OPERS maintains health care plans

Changes effective Jan. 1, 2022

By Michael Pramik, Ohio Public Employees Retirement System

Jan. 17, 2020 – The OPERS Board of Trustees voted Wednesday to adopt changes to health care coverage for Medicare and pre-Medicare retirees. These changes will preserve retiree health care coverage now and for years to come. Over the last two years, we have communicated and engaged with members and retirees about potential solutions. The Board’s plan will retain health care coverage for all eligible members and retirees.

Changes, effective Jan. 1, 2022, extend the life of the health care trust fund from 11 years to almost 19 years. In addition, preliminary 2019 investment returns of 19 percent will further extend solvency to nearly 23 years.

Rising health care costs are a national problem, and OPERS is not immune to that. As costs for medical coverage and prescription drugs have risen, our demographics have trended toward more retirees, longer lifespans and fewer public workers contributing to our system.

OPERS receives no dedicated funding for health care. By law, the employer contribution must first fund pensions. If funding allows, we then can provide a discretionary health care program. Member contributions fund pensions only and, unlike Social Security, are always 100 percent guaranteed to the member and cannot be used to fund health care.

While we understand that health care coverage is part of a meaningful retirement, our retirees’ pensions are a guaranteed benefit and must be funded first. Currently, the pension fund requires all employer contributions for funding for the foreseeable future.

When we embarked on this journey, our health care trust fund could fund health care costs only for the next 11 years. Our objective is to continue to offer health care coverage. To do so, we must implement changes to the current program. Changes to the program will allow us to increase the solvency period of the fund and provide access to coverage for a longer period of time.

The overall goal was to design a flexible, but predictable, health care program that can provide access to coverage based on available funding. We have achieved this objective. As designed, the new program extends our ability to provide health care coverage from 11 years to nearly 19 years. Considering strong preliminary investment returns for 2019, our ability to provide access to health care coverage for eligible retirees will be extended even further.

Pre-Medicare coverage

The biggest change for those under 65 is the discontinuation of the OPERS-sponsored Medical Mutual PPO plan. Beginning in 2022, those enrolled in the OPERS pre-Medicare plan will instead enroll in the health care plan of their choosing. OPERS will partner with a service provider to help pre-Medicare participants find the best plan for their needs, in a manner similar to the OPERS Medicare Connector.

OPERS will provide funding (a monthly allowance) to help participants pay for that coverage. This allowance will be a percentage of a base allowance amount. Each retiree’s allowance percentage is determined by their qualifying service credit and their age when initial coverage began.

The base allowance amount will begin at $1,200 per month and will remain at that level for three years, before it could be adjusted subject to the Board’s review.

Impact on previous grandfathering: Over the years, when changes were made to health care coverage, we used grandfathering to protect some retirees from the full impact of those changes. Under the new health care program, as a current retiree, your eligibility for health care coverage is “grandfathered,” but your allowance amount is not. Depending on your age and years of service when you retired and first enrolled in the OPERS health care plan, your previous grandfathering status could change. Here’s how:

  • If you retired and enrolled prior to 2015 with 20 or more years of service, your allowance could change depending on where you fall on the allowance table. Specifically, this would impact retirees who had an allowance percentage on the table less than 75% but were grandfathered at 75%. Your allowance will be reduced based on your actual position on the allowance table with a floor of 51%. You can find the allowance percentage chart on our website. 
  • If you retired and enrolled prior to 2015 with less than 20 years of service, you were subject to the 75% allowance grandfathering. Your allowance percentage will be reduced to 51%.

For future retirees: Members retiring under age 65 after Jan. 1, 2022, will be eligible to participate in the health care program only with 30 or more years of service. To participate with fewer than 30 years of service, members will need to be age 65 with 20 years of qualifying service.

Medicare coverage

OPERS will continue to offer the OPERS Medicare Connector for those age 65 and over who qualify for Medicare parts A and B.

The biggest change for the Medicare-eligible population is that the base allowance will be reduced from $450 to $350. This allowance is based on a market analysis that shows the average Medigap medical and drug supplemental plan costs $275 per month. OPERS data indicates our program is successful – members are actively using their Health Reimbursement Arrangement accounts through automatic reimbursement and continue to have an average balance of $3,700 in these HRA accounts.

Impact on previous grandfathering: As a current retiree, your eligibility for health care coverage is “grandfathered,” but your allowance amount is not.  Depending on your age and years of service when you retired and first enrolled in the OPERS health care plan, your grandfathering status could change. Here’s how:

  • If you retired and enrolled prior to 2015 with 20 or more years of service, your allowance could change depending on where you fall on the allowance table. Specifically, this would impact retirees who had an allowance percentage on the table less than 75%, but were grandfathered at 75%. Your allowance will be reduced based on your actual position on the allowance table with a floor of 51%. You can find the allowance percentage chart on our website.
  • If you retired and enrolled prior to 2015 with less than 20 years of service, you were subject to the 75% allowance grandfathering. Your allowance percentage will be reduced to 51%.

For future retirees: To access health care with fewer than 30 years of service, members will need to be age 65 with 20 years of qualifying service.

Disability recipients

The current eligibility conditions will continue to apply to current OPERS disability recipients. Grandfathering conditions outlined above apply to disability recipients.

We are committed to helping you and will provide more information and tools in the coming months. Please read all communications from OPERS. We’ll be providing newsletters, blogs, videos, e-mails, a new Health Care 2022 website page and many social media posts. We will be providing more detail and creating scenarios to show how the changes will affect all segments of our retiree population.

Attend OPERS education events. Retirees who have attended one of our education events over the past year have reported they leave with a much better understanding of the reasons this change is needed and how they will be affected. You can sign up for a session by visiting the Member Education Center at opers.org.

 

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

133 thoughts on “OPERS maintains health care plans

  • January 17, 2020 at 3:27 pm
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    I retired in 2016 with 20 years of service at age 63. I am now 66 so what would my reduction be? Shirley B Sevcik email. Ssevcik@columbus.rr.com

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  • January 17, 2020 at 3:37 pm
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    Wonderful news!

