OPERS answers frequently asked questions
The OPERS Member Services center is expecting a record number of calls this month in part because of the implementation of the OPERS Medicare Connector.
In order to help our members avoid long wait times on the phone, we have compiled answers to the questions most frequently asked at the beginning of a new year and also have provided resources where additional information can be found.
If you still have questions you can call us at 800-222-7377. We will do our best to take your call as promptly as possible, but you should expect longer-than-normal hold times.
Q: Why is my January benefit amount different?
A: There are several reasons that a benefit amount might change in a new year. Most changes in January are because of adjustments in health care allowances.
The health care changes that OPERS approved in 2012 include calculating premium allowances based on age and service. The initial transition to this new allowance begins in 2016. OPERS sent Benefit Change Notices recently to those affected.
Members might see additional changes in February because of new tax tables.
If you need more assistance in understanding the recent Benefit Change Notice, please refer to the recorded presentation on this topic in the “Got Mail? Get Answers” section of opers.org.
Q: As a participant in the OPERS Medicare Connector, how and when can I receive reimbursement for my January health care premium?
A: Participants in the Connector can use the Health Reimbursement Arrangement to recover medical expenses, including premiums. However, OPERS will not be able to answer questions regarding your individual medical plan or your HRA. Please contact OneExchange for this information at 844-287-9945, or visit the OneExchange/OPERS portal.
Q: When will I receive my benefit payments in 2016?
Benefit payments will be issued on the following dates this year:
- Jan. 4
- Feb. 1
- March 1
- April 1
- April 29
- June 1
- July 1
- Aug. 1
- Sept. 1
- Sept. 30
- Nov. 1
- Dec. 1
Q: When will I receive my Form 1099-R for tax year 2015?
OPERS will mail Form 1099-Rs for tax year 2015 by Jan. 31. Retirees should expect to receive these forms by Feb. 15. If you wish to retrieve this information online, you can do so by logging into your OPERS account after Jan. 22. Once you’re in your online account, click on “Documents.”
Q: What is a Form 1095-B, and will I receive one from OPERS?
The new IRS Form 1095-B will verify that you and your dependents have minimum essential health insurance coverage. Under the Affordable Care Act, taxpayers who do not have minimum essential coverage might have to pay a penalty when they file their tax returns. Having a Form 1095-B in hand is proof that you had required coverage.
OPERS will mail this form to qualifying retirees by Jan. 31. Retirees should expect to receive the form by Feb. 15. If you wish to access your 1095-B prior to receiving it in the mail, or need to print additional copies, you can do so by logging into your OPERS online account after Jan. 22. Once you’re in your online account, click on “Documents.”
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.
290 thoughts on “OPERS answers frequently asked questions”
We have checked my husband’s account at OneExchange and have yet to see any evidence of the
$300.00 being deposited there. There were many references to an extra $300.00 being available for
retirees medical account, but when is it coming? Where should it show up? We signed up Oct 31st and have received all the material for our new health accounts weeks ago.
That deposit was scheduled to be made by Jan. 8.
The 300.00 RMA deposit, will that be deposited into our checking account?since I gave the lady at One Exchange my personal checking account information. Or will it be deposited into the HRA that is already set up by OPERS?
It is credited to your HRA. You can submit claim forms for expenses you’ve paid in order to access the funds.
I signed up for automatic payment for our medical premium, I gave one exchange our checking account information,
1. Will that payment be withdrawn from our checking account each month automaticly ?
2. Will I have to send a copy of my bank statement each month to HRA in order to be reimbursed?
Payments are withdrawn automatically. You do not have to send the bank statement each month if you sign up for auto-reimbursement.
Where is the additional $300.00 in the health account?
That was scheduled to be distributed by Jan. 8.
Will any balance in my HRA account at the end of 2016 rollover and be available for use in 2017 ?
Yes, it carries over.
Yes, I just found out that my 85 year old aunt ( has dementia ) who had opers, had been throwing all the info you have mailed her, away. Is it to late to have you send her the info again ? If not how can I get her enrolled ? Thanks. Walt
Call OneExchange at 844-287-9945. Ask them about enrolling your aunt. Rather than us re-sending certain mailings, you can get most of this information at the OneExchange/OPERS portal or on our website.
I see NOTHING on OPERS, OneExchange, or my checking account that assures me that I (we) have any coverage.
I have (I believe) signed up for automatic withdrawals and re-imburstment. There is NOTHING!!!!
I have received NOTHING from OPERS on my benefit changes, but notice that my pension is adjusted by about $215/mo.
I HAVE NO CLUE OF WHAT’S GOING ON and “we” should have had some forewarning!
Sure, I’ve read your blogs and followed the sign-up with One Exchange…did everything as you requested, but I have NO understanding of what’s going on!
Do I have coverage?…When will it be de-ducted from my account?…When will I be re-imbursted??
Please, PleasePlease …Help Us!!
To inquire about what health care package you signed up for, and when you’ll receive reimbursement, your best bet is to call OneExchange at 844-287-9945. You also can check your enrollment status at the OneExchange/OPERS website. The big box on the right side of the page has an entry for Enrollment Status.
Just an FYI – to get in touch with someone at One Exchange is next to impossible. I understand everyone else’s anxiousness over all of this transition. Even with all of the information that has been sent out, it is still very confusing for many people. Not everyone has hundreds of dollars laying around to keep paying the health care and prescription premiums and not knowing “for sure” how to get reimbursed.
The biggest issue is One Exchange and not being clear. I have received two different answers from several phone calls. I am afraid to send in anything until I have a clear understanding of what I am supposed to be sending.
On the Reimbursement form one of the boxes you have to complete is the dates of service; i.e. 1/1/16 to 1/31/16. Express Scripts sent a letter after I signed up with the start date, but no end date. Express Scripts told me they will not put that in writing because, obviously, it hasn’t been paid for the entire year. I understand that. However, One Exchange says I have to have it to get reimbursed. So, how does that work?
Lots of things need to be clarified.
I read another blog further down this page regarding a “rude” person at One Exchange. After waiting a grand total of 1-1/2 hours on the phone, I too had rude person.
Last week the Recurring Reimbursement form was on their site – today it is gone. The CS rep in Funding and Reimbursement said she didn’t know why and that “she didn’t” build the website. I asked to speak to a supervisor and she told me her supervisor was busy but that she could transfer me to someone else. After 1-1/2 hours already I the phone, I told her I was going to hang up and I said goodbye.
Signing up was easy. This part is a nightmare.
I called One exchange yesterday 14th, I wanted to make sure I was signed up for automatic reimbursement, I spoke with KeKee, and Lexee, and customer service (I did not catch her name). After answering each one of their security questions (3) times, they continued to transfer me to the next department.
Finally the last hold time was one hour, no one came back on the phone and I hung up in frustration.
Once they brought up my account on their computers, WHY couldn’t they tell if I was automaticly set up for reimbursement?????????? So I still do not have confirmation. I got on the medicare oneexchange OPERS web site and it does show I have automatic reimbursement, but since I have NOT received reimbursement as of today. I worry and need reasurance.
Thanks for your answer!
OneExchange is now telling us it can take 8-10 weeks to receive the first auto-reimbursement payment. You can fill out a form online to request a manual reimbursement if you don’t want to wait that long.
In light of the new information, OPERS should be taking action to reduce the amount of time for reimbursement other than suggesting a manual form. It should not take 8-10 weeks–that suggests that OneExchange is either poorly managed; doesn’t care about it customers; does not have the experience/ability to handle large volumes of work expeditiously or worse. Whatever the reason for the delay, OPERS needs to do something to fix the situation and restore credibility with its retirees
I called OneExchange last week about the reimbursement process since I, too, am signed up for automatic reimbursement. (I also contacted both my Medigap & Part D plans about this.) The insurance providers both told me they submit all if the notifications/verification of premium payments to OneExchange at the end of the month. So, the amount of time necessary for reimbursement following that is dependent upon the timeliness of IneExchange getting that info into their computers & distributed to the individual checking accounts.
You are correct Ron. My medigap plan submits proof of payment to one exchange on the 10th of each month. That reimbursement has been processed out of my HRA as of today according to the website. Hopefully I will see it in my checking 1-22-2016. My part D plan notifies one exchange at the end of each month. However, I paid it with a credit card and sent the reimbursement form to one exchange on 1-13-2016. We will see how long it takes them to process my reimbursement on that one despite the end of month notification of payment since it was submitted manually and according to one exchange it should be 4-5 days. I’ve submitted 3 other ones manually but no sign of the money yet. Thanks for the comment.
I received my benefit for January 2016 with the deductions. I thought that I signed up (when I selected a medical plan) to have also my Vision/Dental amounts automatically deducted from my HRA account like my medical insurance. I want all of my insurances deducted from my HRA account automatically. How can I make this happen? Can I regularly receive an e-mail on my HRA activity and balances?
Please direct those questions to OneExchange. You can go to the HRA section on the OneExchange/OPERS website for detailed instructions on how to make changes.
I logged into my Connector account today and see nothing has been updated since October 1st. Our consultations were done early November. My husband & I specifically requested plans with automatic reimbursements so we didn’t have to spend time & postage to copy & mail forms. I am confused as to how the reimbursements are done…direct deposit into our checking like our retirement benefits? I have not been able to find an “FAQ” section yet. I’m sure others are confused as well. Thank you for your time!
There is a section on how the HRA works on the OneExchange/OPERS website. But generally speaking, the medical expense reimbursements will be deposited into the account where your pension payment is made unless you furnished OneExchange with a different account.
Michael Pramik, I don’t think you are correct. I was confused about how the reimbursement would work. Something I read suggested that my reimbursements would be deposited into the account where my pension is deposited. I called One Exchange to make sure this was correct, and they said they have no direct deposit info for me and I would have to enter it either on-line or submit the form. So you have to take some action to make sure One Exchange and/or PayFlex knows in what account to deposit your reimbursements.
We sent OneExchange the same banking information that we have on file for members’ pension direct deposit accounts. That was for the initial enrollees, so going forward participants will be required to give their banking information to OneExchange. That might explain why you got the answer you did. The bottom line is that all participants should be proactive in checking their banking information that OneExchange is using. It’s also possible to submit information from a different account than the pension deposit account for reimbursement from the HRA.
Diane, One Exchange had my banking information. I double checked with them and they had the deposit information I have in my OPERS account.
When will the reimbursements be deposited ? It sounds like with all the confusion with One Exchange and the time you have to spend trying to get someone on the phone, that OPERS has let their retirees down big time. Maybe you should have done more research on how well this organization operated with other companies.
It could take a couple of months for the first automatic reimbursements to appear in your account.
WHY will it take a couple of months to get reimbursed? They
OE — are dragging their feet, are HOLDING our funds up, and worse, we don’t know if they are putting back in our checking accounts or back into pension acct where we cannot access it. OPERS has let us all down. This OE is a badly run company with seasonal employees working there, who just plain don’t care to give quality service. OPERS is responsible to set it straight and correct these problems.
The Connector is working with more than 100 insurers and more than 1,000 plans. It is taking some time to get the automatic reimbursements set up.
I’m starting to get my reimbursements from the Medicare Supplemental Plan F and medicare Rx. I’m am hitting a wall trying to get reimbursed for my Medicare Part B. My claims have been denied because they need more information. Putting a denied status leaves everyone up in the air and forces us to call OneExchange and try to get the situation corrected. After doing so, I finally (after more than an hour on the phone and speaking with multiple reps) found out it has been denied because the copy of my checking account didn’t have my name on it and I filed the recurring reimbursement form. I had to refile the basic claim form and re-send all my information.Since CMS Medicare does everything by electronic banking, I cannot access my checks and since I prepaid my Medicare 3 months in advance, I didn’t receive a bill for Jan. and Feb. 2016.
What’s the problem?? We HAVE to have both Medicare A & B to join OneExchange and this should not be a problem.
Besides my time and finances being tied up, Both I and One Exchange waist time for something that should be a gimme. All this time could have been avoided if they would just post what is needed to correct a claim on our file so we can follow through on the claim. It would also be nice if they would post that they received a faxed or mailed claim instead of making us wait in limbo.
Amen and Amen. I couldn’t have said it better myself.
The expectation of OPERS “should have been” that OneExchange was more than ready for the increase in business. It is very aggravating to hear that because OneExchange has taken on a lot of new business, that it’s customers are suffering (mores specifically; OPERS retiree’s).
