Answers to Health Care 2022 questions

This month: Learn details regarding health care and re-employment

By Michael Pramik, Ohio Public Employees Retirement System

Oct. 28, 2021 – As we draw nearer to 2022 and the changes that will affect OPERS 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 how health care will be applied in 2022 for retirees who are re-employed in an OPERS-covered position.

Q: If I become re-employed with an OPERS-covered employer in 2022, I understand that I will not have access to the funds in my HRA. Why?

A: The OPERS HRA is a retiree-only plan. Federal regulations state that re-employed retirees are eligible to receive monthly deposits to their HRA plan, but ineligible from receiving reimbursements for expenses incurred during the re-employment period. For this reason, during your re-employment period, HRA deposits will accumulate in a separate Re-employed Accumulated HRA which is not combined with your existing HRA balance until you terminate re-employment.

Q: If I become re-employed with an OPERS-covered employer in June 2022, will I have access to my HRA deposits prior to the start of my re-employment?

A: Yes, you will have access to your existing HRA balance, but you can be reimbursed only for expenses prior to your re-employment period. 

Q: I’m a Pre-Medicare retiree. If I plan to continue my re-employment in 2022, what are my health care options?

A: Like other Pre-Medicare retirees, you will opt in to the HRA and select an individual or family health care plan on the open market or through your employer. If you haven’t done so already, you’ll need to contact Via Benefits and set up an appointment between Nov. 1 and Dec. 15 to opt in to the OPERS HRA and explore individual and family medical plans for 2022.

Regardless of whether you plan to enroll in a new medical plan through Via Benefits, you must opt in to the HRA to begin receiving HRA deposits in 2022.

The difference with being re-employed is that you will not have access to your Re-employed Accumulated HRA for qualified reimbursements during your re-employment period. Remember, if you choose to enroll in a marketplace plan, we encourage you to work with Via Benefits so that you can benefit from the individualized support when thinking through your plan options. Learn more about Via Benefits at marketplace.viabenefits.com/opers.

Q: I’m a Medicare retiree. If I plan to continue my re-employment in 2022, what are my health care options?

A: If you are enrolled in a medical plan through Via Benefits, effective Jan. 1 you will receive monthly HRA deposits in a Re-employed Accumulated HRA. Think of this as a holding place for HRA deposits. You will not be able to receive reimbursements during your re-employment period. However, upon termination of your re-employment, you will have access to the accrued balance to receive reimbursement for expenses that are incurred outside of re-employment. To enroll in an individual Medicare plan through Via Benefits effective Jan. 1, contact Via Benefits between now and Dec. 7.

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

  • I am very interested in knowing who I can call to inquire about my time of service and the amount Accumulated .

  • I’ve asked before and think I understand but to be sure. When you retire and have pre Medicare and you get HRA money monthly. If you are married and your spouse can get insurance through their work place and for example it cost the spouse 700 dollars a month for a family plan through their employer could the HRA monthly money be used to pay for that and if so how would that happen ? Thanks In advance

    • Thomas,
      The HRA allowance can be used to be reimbursed for post tax health care premiums.
      Thanks,
      MS

    • Joseph,
      Please forward you questions through the online message center or contact our Member Service Center at 800-222-7377, there we can review your account and answer your account specific question.
      Thanks, MS

  • If I qualify for a subsidy for my premium for the Marketplace Health insurance for Pre-Medicare and decide to take it initially, I understand that I cannot receive the HRA money at the same time. My question is, if anything changes, like qualifications change and I no longer qualify for the subsidy payment can I start receiving the HRA deposit at a later date?

    • Robert,
      There is a special enrollment period for a recipient that enrolled into the premium tax credit and their eligibility changes during the year. If you have additional questions about the process please contact OPERS through the online message center or by phone at 800-222-7377.
      Thanks, MS

  • We need help with Via Benefits. We had an appt at 4pm today 11/1, to call in and ask questions about Healthcare for retirees. It is now 7:28pm, and we are still on hold! This is a nightmare!

    • As is typical during open enrollment, OPERS and Via Benefits are experiencing a high volume of phone calls, and on-hold times have been extensive for some. We recommend calling first thing in the morning, and the best days to call are Wednesday and Thursday. Please be assured that both OPERS and Via Benefits are committed to providing each retiree with the assistance they need.

      • J Glomski had an appt. scheduled for 4 pm – what is the point of an appointment if 3 1/3 hours later you are still on hold. OPERS has pushed for this for over 2 years and selected a vendor that is not capable of handling the work. The suggestion of calling early in the morning when you don’t have an appt is a strange solution. Can you go with a different vendor to hold your account if they are unable to appropriate service your account!