    Just to clarify; I assume we could use our monthly base amount to fund a FAMILY plan instead of a SINGLE plan – yes?

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    • January 17, 2020 at 3:49 pm
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      Yes – Beginning Jan. 1, 2022, pre-Medicare retirees can use their Health Reimbursement Arrangement allowance, or HRA, to pay premiums for the health care plan of their choosing. This plan can be offered through the healthcare marketplace, a spouse’s employer or any private health care insurance carrier.

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      • January 18, 2020 at 7:03 am
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        I would just like to clarify if you try to retire before your 65 with less than 30 years of service you get zero for healthcare coverage. Is that correct?

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        • January 24, 2020 at 11:59 am
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          Paul,

          Health care eligibility requirements will change for those retiring after Jan. 1, 2022:
          • Medicare Retirees (after Jan. 1, 2022)
          o Age 65 with a minimum of 20 years of qualifying service credit

          • Pre-Medicare Retirees (after Jan. 1, 2022)
          o Group A -30 years at any age
          o Group B -32 years at any age or 31 years minimum age 52
          o Group C -32 years and minimum age 55

          Julie, OPERS

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    • January 22, 2020 at 9:04 pm
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      I’m glad to hear we can use any additional money for spousal medical coverage, if needed. My concern is the future of the ACA as it appears some are trying to systematically dismantle the program. Then what for us pre-medicare retirees? From my opinion, the ACA has become more expensive each year with less coverage.

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      • January 27, 2020 at 4:27 pm
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        Pre-Medicare participants will be able to use their HRA dollars to pay for premiums for the health care plan of their choosing. In addition to the health care marketplace, you can choose your spouse’s employer or any private insurance carrier. Researching what is available in your area will help you be that much more prepared to select a plan for 2022. The Ohio Department of Insurance at insurance.ohio.gov is an excellent resource for learning about insurance products and plans.

        Julie, OPERS

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  • January 17, 2020 at 4:10 pm
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    I AM 69 YRS. OLD , RETIRED IN 2007 I DO NOT UNDERSTAND WHAT BENEFITS I WILL BE LOOSENING . PLEASE EXPLAIN SO I CAN UNDERSTAND .

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    • January 24, 2020 at 11:23 am
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      Please call us at 1-800-222-7377 and a member of our staff can explain how the changes will impact you.

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  • January 17, 2020 at 4:10 pm
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    You try and put such a positive spin on this but it just doesn’t work. We see right through it. The bottom line is that for many of us, you are cutting the Medicare reimbursement to the point that it won’t cover what you yourself say is the average Medigap medical and drug supplemental plan cost. I quote , “ the average Medigap medical and drug supplemental plan costs $275 per month”. Again our cost of living goes up and that doesn’t even include the COLA freeze you want.

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    • January 22, 2020 at 4:25 pm
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      We realize any reduction in your monthly benefit is difficult. Our goal is to continue providing some health care coverage for current and future retirees. Because all funding is currently needed to strengthen the pension fund and health care costs continue to rise, changes must be made to the way we administer health care coverage.

      Reply
  • January 17, 2020 at 4:14 pm
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    Why wasn’t cutting off the spouses medical enough?

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    • January 24, 2020 at 11:23 am
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      Carol,

      Our objective is to continue offering access to health care, in some form, to all eligible retirees. To accomplish this, we needed to implement changes that extended the solvency of the Health Care Fund. Without the changes, the Health Fund would run out of money in 11 years. Removing spousal coverage made an impact but it wasn’t enough.

      Julie, OPERS

      Reply
  • January 17, 2020 at 4:19 pm
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    Good luck trying to get a timely reimbursement from Via Benefits for things other than your premiums. Check out their list of BBB complaints. OPERS should address that.

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    • January 29, 2020 at 11:45 am
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      Gina,

      We understand the importance of receiving your reimbursements in a timely manner. At the beginning of the year there can be a delay in processing time, currently up to six business days, due to the volume of reimbursement requests. Via Benefits has increased the size of their reimbursement team and are working seven days a week so the level of service you expect can be delivered.

      Julie, OPERS

      Reply
  • January 17, 2020 at 4:24 pm
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    What’s my answer? I’ve looked through the website, however, may have overlooked or missed something.

    I retired at 51 on February 26, 2010. For much of the time since we’ve (my wife and I) have been without health insurance. I’m now 60 and my wife is 59. Currently without insurance.

    From what I can figure through the website. To get health insurance (for myself and my wife) the cost would be nearly $1,600.00 each month.

    Are we missing something here?

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    • January 24, 2020 at 11:24 am
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      Please call us at 1-800-222-7377 and a member of our staff can explain how the changes will impact you.

      Reply
  • January 17, 2020 at 4:42 pm
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    I retired in 2007 at age 60 with 20 years of service. Will my base allowance be reduced to $350 or remain at $450 when the changes become effective in 2022?

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  • January 17, 2020 at 5:29 pm
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    Scenario – I plan on retiring 10/1/2023 with 31 years of service. Will the 1200.00 base allowance for 3 years begin on my retirement date or will this begin on 1/1/2022 and be in affect for me for only 2 years? Please explain.

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    • January 24, 2020 at 11:32 am
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      Karen,

      After the changes go into effect, all retirees will receive an allowance based their years of service at retirement and age when they enroll in OPERS health care.

      For pre-Medicare retirees, the base allowance will be $1,200 for the first three years (2022, 2023, 2024). After 2024, we plan to continue to offer an allowance at an amount based on market conditions and funding. and reduced to $900-$1,000 in subsequent years.

      If you retire in 2023, your base allowance will be $1,200 for the first two years.

      Julie, OPERS

      Reply
      • January 24, 2020 at 12:21 pm
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        After 2024 OPERS plans to continue health care based on market conditions and funding according to your answer but unless I am reading it incorrectly you are also saying the funding will go down after the first three years to 900-1000 a month, so were already saying it will go down?