Totally agree. I appreciate rathe non-taxable reimbursement process, but the company stinks. The saddest part is that it seems that they are the number one player in this industry. Does not say much for this country if such a badly operating company is one of the major players. I wanted to write the CEO but could not find an address for him anywhere.
Hey folks. What can I say? One Exchange is terrible. Their customer service is the worst I’ve experienced in my life. What is sad is the they tell you one thing and OPERS tells you another. This is no way to run a railroad. One hand does not know what the other is doing or supposed to be doing and us retirees are the victims. For what it’s worth, All of my reimbursements for January are paid. But not without a lot of phone time and delay. My recurring reimbursement at set up for the rest of the year. Including my OPERS Dental and Vision. Medicare B is also set up correctly. As far as financial corrections go, one exchange should be able to fix it with the punch of a button, but from what I’m reading on the blog, a request to do so is falling on deaf ears. If I was OPERS management, I’d be all over this company for such poor service and performance. Neither me nor you should have to be subjected to this much inconvenience and sloppy handling of our monies.
Completely agree (and of course, maybe they are doing this to no avail and we simply do not know about it. Hopefully they are looking for a new vendor for next year. What scares me is that this is a huge company that that’s all of their customers poorly but they still get business. I called twice over the weekend speaking with two different people. Firstly, neither spoke decent English. Neither seemed to understand my question or know how to navigate their website. I can’t imagine why in our electronic world it takes three months to get an automatic reimbursement. These people know nothing and it’s not getting any better. I consider myself to have good computer literacy and good business acumen and I have trouble. What do the non-computer savvy retirees do?
Agree they are Terrible
How can I find out what the withdrawals from my checking account is being paid for?
I could not find the information on the one exchange web site and I tried calling the one exchange phone no. All I got was the automated system and hung up on yesterday.
Call your bank and ask them to tell you who the payments are going to.
I know who my payments are going to, Humana, but I don’t know what the payment is for.
How do I find out?
That’s information that we do not have. Your options are your bank and OneExchange, or your insurer.
I know what you are going through. We apply for reimbursement and if we submit a claim form for more than one claim, it comes in as a combined payment.
At this point,I feel we have no input from OneExchange as to what we are being reimbursed for. There is no explanation at all. We are at the a point that we are being screwed. I can’t get reimbursement because of some receipt of payment isn’t included. I call and they always find something else I need to produce. (I have logged almost 22 hrs. of my time filing, getting denied, refiling by fax, talking to Medicare and Social Security, and had to have a three call with with Medicare, Social Security and myself trying to just get a receipt from prepayment of my medicare premiums. I prepaid my January and February payments and could not get a bill. Not having a “bill” they would not approve the claim even though I submitted, re-submitted all my information.)
OneExchange should state who it’s for on our checking statements and our OneExchange reimbursement accounts.
Actually One Exchange should provide an EOB like insurance companies do. There is no way to know what they are reimbursing us for so that we can keep track of it.
Lorene, If your pension check is directly deposited to your bank account, that is where you reimbursements from your HRA are deposited. If you have online access to your bank account, you will see all deposits and withdrawals. If not, you would have to wait for your end of month bank statement to see everything or call the bank and ask them for your transaction information.
Personally, I don’t believe that the volume of OneExchanges business should affect anything for OERS retirees. If OneExchange wanted the OPERS contract along with all of the other companies it just picked up, It should have planned accordingly.
Where do I find the previous questions that I asked and that were answered?
You just look at the blogs on which you commented.
My husband and I both retired from OSU. I received a cost of living allowance, but he did not….WHY???
We cannot access your personal history via the blog. You’ll need to direct that type of question to our call center at 800-222-7377.
Can you get reimbursed for the full $104.90 that comes out of your social security check for medicare premium. Can it come out of the hra account. One of the reimbursement forms that I received with the reimbursement packet shows it being deducted also the award letter referred to was not received but I did get a (your benefit amount) statement recently, is this what I would use. Thank you!
Are you talking about the Medicare Part B premium? You can be reimbursed for it, but only for the portion that OPERS doesn’t reimburse you for.
At what point can I drop my spouse from my healthcare plan… We have been separated for several years.
Thanks for your comment. There are several moving parts in a situation such as yours, so we recommend that you call us at 800-222-7377 to discuss rather than us providing a possibly incomplete answer via the blog.
If I understand this system correctly, I have to pay my Humana and medicare premiums up front and then be reimbursed. Is the reimbursement deposited in the same bank account where my pension is deposited?
Unless you supplied a different account to OneExchange, the medical reimbursements will go into the same account as your pension payments.
Where can I find the Allowance Percentage Chart for Health Care which gives the % OPERS will pay toward HC premium based on service years and age at enrollment in OPERS health plan? I had printed a copy from the Comprehensive Guide to Pension and Health Care Changes when it came out on the website but cannot find this same chart in any of the more recent, regular publications available such as the Benefit Guide or the Health Care publications.
It’s on our website — here it is.
Thank you. One other question I have concerning health care premiums paid by OPERS vs. retiree. Does the years of service and age at enrollment in HC allowance percentage only pertain to non-Medicare eligible retirees? I keep reading about this HRA pertaining to the Connector and do not understand how much is deposited into that account. Is it the same for everyone regardless of years of service and enrollment age? Is there still an advantage to being older with more service years as far as what OPERS will pay for when retiree has to begin using Medicare and plans through the Connector?
The age-and-service rules apply to all retirees. If you have additional questions about your individual situation, call us at 800-222-7377.
Hello, I work for a city and I have 37 years of employment in opers, I also have 10 years in sers concurrent with opers. I understand that I can only use the money part of the sers on top of my opers for retirement.
I would like to know if my health care will still be in effect after 2018, I plan on retiring in 2019 with 40 years in opers.
The requirements for health care coverage eligibility at OPERS are 20 years of qualifying service credit and an attained age of 60, or 30-32 years of qualifying service credit at any age. Certain kinds of purchased service credit do not count toward health care. But if you have worked for 37 years in an OPERS-covered position, then you would qualify.
We can’t access your personal information via the blog. If you’d like detailed information, call us at 800-222-7377. But in general, premiums rose this year because we’re now basing your allowance on age and service. That will result in higher premiums.
I called One Exchange about my monthly reimbursement since United Healh Care already charged my premium to my account. The rude lady at One Exchange referred me to OPERS. Sorry I did not get her name. OPERS see above states to talk to OneExchange. Are you just late or what is the correct agency to receive information?
OneExchange should be able to handle questions about HRA transactions. We had been saying since early in 2015, however, that you might have to submit paper claims for the first month or two before auto-reimbursement kicks in. You didn’t indicate whether you are relying on auto-reimbursement or whether you submitted an individual claim for the January premium.
Here is the link to the reimbursement claim form. You might want to submit that if you haven’t already. Either way, I wouldn’t accept rude answers from someone on the phone.
So what would you do if you got rude responses? Ask for a supervisor only to be told they are in a meeting.
Does One Exchange control all monies: i.e. $300 annual amount and monthly OPERS allowance?
I understand the retiree will submit a reimbursement form for other allowable expenses other than medical and pharmacy costs that will be automatically reimbursed? At that time, all the amount unused will be held by One Exchange…is that correct?
Yes, the allowance provided by OPERS is not given to participants until they submit a claim for qualifying expenses.
Following instructions in OneExchange Getting Reimbursed Guide, pg. 13,TO SUBMIT YOUR RECEIPTS BY FAX…you will need to use a cover sheet, which you can print from your online account…followed by 4 steps to do so. Could not find the cover sheet or the Fax button. Called OneExchange and they could not tell me how to find the cover sheet or the fax button. Told me to just print out whatever form I needed and use the form as the cover sheet.
If OPERS retirees are going to be forced to continue to work with this company, please OPERS work directly with this company to improve their written instructions, websites, and overall employee knowledge. We may be retired but the poor written and oral communication from this company is a waste of our time and money. Thank you.
Received and paid my bill for med sup policy on 12/20/15. Applied and mailed paperwork for reimbursement on the next day. Reimbursement automatically deposited on 1/5/16. Can’t beat that !!
Good! Glad to hear it worked well for someone. I mailed reimbursement forms today, and I hope my reimbursement works as well as yours.
Consider yourself lucky.
Did you sign up for automatic rembursement? That’s the hold up for those of us who did. May be 2 to 3 billing cycles I understand.
My DS-2019 table will expire at the end of this month, How can I get back my retirement money? Thanks！
Please call our Member Services department at 800-222-7377. This is not a question we can handle in the blog.
i paid my ins. when will i get back the money opers,they say they will pay it for three years how long
We are issuing extra HRA deposits in the amount of $300 each January for this year and for 2017 and 2018. These deposits are scheduled to be added to your HRAs by the end of business today. If you have submitted a claim form for your monthly insurance premiums, the first reimbursements could take a few weeks. After that, they should be more regular, especially if you have selected auto-reimbursement.
I was under the understanding that you do not have to file a claim to get your monthly insurance premiums back —- if I automatically signed up – I should have it automatically put back in my checking account — but how long does it take??????
We are advising participants that it could take about eight weeks to receive their first auto-reimbursement, so they might want to file manually before then if they do not want to wait for auto-reimbursement.
But if you file manually, where do you get the proof it was taken out. Your statement at end of month????
Yes, or you can go to your online account where you can print a copy of the premium receipt/letter for the current month or any previous months beginning with January.
So if we used the automatic rembursement we should still fill out the rembursement form for the first month?
You don’t have to. If you want to get that first reimbursement sooner, it is an option.
I have read the numerous questions put forth by our members regarding their HRA’s. I think they need some clarification by OPERS.
Most of them seem to realize that the monthly HRA contribution that comes from OPERS will be accessible only through OneExchange. The confusion is coming from the $300 initial shot of money to carry our finances over during the reimbursement process. They need to know when they can access this money and where will it be put, into OneExchanage’s accounts or their personal bank account.
Whenever people call OneExchange, they get put on hold and then ultimately are told, “they don’t know that answer”. I agree, it’s a mess and OneExchange is causing most of the mess.
I think part of the problem is a misunderstanding of what the HRA is. The HRA is a health care plan established by OPERS. By itself, the HRA is not a bank account. When participants enroll in health care coverage through OneExchange, an HRA account is set up for them. This account is just a bookkeeping entry — it records money coming in and money going out.
We “deposit” money for the HRA plan into the HRA account established in the retiree’s name. The retiree then can request that all or part of the balance in this account be transferred to his or her bank account after the retiree pays a qualifying medical expense.
As we have stated in previous blogs, the monthly allowance should be deposited into the HRA account at or near the beginning of each month. The extra $300 deposit is scheduled to be in the account by Jan. 8.
Much of this is stated in the Summary Plan Description of the HRA, which is on the OneExchange/OPERS website.
You say that “whenever people call OneExchange, they … ultimately are told ‘they don’t know that answer.’ ” Can you offer proof of this? If so, we will contact OneExchange and draw attention to those representatives who don’t understand the basics of how the HRA works.
I called One exchange on Monday, January 4, and was transferred to Ricky in customer service. He knew that there as to be a $300 extra deposit, but didn’t know that it would not be available before tomorrow. He was helpful and promised to follow up for me.
You can submit the annual payment now, and you’ll be reimbursed as funds become available in the HRA.
You directed us to the website OneExchange/OPERS, but didn’t tell me the address. I would like to read the Summary Plan Description of the HRA. I have looked on OPERS’s website, but as usual, nothing is easily found there.
Could you give the website address?
Sure. It’s: http://www.oneexchange.com/opers
I’m really confused. I enrolled for automatic deductions and re-imbursment during my calls to One Exchange. I signed up on their plans and just found out that HumanaRx-Walmart sent me a payment book and I was to pay the monthly premium each month, send in a receipt to file a claim, and wait.
They sold me a product, have the right to take costs out of my bank account, and can’t get this set up since October??
I thought this was automatic and find someone is dropping the ball. Why can’t this be simplified? We should not have to go through all this!
Also, all these costs and problem are stated that our medical insurance changes are due to the up coming “Cadillac Tax”. This has been repealed! OPERS is reneging on their promises of medical care for myself and spouse. How can they do this to their retirees?
We suggest calling your insurer to settle this matter.
And regarding the Cadillac tax, OPERS did not increase premiums because of this tax. The tax has not been repealed — only delayed by two years. That happened in December. We had to have our 2016 plan set before open enrollment in November.
what happen’s if you don’t use the hra at all? if you are pretty healthy,and don’t go to doctor’s much, or hospitals,do you still get a reimbusment?
