OPERS searches for Connector participants

The Ohio Public Employees Retirement System is going the extra mile to locate the last of our potential Connector participants.

When we introduced the OPERS Medicare Connector, our information indicated that more than 143,000 retired members would be eligible to take part in Medicare coverage on the open market. As we prepared for a historical outreach effort to these retirees, we said we would take extraordinary efforts to reach out to those who didn’t get the message if need be.

As March approaches, OPERS is still looking for about 230 members, because of incorrect or unavailable phone numbers and outdated addresses, who are eligible for the Connector. So we’ve contracted with an insurance industry investigative firm to find them. They will spend the next two weeks locating these OPERS retirees.

Our records indicate these retirees did not select a new health care plan through the Connector, but it’s not our intention to ensure that they sign up for a plan this way. Rather, we want to make sure they understand their options for health care under the Connector.

In some cases, the members might be re-employed in an OPERS-covered position and have enrolled in their employer’s coverage. Some might have coverage available outside of OPERS, or through a federal program such as TriCare or Medicaid.

Some people do not want any coverage in addition to Medicare or want to be enrolled in only Medicare Part B.

But there is a chance that some might not be aware of the options available through the Connector, and those are the people we’re trying to find. Our representatives will be attempting to contact them by the end of the month, the deadline for securing coverage through the Connector without potentially having to go through underwriting.

OPERS also wishes to gain insight on why participants didn’t respond to our communication efforts if they were in receipt of them, and whether they understand the impact of not taking action.

We believe this illustrates the extent to which we’re going to make sure the Connector is working for all eligible participants should they opt for it.

 

Michael Pramik

Michael Pramik is communication strategist for the Ohio Public Employees Retirement System and editor of the PERSpective blog. As an experienced business journalist, he clarifies complex pension policies and helps members make smart choices to secure their retirement.

Michael Pramik

Communication Strategist

  • I enrolled in prime time ault and now I would like to change as I was declined help at Mercy Stst Care last week. I thought I was covered anywhere Medicare was accepted. I would like to change ins. But not sure how!!

    • Carol,

      It’s our understanding that you will have to wait until this year’s open enrollment period to change. You can call OneExchange at 844-287-9945.

      –Ohio PERS

  • I’m one of the many people had to switch from Humana Medicare as of January 1, 2016! I loved Humana Medicare had it for years and very satisfied. I am a widow of 16yrs covered under my husband under OPERS. I never had a problem and prior to his death and retirement he handled all of this. So not knowing much about health insurance I was thrown into an unfamiliar world. It was advised by OPERS to go through One Exchange and after many phone calls, tons of mail, many more phone calls I am covered under The Health Plan Medigap F. So far I am very dissatisfied, don’t begin to understand it all and not sure what is covered and what isn’t. You call and after talking to five or six different people you don’t get an intelligent answer. Some of my prescriptions have gone up in price, the reimbursement part has not been effective YET, and Physician’s offices are calling saying they have denials etc. As a senior, at 76 yrs old, a widow of 16yrs, and dissatisfied with the plan I have I have no idea what my options are at this point.
    I never had one problem with Humana Medicare for many years. Any advice would be appreciated.
    Thank you

    • Sally,

      There were delays in the initial reimbursement of premiums for spouses. We were told by OneExchange that they have worked out the issues and that reimbursement should be back on a steady time period soon. As for your plan, unfortunately the next time that you can change the plan isn’t until open enrollment in the fall for the 2017 coverage year.

      Your insurer should be able to tell you what your coverage is, and we encourage you to contact the insurer.

      –Ohio PERS

      • I’m in the same boat. They denied my claim under my husband and One Exchange set both of us up on a new Humana Medicare Advantage policy.
        I spent 2 days on phone with them and all they did was pass the buck. Apparently none knows what they are doing. I still am not get a re-embursement .

        • Thank you for your response. I know I’m not alone in my dissatisfaction and I also spent several hours/days on the phone looking for answers. One Exchange should have been ready for the on-slot of new members but it seemed like they weren’t. It seems to be getting “some” better but I still am not receiving Explanation of Benefits (what they’ve paid for doctor visits etc) and so I don’t really know what’s been covered and what hasn’t been. This is very frustrating. Seniors should not have to be exposed to all of this confusion/changes!