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        • January 27, 2020 at 4:02 pm
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          The allowance amount will be reviewed periodically. It’s too early to say exactly what the allowance will be after 2024.

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  • January 17, 2020 at 5:47 pm
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    What about those who retire between now and 2022? They continue with what current retirees are getting? The medical mutual? Retirees can’t purchase the better insurance that they had while employed, but using their allowance? My concern is those with pre-existing conditions may only qualify for Obamacare, which is not only expensive without subsidies but generally high deductibles and poor choices for doctors.

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    • January 24, 2020 at 11:29 am
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      Gail,

      Pre-Medicare members who retire before December 2021 will receive OPERS-provided health care from Medical Mutual. All pre-Medicare retirees, regardless of retirement date, will move to the open market beginning Jan. 1, 2022.

      Julie, OPERS

      Reply
        • January 29, 2020 at 11:47 am
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          You’re welcome! Please let us know if you have any other questions.

          Julie

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          • January 29, 2020 at 2:25 pm
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            To clarify fully: Current pre-Medicare retirees, as well as those of pre-Medicare age who retire between now and December 2021, will receive the OPERS-provided health care from Medical Mutual only until December 31, 2021. Then beginning January 01, 2022, the OPERS-provided health care will cease for all, and ALL pre-Medicare retirees will move to the open market?

            I had heard rumors of the OPERS-provided health care being maintained for “grandfathered” retirees, but from the answers provided here, that now sounds like a false rumor.

            Thank you for maintaining this site and answering questions. It has been very useful to me.

          • January 30, 2020 at 11:10 am
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            Mark,

            Through Dec. 31, 2021, pre-Medicare retirees will receive access to the group plan through Medical Mutual. Beginning Jan. 1, 2022 all pre-Medicare retirees, regardless of when they retired, will move to a plan on the open market. Any rumor that OPERS will grandfather retirees in the Medical Mutual group plan is false.

            Julie

  • January 17, 2020 at 6:35 pm
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    Since I retired in 2011, OPERS has constantly taken action which has eroded my benefit. First the Medicare Part B reimbursement was taken away, then the process to obtain medigap insurance was changed with the promise of an allowance to cover premium costs. At first it did cover the premium cost, but not now as the premiums increase each year. After the current proposals go into effect, I will receive $132.00 dollars less each month toward the cost of the insurance premiums. Also the allowance toward the cost of spouse insurance was removed along with the $300.00 allowance we received at the beginning of each year. All of these cuts, also with the fact that I’m affected by the Windfall Elimination Provision cut to my Social Security, makes it difficult to maintain financial solvency.

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    • January 22, 2020 at 4:24 pm
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      The health care changes will preserve retiree health care coverage now and for years to come. Over the last two years, we have communicated and engaged with members and retirees about potential solutions. The Board’s plan will retain health care coverage for all eligible members and retirees.

      The Windfall Elimination Provision (WEP) is a federal law administered by the Social Security Administration. We consistently advocate for changes to the formula.

      Reply
  • January 17, 2020 at 7:23 pm
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    Will the stipend be added to monthly benefit for premedicare recipients?

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    • January 24, 2020 at 11:32 am
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      The allowance will be deposited each month in a separate account so you can be reimbursed for your eligible health care expenses.

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  • January 17, 2020 at 7:51 pm
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    Will you be proposing reducing out montly VIA funding ?

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  • January 17, 2020 at 8:37 pm
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    I find this statement misleading:
    “ If you retired and enrolled prior to 2015 with 20 or more years of service, your allowance could change slightly depending on where you fall on the allowance table.”

    Slightly?? I am currently on Medicare and retired before 2015. I had 30 yrs of service and was 55yrs old when I retired. If I understand the changes correctly, in 2022 I will get 71% of $350 instead of 75% of $450 resulting in a decrease of $89/mo. That doesn’t sound like a slight change to me. This also coincides with the COLA freeze..ouch!

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  • January 17, 2020 at 8:48 pm
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    Where can we find a chart that shows the percentages for those who retired younger than age 60? If we are going to get less than 75%, it would be good to know how much less so we can use more discretion in claiming reimbursement in the years leading up to the reduced HRA allowance. That would let our current balance build up to cover premiums longer when our allowance is cut.

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  • January 17, 2020 at 9:49 pm
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    We pay for our Medicare parts B & D through a deduction from the Social Security Checks. We pay for our vision and dental through OPERS. We pay for the Medigap plans additionally. We worked hard for 30 years plus to not endure the Windfall Provision and retired with 38+ years credit. We get reimbursed $378 per month and gladly pay the rest. This not luck; it’s good planning. People like us did not retire with less than 30 years of service. The pre-Medicare retirement seems to be the problem requiring a percentage of $1200 month to fund their health insurance, if I understand this new plan. Retirees like us are not your problem!! We understand you at OPERS are not mandated/required to offer healthcare and quite frankly most all understand this and are tired of hearing you reiterate the continual implication of this. Please stop pounding us with this unnecessary statement! We are grateful for what we have with
    OPERS and worked hard, like others to support OPERS over the years.

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  • January 17, 2020 at 10:24 pm
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    Thank You for the clarification and details. This is helpful to know!

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  • January 17, 2020 at 11:13 pm
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    Why happens to children under 26 years old who would have been covered by the OPERS self funded plan at certain percentage depending on the parents years of service? Will there there be a subsidy for them?

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    • January 24, 2020 at 11:44 am
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      There will be no allowance for dependents beginning Jan. 1, 2022; however, you could use your allowance to be reimbursed for qualified medical expenses for an eligible dependent.

      Reply
  • January 18, 2020 at 12:55 am
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    Of you retired prior to 2013 with 30 years of service what amount would you receive?

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  • January 18, 2020 at 1:17 am
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    if you retired and enrolled prior to 2015 with less than 20 years of service, you were subject to the 75% allowance grandfathering. Your allowance percentage will be reduced to 51%. What does this mean?

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    • January 24, 2020 at 11:55 am
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      Linda,

      OPERS provides an allowance determined on an increasing scale based on age and years of service. Previous changes set the minimum allowance percentage at 75 percent for those already retired, even if they had fewer than 20 years of service at retirement.