Yes, the allowance still will be credited to your HRA account. The money carries over and accumulates, and you can submit claims for the funds in the future when needed.
Regarding the answers from One Exchange giving up incorrect info. Have you heard of mystery shoppers, try mystery callers. I am glad to know that I am not the only person getting the run around. I have been told to refer my questions to OPERS. who in turn say, this is a question for One Exchange. I think there was not a lot of meeting of the minds when this plan was set up. There is no way we can really prove the answers we are getting, it is our word against theirs. Bottom line is we are in the dark about reimbursements. Some of us have used money allotted for other things to insure we have medical insurance in hopes the reimbursement would not take long. We are now told it’s a 4-6 week wait.
Good comment Valori. The performance of One Exchange is very poor for a company that has been doing this for over 10 years, whether OPERS is a new client to them or not. I thought calling customer service of a large corporation and getting shipped off to a customer service representative in India, the Philippines, etc was bad. But this customer service is worse. On a positive note, customer service when we signed up on the “pick a plan” enrollment side of the fence was very good. On the reimbursement side…it’s terribly lacking.
Will an online video be made available of the OPERS seminar “Moving Forward With OneExchange,” especially the Health Reimbursement Process, for retirees unable to attend the seminar in person?
Yes. It’s on the OPERS website now.
On Dec. 2nd, 2015 I called Coventry(Aetna) to have my Drug Part D premium set up to come automatically out of my checking account. I was given a confirmation number and assumed that everything would go smoothly. WRONG! After checking every day since the New Year kicked in, I finally called today(Jan. 8th) and was told that they have a new system and I need to start over because what I already set up would not transfer to the new system. I have had my cards and coupon book for over a month and now the past due date is Jan. 10th. It has been one nightmare after another and absolutely no follow up from One Exchange since my enrollment in early November!
Who then do we call to make sure that it will automatically be put back in our checking accounts? I gave my checking information, but do I assume I have to do it again?
My husband passed in August of 2015. I have yet to receive my monthly benefit or the lump sum. I did receive the one time death benefit. Can you tell me when this will start?
That benefit is being paid this week. If you have questions about it, please call us at 800-222-7377.
I just logged into my OneExchange OPERS account. Under the “Funds & Reimbursements” tab, I found a “Review & update automatic reimbursements settings” section on the bottom right of the page. There, it shows that my husband and I both have automatic reimbursements “turned on” for our Medicare and our Prescription Drug Plans. I had not submitted any forms, so I assume since we requested our premiums be automatically deducted from our bank account, we were automatically enrolled in automatic reimbursement deposits. We have seen nothing yet, but will wait until next month to inquire again. Hope this helps some of you check your status.
It’s not correct that because you requested that premiums be automatically deducted from your bank account that you are then automatically enrolled in reimbursement. Those are separate functions, and you have sign up for both separately. You will have to request reimbursement.
I just hung up from speaking with 2 folks from One Exchange. First was Shiree (sp?) who confirmed that with those functions in my account “turned on”, I am set for automatic reimbursements. HOWEVER, she forwarded me on to Lakeshia in the Funding Dept. In short, she told me that once premiums are paid, they are notified by the Insurance Companies & reimbursement is then made to our bank account info provided. I asked her several times about the process & after putting me on hold, she again confirmed me all will be reimbursed…though it might take 3 months.
I paid Aetna PDP directly for my entire year of premiums with a credit card. Lakeshia said Aetna, like Humana Medicare, that they will notify One Exch. & reimbursement will be sent to my bank account. I have a feeling come March, I will be making the same calls.
Thanks for these posts…I hope they are helpful to many.
Yes, that’s how the process works. Thanks for your comment and for reading PERSpective.
Marcia, I was told the same thing during open enrollment. I have re-reviewed all the videos and the documentation I have received about the medicare connector. It does not all agree in detail. We will see if reimbursement is anywhere close to timely.
If my spouse picks up Medicare Part A effective July 1, 2016. Will she receive the $300 payment?
The extra deposits do not apply to current spouses or surviving spouses of OPERS members.
I just checked to make sure that my new health insurance company deducted the premium from my checking account. Well they did deduct the premium for my husband but they not deduct my premium. I have tried to call Towers Watson, the insurance company (Medical Mutual), and PERRS, but no one is available to talk to me.If you have a problem on the weekend you just have to wait until Monday to address it, I guess. I received a letter stating the premiums would be deducted on the the 4th business day of the month. Now I am VERY concerned that I am not insured. I had called the insurance company earlier in the month to confirm the the amounts of the deduction, because the letter the insurance company sent me only stated they were going to make the deduction, they did not state the amounts. Now they have only deducted my husbands premium and not mine. If anyone has signed up for the automatic deduction for their health insurance you should make sure they made the deduction. And if they didn’t you can forget about talking to ANYONE on the weekend. I sure do hope I still have insurance!!!!!!!!!!!!!!!!
In order to use the One Exchange automatic reimbursement program, do I have to sign the agreement ? Which so happens to take me OFF the One Exchange web site?
Which says they can never be held liable for ANYTHING THAT GOES WRONG ON THEIR PART?
I don’t like that. It also says that I must maintain my computer, which sometimes I cannot get fixed.
You can either authorize it over the phone or follow the instructions online.
It is nearly “impossible” to get to a person at One Exchange. Try it. When you do get someone – they transfer you some where else. Conflicting answers.
Are PERS vision and dental premiums reimbursable as well a medicare premiums deducted from retirement benefits ?
Yes, those all can be reimbursed.
Thomas, I called OPERS today and learned that you don’t have to call them to get a Health Care Premium Receipt. Login to your account at OPERS. On the home page under Requestable Documents (look on the right side of the page) click on Health Care Premium Letter. Click on the “Documents” tab at the top of the page. The Health Care Premium Receipt will be available. Much easier than having to call OPERS for the form.
I paid the premium for January for both my & my husband’s drug plans online a week ago & requested reimbursement on the same day. My request was accepted. As of today, I have not received the reimbursement. Also, the premium for one of our medical plans was automatically deducted from our checking account. I would like to apply for reimbursement now, but have no invoice or paperwork to use to do so. I am concerned that reimbursement will be very slow & we will all have a lot of money tied up while we wait. This is not off to a good start. One Exchange has not been impressive from the beginning of the insurance enrollment. I am hoping that OPERS will look into all these problems & take steps to speed up reimbursement.
There is a link to a reimbursement form on the OneExchange/OPERS website.
I don’t need a reimbursement form. I already submitted for reimbursement of the premiums for 3 of our plans. Will be applying for reimbursement for the 4th one, when ever I receive the proper paperwork to submit. My complaint is that I have not received any reimbursements.
I requested an invoice from Medical Mutual so I could submit a request for reimbursement instead of waiting for automatic reimbursement. I was told by Medical Mutual that they could not provide an invoice since the premium was automatically deducted from my checking account. That is one more problem associated with the reimbursement process. I did request & receive reimbursement from Aetna & Silver Script & am awaiting a reimbursement for my Cigna premium.
My understanding is this: I signed up for auto-reimbursement and it may take a few months that when your money for medical and prescriptions is automatically taken out of your checking account, it will be put back in (mind you, I said they told me it may take a few months (cycles). When you get a prescription, you will have to file a claim form to get reimbursed. I hope I am saying this right. Please, anyone reading this, if I am wrong, say so! Thanks.
That’s correct. You also can file for automatic reimbursement of prescriptions. Here is a list of the items that qualify for reimbursement.
My automatic Medical Mutual premium withdraw was NOT withdrawn, while my husbands automatic Medical Mutual premium WAS withdrawn from my checking account. I contacted Medical Mutual this morning. The checking account number Towers Watson One Exchange provided Medical Mutual was missing the the last number. I know I gave them the correct number ( because my advocate read the numbers back to me) but somehow it the last number was omitted when it was sent to Medical Mutual. So I would advise members check and make sure the their insurance has been deducted or they may find themselves without insurance. Also the automatic reimbursement will take up to a month. So if people are thinking they will get reimbursed right away, they will not. It takes time to process.
I too, like Robert and others on this blog were told by one exchange when we signed up that if you signed into a plan that allowed for auto deduction for the healthcare premium (s) that I did not have to send in a recurring reimbursement form with the appropriate documentation required and that I would automatically be reimbursed when one exchange received notification from the healthcare provider that they got my payment for the premium. As far as those providers that would not allow for auto deduct for premiums at the outset that I would have to send in a recurring reimbursement form to one exchange before a reimbursement to me would happen. I have one auto deduct and one paper billing situation. My auto deduct took money from my savings on January 4th. One exchange’s site says under this arrangement I would be reimbursed in 3-4 days. It’s been a full week now. I just sent the other one for the paper billed provider today with all the stuff requested on the form. Their website for my acct show that auto reimbursement is “ON” for both medical and prescription plans I have. The way I’m reading your responses to this issue on the blog is that for auto deduct, I still have to send in a form to one exchange so auto reimbursement will kick in. I just talked to one exchange an hour ago about this. The representative denied that their site said 3 to 4 days and that I would probably not start seeing reimbursements for any situation until after 2-3 billing cycles. I have read (in detail multiple times) every piece of info you or one exchange have provided including all of OPERS videos. What is happening is not what was indicated. This is the worst contracted system I have ever seen. It’s even worse than when the State of Ohio mandated all counties to convert to a state operated child support system (which I was in charge of implementing for Stark County. It did not work as planned and took 3 years to get the bugs out of it. I suggest you get together with One Exchange and get this program implemented more efficiently. Our retirees deserve a lot better that what we are putting up with presently.
It was our understanding that OneExchange has always been saying that it will take one or two billing cycles for auto-reimbursement to begin. Can you be specific about where you saw OneExchange state it would take three or four days? We’ll ask them about it if you can send me the website address where you saw that.
The following is right from the Towers Watson website:
How will I be reimbursed for eligible expenses?
“Once your claim(s) and receipt(s) have been received and approved, you will receive your reimbursement within 14 days. If you have elected direct deposit, your reimbursement will be deposited onto your checking or savings account within two to three days of the claim approval.”
To get to the above statement, you have to access your Towers Watson account online.
Select the Funds and Reimbursement tab.
Under the heading Contacts and Resources select submit a request for reimbursement or download direct deposit forms.
You will be sent to another website (HRA Service Privider’s Site.
One the left side of the screen under FAQ Quick Links:
Select All About Reimbursement Accounts.
Read everything but the statement I referred to is the 3rd paragraph down.
In addition, the ‘Getting Reimbursed Guide’ which I received after I enrolled in my healthcare plan, See page 22 at the bottom. This reads as if it is for reimbursement requests manually submitted by the retiree and the you would receive your reimbursement within 3 days. That too does not agree with the statement on the website as it indicates “within 14 days”.
Also, in the Guide on page 23 the section for How Long does Automatic Premium Reimbursement take?, you will find statements that also do not agree with their website statement.
I fully understand why there is so much confusion by retirees. There is lots of conflicting information in the documentation, websites, phone calls and videos. It’s about time these inconsistencies get reconciled to a single correct answer.
And just for your information, Humana told me they send the “ Premium Paid” information to One Exchange electronically on or about the 10th of each month. Silver Script also does this but not until the end of each month.
My automatic reimbursement for my prescription drug plan premium was deposited into my checking account yesterday. Much quicker than I expected. Yay, One Exchange! I am surmising that any delay in automatic reimbursement might be because the insurance companies delay notifying One Exchange that our premiums have been paid.
I paid the prescription drug premiums for two months because I thought the first was lost in the Christmas mail. It finally showed up, and now I am paid for both Jan and Feb premiums. My deposit into my checking account included both premiums. Since OPERS said it would take a couple of months to set up auto reimbursement, you might have to pay premiums for two months before it kicks in.
I was inquiring about the HRA, the reimbursement that people are taking about is for the One Connector which is for Medicare only is that correct. Or do non Medicare participants also have an automatic $300.00 deposited to the HRA. I have received notification of an HRA account I have and the amount is different then the $300.00
The $300 is only for participants in the Connector. There also is an amount going into the HRAs this month as the regular allowance, which is a different amount than $300.
I mailed my “Request for Enrollment in Medicare Part A” form to the designated office in Columbus on Dec 9. I haven’t received anything to date. How is the process going? Please advise.