  • Included in your most recent video is an explanation of how to get documentation for HRA reimbursement of Vision and Dental premiums deducted from pension checks. I was not aware that keeping the current Dental and Vision plans through OPERS was an option for those of us whose Part A is effective 7/1/2016. Is it an option? I actually assume that the answer is “no” and that the above deduction would be for a family member who is in the OPERS group plan. Am I correct?

    • Ireva,

      Yes, it is an option. In fact, if you are in Medicare Part B only and you had OPERS dental and vision coverage last year, it automatically continues this year. If you want to change it, you can do so during open enrollment.

      –Ohio PERS

  • Trying to find benefits for past employment. Once employed at Applecreek State Hospital. Prepareing to retire what to know how to find out what benefits are available.

  • Per the webcast held on December 8, I assisted my grandmother to apply for Medicare Part A using the documents provided by OPERS. The documents were mailed on December 28, 2015. To date there has been no response from Social Security about her application. Since this application process was specifically designed to assist those formerly ineligible for Medicare Par A, is there a person or special number I can call in the Columbus Social Security office to check on her application status?

    My grandmother is 98, in a long-term care facility and I have her Ohio Power of Attorney.

  • I have been having major problems with opers and one exchange re My deceased husbands Hra acct No one has been able to fix the problem I am also unable to open an acct on opers.org due to an “IT” problem Can you give me some help re these matters

    • Elizabeth,

      We can’t help you through the blog because we do not have details of your account. Your best bet is to continue to work through our Member Services department: 800-222-7377.

      –Ohio PERS

  • what does the opers plan have to do with government medicare plan. I don’t understand all the transfers of money. do I have to file for a refund on anything or is I automatically reimburded

  • I would like to know what One Exchange does with the money they are holding in our accounts. I Don’t understand how this system works for them. How can they “forget” to charge administrative fees and meet their own expenses?

  • Dear OPERS Officials,

    I enrolled with the Oneexchange but seriously, what is the need for a third party entity in our medical well being. I had wanted to write to OPERS about it now I take this opportunity. Why paying a premium first and then be reembursed later.. This makes no sense to me. Also we have to be reembursed the medical premium we pay to medicare and other medical expenses in the month. I understand that OPERS pay $ 360 monthly into our account with One Exchange, and we are to be reembursed from the amount.

    To OPERS Official, with all due respect, personally this is not very nice to treat us as such, why not pay the 360 dollars allowances directly to the individually member whether added to their monthly benefit or deposited directly to their account? what is the need for a thirt party connector between me and the insurance. This is an added stress created for us. We dealt with beaurocracy throughout our labor years of 30+ years, we survived that, now we have to deal with the scrutinity of submitting and resubmitting of receipts, bills, invoices and all that nonsense to get what we are entittled to. This is very stressful and unfair to many of us who do not want any additional stress during our retirement.
    May I suggest you take a survey of the participants in the OneExchange and find out their thoughts and experience with it in the last 2-3 months and see whatwho wants to continue in this trend next year, God willing. Personally, this is a waste of the Retirement systems resources to pay additional fees to a connector that is irrelevant.to our medical health. If any retiree member wants someone to be responsible for their finances, let them be free to choose their own financial firm to do that for them. I donot appreciate a third party beauracrates again in my life. Thank you

  • I am sorry so many people are having problems – I think the multiple parties involved is confusing (OPERS, One Exchange, Your health care company, your Part D company, and your OPERS Dental and OPERS Vision) for example. Being a fairly recent retiree and having used computer extensively in my work life I have been very successful in getting everything set up and reimbursements are coming regularly. It has to be difficult if you are not super computer savvy navigating all the websites, etc. Perhaps you need some savvy retirees paired with some retirees that are having trouble……also, if you depended on someone else for years and they are no longer living it would be a huge learning curve. But I just wanted to say that everything has worked out just fine for me and OPERS and One Exchange have been great!

    • I have a computer and an iPad. I know how to use them. I was a medical secretary. I entered my information on one exchange correctly. One exchange made my husband the OPERS employee and I have spent hours and hours of my time trying since September of 2015 to get them to correct THEIR mistake. Of course I couldn’t receive any reimbursement because they have it in his name and now they know he isn’t the employee. They say they have been working on it since December. Don’t they have an IT computer person? This is the worst company I have ever dealt with. They tell you they will work on your problem, call you back etc. and they never do!!!

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