opers? How much money is being saved by opers , now they don’t have to take care of these 132,000 happy retirees? I turn 65 in two years, is there any hope that opers will change from One Exchange to another company? Mike,why don’t you & your partner call One Exchange next year as a retiree to see what some of these people are talking about.

    • David,

      We are continuing to pay for health care benefits. If you’d like more information, read the annual reports on teh OPERS website. OneExchange is paid by insurers to be on their roster. The licensed benefit advisors are not compensated based on any plan selected by the participants. OneExchange also is compensated for administering the Health Reimbursement Arrangement through administrative fees assessed against participants’ HRA accounts.

      –Ohio PERS

  • My Plan F carrier and Prescription Part D carrier have both directly withdrawn their premiums for January from my checking account. I spent almost two hours on the phone today waiting to get through to One Exchange and speaking to One Exchange “funding” and “customer care”departments. No one at One Exchange can tell me when I will be reimbursed from my OPERS allotment for the premiums withdrawn for me and my spouse’s premiums. I was told it could take up to three months for the first automatic reimbursement to be made to me. I was able to confirm that I had properly set up for automatic reimbursements. I think OPERS needs to follow up with One Exchange and get an answer on this.

  • Submitted my first claim for medications I purchased on Friday, January 8. Eight pages!!! I called One Exchange three times and got different answers, so I faxed the sum total that all three callers wanted. Including the “evidence of coverage” because, as one put it, “Just because you have the card doesn’t mean you have the insurance.”

    The list of stuff you need to fax or send is in their literature, but I had a question…..so I called.

    Somewhere I read where money will be deposited in my account on file with them (I have auto reimbursement) but the customer service person said it would take five days to process. From Friday 1/8 until Friday 1/15 then to process and so three days after that for the money to be deposited in my account?

    Oh, and if there is a “problem” (clerical or otherwise, I guess) with your faxed (or I suppose mailed or online as well) claim, you will eventually get a letter denying it. Between when you send it and when you get denied, or get your money deposited, there seems to be no way for customer service to tell you if it even arrived there in tact (eight pages — many a slip.)

    This process needs to be streamlined.

    I called at 8. I asked to speak to a supervisor, when she was unable to answer all my questions and was told that the supervisor didn’t come until 11.

    I don’t know about you — but MY supervisor at the county was always there when I started my work day.

    OPERS is paying these folks…..and they knew we were coming.

    • I thought that if you signed up for automatic payment and reimbursement that you did not need to submit something and that the reimbursement shows up in your bank account like magic?

      • Sheri,

        That is true of your medical premium. It could take a while to receive the initial reimbursements. If you want to receive it sooner you can turn in a manual reimbursement claim.

        –Ohio PERS

      • That ONLY pertains to reimbursement for insurance premiums you’re paying for policies obtained through OneExchange. Unfortunately that doesn’t even cover dental and vision insurance premiums deducted from your pension check because OPERS doesn’t participate in the automatic reimbursement for those premiums they deduct from your pension, if you get them through OPERS!

        My impression of this whole process is that, IF you signed up for automatic reimbursement, the insurance companies’ computer feeds OneExchanges computers the confirmation of premium payment at end of the month, or early the following month, AND WE ARE REIMBURSED WITHIN 2 DAYS! But, human intervention, i.e., manual confirmation, is going to take 4-6 weeks for reimbursement, or as my father used to tell me when I was a kid, “it’s on the slow boat to China!”

        When I questioned them about the slowness for reimbursement of approved expenses for something other than automatic reimbursement, they blamed it on “…inclement weather.” In other words, hurry up and wait!

  • I would like to request or petition One-exchange to make available the Medical Mutual’s new offering (Plan G).
    The One-exchange does ntly offers all of Medical Mutual’s other medigap plans including their Plan A, Plan C, Plan F, HD-PlanF, and Plan N. Medical Mutual’s new plan-G is very well priced compared to other insurance carriers.

    Outline of coverage 2016 (including Plan-G): https://www.medmutual.com/~/media/MedMutual/Files/For-Medicare/2016%20MHICO%20MS%20Outline%20of%20Coverage%20X9602.ashx

    Once Exchange’s recent suggestion to simply wait for months and months for access to their Medical Mutual’s Plan G would not be in my best interest because the timeframe for guaranteed issue for me and my spouse is quickly slipping by. The one exchange rep agreed to forward my request to “the management”.

    Can OPERS make a contact to encourage One-exchange to offer Medical Mutual of Ohio Plan G in the very near future?

    Thank you for reading this.

    Bob

    • Robert,

      OneExchange chooses the plans they make available. You need to make your comments and suggestions to OneExchange on this, but thanks for reading PERSpective.