If you are referring to our plan for those who did not qualify for premium-free Medicare Part A coverage, here is the schedule:
* You will remain in the OPERS group Medicare plan through June.
* The Medicare open enrollment period is now through the end of March for a July 1 effective date.
* From April through June, you select coverage through OneExchange.
* Once you pay the initial premium, Medicare will send you a Notice of Award letter.
* You can submit the letter to OPERS for reimbursement (through your pension check).
* Your new coverage begins July 1.
I made my third phone call to Coventry(Part D) regarding my premium not coming out of my checking when I set it up in early December. I was told last week that they had a “new system” between December and January so I gave them my information again and was told it would be 1 business day for the transaction to start deducting my premium. After 3 days of no transactions, I called again and was told that I missed the cutoff date is the reason it hasn’t been deducted. At no time during that last call was any kind of cutoff date mentioned. Now they are supposed to take 2 payments out in February even though I might get a letter saying I’m past due. I have had the coupon book for over a month and just wanted to do this electronically as the letter stated along with the coupon book. This has been awful.
OPERS has done a terrible disservice to it’s retirees who were required to go through Towers Watson to not only select a Medicare and/or prescription drug plan but also rely on them to process reimbursements from my OPERS HRA medical benefits entitlements. OPERS was sold a bill of goods when they contracted with Towers Watson to handle reimbursements in a timely manner. Your desire to rid yourself of picking healthcare plans, payment processing for premiums and reimbursement for retirees health care entitlements is understandable, but you contracted with a third party whose past performance has been nowhere close to efficient. It was flat out a bad decision. 2-3 billing cycles or 6-8 weeks or even a month to process reimbursements against proof of payment from healthcare providers is totally unacceptable in todays’ modern world of highly efficient financial transactions between companies and individuals. You should have contracted with Towers Watson to help retirees pick healthcare plans and then let the plan provider(s) or the retiree(s) demonstrate to you that the premium/bill has been paid and then you reimburse the retiree along with their monthly pension check. How hard would that be? Not very difficult. (trust me…I know how to set up computer programs that do just that.) You are not paying the $2.00 per month that Towers Watson is getting for every plan they sell. The healthcare provider is paying for it to sell their goods. Sorry, you messed up and our retirees are the victims, many of whom budget their money day to day, week by week or month by month to survive, especially when it comes to the high cost of healthcare, food costs, gas costs or utility costs.
why was my opers benefits deductions for vision & dental taken our of my benefits check. I had signed up with One Exchange as required. Is this going to be corrected or will this continue for the year? I need that $25. you have removed from my check. I have called the 800 number for days & was always told to call later. This is ridiculous for us to have this kind of problem when we did our part. Please reply! Thanks
If you are enrolled in OPERS vision and dental care, that’s how the premiums are paid. It was the same when we had our own health care coverage. You can request reimbursement of these premiums from your HRA.
when we signed up with One Exchange these were supposed to have been canceled automatically. So why should we as Retirees have to ask for reimbursement when it is a mistake made by OPERS. I wish to see this corrected before my February check. Can u give me the correct person to contact, or please send this information to their attention. Thank You
Thanks for your comment. We are doing nothing different with vision and dental coverage. There is no change, thus there is no mistake and nothing to correct. We are perhaps not on the same page here. The vision and dental coverage is separate from medical coverage. Those plans were not terminated as our group health care plan was.
I have VSP vision which I paid for & no dental. I forgot to answer that question.
No, you won’t have to contact any of our trustees. However, you’ll have to call us at 800-222-7377 and speak with a Member Services representative, because this is not the kind of issue we can solve through the blog.
What I am reading from all of OPERS members is total confusion. Because you are not on this side of the fence, it is hard to understand. The entire One Exchange process is extremely confusing and their Customer Service is less than desirable.
This entire situation with One Exchange could have been made so much easier than what it is. I am sitting here (daily) trying to figure out how to get my money.
Last week on One Exchange site (under the Reimbursement section) there was a Recurring Reimbursement Form and no form concerning Medicare part B. I was to receive a “special” form in the mail from One Exchange that pertained specifically to Medicare Part B reimbursement. However, now I see that the Recurring form for Medicare Part B is on the site – BUT – now the plain ol “Recurring Reimbursement Form” is gone. (and by the way – I never did receive the form in the mail, as I suspected I wouldn’t).
Is it no wonder people are confused?
It is not easy to just call “One Exchange” unless you don’t have a life.
The recurring reimbursement form is on the OneExchange/OPERS website. You can use this form for your Medicare Part B reimbursement.
Since last week, this site is changed. Last week the Recurring Reimbursement Form was on the site (with the Reimbursement Form. This week (as of Monday) The Recurring Reimbursement Form Medicare Part B is on the site as well as the Reimbursement form. The Recurring Reimbursement form for Medicare Part B is specifically for that.
The Recurring Reimbursement Form was on One Exchange and now it isn’t. The explanation that One Exchange gave me is that they are constantly changing their site.
This form is no longer available on the site for OPERS participants to view.
I was also told by One Exchange that the address on that form is incorrect. (correct is El Paso Texas – so they say)
Thanks for pointing that out to us. We have looked into it, and you are correct. OneExchange is editing the forms that are on the OneExchange/OPERS website, and the corrected versions should be online shortly.
I have already mailed two requests for reimbursements to the address on the previous forms, which was a P.O. Box in Omaha, Nebraska. Does this mean they won’t receive my reimbursement requests. One of my requests was the Recurring Premium Request Form on which I requested reimbursement for my medicare Part B premium. If One Exchange receives it, will they not consider this because I used the form that was available at the time? Also, on the new form, it shows a beginning date of 4/1/2016. I don’t understand that. I am paying my medicare premium in January of 2016. Is that a mistake on the form, or does that mean we cannot get reimbursed for our medicare premiums until 4/1/1026. Also, the amount of the requested premium is pre-printed on the form as $104. My medicare premium is more than that. I think I should be reimbursed for the premium I pay, not for the premium somebody else pays, because that is my actual expense. Are we limited to reimbursement of $104 for Part B?
The form will be forwarded from Omaha to El Paso, Texas. It will take a couple of days longer to process.
I don’t know why that form has an April 1 date. That’s a question for OneExchange.
Regarding the Med B premium, you can request only what you paid. That would be the premium minus OPERS’ contribution, which this year is $31.81.
I thought the correct reimbursement form was to El Paso, TX. This one is for a different state.
The correct address is in El Paso. OneExchange recently updated its forms. If you have one that states to send the form to Omaha, it will be forwarded to El Paso.
Automatic Reimbursement – Confusion
Guide to Requesting Recurring Premium Reimbursement: 2nd page – 1st paragraph of Recurring form.
Option available to those who do NOT have Automatic Reimbursement available on a policy.
In my mind this means if your insurance company has Automatic Reimbursement available – your payment will be drafted from your bank account, the insurance company will send a report to One Exchange and then your will be “Automatically Reimbursed”.
On One Exchange Resources tab in the Reimbursement section under Educational Materials:
Using automatic reimbursement, YOUR INSURER WILL DRAFT PREMIUM PAYMENTS DIRECTLY FROM YOUR BANK ACCOUNT AND SUBMIT YOUR REQUEST FOR PREMUM REIMBURSEMENT TO ONEEXCHANGE AUTOMATICALLY.
I received a call from a Senior Tech last evening regarding the above. Kursten told me that this information was incorrect.
If I originally signed up with the insurance company to receive a bill and pay by check I could still use the automatic reimbursement and the Recurring Reimbursement Form.
This information is not for OPERS. This is for all of the weary souls out there wondering why they can’t understand.
Very unclear information.
You are exactly correct Vicky. The exact thing happened to me. I was told however that the “special” Medicare part B form would take about 8 days before I would receive it as it was being mailed out of Texas. It has not been 8 days yet in my situation. But I downloaded the form (when it showed up on line), filled it out with all pertinent info and mailed it on Jan 7th. We shall see what happens but based on the conflicting information about the speed of getting reimbursed, I am not holding my breath that I was see any monies anytime soon. Yes, this could have been made so much easier and more efficient.
The answer you provided to my question of January 12, 2016 at 12:21pm. regarding my “Request for Enrollment in Medicare Part A” form was not the answer I’m seeking. I understand the process. My question is regarding the “Request for Enrollment in Medicare Part A” form that I sent to the designated Social Security office. I mailed it 12/09. I have not received anything to date. I am concerned as to what has happened to my request, Did they receive it? Are they working on it.? Is there another contact source to find out the status of my request?
If you’re asking what happened to a form that you submitted to Social Security, you’ll have to ask Social Security about its status.
One Exchange did not seem to have any problem arranging for the insurance providers to get their premiums automatically deducted from OPERS members’ bank accounts on a timely basis. How come they cannot arrange for the OPERS members to get their reimbursements timely?
They have had control of the members’ allotment money deposited by OPERS since prior to January 1st. That money is in One Exchange’s account / control, and they do not seem to be making it a priority to be reimbursing OPERS members’ accounts. Maybe it is time for OPERS to be talking to One Exchange on behalf of the OPERS members.
After reading the massive amount of paperwork regarding the new OPERS health care, I signed up and paid for the first months’ premium. I must have missed the part where you don’t actually receive the dollars in your bank account to be spent like an HSA, but One Exchange keeps all the money until you submit for reimbursement. So, One Exchange could possibly have thousands of MY allocation money for my family and One Exchange will no doubtedly earn interest, etc. on my allocation money if I don’t spend any of it. Multiply that by all of the OPERS retirees that also receive allocations and see what kind of money One Exchange has.
Knock on wood, we are pretty healthy now so we may only have to use the allocation for the premiums. Why can’t this be treated like an HSA account that I have now from when I retired and have used very little of it?
We wanted to allocate allowances for an exchange on a tax-free basis, and this was the way to do it.
Not an HSA per se, I understand that, but isn’t there some way that One Exchange does not profit from us not using all of our allocation and we earn the interest on OUR money-not them?
Based on some of the other comments, One Exchange really, really needs an overhaul to be able to talk clearly and understandably to the retirees it supposedly serves. How much does OPERS pay them to handle all of this???
Also, I don’t quite understand what takes so long to get auto reimbursed on premiums paid…
The money in the notional HRA accounts is never in the hands of OneExchange. Thus, they cannot earn interest on it.
OPERS oversees this funding — it is placed in notional HRA accounts until the participants request reimbursement. By notional, we mean used only to calculate payments.
This message is to OPERS regarding OneExchange and the medical coverage nightmare you have imposed upon your retired Medicare recipients. OPERS signed the contract with OneExchange/Tower Watson and are therefore responsible for these problems. Of course, if anyone expresses frustration to OPERS, one is immediately referred to OneExchange where we experience wait times and wrong ambiguous answers beyond anything we should have to endure. On top of that, it is beyond my understanding or comprehension why we have to wait 6-8 weeks for EFT premium reimbursements when anyone in the civilized world can perform that transaction within 24 hours of the premium being received from the retiree. I’m very angry with this! But wait, this is not your problem, even though you created it by signing the contract without any consideration for the retirees who have to grapple with the consequences. I have talked with several Medicare OPERS retirees who are equally as angry and feel abandoned by people who have historically acted on our behalf. You have failed miserably with this.
During the OPERS seminars and information about retirees’ 2016 health care changes, we were assured of the knowledge and competency of One Exchange to broker this life changing events. How horribly disappointing this transition has been. We have spent hours on the phone with One Exchange before 2016 when selecting a plan. We have also spent hours on the phone since 2016 began. One Exchange is not capable of providing a good product. The employees cannot answer questions, and often just read a canned statement from the website. We enrolled in automatic premium payments but now are receiving bills. No one at One Exchange can look at our account and verify that we have enrolled in automatic electronic funds transfers for the premiums. They can’t see that information and neither can we when we access our account online. There is nothing that shows what method was chosen to receive premium statements. The latest advice given today is: Just pay the bill you receive, it may take 90 days to process EFT requests. It may also take 90 days to receive automatic reimbursements. Surely, there are more efficient brokers available than One Exchange to provide these services. Seriously disappointed in the choice made by OPERS to contract with this organization. It’s going to take diligence to ensure we are not paying the same premium multiple times via multiple avenues and then to ensure we are properly and completely reimbursed. Nice burden for senior citizens. Not so sure all are up to the task or even aware of the issues.
Ditto!!!!!! Such an awful transition and horrid experience with One Exchange! Immensely disappointed in OPERS. What a disservice to the retirees.