      Beginning in 2022, those who were subject to this grandfathering with fewer than 20 years of service will have their allowance amount reduced to 51 percent ($612 per month for pre-Medicare; $178.50 per month for Medicare).

      Julie

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      • January 24, 2020 at 11:58 am
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        Is this true for the disability people also?

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        • January 29, 2020 at 4:10 pm
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          Michelle,

          For disability recipients, health care eligibility requirements are not changing.

          What is changing for all disability recipients and retirees is the allowance amount. The allowance charts on the OPERS website apply to disability recipients in the same manner as retirees. For more information, go to https://www.opers.org/healthcare/health-care-2022/index.shtml.

          In addition, disability recipients returning to work in the private sector will not receive a monthly HRA allowance. Income thresholds will be determined.

          Julie, OPERS

          Reply
  • January 18, 2020 at 5:29 am
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    I fully understand why the change is needed. I hope I am provided with information that I can fully understand how the changes will affect me and how I will find me and the family insurance.

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  • January 18, 2020 at 7:36 am
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    Assuming your retired and pre Medicare and your spouse could get a family plan through their employer for example 500.00 a month could the stipend you get go towards that policy?

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    • January 24, 2020 at 12:00 pm
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      Pre-Medicare participants will be able to use their HRA dollars to pay for premiums for the health care plan of their choosing. These plans can be through the health care marketplace, a spouse’s employer or any private insurance carrier.

      Julie, OPERS

      Reply
  • January 18, 2020 at 8:26 am
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    If the average balance of retirees is $3,700 what percentage of retirees carry a balance of $0? By the time I pay my premiums I have no balance left in my HRA account where I can even submit one claim for a reimbursement co-pay. I would like to know how many retiree’s are in the same boat I am.

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    • January 25, 2020 at 1:16 pm
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      …”the average balance of retirees is $3700″… Is this supposed to suggest to us that the current $450 base allowance is too generous? If you have just ONE hospitalization, that $3700 balance can be completely wiped out by just the deductible alone on many of the Medicare Advantage plans. I do give OPERS credit, as when a reduction in benefits is proposed, it’s definitely a REDUCTION! For example, going from a $450 allowance to $350. Now, THAT’S a reduction…. No pussy-footing here.

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      • January 29, 2020 at 11:35 am
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        Joe,

        Every retiree’s experience is different. Some have chosen to save their allowance for future health care expenses, letting the allowance roll over from year-to-year.

        Julie, OPERS

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        • March 2, 2020 at 11:14 am
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          Yeah, right. I see fellow OPERS recipients in line at the short term loan places just like me. We were promised a “decent” retirement. We jumped through all the hoops to make sure we did. OPERS has nibbled away at my retirement benefits EVERY YEAR since I retired in 2011. The stress of not being able to just RELAX and be retired is shameful, imo.

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    • January 25, 2020 at 1:47 pm
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      I too find it interesting when they talk about this high average balance in the HRA. Either folks are doing a zero premium advantage plan and therefore not using any dollars or they are not requesting their funds from the HRA. One education event I went to given by OPERS stated that some folks think the HRA will pass on to someone when they die. This is not that type of account, do folks fully understand that? Use the money in the account you cannot take it with you nor leave it for someone else. I have very little left from the HRA each month once I pay a supplement, Part D drugs, and the get my medicare part B money back. Once the changes happen in 2022 it will not cover all of that. Maybe they want to steer everyone to the advantage plans which look good on paper with the zero premuim, I prefer the supplement but that is me.

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      • January 29, 2020 at 11:35 am
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        Sherry,

        Your Health Reimbursement Arrangement (HRA) allowance will roll over each year. You may use your account for expenses until it is depleted. If you pass away, your authorized representative can submit claims for qualified expenses incurred prior to death for up to two years. After two years, the balance will be forfeited.

        Julie, OPERS

        Reply
  • January 18, 2020 at 9:25 am
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    As a 65+ retiree, OPERS do you have an estimate how long the $350 base allowance will stay at the amount?

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      • January 24, 2020 at 1:17 pm
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        If I understand the Health Care Allowance Package If your years of service is 30 and you retired before 60 years of age your percentage is 71%. If you retire at age 65 or older with 30 years service your percentage of the monthly allowance would be 86 %. If this is correct why are you penalizing the younger age when they have the same amount of time in PERS?

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        • January 29, 2020 at 4:08 pm
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          The allowance percentage, which has been in place since 2015, is based on your years of service and age when you first access OPERS health care. The allowance table is structured to reward career public employees.

          In addition, the longer someone is participating in the OPERS health care program prior to Medicare eligibility, the more expensive it is to provide them with access to coverage. Therefore, the younger you are when you first enroll in coverage and the fewer years of service you have at retirement, the lower your allowance percentage.

          Julie, OPERS

          Reply
  • January 18, 2020 at 9:33 am
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    This is “good news – bad news” . . . OPERS has made timely adjustments to rescue the health care fund, but another financial setback for current retirees. All in all, I commend OPERS for their foresight and making tough (unpopular) decisions for our benefit. Your hard work is appreciated.
    When will you revise the “Health Care Allowance Percentage” chart to reflect the new (lower?) percentages? I retired in 2000 at age 51 with 32 years service and currently receive 75% of the allowance. Will that be reduced?

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  • January 18, 2020 at 10:38 am
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    When I’ve read through prior changes, it mentioned stability in retirement as a goal. This is 3rd change since I began my career 20 years ago. The first change was increasing the withholding to fund a health care trust fund, then that funding decreased and now stopped. The second was dropping the spousal coverage and increasing the time requirements, and dividing participants. And now this. This is not stability for retirees or employees. It seems every downturn is used as a reason to reduce benefits. The market has recovered, why didn’t this drastic plan? The next change sounds like the new employees will be paying the same and getting less, how is that fair and equitable?

