Answers to Health Care 2022 questions

This month: Learn about various costs associated with the new plan

By Michael Pramik, Ohio Public Employees Retirement System

July 27, 2021 – As we draw nearer to 2022, and the changes that will affect OPERS Pre-Medicare retirees next year, we will periodically post questions and answers to key topics we believe will benefit our members.

This month we’re answering several questions regarding the various costs associated with different aspects of Pre-Medicare coverage.

Q: How much more is a new individual medical plan going to cost?

A: It won’t necessarily cost more. In fact, depending on their HRA allowance and which plan they choose, some retirees will find the HRA covers their entire premium and they will have extra funding to pay for out-of-pocket costs. Further, money can accumulate from year to year in the HRA to be used for future health care expenses.

All retirees will have choice and flexibility in plans. Some retirees may find that they like the additional choices and are better off financially, while others may find that they will have to pay more in premiums and/or out-of-pocket costs. This will depend on the available plans in your county.

Q: What will happen to the money that was taken out of my pension benefit to pay for health care coverage under the group plan?

A: Pre-Medicare retirees will no longer have group plan premiums deducted from their monthly pension, so their monthly benefit payment will increase by the amount they are currently paying for coverage. Retirees would be wise to earmark these additional funds toward out-of-pocket health care costs. Premiums for vision and/or dental coverage will still be deducted from your monthly benefit if enrolled.

Q: Based on what I’m going to receive monthly in my HRA, I don’t think OPERS is providing me enough money to cover my premiums.

A: Covering the entire cost of health insurance is not the intention of the OPERS Health Care Program. In the current group plan, all retirees pay some percentage of the monthly premium, based on age and years of service credit. (See the allowance table on OPERS’ website.) It will be the same way with the new coverage. However, there’s more flexibility. To the extent that a participant opts for lesser coverage, he or she may be able to cover the full premium, and even have money left over to go toward dependent coverage or to save for future health care expenses.

Q: What about out-of-pocket costs?

A: Some retirees, especially those with chronic conditions or those taking high cost prescription drugs, may be required to pay more up front than they’re used to paying, in terms of higher deductibles and co-insurance amounts.

Q: What if a retiree chooses not to enroll in a plan and just pays for expenses out-of-pocket, will they still receive HRA deposits?

A: Yes. Enrolling in a medical plan is not a requirement for Pre-Medicare retirees to receive HRA deposits. Pre-Medicare retirees only need to meet eligibility guidelines and opt-in to receive the HRA deposits.

For more information on this transition, visit the Health Care 2022 page at opers.org. Also, plan to attend a Retiree Health Care Under 65 webinar. This webinar was updated with new information in February. If you have attended one of these sessions, you may consider attending again this year. Visit the Member Education Center at opers.org to register. All webinars are also available as Recorded Presentations to watch at your convenience.

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

  • Can my monthly HRA be saved each month to purchase insurance at a later date or must I chose an insurance plan? In other words save money money to use for health care at a later date.

    • Johnny,
      The pre-Medicare HRA does not require the recipient to choose a medical plan to receive the allowance monthly. The pre-Medicare recipient will be required to opt-in to the HRA during the open enrollment period 11/1-12/15/2021 to start receiving the HRA starting 1/1/2022. The funds in the HRA will accumulate until the member submits for reimbursement of qualifying health care expenses.
      Thanks, MS

  • I am basically being told that if I retire after 2021 I will not receive a health care benefit in my situation because even though I am close to 28 years I would fall just short for a payment if I retire after 2021 for my planned retirement date of March in 2024 because I will not have 30 years even though I am over 60. So if I got laid-off or had to retire after 2021 but before my retirement date in 2024 I would not get any healthcare from OPERS.

    OPERS is not Grandfathering those of us in group A that fall into this Grey area of not having 30 years in even though you are over 60. If I retire before 2021 then it is ok that I fall a little short of 30 years. But I have always made my retirement plans based on doing 30 years like OPERS has suggested.

    For 28 years I have paid into OPERS with what I thought was part of that money going towards protection for possible Healthcare gaps like this.
    Will I be refunded part of that money as I am being told now the end of the race you have to retire by 2021 or you will not be eligible for healthcare until you hit 30 years.

    I will basically hit 30 years the same time when I turn 65 and go on Medicare.

    • Alan,
      Please forward your question through the online message center or contact Our Member Service Center so we can review your account and provide an account specific answer.
      Thanks MS

    • Jim,
      The pre-Medicare HRA can be used to be reimbursed for post tax medical premiums.
      Thanks, MS

      • Question: I am planning on going on my Husbands insurance through his employer (Not an OPERS employer). Several questions: Am I still eligible for the HRA account, do I get the initial “bonus” money of $1200 in that account and can I opt back in once my husband retires in 5 years?