Will you be having webinars as well as the “Moving Forward with OneExchange Seminars?”
The Moving Forward with OneExchange seminar is in video form on our website.
Looks like OPERS has failed the retirees. This complete process in well beyond comprehension. Talk is cheap and that’s all we’re getting is TALK! Do this… Do that!… Then…
These forms are confusing, let alone trying to supply receipts and documentation. Why are we required to send in receipts and such for drug coverage that we arranged through One Exchange that we have requested to be automatically taken from our bank accounts and signed up for automatic reimbursement?
Why do we have to required to send in an additional form for our Medicare B that is also to be automatic? (we can’t join the One Exchange program unless we have Medicare A & B! They have all of our banking info and our requests for auto payment and reimbursement. What’s the problem here?)
Also, these forms require all our personal information. They are putting everyone at risk for identity theft, requiring our Social Security numbers, FULL name, etc. Why didn’t One Exchange assign everyone a
personal account number? Mail or fax… it very risky.
I faxed in my forms, however, I have no idea if they were received. Nothing on my web site account… no nothing! Some sort of contact would really be nice instead of keeping the retirees in limbo.
Connector participants are not required to turn in receipts for auto-reimbursement of premiums that they signed up for during enrollment unless they want to avoid waiting a couple of months for the first reimbursements.
Also, participants are required to turn in receipts for Medicare Part B because they are paid through Social Security. You can submit a recurring reimbursement form to OneExchange for this reimbursement. You’ll only have to do it once per year, although you will have to set it up again at the beginning of 2017.
Thanks Mr. Pramik for the response, but maybe you don’t understand the situation.
Upon joining OneExchange, I was informed that by suppling my banks information for automatic payments and reimbursement and signing up for Florida Blue, Humana Rx, and proving enrollment in Medicare B , that all would be taken care of. I contacted OneExchange Mid January and was informed that I must apply for everything by contacting my insurance companies and also must mail or fax all these receipts and acceptance letters for consideration/re-payment. As to date, I have been reimbursed for my January payment for Florida blue (Plan F). On the same fax as my Plan F, I included my monthly information for my Plan D coverage, contacted OneExchange and was told they don’t show anything…can’t access my records and to give it another week or so. Same fax… 2 items… process one…and no record of the other? What’s wrong here?
Also, same day and time, I faxed all my required information for my Medicare B requesting reimbursement for my Jan. and Feb. payments I have made. Once again, they show nothing.
I have had to call both Florida Blue and Humana and re-sign up for auto pay from my checking because the had no such information.
Somebody at OPERS needs to get on top of this and do something for the retirees. Pick up the ball and get this figured out!
Hi Michael. What is this man referring to. I have not submitted anything to get my part B reimbursement. I must have missed something. Please tell me…please don’t ask me to call One Ex. All I do is call them. It gets worse every time. I wouldn’t know how even to ask my question, here. JA
I encourage you to read the recent Q&A about the HRA reimbursement that’s on the OPERS websit
We believed he was paying his Med B premium by himself, either monthly or quarterly. That’s opposed to having it deducted from his Social Security check.
In those cases, here is how OneExchange explained the reimbursement process to us:
Connector participants who have their Medicare Part B premium deducted from their Social Security check receive an award letter. It states the amount that is deducted on a monthly basis, and it serves as both proof of coverage and proof of payment; no further documentation is needed. These participants may use the recurring reimbursement form for their Medicare Part B premiums. They will need to resubmit a recurring reimbursement form on a yearly basis.
Connector participants who pay Medicare premiums on a monthly or quarterly basis need to provide proof of coverage and proof of payment, and submit both using a standard form from OneExchange. The reason is that the statement they receive from the Centers for Medicare & Medicaid Services does not indicate coverage for an entire year — only for the relevant month or quarter.
Several options are available for proof of payment for these participants. They include canceled checks, copies of bank statements showing payment of the named premium, credit card statements indicating payment of the named premium, or a statement from CMS showing they have provided payment for the months in which they are seeking reimbursement.
Yes Michael, I DO NOT RECEIVE SOCIAL SECURITY, therefore I must make monthly or quarterly payments an submit the standard form to OE for reimbursement. I have enrolled in automatic payments from my checking account and they said they have forwarded the information to OE. I have found that auto reimbursement for Medicare B is not available and must be mailed/faxed to OE on the basic reimbursement form. I just ask why! We MUST BE ENROLLED IN BOTH MEDICARE A & B to sign up with OE. I have been denied reimbursement for Jan. & Feb. and just don’t understand. I have re-faxed all information and have heard nothing. Did OE receive my request? is there a problem?… They need to address keeping our retirees informed. Phoning OE is a pain because NOBODY can answer anything.
If retirees have the Medicare Part B premium deducted from their Social Security check, they can get the annual statement from Social Security documenting that payment and use that for the proof of payment needed for the recurring claim form. They can obtain that statement online or by calling Social Security to request it.
If they are making monthly payments they have to submit proof of payment monthly (or periodically as the case may be) along with the regular claim form to receive reimbursement. This requirement to regularly submit proofs of payment negates the ability to use the auto-reimbursement process.
question to OPERS about medicare Part B reimbursement. I asked a question, but you answered a question I did not ask. You told me I could only get what I part for Part B minus the $31.81 that OPERS is reimbursing me. I already knew that. I am concerned whether One Exchange is going to limit my reimbursement to $104.90. Because of the premium I paid, I should get more than that even after subtracting the $31.81. I am expecting (hoping) to be reimbursed for the Part B premium I actually paid (less the $31.81).
You should receive the difference between what you paid and $31.81, providing there are sufficient funds in your HRA account.
I firmly believe that the biggest issue people are having at this time is with OPERS and their washing their hands of any responsibility whatsoever. The answer from OPERS continually has been to call the One Exchange number and or a brief response with a link back to One Exchange. What you all don’t seem to understand, nor obviously care about, is that first you wait for “hours”, then you are transferred, then you are transferred again, given conflicting information and wind up where you were at the beginning.
So, it is left to the retirees to struggle with this situation without any assistance from those we had so much confidence in for years and years. It is a sad state of affairs.
Okay, I have read all the information sent to us. I have watched all the videos. How do I get HRA reimbursement for the vision and dental premiums deducted from my monthly checks? The video said call OPERS for a receipt. Can’t get through! On the blog, one person said it was available from the OPERS homepage. I looked & looked & looked. How do I get the receipt?????
It is not available on our home page. You need to log into your online account to find it.
Here is information from our latest Q&A on HRA topics:
In order to receive reimbursement through your HRA, you will need to a file a reimbursement claim with OneExchange. When you submit this claim, you’ll need to attach a premium receipt/ letter from OPERS which serves as proof that you have paid the OPERS premiums. You can get this premium receipt by logging into your OPERS online account and printing a copy of the premium receipt/letter for the current month or any previous months beginning with January 2016. Reimbursements for premiums paid to OPERS are not eligible to be set up as a recurring reimbursement with OneExchange. However, you can request reimbursement for multiple previous months at one time.
I talked to a woman at One Exchange about Medicare Part B reimbursement. Didn’t get her name, but she seemed to know what she was talking about. She said in order to get Part B reimbursement, you have to send your benefit award letter from social security showing the amount of your Part B premium. You also have to send something from OPERS showing the reimbursement from them for $31.81. She said they need that for tax purposes. I sent a copy of my benefit change notice statement that I got the first of the year. It shows the monthly benefit from OPERS, all deductions and the $31.81 medicare reimbursement.
On January 11, I called One Exchange to inquire about how to submit reimbursement requests for the monthly vision and dental premium payments that are deducted from my OPERS monthly benefit payment. I asked if it was appropriate to submit a Recurring Premium Reimbursement Form, as the same amounts are deducted each month. The benefits advisor told me “Yes, you can submit your vision and dental premium reimbursement requests on the Recurring Premium Reimbursement Form.” I know I did not misunderstand her, because she also confirmed that I can list both the dental and the vision premium reimbursement requests on different lines of the same form. I did as she instructed and mailed the form to One Exchange. On January 15, OPERS sent me an email releasing their latest “Moving Forward with One Exchange Seminar video, as well as a link to “Answers to Common Questions.” Both of those resources stated that one cannot submit these types of reimbursement requests via a Recurring Premium Reimbursement Form. This is yet another piece of incorrect information that was directly told to me by a One Exchange employee. (I also had a benefit advisor give me incorrect information during my enrollment phone call last October.) OPERS needs to get after One Exchange to ensure that their employees are giving accurate, clear information to us. I dread making any more phone calls to One Exchange, because their answers to my questions are so unreliable.
Agree with Willam E Murphy’s take on One Exchange. Called numerous times to Funding/Reimbursements & got conflicting information each time. I have even gotten direction and instructions from the staff on what to do – two times – only to find out it was flat wrong. One with dental and vision (just found that out thru OPERS notification can not do recurring) and one with auto reimbursement giving double reimbursements for same thing. Those mistakes cause unnecessary problems for me and my HRA. How do you work within such a system with any level of confidence? You can not. They do not have adequately trained staff to field questions, have not been adequately trained on OPERS customer needs and they can not or will not resolve a problem. This is a sampling of what I heard from them in my 5 calls to-date – well this is all that is on the screen at this time; your requests that have been faxed could take 3 -5 days or 7 – 10 days to process – no I have no way to check to see if they have been received or are being worked on; I do not know if you get notification if it is denied; oh that DPA for your mother that you submitted and OneExchange accepted may be visible on your screen in your account but it is not visible or available to me so because I can not view it in Funding and Reimbursements you will have to resend the information to Funding and Reimbursements at this fax number before we can process anything for her (she is 96) so even though it is in One Exchange system Funding and Reimbursement needs it again or they can not process her requests ; Oh you sent in recurring reimbursement paperwork for an auto reimbursement account – should not have done that – I did it because your representative told me to do it – that really messes up a HRA – what do we do – should resolve itself by March, if not call back; we never know when the auto reimbursement for a particular premium comes to you it might be same date each month/ might not just depends; received a reimbursement but could not get details what it is for – though it was duplicate – yep it is duplicate – but this representative said not a duplicate could not be a duplicate probably the insurance company had taken out February premiums early (I called bank no the insurance company did not take out February premium early) you just need to wait for it to resolve itself – can I talk to someone to be sure; this representative I talked to in Refunds/Reimbursement did not even know that the people who approved/denied reimbursement form requests were in her department. She forwarded my call to the Customer Service – the folks that sell you the insurance product and that fellow told her reimbursement issues were her side of the house to resolve not his. Call them back? Why? You get nothing. Instead, I have tried a new tact – I e-mailed One Exchange and requested a person be assigned to call me back to resolve all my issues. We will see how that goes. Hope it will be resolved; but, have my doubts. But I will say this they are all very nice, pleasant people. So if they e-mail does not work I will be on the phones again.
Dental and Vision Issue/Medicare (Perfect Example)
In November, after I got my Funding Reimbursement Kit, I contacted One Exchange Funding/Reimbursement Department concerning recurring reimbursements (there was not a form for that in the packet). Specifically, talked with them about Dental/Vision purchased from OPERS thru payroll deduction and Medicare Premium for a person who does not receive a social security check; but, pays with EFT the monthly premiums to CMS. They said all three not only are eligible but can be paid as a recurring premium and sent me the recurring premium funding forms to use. At that time, we also talked about what support information they needed from me for each item. I told them for dental and vision I would have my Benefit statement in January which shows that dental and vision is deducted monthly from my pension check; and, they said great works for them. And, I told them what I had for my medicare premium statement (THIS IS NOT A BILL) to show that my medicare premium was paid monthly (I called CMS and they told me that was the proof of monthly EFT) and One Exchange said yes that works for them. So, on January 4th I faxed my three recurring premium requests plus the support materials in and to-date have heard nothing.
