Answers to Health Care 2022 questions

This month: Learn details about the enrollment process

By Michael Pramik, Ohio Public Employees Retirement System

Aug. 31, 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 enrollment procedures for both Pre-Medicare coverage and the OPERS Medicare Connector.

Q: When will we receive information about open enrollment for 2022?

A: At the end of September, OPERS will mail open enrollment materials for 2022 to all eligible benefit recipients. These materials will feature general information on the OPERS health care program and details about the optional OPERS vision and dental plans for 2022.

Open enrollment periods are as follows:

  • Pre-Medicare: Nov. 1-Dec. 15
  • Medicare: Oct. 15-Dec. 7
  • OPERS dental and vision: Oct. 15-Dec. 15

Q: I’m enrolled in the OPERS Pre-Medicare health care plan. When we find our own insurance plan for next year, how will OPERS or health care providers know that we are currently enrolled in the group plan?

A: In late September, OPERS will mail a Loss of Coverage letter to each individual enrolled in an OPERS group medical plan. As you enroll in a new plan, you may be asked to provide documentation of your prior coverage. This letter will serve as your proof of prior coverage with the OPERS group medical plan.

If you enroll in a medical plan with Via Benefits, you will not need to provide this letter to them since we have already sent them a copy. You may put this letter in your files. If you choose to enroll in a medical plan through an organization other than Via Benefits, you may be asked to provide this letter during the enrollment process.

Your Loss of Coverage Letter (and letters for any enrolled dependents) will also be available to download and print from your OPERS online account.

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 an individual or family medical plan 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. Also, keep in mind that the current amount you have deducted from your OPERS benefits for your medical premiums will be added back into your monthly benefit. 

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.

Q: If a Pre-Medicare retiree is covered as a dependent on their spouse’s medical plan or enrolled in an employer’s plan, are they still eligible to receive HRA deposits?

A: Yes. Once they’ve opted in, retirees will receive HRA deposits regardless. This is how an open HRA works.  Retirees can use the funds within their HRA to be reimbursed for qualified medical expenses such as post-tax premiums, deductibles, co-insurance and other out-of-pocket expenses.

For more information on this transition, visit the Health Care 2022 page at opers.org. Also, plan to attend a 2022 Open Enrollment webinar. OPERS will offer a webinar for both Pre-Medicare retirees and Medicare retirees this fall. 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

  • What does this mean for two family members who retired from the State? Will they be able to use funds from both HRAs to purchase a family plan if it would be cost effective?

    • Jim,
      For a household with multiple benefit recipients they can both have the HRA and be reimbursed for post-tax health care qualifying expenses.
      Thanks, MS

  • Plain and simple, Since you will be saving Millions of Dollars under the new health care plan, I do not believe you need to stop our Cola for 2 years.

  • I believe the last question’s response needs to be clarified… My understanding was that if I remained covered on my employer plan the HRA deposits would be placed in my account but that I could NOT use them to cover allowable expenses UNTIL I WAS NO LONGER COVERED ON MY EMPLOYER PLAN. The current response infers I can be.

    • Vicki,

      You’re referring to rules for retirees who are re-employed in an OPERS-covered position. In that case, they can receive HRA deposits, but they can’t use them for expenses incurred while they are re-employed.

      • Vicki,
        In 2022 an OPERS re-employed retiree can receive the HRA deposits into an accumulated HRA while re-employed and once the employment terminates the member would gain access to the funds to be reimbursed for qualifying expenses. The member would not be eligible to be reimbursed for expenses the occurred during the re-employment period.
        Thanks MS

  • I know that my allowance will not be enough to cover my insurance premium. Im enrolled in auto withdraw from my bank, my question is will via benefits still continue to withdraw the full premium payment monthly and withdraw the difference from the bank account automatically or do i need to make new arrangements to pay the difference? thank you

    • Edward,
      The premiums you will pay in 2022 will need to be paid out of pocket and if the premiums are an eligible expense they can be reimbursed from the HRA.
      Thanks MS

  • OK so..I am now eligible to receive the monthly HRA as a Pre-Medicare, Re-employed retiree with an OPERS -covered employer AND keep my selected medical plan with my employer? I need only to Opt-In? Understanding that HRA accumulated funds are available only after my re-employment ends?

    • M. Reese,
      An OPERS re-employed retiree will receive the HRA deposits into an accumulated HRA while re-employed and once employment ends they would gain access to the deposits to be reimbursed for qualified expenses. The member will not be eligible for reimbursement of expenses that occurred during the re-employment period. The HRA opt in period for Pre-Medicare recipients will be 11/1/2021-12/15/2021.
      Thanks MS

  • For the last question in the answer is an HRA can be used for “qualified medical expenses such as post-tax premiums, deductibles, co-insurance and other out-of-pocket expenses.” My question is why “post” tax? why not pre tax? is that a Federal, State, or OPERS rule?

    • IRS Publication 502 spells out qualified expenses and specifically excludes employer-sponsored health insurance plan
      premiums unless the premiums are included as income. Most employer-sponsored plans are paid using pre-tax
      deductions, meaning the premium itself is not reported as taxable income for the employee. Because the employee has
      already received a tax-free benefit on the premium when it was deducted on a pre-tax basis, they may not receive a
      second tax-free benefit by receiving a reimbursement from their HRA for that same premium. Thanks MS

  • I appreciate what OPERS has done for their retirees, however I don’t think it it is fair to reduced my HRA, with 30+ years of service, I was 58 years old when I retired, and in 2022, my HRA will be reduced from 75% to 71%. It is the same reaction, I get from receiving a reduced Social Security amount because of the Windfall having worked in both the public and private sector. Sometimes having a good work ethic can turn into a loose/loose situation. I know 2022, the COA will remain in effect, but it just a matter of time before the other shoe drops.

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