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  • January 18, 2020 at 11:26 am
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    Your examples didn’t include someone like myself who retired on January 2017 at the age of 57. I’ll be 62, of course, when the change takes place. I have 26 years of active service, I purchased 4 years of military, so I retired with 30 years. Is my percentage 69% of $1200?

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    • January 24, 2020 at 12:05 pm
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      We created examples for the most common scenarios. Please call us at 1-800-222-7377, or send a message through your online account, to determine how the changes will impact you.

      Julie, OPERS

      Reply
  • January 18, 2020 at 11:28 am
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    Not happy with changes take away cost of living first now this insurance on the open market will cost more as a old senior on fixed income none of this is helping me

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    • January 24, 2020 at 12:06 pm
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      The changes will preserve retiree health care coverage now and for years to come. The Board’s plan will retain health care coverage for all eligible members and retirees.

      Reply
  • January 18, 2020 at 11:31 am
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    Well, NPR and the Plain Dealer were all over this announcement a couple of days ago. Sad, that any cola via OPERS and/or SSA wont begin to cover the premium increases and other health expenses of us fined income people. Don’t misunderstand me, I get it

    Reply
  • January 18, 2020 at 12:08 pm
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    I’m under age 65. I have a dependent child that I receive a 50 percent allowance benefit. In 2022, will I receive a separate stipend amount for my child? Thank you for your response.

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    • January 24, 2020 at 12:06 pm
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      There will be no allowance for dependents as of 01/01/2022. However, you could use your allowance to be reimbursed for qualified medical expenses for an eligible dependent.

      Reply
  • January 18, 2020 at 12:10 pm
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    Maybe the clarity of this formula is needed. I had 20 years and began taking ss at 65. According to my calculation I will be reduced significantly.Retiree’s are always the victim of changes with OPERS!

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    • January 24, 2020 at 12:07 pm
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      Could you be thinking of the Windfall Elimination Provision (WEP)? That’s administered by the Social Security Administration, not OPERS.

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  • January 18, 2020 at 6:57 pm
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    Can the monthly allowance be used to pay for COBRA upon retiring?

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    • January 24, 2020 at 12:08 pm
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      Pre-Medicare participants will be able to use their health reimbursement allowance dollars to pay for premiums for the health care plan of their choosing. These plans can be through the health care marketplace, a spouse’s employer or any private insurance carrier.

      Reply
  • January 18, 2020 at 9:30 pm
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    First it was COLA now health Insurance what is next take away my pension I think it is time retires stand up for rights

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    • January 24, 2020 at 12:09 pm
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      The new plan maintains access to health care for all eligible pre-Medicare and Medicare retirees. Without the changes, the health care fund would have run out in 11 years.

      Reply
  • January 19, 2020 at 9:57 am
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    Is there an idea of what Medical, Prescription, Dental and Vision Coverage would cost per month in 2022 for single coverage ? And are there really good, affordable policies that can be purchased on a private level? Thank You

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    • January 24, 2020 at 12:08 pm
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      Pre-Medicare participants will be able to use their HRA dollars to pay for premiums for the health care plan of their choosing. These plans can be through the health care marketplace, a spouse’s employer or any private insurance carrier. Researching what is available in your area will help you be that much more prepared to select a plan for 2022.

      The Ohio Department of Insurance at insurance.ohio.gov is an excellent resource for learning about insurance products and plans.

      All ACA qualified plans for 2020 are available for review at http://www.healthcare.gov. Click on the “Preview Now” button under the “See Plans & Prices” section just below the main body. You will be asked a few questions about income and where you live. You can then preview 2020 plans in your area. In addition, based on your income, you will find out whether you qualify for the tax credits, also known as the federal subsidy, that can lower your premiums. Please know that rates, plan options and carriers are likely to change each year.

      Julie, OPERS

      Reply
  • January 19, 2020 at 10:54 am
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    I retired in 2013 with 35 years of service at the age of 55. Since hired before 1985 I was grandfathered in and never paid into Medicare. Will I be eligible for Medicare coverage when I turn 65 in 2023. I thought I would always have the Opers insurance. Or is this a question for Medicare

    Reply
    • January 24, 2020 at 12:14 pm
      Permalink

      The Board voted to keep the current Medicare A premium reimbursement policy. There is no change. Retirees are required to enroll in Medicare at 65 and we will reimburse them for part A cost and penalty.

      Reply
      • January 24, 2020 at 12:50 pm
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        So if I leave Opers insurance in 2022 and go on husband’s work insurance will I be able to return to Opers insurance in 2024 and be reimbursed for Medicare part A. I turn 65 in May 2023. I was told when I retired if I declined the Opers insurance I would never be able to enroll or if I left Opers insurance you could never re enroll

        Reply
        • January 24, 2020 at 1:26 pm
          Permalink

          Please call us at 1-800-222-7377 to review your options.

          Reply
          • January 24, 2020 at 1:51 pm
            Permalink

            It was a yes no question. If I leave by Opers insurance in 2022 am In able to sign up for Medicare Part A on 2024 and have Opers pay for it since I never paid into Medicare. I tried the number they say call back later we are too busy

          • January 27, 2020 at 4:01 pm
            Permalink

            Yes. OPERS will continue the current Med A reimbursement program. You are required to enroll in Medicare at 65 and we will reimburse you for the cost of Medicare part A and penalty.

            Julie, OPERS

  • January 19, 2020 at 2:16 pm
    Permalink

    Hi Michael,

    Thank you for the great information.

    Sorry to vent, but keep in mind many of us have worked a lot of years in PERS with the beliefs such as if I had close to 30 Service years in and had to retire a couple of years short of age 65, that I would be able to buy healthcare from PERS for a couple of years until I reached Medicare age. PERS needs to understand that it is to late for us to make changes at this point in our career.

    If I am reading this part correctly:

    “For future retirees: Members retiring under age 65 after Jan. 1, 2022, will be eligible to participate in the health care program only with 30 or more years of service. To participate with fewer than 30 years of service, members will need to be age 65 with 20 years of qualifying service.”