Now, to my surprise I receive on my SmartPhone on January 15th the OPERS Answers Your HRA Questions. In that document, OPERS states the One Exchange can not do Dental and Vision as a recurring premium reimbursement; but, can do as a monthly, quarterly, semi-annual or annual reimbursement because OPERS pays the premium. OPERS may write the check; but, it is retiree money paid in full – it is not subsidized by OPERS. What is the difference between that and a person who gets a social security check and on their annual statement of benefits for the year received in January 2016 it shows that you pay for your Medicare premium through a reduction in benefits and they send the dollar to CMS. One Exchange can process that. Right? Is that not the same thing for dental/vision and OPERS? It is a pass thru. It is a reduction in benefits (one from social security and one from OPERS) because the pension holder is paying the premium in full using their pension funds. OPERS like Social Security is just the collector of premium dollars and forwards it on. I request that you get a legal opinion on this “paid by OPERS” and do a “workaround” with OneExchange to enable OneExchange to permit us to use dental and vision as recurring premium (One paper per year). Lord only knows what I will hear from OneExchange(if I ever do) on my request for recurring reimbursement for medicare because I do not get a social security check. Somehow I think it might get a little sticky too.
I was told by One Exchange to use the Recurring Reimbursement for the Dental & Vision that OPERS takes our of the pension check. I sent in the receipt from OPERS and the recurring form. If that is not correct – big surprise.
Yes, that is incorrect.
Here are the basics about dental/vision reimbursement:
You can set up auto-reimbursements for medical premiums for plans you enrolled in through OneExchange.
You cannot set up either auto-reimbursement or recurring reimbursements for dental/vision coverage that you secure through OPERS. You can get a receipt from us to submit for your current premium or for prior 2016 premiums.
You can set up recurring reimbursements for premiums of dental/vision plans you have enrolled in through the Connector.
You can set up recurring reimbursements for premiums of dental/vision plans (medical/pharmacy premiums as well) you have enrolled outside of OPERS or the Connector.
I spoke to the Customer Service Escalation Department at One Exchange on Wednesday evening, 01/27/2016 due to many issues that I have had with understanding Automatic Reimbursement and the Forms..
Kursten Ellerman “specifically” told me to use the “Recurring Reimbursement Form” for the Dental and Vision through OPERS. I told Kursten I was told a different version and that I was not to use this form.
Kursent said whom ever told me that was wrong and that I should use the “Recurring Reimbursement Form” for the Dental / Vision that is deducted through OPERS. I needed to send the Awards Letter from OPERS and the Recurring Reimbursement Form so that I only had to submit this once a year.
That was 2 days ago. The information that you just gave is in stark contrast to what OneExchange just told me.
The comment posted by OPERS on Jan. 29 at 9:55 a.m. to your previous comment is correct.
The change for retirees have been somewhat overwhelming. However, the material sent for many months did include some important information about this change. It took about three hours to select and enroll in the plans. I received the allowance in my checking on January 8 as well as the medical reimbursement. Am awaiting the reimbursement on the pharmacy since auto reimbursement is activated. I went to the OneExchange site and found the new reimbursement form under resources.
How do I receive reimbursement for my spouse’s Medical Mutual health premium? It is automatically deducted from my monthly pension check. I do not receive a bill from Medical Mutual and cannot show proof of payment. According to OneExchange, this does not meet their requirement for reimbursement.
Given these circumstances, what would OneExchange accept as proof of payment so I can obtain reimbursement?
Each retiree and dependent is considered a separate account, and auto reimbursement must be requested for each individual. See page 9 of the Getting Reimbursed Guide for help in setting up auto reimbursement.
Our sign up with One Exchange went fairly well. However, now that we are in the process and have questions about reimbursement the folks at OneExchange seem to know little or nothing about how it works. The answers I have been getting are vague and often nonsensical. The company was very poorly prepared to take on the OPERS account. I really hope that the powers that be at OPERS evaluates the problems the members have been having.
I take visual ins thru OPERS. One exchange says I need documentation for reimbursement. How do I get this and do I have to file every month for the reimbursement or use the recurring form?
In order to receive reimbursement through your HRA, you will need to a file a reimbursement claim with OneExchange. When you submit this claim, you’ll need to attach a premium receipt/ letter from OPERS which serves as proof that you have paid the OPERS premiums. You can get this premium receipt by logging into your OPERS online account and printing a copy of the premium receipt/letter for the current month or any previous months beginning with January 2016.
Reimbursements for premiums paid to OPERS are not eligible to be set up as a recurring reimbursement with OneExchange. However, you can request reimbursement for multiple previous months at one time.
Thats the 1st I and others have heard that,one exchange when talking to them last week assured me that my open enrollment statement opers sent retires would get me reimbursment for my wifes premium.So I faxed all in last week as instructed.I guess I will need to start over again.
There was a programming delay that has affected some of these reimbursements. That has been addressed, so the reimbursement process should be done on a more-regular basis in the near future.
I’m very disappointed in One Exchange and OPERS’ choice in using them. I called One Exchange again today to find out why, even though my bank account shows automatic reimbursement for my Medicare monthly premium, my husband’s automatic reimbursement has not been deposited, even though we both signed up for this during enrollment last year. I asked why his hasn’t been reimbursed and was told it is a technical glitch by OPERS and all reimbursements for spouses have not occurred. I was informed I must complete and return by snail mail a “One time reoccurring reimbursement form”; there is no way to do it online. What?! Why not?! If the reason really IS because of a technical glitch by OPERS, why in the world were we retirees not notified of this? As a retiree of OPERS, with 36 years of service, I am so disappointed. I never dreamed this transition would be so confusing. I hate to think that this is what we retirees can expect from now on. It’s a full time job just trying to keep track of all the paperwork and not at all as easy as was presented to us last year during informational seminar.
There was a programming delay that has affected some of these reimbursements. That has been addressed, so the reimbursement process should be done on a more-regular basis in the near future.
Just today I received a phone call from Medical Mutual advising that there had been a “problem” with the doctors who I was told were in their network when I signed up.
Luckily, my doctors were still included in network,but the representative said some had changed to out of network. This is a heads up to anyone with Medical Mutual to call and check and make sure your doctors are still in network before you go to them or you may have to pay out of network charges.
My first reimbursement for my Medigap policy is on it’s way to my checking account per my one exchange account. However, the reimbursement amount is $2.00 less than the premium amount that I paid. I know I read or heard in a video about a $2.00 fee. Is this fee taken out of every transaction or from just certain transactions? Who gets the money, the insurance company or one exchange?
OneExchange charges a monthly, $2.33 fee for conducting the HRA transactions. It is not a per-transaction charge.
I got an auto reimbursement from the wrong company. It’s a long story, but it was my fault because I changed plans. Anyway, that company charged my credit card for the premium and submitted reimbursement info to One Exchange for $2 less. This was not the fee that One Exchange charges. The insurance company did that. I would be complaining and demanding an explanation but this is not the insurance company I eventually went with. Glad I chose another insurance company.
Thanks for the answer. However, as I stated, total reimbursement was for $2.00 less not $2.33. Why the difference between what I said and what you said. I believe I know why but I’d have to write a book to explain it. Would be easier to speak with you on the phone.
Also, why aren’t all of my posts to the blog showing up? I sent 3 last night. You answered 2 of them. Perhaps you don’t have an immediate answer my question should be there with an acknowledgement that you are looking into it. Just wondering.
It appears that the $2 discrepancy might be related to electronic funds transfer payments. We are investigating this possibility.
Regarding your posts to the blog, we screen every comment that is sent to us. Sometimes it takes us a while to get to them. But comments are not automatically posted and then taken down by OPERS.
Regarding the $2.00 of which I thought was a fee, I along with One Exchange called Humana and they said that was a discount for something, and in next month’s payment back, I would receive the $2.00 that was taken from me. Please call Humana about the $2.00.
My husband and I were told the same thing. We were “shorted” $2 in our reimbursements, but Humana confirmed that the $2 for EACH of our accounts will be reimbursed by lowering our premiums next month by the $2 each. The regular amount of our premiums will “catch up” with the March automatic payment to them.
On a side note…I hope others have better luck with Aetna RX…my costs quadrupled and one med is not covered. Wish I had Express Scripts still…they were wonderful.
I pay 209.00 per month for my insurance but was reburisement 198.00. Was never iformed about extra fee.
You may see differences in this amount initially. That’s because insurance carriers may offer various discounts that many times are not calculated until after the first premium payment is made. These discounts could include opting for electronic payments, a family discount or a discount for using a credit card. The difference is typically made up with your next premium payment.
If I choose to buy a medicare and/or prescription plan directly from an insurance company or other source and not thru the Connector, will I still be able to submit for reimbursements from my OPERS HRA allowance, even if the price of the plan is higher/lower than a plan offered thru the connector?
You wouldn’t be eligible to receive an HRA allowance unless you chose a medical plan through the Connector. Once you do that, you are able to select a drug plan outside the Connector and be reimbursed for this plan through the HRA.
My spouse and I each receive contributions from OPERS to our HRA accounts. My spouse’s contribution from OPERS will end in about two years. Do we have separate HRA accounts from which our medical expenses are reimbursed or is it a single account from which we are both reimbursed?
Is there a way to find out the balance of the money in our HRA account(s)?
Both your and your spouse’s allowances will be placed in your HRA account. You can find out how much is in the account by logging into your OneExchange online account. If you don’t have one, there are instructions on how to create one.
I took disability retirement in October of 2009. I am still on disability retirement. Do I stay on disability, or do I come of it at a certain age? I’m confused about how it all works!
We recommend that you read the disability benefits leaflet. There is a section on continuing benefits and termination of benefits that should help you. If you have further questions, call us at 800-222-7377.
It can take eight weeks or so for the first auto-reimbursement because, as we were told, OneExchange works with more than 100 insurers and more than 1,000 plans, and some plans reimburse faster than others. As for one being reimbursed faster than another, that is an issue that OneExchange is working on.
Lucy, the very same thing happened to me, but with a different healthcare company. My reimbursement came through last week but no sign of my wife’s. Again, they both were paid with one check. I hope OneEchange can get their act together soon, after all we are paying them each month to do this!
There was a programming delay that has affected some of these reimbursements. That has been addressed, so the reimbursement process should be done on a more-regular basis in the near future.
You are referring to the disease management program offered by Medical Mutual. That program, along with the plan, was terminated at the end of last year. We did send a letter explaining this to all disease management program participants. As a result, brand diabetic supplies and meds are no longer covered at zero copay, but generic diabetic meds are. Unfortunately, the test strips and insulin you mention are brand-name supplies and have no generic equivalents.
Healthy U, a proven program offered through the Ohio Department of Aging and the Ohio Association of Area Agencies on Aging, is available for those who have a chronic condition such as arthritis, diabetes, lung disease, high blood pressure, heart disease, cancer or depression. It’s a free, 6-week workshop available through your Area Agencies on Aging. For more information, call 866-243-5678.
You can also talk with your doctor about other resources to help with chronic condition management, such as lower-cost or store-brand testing supplies.
For more information from us about your concerns, call 800-222-7377.
The PERSpective blog is not a resource to use to seek premium refunds. To discuss your personal situation with us, call 800-222-7377.
Donna, I too have Silver Script. When I signed up for this during open enrollment I was told that Silver Script did not allow for auto-deduction for the first month and the that I would receive a paper bill each month (which is what I wanted). This bill was due on January 15th (I also used a credit card on January 11th). After that, Silver Script would notify one exchange automatically each month if I paid the bill and from then on, One Exchange would automatically process my reimbursement after receiving notification from Silver Script. I just today received my reimbursement in my checking acct. We will see what happens when I pay my February premium. Also, after you receive your first bill from Silver Script, you can request (from them) that your premium be automatically withdrawn from your bank account. That info is on the Silver Script bill. Total turn-around time was about 15 days.
My spouse and I each have our own HRA from OPERS and each have our Humana Medigap medical premiums taken directly out from our checking accounts. We each just received our first reimbursements and mine was $10.78 short and my spouses was $10.36 short of what was taken out for the medical premiums. Why was this amount taken out, when I read your answer to another question above that only a monthly fee of $2.33 was to be taken out? How come there was no mention of the fee before or in any of the correspondence we received in the months before or from One Exchange on our calls to them?
You may see slight differences in this amount initially. Carriers may offer various discounts that many times are not calculated until after the first premium payment is made. These discounts could include using Electronic Funds Transfer (EFT) to pay, family discount, discounts for using a credit card to pay and some carriers even provide a discount if you use a preferred hospital. The difference is typically made up with your next premium payment.
I married a woman who is retired from the US Navy and I was enrolled in Tricare for Life Oct 12, 2015. In December I enrolled through Tower Watson in a Medicare supplement plan with Blue Cross/Blue Shield of Texas and a Cigna-Healthspring prescription plan. My question is do I need to be enrolled in these plans or can I just use Tricare for Life as my primary Medicare supplement plan as it is a much better plan and a lot simple to use? Also even if I am enrolled can I just use the Tricare for Life plan?