      –Ohio PERS

  • After several phone calls concerning reimbursements of a verified automatic reimbersement option for health care and subscriptions service premiums, all busy with other coustomers, I gave up on hold. I then twice used their contaact me service where I selected TODAY option as they had my info and phone in this option. The next day 1/7/2016 I received two emails informing me they had my requests to contact me and would be contacting me soon. This day 1/14/2016 I am still waiting. The other day I was determined to get an answer and spend whatever time doing so. I called the talk to an exbert number 844-287-9945 and after 47 minutes on hold I got an expert, and he had no idea when I would be reimbersed, and he transfered me to another exbert, on hold for another 22 minutes, now in the support part of on one exchange, this exbert also did not know and transfered me again to another part of one exchange holding again for 21 minutes. Now this exbert put me on hold because she did not know to talk to someone else and after 15 minutes on hold came bact to inform me she thinks it would take four or five (4 0r 5 ) months or more to get reimbersed. My premiums are over $250. a month, the first I already paid on 1/5/2106, all paid through automatic checking payments. In 4 or 5 months I will be forced to pay out over $1,000 to $1,250. I do not have this money and after one more withdraw my checking will be overdrawn and the premiums will go un-paid and canceled. I paid through my retirement before this $7 a month for health care , and now this.

    • The sad thing is that Towers Watson is a huge global corporation and perhaps the best of the choices. I hope OPERS can negotiate an improvement in customer service.

  • This is just an FYI. Even though I have signed up for automatic refund on my premiums, I wanted to test the system. I took a screen shot of the premium withdrawal, saved it to documents, applied for the refund, following steps outlined. I did this on the 5th and had my premium back in my checking account the 13th. Well-done by Towers.

  • i have been told i have $1,119 in my account… i am trying to get it on automatic transfer to my retirement bank checking account… i am also confused about the amount… i have been told i will get 409.00 a month, plus a one time $300 amount…. i have been told that my wife (who has her own pers retirement) will get $396, plus a one time 300.00 cash amount) that totals more then the $1.119 … where is the difference…. PLEASE HELP.

    • Frank,

      Spouses will not receive the additional $300 HRA deposit. So it looks like the amount you say is in your account matches up closely with what you had understood your allowances to be.

      You should have been able to apply for auto-reimbursement of your premiums during your enrollment call. If you have additional questions, call OneExchange at 844-287-9945, or visit the OneExchange/OPERS website, where you can find reimbursement forms.

      –Ohio PERS

  • Once again I have applied for all my premiums due. Medicare, dental and vision and all have been paid.
    Well done to Towers. This is the phone number with very little hold time to check on reimbursement !

    1-866-625-0488

  • I enrolled through Towers Watson in November 2015 for a Humana Plan F. A few weeks later I received insurance cards for a Plan G. I contacted Towers Watson and we cancelled the Plan G and re-enrolled in Plan F. It is almost February and I still do not have insurance cards. I have contacted Towers Watson numerous times and all they do is call Humana and Humana says my insurance has been cancelled. When I look at my profile on OneExchange it shows Plan G cancelled and Plan F issued. I seem to be going around in circles without getting a resolution. I had rotator cuff surgery in September 2015 and should be doing PT but can’t until I get my insurance card. Can OPERS help?

    • Thomas,

      Have you contacted Humana directly? If so, they should be able to tell you what plan you have.

      –Ohio PERS

      • While on the phone with OneExchange we contacted Humana and they say I have no insurance. OneExchange insists I do have insurance. I really don’t know what else I can do.

  • Went to opers presentation on connector program in 2014 before turning 65. Decided not to sign up for healthcare with opers because plan was not accepted by OSU hosp. or James Cancer Center. Couldn”t take that risk so signed up with United Healthcare AARP and have been very satisfied with coverage. After receiving info about HRA found out could not keep my ins. plan without a one month waiting period and facing the possibility of a pre-existing condition raising my monthly rate and unable to reapply through One Exchange or United Healthcare for same plan. After many phone calls and hours of being on hold with One exchange I need to have AARP ins change agent of record which they will not do. I have earned the HRA but unable to utilize it. Seems like this is just a money play with One Exchange and OPERS at my expense. I am very frustrated as I began this process on 10/23/15. Do I have any other options and are there others in this same situation?

  • One Exchange has gotten NO better!!! I am speaking to a rep. She does not know how to use a computer and she knows nothing. I had 2 reimbursement requests that appear denied and I have trouble getting back to that page. I asked how to get back to that page. She is sending me all over the place. Now I am on hold and she is getting help. Things got no better. She told me right or wrong that they do not notify me if a reimbursement request is approved or if it is denied. Then she said. Well you might get something if it is denied and they need more information. I said, “I MIGHT?” She said yes. I said so I might or might not? She said correct. I said thank you for your help and aid good by. How does this company get by with such poor customer service? I would say stupidity, but the woman is not stupid. She just does not know anything about what she is hired to do.

    • Sheri, if you are still having difficulty maneuvering your account on P/C. Send me an E-mail and I will send you my phone number ! I am very knowledgeable on the site !

  • Here it is April and I still do not have insurance. Every week OneExchange calls me to tell me they are working on it but I never get results. We spoke with Humana during one phone call and Humana says I was denied coverage through underwriting. I applied for coverage last November. Can OPERS help with this or do I just assume I will not have health insurance anymore unless I go through Obamacare.

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