    In my own personal case. for the first half 2022 I will have 29 years of service and be 63 years old. So if I got laid off or retired in the first half of 2022 I could not get healthcare?
    -But if an eligible person also under 65 years with less Service years than me retired at the end of 2021 they could buy healthcare from PERS.

    If so that does not seem fair.

    I am actually giving serious thought to retiring in July of 2022 as I will turn 63 and just have reached 30 years Service in PERS that month.
    I was then going to buy PERS healthcare for 2 years until I turned 65 and went on Medicare.

    So if I got laid-off in the first half of 2022 or had to retire in my case I will be just short of 30 years of Service in PERS so I will not be able to buy healthcare?
    Yet if I am reading this right I could chose to retire at the end of 2021with less than 30 years but be eligible to buy healthcare from PERS.

    Hopefully I am misreading this, as trust me those are the real life scenarios that will happen and that would not be fair to PERS members.

    If I am reading this right, has PERS given any thought on maybe creating an appeal board to look at the odd scenarios that could happen and make 1 time exceptions so people can appeal them.

    Thank You

    Reply
    • January 24, 2020 at 12:16 pm
      Permalink

      Alan,

      Eligibility requirements will change for those retiring after Jan. 1, 2022:
      • Medicare Retirees (after Jan. 1, 2022)
      o Age 65 with a minimum of 20 years of qualifying service credit

      • Pre-Medicare Retirees (after Jan. 1, 2022)
      o Group A -30 years at any age
      o Group B -32 years at any age or 31 years minimum age 52
      o Group C -32 years and minimum age 55

      For more information on how the changes will impact you, go to https://www.opers.org/healthcare/health-care-2022/index.shtml

      Julie, OPERS

      Reply
  • January 20, 2020 at 11:09 am
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    OPERS should have offered this as an option when they began reducing allowances and dropping spouses from the “grandfathered” retirees plans. This could have been a better option for many and could have saved us a lot of money and headaches.

    Reply
  • January 21, 2020 at 10:37 am
    Permalink

    Under the heading Pre-Medicare Coverage, the sentence “Beginning in 2022, those enrolled in the OPERS pre-Medicare plan will instead enroll in the health care plan of their choosing.” implies that all non-Medicare eligible retirees, both those who were already retired prior to 2022 as well as those who retired in 2022 and after would essentially on their own to find health insurance coverage (because OPERS’ pre-Medicare plan was being discontinued.

    Later in that section, however, the phrase, “…your eligibility for health care coverage is “grandfathered,”…”, implies by use of the term “coverage” and its usage under the heading of grandfathering that current retirees at that time will maintain a different type of health insurance benefit than new retirees.

    So the question at hand is…

    With respect to non-Medicare eligible retirees, will they all be treated the same on 01/01/2022 (e.g., all forced to find insurance on their own), or will those who were already retired at that point (or some subset of them) be treated differently from those who retire after that point.

    Thank you in advance for clarifying.

    Reply
    • January 24, 2020 at 12:17 pm
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      Beginning Jan. 1, 2022, all pre-Medicare retirees will purchase their health care coverage on the open market regardless, including those who are already retired.

      Reply
  • January 21, 2020 at 2:21 pm
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    This perspective uses opers premiums of 2019 and 2020.. in the examples.
    For pre-medicare situation :

    How or what premium dollar amount will be used or established for 2022 and beyond .. since this will be an open market situation and not an opers health care premium. How will that health care premium be established and applied to the percentage allowance for each retiree?

    I assume the open market total premium is anticipated to be less that the opers premium of $1379 for 2020?

    Will each retiree need to show proof of payment for health insurance in 2022 to receive the opers allowance each month ? For example .. if a retiree returns to work and receives health care from the employer – will the opers allowance amount to the retiree stop ? Or will the retiree continue to receive the opers monthly allowance?

    Reply
    • January 24, 2020 at 12:19 pm
      Permalink

      Beginning Jan. 1, 2022, pre-Medicare retirees will receive an allowance, based on their years of service at retirement and age when you first enroll in OPERS health care, for their health care coverage and other eligible health care expenses. The monthly allowance will go into a separate account and you will have to submit proof of payment for a qualified expense in order to be reimbursed.

      For information on the allowance amounts in 2022 go here: https://www.opers.org/healthcare/health-care-2022/index.shtml

      Reply
  • January 21, 2020 at 10:04 pm
    Permalink

    If a pre-medicare retiree declined health care when they retired prior to 2022, are they eligible for a portion of the 1200/month HRA payment after Jan 1, 2022 based on the years of service that they had worked?

    Do you anticipate that the 1200 / month value will increase or decrease after three years?

    Reply
    • January 24, 2020 at 4:39 pm
      Permalink

      Any current retiree eligible to participate in the health care program will continue to be eligible after Jan. 1, 2022. Your allowance will be based on your years of service and your age when you first enroll in OPERS health care.

      The base allowance amount for pre-Medicare retirees for calendar years 2022, 2023 and 2024 will be $1,200 per month. After 2024, we plan to continue to offer an allowance at an amount based on market conditions and funding.

      Julie, OPERS

      Reply
  • January 22, 2020 at 1:30 pm
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    The grandfathering addresses retiring PRIOR to 2015. What about someone that retired in 2015 or up until the 2022 change?

    Reply
    • January 28, 2020 at 10:32 am
      Permalink

      Kathy,

      Anyone retiring prior to Jan. 1, 2022 will need to meet current health care eligibility requirements. Anyone retired and eligible for health care prior to Jan. 1, 2022 will continue to be eligible for health care coverage in 2022 and beyond.

      OPERS provides an allowance to both Medicare and pre-Medicare health care participants. The allowance amount is determined on an increasing scale based on age and years of service. Changes effective in 2015 grandfathered those already retired at minimum allowance percentage of 75 percent, even if they had fewer than 20 years of service at retirement. Those who retired after Jan. 1, 2015, are already being provided an allowance based on where they fall on the allowance chart, so their allowance percentage won’t change.