There are Medicare plans that coordinate with TriCare. We wanted Connnector participants to speak with OneExchange so ObeExchange could find a plan for them. You don’t have to be enrolled in these plans, but if you drops your plans through OneExchange you will not receive the contribution to your Health Reimbursement Arrangement. You must be enrolled in a medical plan through OneExchange to get the HRA.
I received my auto-reimbursement, however, my wife has not. Looking online it shows that she is set up for auto-reimbursement. Is there a delay for spouses?
There was a programming delay that has affected some of these reimbursements. That has been addressed, so the reimbursement process should be done on a more-regular basis in the near future.
I have been reimbursed for my medical and prescription premiums through auto-reimbursement; however, my wife’s premiums have yet to be reimbursed. Both of us are signed up for auto-reimbursement on the One Exchange site.
Is there any reason for this delay?
There was a programming delay that has affected some of these reimbursements. That has been addressed, so the reimbursement process should be done on a more-regular basis in the near future.
I did not receive the survey to evaluate One Exchange. Let me tell you my recent experience. On Monday morning, January 18, because I could not get through by telephone to One Exchange, I entered the request for One Exchange to telephone me. I did not receive a call. Early Tuesday, January 19, I again attempted to reach One Exchange by telephone and after holding for a long time I made another request for One Exchange to please telephone me. I did not receive a phone call on Tuesday or Wednesday. On Thursday morning, January 21, I sent a message via email to One Exchange with a message about my concerns asking for assistance. Just yesterday, Wednesday, January 27, I received an email reply telling me that my questions could only be answered by the Reimbursement and Funds department and that department is not accessible via email and I was given a telephone number to reach them and to press option 3. Option 3 does not connect you with a real live person but with 3 additional automatic recorded messages. After attempting 3 or 4 times to get beyond the recorded messages, I simply blurted out on the phone “speak to a representative” and then, ONLY THEN, did my phone actually get to a telephone line that let me know how terrible busy they are and would I please hold. Finally I spoke to employees. It was clear that some employees of One Exchange are not well trained. Further, some forms are still not available on the site .
I sent in a recurring reimbursement form for my husband’s medical premium. The form was sent to a wrong address (Omaha, NE). Since I got a tracking on the form, I was told that it was forwarded to ElPaso, TX. I originally sent the form on January 5, and it was supposed to be delivered to Omaha on January 7. However, it finally made it to El Paso on January 17 at 4:46 P.M. I called One Exchange on January 21 and again on the 28th to see if they received the forms. I was told it was not in system yet, and it may take 3-4 months. So I apparently I can’t even see if they’ve received the form for 3-4 months. If they don’t have them in their records, then I have to start all over again. I think 3-4 months is a bit long, especially since they received the forms on the 17th. So, if I have to wait the 3-4 months, then maybe I may have to get my attorney involved in this.
This is all so disheartening. One Exchange has all our health care selections online. I don’t see why One Exchange employees cannot access the selections we made for our health care, see the cost of the monthly premium and once they have either a copy of a bank statement showing payment of that same amount that corresponds to our selection, in my and my husband’s cases, Medical Mutual, SilverScripts, then make the allocations to our HRA. I think One Exchange must have a seriously ancient and/or inadequate computer program. There is no facility for cross referencing the information.
I would like to see the option where we could either use OneExchange or could have our funds deposited directly in our account at our bank, etc. I understand that receiving the funds directly would cause a tax liability for us but it may be worth it not to have to deal with all the problems we are running into with OneExchange.
is the connector open all the time
We’re not sure exactly what you mean. Call us at 800-222-7377 about eligibility for the Connector, or visit our website at http://www.opers.org.
I’m still waiting to see if One Exchange received my reques for recurring reimbursement for my husband’s Medical Mutual premium. As stated on 1/29/16, I mailed the request on 1/5/16 it, of course had the wrong address, so it took until 1/17 to get to ElPaso. I called One Exchange on 1/21 & 1/28, and they still can’t tell me if the forms have been received. Now reading other posts, it seems that they will probably refuse to pay the premium because one can’t do a recurring reimbursement on premiums not in the One Exchange system. However, on 10/29/15, a Khara Gibson (OPERS) told me that in order to provide proof of premium I could send a copy of the 2016 premium shown in my Health Care Open Enrollment Statement. I was also told to send a copy of “Proof of Income” statement to One Exchange. Then on 1/27/16 I spoke to a Tyler Wilcox (One Exchange) and he indicated that I could use the “Recurring Reimbursement” form and it could be filled out once per year and sent with documentation. So the above forms are what I sent to One Exchange as proof of payment. I guess I just don’t know why it would take a month for me to even know if the forms are received??? If they haven’t, then I suppose I have to start over again. You guys are just making this process too cumbersome for retirees. Maybe you should have to go through this to see what it’s like. This company is a “joke”!!
RE: My 1095-B (proof of health coverage) only listed my name, why didn’t it list my spouse as having health insurance last year? His health insurance was deducted from my pension all of 2015.
I called PERS today. The reason is that my spouse is on Medicare so the Government already has proof that he has insurance.
I am still trying to understand how OPERS has recalculated service credit coming over from another retirement system. Specifically, I originally earned 0.80 years of SC in STRS from sub teaching. Most of this time was concurrent with full-time employment in which I was paying into OPERS so I understand the rule of not earning more than 1 year worth of SC. Back in 2014, I was given .370 SC for my STRS time by OPERS. In February, 2015 this was reduced to .197, presumably due to SB 42 which went into effect March 23, 2015. I have the printouts from OPERS to show the .197 was used in February, 2015, even though law did not take effect until next month. Regardless, I just found out that my STRS credit of .197 has been further reduced to .032. Why this second reduction to almost nothing?
I do know that this whole recalculation has something to do with calendar versus fiscal years, the latter which is used by STRS. In my case, it appears that OPERS is taking away some of my STRS time that I earned after I had left my OPERS covered employment in the year 2000 so it was not concurrent. My concern is I do not trust the numbers that OPERS is generating with regards to my STRS time and I certainly do not understand this second reduction. Can you help??
For complicated service time situations such as yours, we recommend coming in to the OPERS office in Columbus and speaking with a counselor. Or, you can try to discuss it over the phone. Either way, call us at 800-222-7377.
I have actually scheduled an in-person consultation with a counselor and am hoping I have the opportunity to speak with someone in the OPERS office who actually deals with these SC issues. Thank you for your time.
Under my old plan I got Humalog pens, Lantus vial, pen needles, syringes, at no cost to me. I signed up under 1 exchange for AARp MedicateRx Plan and was told my insulin cost would go up. During the first part of January I tried to renew my Humalog perscription and was told it would cost $377. I shopped and found Novolin R at Wal-Mart for $24.88/val. I am happy usiing Novolin R. I get a letter form AARP saying Humulin R is not covered and that the Novolin R is a temporary supply and I must get a doctor’s statement to maybe continue using this drug. I realize that we are not all on the same units and I have no idea what Humulin R is. Even if there is the equevelent of 10 vals in the $377 Humalog, the Wal-Mart version is Still chealer. Something is wrong here!
My husband and I have had several problems with One Exchange. The latest was today when my claim for Part B reimbursement was reduced twice by the amount being reimbursed by OPERS! I had the proper documentation (letter from SSA as well as my Jan. award letter from OPERS). I even did the appropriate calculation for them on the form and they still got it wrong. I called them and after telling the customer service rep the problem twice she said she can’t help me. She then referred me to “funding” and that rep immediately saw the problem and admitted it was a mistake. She can’t correct it but sent an e mail to whomever for a review!
My husband’s claim for dental was denied because they said it was a duplicate claim! It just so happens that the dental premium and prescription premium are the same amount. Whoever reviewed this never looked at the kind of premium _just the amount. Their explanation on line in the account and paper explanations only state “premium” and don’t differentiate. Their IT dept. should correct this. You don’t know what premium is being approved or denied if the premiums happen to be the same amount. Obviously they had to hire a lot of employees to cover these jobs and aren’t trained!
Terry, There is a way on your One Exchange online Account to see what the reimbursement amount was for. If your claim has been processed (even if it has not hit your checking account yet), there is a claim number for the reimbursement (it’s highlighted in blue). Click on that and it will show you what the reimbursement is for. This is in your Funds and Reimbursements section under transaction history.
Received a letter from Social Security yesterday. It stated the my wife’s Part A coverage would be effective February 1, 2016. I called today to try and change the effective date to July 1, 2016 after explaining why she stated that the Social Security admin was a large agency and it wasn’t as easy as just changing a date. I explained to them that yes it was. She went on to explain why It was a good idea to have two policies. When I explained that I wound not be getting any reimbursement, she tasted it was not their problem. To wrap up They said in 30 days we will receive a letter stating she has been dropped and we must reapply. Just wanted to give OPErS a shoutout and thank them for such a great job on this. Can’t to start dealing with OneExchange.
Two issues recently identified:
One – I have not received any emails from One Exchange even though I had signed up. I discovered that I needed to confirm my email address, however, OneExchange’s web site has that box “blocked” so that you cannot confirm your email address.
I reported this to OneExhcange and was assured that their IT Department would look at the issue. That remains to be seen.
Also, the last representative that I spoke to a week ago enlightened me as to why OneExchange is under water. Apparently, OPERS was only 1 of a few very large companies that it contracted with this year. She told me the company names (which I will not mention here) and now it makes sense as to why OneExchange is functioning the way that it is. I was told once again that OneExchange had hired over 1,000 new people and there was a learning curve. Amazing!
Today, I received my Connector Readiness package. It has all of the goodies to send to PERS after I am enrolled through the North High Street, Columbus, Ohio SS office. I think you people need to be aware of a serious problem with your plan. Apparently, you sent thousands of retirees to that office.
I mailed my pre-addressed form to the North High Street office on December 18th, 2015. I have called them twice, on December 29th, and was told there was no way of knowing if it had been safely received and to call again in two weeks. On January 11, I called the North High office again. I was told there was nothing for me in the system, but to check back again and “Michael” told me that there were over 1,000 applications in their office at that point, that they were swamped and doubted if they would finish by March 31st and I could reapply again but it probably would not speed things along.
I have spoken with 3 other persons who sent their form in within a few days of mine. They have not heard either. My question to you: Since this is a problem of your making by not foeseeing the logjam that would be caused in that office, what do you suggest that we do?
I also made an appointment with a local office and spoke with their manager. She said I could re-apply at her office and this should not have taken more than a few weeks. Again my question: What are we to do?
Thanks for your comment. We are looking into it. Keep in mind that your insurance won’t begin until July 1. March 31 is just the date by which Medicare A enrollment forms need to be turned in.
Still have not received direct deposits for myself or my husband. Talking to one exchange they say it could be another month . Asked for forms on Feb 2 still no forms, though these are not for premiums as I was told these are set up for direct deposit. When will this nightmare end. Medical Mutual told me they notified One Exchange on the 5th of the month.
Simply kindly putting OPERS on notice. I applied for a reimbursement of my Medicare Part B and it was processed today. That is very nice. However, I only requested the portion that I had paid and should be reimbursed for. OPERS may wish to clarify this with One Exchange or there may be lots of overpayments. I will also contact One Exchange.
Thanks for the comment. We have been saying all along that members should request only what they actually paid for the Medicare Part B reimbursement.
Mike, I see that I missed an important phrase in my above comment regarding Medicare Part B reimbursement. I did request only the portion that I had paid but they reimbursed me for the entire amount ( my out of pocket amount plus what OPERS had paid) even though I requested only my portion. So they are doing it wrong. I was told that I had to put in a second request to get it taken care of. This time, I included a copy of my recent statement fromOPERS which says what they pay. I specifically asked them to credit the overpayment to next months reimbursement and to correct the reimbursement amount. I am guessing that there may be a lot of overpayments. If this doesn’t work I will let you know.
Let us know what happens.
That is what I had to do also. Irritating that I had to go through all the hoops for their error. Guessing they are reimbursing everyone the full amount you even included your OPERS statement. Guessing my resubmission will do nothing. They also arrogantly told me that they have standards to go by and they don’t mess up.
I prepare taxes for AARP. I’ve noticed that some 1009-R’s for OPERS retirees show a healthcare deduction amount. Would these premiums be considered “subsidized” for Ohio tax purposes (Schedule A, line 32)? We’ve been assuming Yes, but wanted to confirm. Thanks.