        • Brenda,
          Please forward your questions through your online account message center so we are able to review you account and provide account specific answers or you can reach our Member Service Center at 1-800-222-7377.
          Thanks MS

    • Terri,
      Your plan options will be determined by the county you live in. Please contact Via Benefit once the enrollment period begins to get additional information on your options.
      Thanks, MS

    • John,
      Pre-Medicare recipients can opt in to the HRA during the open enrollment period 11/1/2021-12/15/2021. Thanks MS

      • Do you have to be retired or put in for retirement to opt-in to Via Benefits to receive the HRA allowance? Can I continue to work for Opers and open an account with Via Benefits to receive the HRA allowance ?

        • Matt,
          The pre-Medicare HRA is only offered to benefit recipients that are eligible for OPERS health care program.
          Thanks MS

          • So I have 38 years of opers and I’m 61 years old and still working for opers. I should be getting around a $1,000 allowance. Can I still receive that allowance and set up an HRA account with Via Benefits? Or must I be retired to set up an account with Via Benefits?

          • Matt,
            The HRA allowance is only offered to benefit recipients not active members.
            Thanks, MS

    • Steve,
      The Medicare recipients are in a closed HRA which requires the recipient to enroll into a medical plan through Via Benefits to receive the HRA allowance.
      Thanks MS

    • Jan,
      The Medicare recipients will still have the Medicare Connector that is administrated by Via Benefits. The pre-Medicare recipients will opt in to the HRA and will have the option to use the pre-Medicare Connector with Via Benefits, choose a plan through healthcare.gov, or through a Insurance Broker.
      Thanks, MS

    • Lisa,
      The HRA will remain active for 24 months after the date of death for submission of eligible claims. For the exact date of HRA forfeiture, refer to Via Benefits.
      Thanks MS

    • Lisa,

      Unspent money in your HRA rolls over year after year, even once you become Medicare eligible.

  • I am in the pre-Medicare group on disability through OPERS since October 2009. Are we supposed to be contacted by Via Benefits soon to figure out what our coverage will be effective January 2022?

    • Tracey,
      This week a letter is being mailed to all pre-Medicare recipients to provide additional information about actions required and what to expect.
      Thanks, MS

        • Carol,
          We offer information about health care 2022 on our website under the health care 2022 section. If you would like us to look into your account and provide account specific answers please forward your questions through your online account message center or contact our Member Services Center at 1-800-222-7377.
          Thanks MS

  • How will the HRA account work? Is it a reimbursement only? Can medical bills be submitted directly for payment without pre-payment out of pocket? Can our premium cost be auto-deducted, or will we need to submit a request every month for payment/reimbursement?

    • Lori,
      The HRA is a reimbursement account only. The member will be required to submit for reimbursement for qualified expenses.
      Thanks MS

  • I am planning to retire at the end of the year (12/31/2011). When should I enroll to begin receiving the HRA monies in Jan. ’22?

    • Mac,
      Please forward your questions through the member online account message center or call our Member Services Center at 1-800-222-7377.
      Thanks MS

  • If the proposed 2021 democratic budget plan results in the lowering of the eligibility age for Medicare (from 65 to 60 or even 55, if some have their way), it will result in a windfall of excess financial resources in our healthcare fund.

    Under such conditions, I would implore our board to consider using these unexpected funds to once again provide healthcare coverage for our spouses.

  • I am going to turn 60 on October 27, 2021 and I have 22 years of service. I really do not want to retire just yet but I feel like I have to because if I do not I will have to work until I am 66 which is 6 more years and I really do not want to work that much longer. If I was to work just 2 more years which would be ideal what would happen to my HRA? I would not get any of it until I turned 65 correct?

    • Jackie,
      Please forward your account specific questions through the online message center or contact our Member Services Center at 1-800-222-7377.
      Thanks, MS

  • I am in the pre-Medicare group. Looking for answers in clear language (because I am confused). 🙂 After opting into the plan:
    1. My husband still works. His employer’s health insurance may cover me (or may not, still investigating). Am I able to use the HRA funds to cover costs that his employer passes on to us to add me?
    2. I’ve been researching potential costs on the Marketplace. Am I required to go through Via Benefits, or can I choose a plan direct from the Marketplace?
    Thank you

    • Tonia,
      The pre-Medicare HRA does not require you to use Via Benefits to choose a plan, you would only be required to opt in to the HRA to receive the HRA in 2022. The HRA can be used to be reimbursed for post-tax qualified expenses. In order to be reimbursed for a medical plan premium the plan would need to be paid for with post-tax funds. Please send any additional questions you may have through your online message center or contact our Member Service Center at 1-800-222-7377.
      Thanks, MS

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