      If you are considering a retirement date between now and when the changes become effective in 2022, we strongly encourage you to attend an OPERS educational seminar as well as schedule a meeting with an OPERS retirement counselor to evaluate your individual options. In general, current health care coverage will continue through 2021.

      Julie

      Reply
  • January 22, 2020 at 3:04 pm
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    Can you tell me how this change will affect people on disability? Will we still be eligible for health care and do we receive any allowance for it?

    Reply
    • January 28, 2020 at 10:33 am
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      Michelle,

      For disability recipients, the current conditions apply:

      1. First 5 Years – Provide health care coverage/allowance for the first five years of disability regardless of service credit and age.

      2. Post 5 years – Continue providing health care coverage/allowance but the recipient must meet health care eligibility requirements.

      Recipients with a disability effective date prior to Jan. 1, 2014 are not subject to the “First 5 Years” provision described above. Their eligibility for the health care program will not change.

      What has changed: Disability recipients returning to work in the private sector will not receive a monthly HRA allowance. Income thresholds will be determined. Disability retirees will be treated the same as all other OPERS retirees when it comes to allowances. For more information on 2022 allowance percentages and amounts, go to https://www.opers.org/healthcare/health-care-2022/index.shtml.

      Julie

      Reply
      • January 28, 2020 at 12:06 pm
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        Thank you for answering my questions and for the information.

        Reply
        • January 28, 2020 at 12:48 pm
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          Michelle,

          You’re welcome! Please let us know if you have any other questions.

          Julie

          Reply
  • January 22, 2020 at 6:07 pm
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    I am going to be 67 with only 15 years of service. I am currently in the member direct plan, do I need to switch to the traditional plan seeing that I will not qualify? That’s the way it looks to me. Thank goodness I’m a Veteran and have a that to fall back on.

    Reply
    • January 28, 2020 at 10:33 am
      Permalink

      Please call us at 1-800-222-7377 or schedule an appointment through your online account so we can review your options.

      Reply
  • January 22, 2020 at 7:33 pm
    Permalink

    The title of this article should not be “OPERS Maintains Health Care Plans” – it should be – OPERS Drops Health Care for ALL Retirees Not Eliglible For Medicare! Two things are going to happen from this fiasco and neither are good. First, no millenial or young person will ever want to work for the State of Ohio if they know they have to work decades to keep their healthcare in retirement. They will do much better in the private sector. Good luck finding employees. And we’ll be watching if you offer some sweet deal to the new hires with your new Group D scheme. Secondly, older employees will never retire now. They won’t be able to afford to, unless old enough to get Medicare. In addition, employees don’t trust a word you say or promise anymore… Truly sad… Please post.

    Reply
    • January 27, 2020 at 4:28 pm
      Permalink

      As we have noted for more than a year, OPERS is not immune to the high cost of health care. Our objective was to continue offering access to health care, in some form, to all eligible retirees. To accomplish this, we needed to implement changes that extend the solvency of the Health Care Fund. Without the changes, the Health Care Fund would run out of money in 11 years and no one would have an allowance.

      Julie, OPERS

      Reply
    • March 2, 2020 at 11:20 am
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      Yes! 👏🏾👏🏾👏🏾👏🏾👏🏾👏🏾👏🏾👏🏾👏🏾👏🏾

      Reply
  • January 22, 2020 at 9:35 pm
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    I continue to ask but never see an answer. As of now my child is covered proportionally under OPERS health care. Wile I will receive 76% of the $900 allowance sin the form of a subsidy, what type of subsidy will OPERS provide for my child who in the past had health care coverage?

    Reply
    • January 27, 2020 at 4:26 pm
      Permalink

      Eligible dependent children will not receive an allowance as of Jan. 1, 2022. However, you can use your HRA dollars to be reimbursed for qualified medical expenses for an eligible dependent.

      Reply
  • January 23, 2020 at 8:28 am
    Permalink

    So if I retire at age 54 with 32 years of service will I automatically get the 1200.00 sent to me each month if I continue to remain on my wife’s policy? Or if I pick a policy that’s cheaper will I get the remainder?

    Thank you for your time

    Reply
    • January 27, 2020 at 4:26 pm
      Permalink

      The $1,200 is the base allowance. You will receive a percentage of that amount based on your years of service and your age when you enroll in OPERS health care. With 32 years of service and age 54, you will receive a 75% allowance or $900 a month.To see how the changes will apply to you, go to https://www.opers.org/healthcare/health-care-2022/index.shtml.

      You can use your allowance to pay for health insurance through your spouse and other eligible health care expenses. The monthly allowance will go into a separate account and you will have to submit proof of payment for a qualified expense in order to be reimbursed. More details about the process will be available in 2021 as we get closer to implementation.

      Julie, OPERS

      Reply
      • January 28, 2020 at 9:54 am
        Permalink

        Thanks Julie. More information has been made available since I’ve posted my question.

        Reply
  • January 23, 2020 at 10:38 am
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    How will the current changes effect a minor child, dependent, in the home under 18 who is currently covered by Med Mutual?

    Reply
    • January 27, 2020 at 4:24 pm
      Permalink

      There will be no allowance for dependents as of Jan. 1, 2022. However, you could use your allowance to be reimbursed for premiums or other qualified medical expenses for an eligible dependent.

      Reply
  • January 24, 2020 at 11:34 am
    Permalink

    Starting 2022 are we on our own for dental and vision as well as health care?

    Reply
  • January 26, 2020 at 7:49 am
    Permalink

    Thank you for so many answers from so many questions. After further reading, I think it’s understood better, but I’d like to furnish a quote from one of your emails, ask a few questions about that and then offer my details and what “my” answers are from the details I offer.

    The quote:

    “ Beginning in 2022, those enrolled in the OPERS pre-Medicare plan will instead enroll in the health care plan of their choosing. OPERS will partner with a service provider to help pre-Medicare participants find the best plan for their needs, in a manner similar to the OPERS Medicare Connector.”

    Quote:
    “OPERS will partner with a service provider” – I assume that’s a paid third-party company who will have a list of “approved” Health Insurance Providers?