        • Jim,

          We acknowledge that OPERS and Via Benefits are currently experiencing the same labor shortages affecting businesses all over the country, but we are training and adding staff members as quickly as we can. We apologize for any inconvenience and frustration this may cause. Please be assured that both OPERS and Via Benefits are committed to providing all retirees with the assistance they need.

          To answer your question, Via Benefits is the sole administrator of the Medicare and Pre-Medicare Connectors.

  • Is there anyway my wife and I (both OPERS pre-Medicare/HRA eligible retirees) can get our HRAs merged so that we can buy a family plan with our joint HRA monies to avoid paying for two, more expensive individual plans. It seems we are being punished for being married to another HRA eligible person! Via benefits say they can link our separate Via Benefit accounts but that does not help unless our HRAs can be linked by OPERS. Suggestions?

    • David,
      Households with more than one retiree with an HRA cannot merge the HRA deposits to receive both allowances into one account.
      Thanks MS

  • Can one spouse, in a couple who are both pre-Medicare OPERS retirees & eligible for HRAs take the HRA allotment but not join a medical plan while allowing the spouse to pay for a family plan with their HRA allotment only (assuming the non-medical program spouse accepting the HRA only could not use their HRA funds until such time as they gain a medical plan at a later date). On alternative years you switch roles as to which one buys coverage and which one accure unused HRA funds?

    • David,
      The pre-Medicare recipient is not required to enroll into a medical plan through Via Benefits to be eligible for the HRA. The member must opt into the HRA during open enrollment to receive the HRA allowance in 2022.
      Thanks, MS

  • Bob

    I’m 61 years old if I retire with 27 years of service and I wait until February of 2022 am I entitled to the pre Medicare HRA Allowance? Or do I have to retire before December 31 2021 to be eligible for the pre Medicare HRA allowance ?
    Thank you

    • Bob,
      Please forward your questions through the online account message center or contact our Member Services Center at 800-222-7377 for further assistance.
      Thanks,
      Megan

      • Bob
        Can you shop for plans for pre Medicare from the link above if you did not apply to retire yet? I am looking to retire in February or March next year and would like to see what plans are available to me.
        Thank you

        • Bob,
          For further assistance Please reach out to OPERS through the online message center or by contacting us by phone at 800-222-7377.
          Thanks, MS

  • Am I reading the 2022 OPERS Health Care Program Guide correctly where it states on page 1, in bold print?:
    Effective Jan. 1, 2022, OPERS no longer provides a group medical or prescription drug plan.
    If this is correct, what options do we have as far as getting medical and prescription coverage?

  • I see from other comments, that you suggest calling 1-800-222-7377 for any information on various questions. I tried numerous times, and the message was, “we are experiencing a higher than normal call volume. Call back later”. 2:20pm on a Thursday, one would expect there not to be a high call volume. I would not be surprised if one were to call anytime, during business hours, that they would receive the same message.

    • Bernard,

      The reason for the higher call volume is that open enrollment is now effective for both our Medicare and Pre-Medicare retirees, and our Pre-Medicare retirees are going through choosing their own health care insurance for the first time. There is always a high call volume this time of year in the afternoon. We encourage members to call early in the day.

  • I am 61, pre Medicare and currently on my spouses health plan coverage through his work. I will be taking COBRA from my spouse’s employer plan when he retires starting Jan 2022. Can I use the HRA to pay for the COBRA premiums for myself?

    • Mary,
      A Pre-Medicare retiree who enrolls in COBRA coverage through another employer can submit the COBRA premium as a qualified medical expense to be reimbursed from his/her HRA.
      Thanks, MS

  • I was told to call VIA Benefits last night for at 645 pm for them to help me pick out a new insurance plan. I was on hold for an 1.50 hours and never was able to speak with anyone. This process has been a nightmare already. I can’t wait to see how long the processing of the actual reimbursements take. It will be a head ache of getting invoices for the premiums from the insurance company every month. Will we have to provide that from the insurance company??? I don’t see them sending out individual invoices….

  • I am a pre medicare OPERS I would like to get in my Husbands insurance plan where he is employed. But he plans on retiring in April. So should I take the HRA or the Tax deduction? If I take the HRA can we later take the tax deduction since we will have a change in status?

    • Dusty,
      Please send your questions through the online account message center, there we can review your account and provide account specific answers. If you do not have access to the online account please contact our Member Service Center at (800)222-7377.
      Thanks, MS

  • I’m 57 years old, with over 30 years of employment – is there an age qualifications to receive HRA.?