Generally, the amount represents money the retiree has had withheld from his or her pension to pay for health care premiums through OPERS. The Ohio Department of Taxation has provided guidance on this issue, concluding that it is subsidized because the employer has contributed to the health plan covering the retiree.
See Inquiry #2 on this department release.
Not sure how to start a new topic on here. Does anyone have a good recommendation for a free software that will merge the PDF and non-pdf pages of reimbursement requests?
I am not sure which direction you want to go. I would go all PDF. If you have a scanner or printer with a scanner then you can usually scan hard copy receipts to a PDF file. Your print options will allow you to print digital receipts to a PDF file. One Exchange will allow you to upload multiple files on their Payflex site.
I agree. I have been doing it the way you suggest from the beginning and it has worked very well so far. I use the One Exchange site to monitor the status of the claims I have submitted and the balance of the finds available.
Thanks Ed. When I first tried I did not see or they did not have the option of uploading more than one document. That makes it a lot easier.
All I have to say is the One Exchange has been one big NIGHTMARE…poor customer service. I have talked to people for hours and supervisors who hang up on you and also…I finally got my paperwork for reimbursement and sent it in by mail by cerfified and it took me forever to get the right information from the ONE EXCHANGE customer service….I have called again tonight same thing over again POOR CUSTOMER SERVICE. They cannot find my paperwork that has been mailed to them….it is probably sitting in their P.O. Box. Now they want me to fax it…when I do not own a fax machine….they are so rude and all of them are not on the same page…who knows if I selected the right insurance!!!
My Silver Script automatic reimbursement has been denied again this month. OneEx told me in Feb. that it was denied because it looked like it had already been paid because my dental premium is the exact same dollar amount. I’m pretty sure I’m not the only one who has two identical premiums. I should not have to contact them every month to tell them to do their job.
I sent an e-mail and the reply was that they would correct it this month (again) but that I would have to call them yet again. I don’t understand why I have to keep contacting them when it is their mistake and it was pointed out last month.
Just watched the latest video. It stated that we can now get recurring reimbursement for our Medicare that we pay monthly or quarterly. It said that we need to submit a recurring reimbursement form and a monthly “bill.” But also mentioned a letter from Social Security that we receive. I do not receive a letter from Social Security telling me what my payment for the year will be. I just receive that monthly bill stating that it will be withdrawn from my checking account.
I just call the connector and they said my wife could receive the reimbursement of $200 a mouth even if I am still working part time for a county, PERS contributor. I am staying with the PERS Humana plan. Is this true? I thought if I wasn’t qualified she wouldn’t be able to receive any reimbursement.
Steve — A member of our Health Care team will contact you.
– Ohio PERS
I downloaded the recurring reimbursement form and completed it. I sent it along with my 2016 Social Security letter showing the Medicare deduction and a copy of OPERS letter just showing the monthly
Reimbursement and received the amount in my checking account …all within two weeks.
I do not get a letter from Social Security because I do not receive a check from them and have my Medicare premiums deducted from it. I pay my Medicare monthly myself.
A week ago I sent an e-mail to OneEx to tell them that for the second month in a row my automatic prescription premium had been denied. The reason they denied it is because my prescription and dental premiums are the exact same $ amounts. I was told it would take 3-5 days to correct. Today I called OneEx because it had not been corrected and talked to Funding Dept. The person I talked to was very confused about was had or mostly had not been done so she resubmitted it and said it would take another 3-5 days to correct. Since I was there I asked about the info we had received from OPERS about being able to have our monthly and quarterly Medicare payments reimbursed as recurring and what documents we should submit. She had no clue about what I was talking about. The left hand doesn’t know what the right hand is doing. I do hope that OPERS mails out more information about this and notifies OneEx and PayFlex about it. Not everyone uses computers. Phone call took ~ half an hour with most of that time being on hold.
we are very disappointed in Silver Script, our $ 4.00 co pay went to $ 116.00. Why did One Exchange tell us Silver Script would be better for my husband? He should have remained on Humana RX.
He stirred us WRONG. Now we have to put up with it all year! We were not advised with his best interest in mind.
I have been told by a Medicare expert that if you feel a policy has been misrepresented to you that you may request a different policy mid-year. However the increased cost of a different policy would not offset the costs of the prescriptions through Silver Script.
I have been trying for two weeks to get my March drug premium automatic reimbursement. Today when I checked my account, my dental premiums which had been accepted as recurring reimbursement for the entire year had been deleted from my account and still no sign of my drug premium. My drug and dental premiums are the exact dollar amount which PayFlex can’t seem to handle. I am beyond frustrated. I have other things I need to do with my life.
Called PayFlex this afternoon and asked to speak to a supervisor because I had been working on this for two weeks, , the situation is worse than when I started, didn’t want to explain it twice, and didn’t want it relayed through two people.
Got a supervisor with a not too good phone connection. Explained the situation. She said the system only recognizes $ amounts and that is why it denies my prescription premium after reimbursing my dental premium. She said she re-added my dental premium for the year as recurring and would approve my prescription premium for March but no guarantees about April or future months. Said she would put a notation on my account. I find it hard to believe that I am the only one with this situation. She said I could stop the automatic reimbursement and then submit my prescription as recurring. I said but we have to prove that it’s paid. She said I could get a statement from insurance company. A statement would still not show that I pay it each month. I told her that their system should look at what the premium is for–not the dollar amount and to bring that up at their next meeting. She was moderately rude once.
Has anyone submitted their monthly Medicare statement along with a recurring form and had it approved? We were told in an OPERS video that we would be able to have our Medicare that we pay out of pocket monthly set up as recurring. When I asked OneEx/PayFlex about it they had no clue what I was talking about. I haven’t seen any further information from OPERS about it.
Received first three months and now receive monthly.
It just seems like all this should have been figured out before we ever went “live.”
For the third month in a row my automatic prescription reimbursement has been denied yet again. I wrote to OneEx and the reply was that s/he didn’t see the denial (it is there) and that I should receive my reimbursement in 3-5 business days. They always say 3-5 days for everything. I haven’t called PayFlex yet but my guess is that it is the same problem as before. My prescription and dental premiums are the exact same dollar amount. OPERS said they were working on the problem with OneEx and the PayFlex supervisor I spoke to last month said she would put a notation on my file. This is getting to be ridiculous. If I had done my job as poorly as they do theirs I would not have lasted 35 years.
Why is it taking so long to get our reimbursements? Today is July22,2016 and still no amount deposited into my account. One exchange changed the website and it is harder then ever to see where the funds are. Medical Mutual and Express Script takes it out of our account on the first of the month so why do we have to wait this long for reimbursement?
Thank you for sharing your concern with us. Because this matter is HRA account specific, OneExchange, the administrator of the HRA account would be better able to assist you. We have forwarded your concern to OneExchange and a member of their team will contact you.
I talked with OPERS, Med Mutual and One Exchange this morning. Med mutual CS Rep said the auto reimbursement information was sent to 1Exchange on July 15th. The One Exchange CS Rep said the reimbursement information was received by them on July 23rd. Not sure why this would take so long. One Exchange CS REP said they have to wait 11 Business Days before they can investigate why this month’s reimbursement is taking so long. Also spoke with OPERS Medicare and that person said that there had been some computer?problems on One Exchange’s end. I just think that when our funds are accessed by Med Mutual on the 6th of the month that it should not take till the end of the month for our HRA funds to be disbursed.
Automatic reimbursement can take 4-6 weeks from the time the premium payment is made. The 11 day timeframe may account for file exchange and when your financial institution will release funds to the account after OneExchange transferred the payment. Please continue to reach out to OneExchange (1-844-287-9945) with HRA questions.
I’ve been through this and know what is happening, My problems may have been that we got started OneExchange, but everyone had an excuse and I went back and forth for months. I faxed items over and over and couldn’t get anywhere until I put my foot down and talked to a supervisor. She looked at my account and said it would be taken care of. The next day my Medicare reimbursement was posted and I now get monthly reimbursements with no problem. I have not had a problem since. I understand the confusion at first and it seems that the process has been streamlined. Medicare reimbursement should be a gimmie! They know the monthly charge and all retirees get the same pre-paid $31.80… WHY IS THIS A PROBLEM?? WE retirees cannot enroll in OneExchange unless we have Medicare A & B. Why can’t this be automated.
Hopefully, 2017 Open Enrollment will be more streamlined. I’ll bet our rates will rise and we’ll get shorted on our insurance coverage. I’ve asked for 2017 Medicare costs, but no-one knows.
Sorry to drift off the subject, but if you want a quick response, demand that you talk to a supervisor and if you are not taken care of, talk to the next level. (I got tired of being nice and sent back and forth, so I pressed the issue and got everything resolved.) The best of luck to you!
I understand your frustrations Bill. Reimbursement timing varies depending on the method that it is being requested. When the recipients financial institution releases funds to an account is a factor as well…. In regards to rates, most carriers will post plan costs early October. You can access them at medicare.oneexchange.com/opers; you can also check with your current carrier if you have plans to continue coverage into the new year. All carriers must have rates posted by October 15. I hope you find this information helpful.
I also am missing June reimbursement from One Exchange for Medical Mutual Ohio premium that was deducted from my account in early July. I called Medical Mutual on 7/22/16 and they advised the payment file was sent to One Exchange on 7/14/16. She also advised me to call One Exchange, which I did. I spoke to: a benefit rep and a funding rep initially. They advised there must be a problem, that One Exchange would start a trace, the responsibility for resolving was on them, and they would contact me with their findings. They said they were putting notes in the file and would connect me to funding to take the actions. Well, funding said there are no notes and we cannot do anything for 6 weeks. I questioned why, since we know the file was sent on 7/14. My concern was if a problem exists, the August payment would follow the same path. He was adamant that nothing can be done before 6 weeks, and that I would need to call back then to start a trace. Ugh. Well, then on 7/25 I received an email from Medical Mutual saying they found that One Exchange made “a one time error” in loading the payment file this month. That if the reimbursement was not received by the end of this week, to contact Medical Mutual again. The payment has not been received, and the end of the week is tomorrow. One Exchange is HORRIBLE at managing these OPERS accounts. OPERS, you were sold a bill of faulty goods. There is NO reason why, in today’s electronic age, that these transactions are not completed within a day or two. If my account is debited by the 5th of each month there is no reason why I cannot be credited back in less than 5 days. I surely hope that OPERS finds another vendor that can provide adequate service to the OPERS retirees. I feel badly for those unable to research online, use computers or keep track of these funds by any method. I am more than 1 month behind in getting reimbursements for Medicare Part D premiums. I doubt the multitude of Medical Mutual customers are unaware of the problem or trying to solve it independently. One Exchange should at least advise those with that insurance and advise OPERS too. What is the method for relaying data to those impacted when a mass problem occurs? Shame on One Exchange and OPERS for giving sub par service to retirees. Cannot believe better serviced is not offered elsewhere. How much time and money must be thrown away? So very disappointed.
Thank you for sharing your concerns. I would like to get you answers and have forwarded your concerns to our contact at OneExchange. If you have not already heard from them, please know that they will contact you very soon.
I just received my July reimbursement on Aug 2! We will see how long it takes to get Aug reimbursement. If Medical Mutual takes it out of our checking account between the first to the 6th there is no reason we should get our reimbursement the following month!! If One Exchange had a problem then they should be upfront with us!!!
Good morning. There are a few factors with the turn around times as it will vary by the method reimbursement is being requested. The Automatic Reimbursement feature will have a 4-6 week turnaround time from the time the premium payment is made. When faxing in a manual claim, the documentation can take up to 48 hours to be scanned and loaded into the system. Thereafter, the turnaround time is 3-5 business days to process and approval. Also, we must take into consideration of when the Benefit Recipient’s financial institution will release the funds to the account after OX has transferred payment, as this may take up to 72 hours depending on the financial institution.
Because OneExchange has to wait for the insurance company to send in the information that you paid for the premium. Each company has their own policy about when they send information to OneExchange. Most companies wait a send in a batch of information once a month.
I need a new Dental Card from Met Life. Please text me at 6143149453 on how i can get one.
If you are enrolled into the MetLife dental coverage offered through OPERS please contact MetLife at 1-888-262-4874. Thanks MS
Can I get the years from opers if I’m working two jobs at the same time
Please forward your questions through your member online account message center or contact our Member Service center at 1-800-222-7377. Thanks MS