    Quote:
    “ will instead enroll in the health care plan of their choosing.” – Sorry, but Obama said this and we all see how well that turned out. Does the “plan of my choosing” include plans from a source known as “Christian Health Care Ministries”, who IS on “Obama’s” list of “approved” insurance providers?

    Now… I retired February 26, 2010 at the age of 51 with 30 years and 1 month service.

    We had OPERS Offered Health Insurance for a year, but then the “Affordable Care Act – AKA “Obama Care” raised its ugly head and messed up everything.

    I am now 60 and my wife is 58.

    From the “charts” on the OPERS website and when this new plan begins in 2022?

    It looks like we’ll fall in the 71% line which lists $852.00 monthly for pre-Medicare members and $248.50 monthly for Medicare eligible members.

    So the “Service Provider” will help us in 2022 find the best Health Insurance choice and we’ll receive $852.00 monthly to assist in paying towards that monthly Health Insurance premium?

    For the first three years anyway (which is the time OPERS will then review how well this is working and, perhaps, adjust accordingly) or until we reach the Medicare age?

    Thank you,
    Russ

    Reply
    • January 29, 2020 at 11:33 am
      Permalink

      Russ,

      Beginning Jan. 1, 2022, you can use your Health Reimbursement Arrangement (HRA) allowance to pay for your eligible medical expenses, including the insurance premiums for you and your spouse.

      As a pre-Medicare retiree, you can choose a plan from a variety of sources in addition to the Affordable Care Act such as an employer (you or your spouse’s) or any private insurance carrier.

      Researching what is available in your area will help you be that much more prepared to select a plan for 2022. The Ohio Department of Insurance at insurance.ohio.gov is an excellent resource for learning about insurance products and plans.

      More information will be available as we get closer to the changes becoming effective in 2022.

      Your allowance amount will be based on your years of service and your age when your first enrolled in OPERS health care. We anticipate the base allowance to remain from 2022-2024 ($1,200 for pre-Medicare and $350 for Medicare retirees). After 2024, we plan to continue to offer an allowance at an amount based on market conditions and funding.

      Julie, OPERS

      Reply
  • January 27, 2020 at 2:10 pm
    Permalink

    Based on the Health Care Allowance chart on your website, a pre-Medicare participant who is 64 years old and 30 years of service will get $996 which is 83% of $1200 base allowance? Or is it $1145.06 which is 83% of Current Year 2020 full mothly premium of $1379.59?

    Reply
    • January 27, 2020 at 2:32 pm
      Permalink

      The health care changes go into effect on Jan. 1, 2022. For pre-Medicare retirees, you will be given a Health Reimbursement Arrangement (HRA) allowance, a percentage based on your years of service and your age when you first enroll in OPERS health care. The base allowance amount for calendar years 2022, 2023 and 2024 will be $1,200 per month. After 2024, we plan to continue to offer an allowance at an amount based on market conditions and funding.

      Beginning in 2022, the base allowance for pre-Medicare retirees is $1,200. In the example you reference, it would be 83% of $1,200, or $996.

      Julie, OPERS

      Reply
  • January 28, 2020 at 7:23 pm
    Permalink

    My husband and I both retired in 2017 with 30 years of service. He was 57 and I was 52. We currently each pay about $350 a month for the insurance. So per the charts, we will receive a benefit of $852 a month for insurance, AND not have to pay the $350? Is this correct?

    Reply
    • January 30, 2020 at 11:15 am
      Permalink

      You are correct. The $852 allowance and your current $350 premium are not tied together. Your pension check will go up because you will no longer pay your health care insurance premium through OPERS. Instead, as a pre-Medicare retiree, you will receive a monthly allowance in a separate HRA account that you can use for eligible medical expenses, including premiums for the health care plan of your choice. This plan can be offered through the healthcare marketplace, an employer (you or your spouse’s) or any private health care insurance carrier.

      Julie, OPERS

      Reply
      • January 30, 2020 at 3:33 pm
        Permalink

        Thanks for your response. Regarding the HRA account, will we have the option to put more money into it? If we can, would it be tax deferred? If we don’t use all of our allotment, does it rollover every year? Is there a cap on how much can be in the account?

        Reply
        • January 31, 2020 at 4:31 pm
          Permalink

          Laura,

          If you have funds left over in your Health Reimbursement Arrangement (HRA) at the end of the year, you can roll over those funds to the next year. What you can’t do is deposit additional funds into your HRA account.

          Julie

          Reply
        • January 31, 2020 at 4:30 pm
          Permalink

          You’re welcome!

          Reply
  • February 6, 2020 at 6:35 pm
    Permalink

    Hi Julie – Is there a maximum amount for HRA rollovers? What happens to HRA account monies if the employee dies? Thx.

    Reply
    • February 7, 2020 at 2:05 pm
      Permalink

      Mac,

      Your allowance can accumulate from month-to-month and the balance will roll over from year-to-year. There is no limit to the amount you can rollover. If you pass away, your authorized representative can submit claims for qualified expenses incurred prior to your death for up to two years. After two years, the balance will be forfeited.

      Julie, OPERS

      Reply
  • February 6, 2020 at 6:38 pm
    Permalink

    I retired in 2012 at age 64 with 25 years and just learned that beginning 1-1-22 my HRA allowance will be reduced by $82 a month, not leaving enough to cover my health care costs. Also, the COLA will be frozen for 2 years beginning at the same time. That’s going to take a nice-sized chunk out of my income.

    Reply
    • February 10, 2020 at 12:17 pm
      Permalink

      The cost-of-living proposal is pending in the Ohio Legislature.

      Reply
  • March 26, 2020 at 10:39 am
    Permalink

    As a Medicare retiree will I still be able to cover eligible dependents in 2022? Specifically I’m speaking of a child who has not reached the age of 26.

    Reply
    • April 1, 2020 at 1:38 pm
      Permalink

      James,

      There will be no allowance for dependents as of Jan. 1, 2022. However, you could use your own HRA dollars to be reimbursed for qualified medical expenses for an eligible dependent.

      Julie, OPERS

      Reply

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