    • Kenneth,

      You do not indicate whether you are currently active or retired. Eligibility requirements will change next year only for those retiring on or after Jan. 1, 2022. If you’re currently retired and eligible (or retire and are eligible prior to Jan. 1, 2022) to participate in the OPERS health care program, you will continue to be eligible after Jan. 1, 2022.

      Here is a description of new eligibility requirements beginning in 2022 for active members.

  • If you are 62 and pre-medicare and the past several years have got insurance coverage through spouse’s work do you still sign up for the HRA? And does it still deposit money monthly then? If you sign up for the HRA do you have to pick a plan for insurance coverage or can you stay with your spouse’s coverage but get the deposit?

    • John,

      That’s a question in the Q&As on our website. If you’re a Pre-Medicare retiree who’s covered as a dependent on your spouse’s medical plan, you’re still eligible to receive HRA deposits. But you have to contact Via Benefits to opt in to the HRA. We recommend doing so online. Once you’ve opted in, you 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 premiums, deductibles, co-insurance and other out-of-pocket expenses.

  • I heard that OPERS would continue to offer MetLife Dental and Aetna Vision. Is this true or will I need to go through VIA? I am reemployed part time Medicare.

    Was also told that VIA could compare current plan to new plans. After a wait of 2 hours was told that they could not. Had no idea of current OPERS plan. And then, about only 2 minutes into the call, they disappeared and the phone went silent.

    • Ken,
      OPERS will continue to offer the MetLife dental and the Aetna vision coverage. The coverage details are available on OPERS.org in the Open Enrollment Guide for 2022.
      Thanks, MS

  • I had a 9 45 sxheduled appointment with viabenefits today. I was on the phone waiting for over an hour. …until I was disconnected.
    Why make an appointment?

    I’ve been on the shopping/compare site..none of my doctors are on the plans. They are all hmo’s.

    Exactly how I thought it would be..so disappointed.

  • I am very disappointed with my VIA Benefits experiences to date. I won’t share specifics because they are already addressed by numerous other commenters. The counseling, support, and assistance that was greatly lauded by OPERS that this company would provide is non existent. I understand your responses of they are doing their best and high call volumes, etc. but this is really unacceptable. VIA Benefits had plenty of time to prepare. The relationship with OPERS going back to 2016. I navigated the health care options myself and choose a policy. The premium seems very high and I really just made my best guess. No real idea of my options since attempts to connect with a VIA Benefits representative did not come to fruition. The appointment process simply doesn’t work. Please encourage this company to meet their obligations and responsibilities to your members. Thank you in advance for any assistance you can provide.

  • Is OPERS aware of the problems members are having reaching someone at VIA Benefits to help us with selecting our plans? I had an appointment on 11/11/21. Waited on line for 1 hour and no one assisted me. Tried to reschedule today and the earliest they have appointments is December 6, 2021. No one answers the phone when you call, you just get put on hold and they NEVER ANSWER. Tried doing it on line but no plan seems to accept my hospital with my medications. Would appreciate some assistance from OPERS in getting this resolved.

  • Can’t find information on medical mutual. Have had this plan since went on Medicare but when I check the Via Benefits site it’s not even listed. What’s the problem. Phone appointments as are none available, Can’t stay on hold for hours. Got the up dated email about lack of employee issues etc. Tried to get on the the Wednesday webinars but can’t find the banner advertising it to click on. What a poor system, Can’t believe OPERS wasn’t’ better prepared to enrollment.

  • Is a certain number I can call to get my email address changed so that I can give my new email to reset password. Thanks

  • What’s the reason for OPERS denying vison and dental access to a dependent who is incapacitated above the age of 26 when OPERS is not paying any part of the premiums for anyone choosing to have OPERS vison and dental insurance? Seems mean spirited when the person is unable to do for themselves anyway, and the premiums are not costing OPERS anything? This information should be included in OPERS health coverage webinars.

    • Bill,
      The members that were impacted by this change in eligibility have been sent a letter notifying them of the change.
      Thanks, MS

    • Charbeth,
      A member who chooses the premium tax credit must opt out of the HRA making them ineligible for the transition deposit.
      Thanks,
      MS

  • I understand from conversation with OPERS dental benefits person that all retirees that have an adult with a disability over the age of 26 living with them will not be allowed to enroll them in vision and dental coverage. My daughter is in the Medicare connector plan but cannot have dental or vision coverage? I have seen no notice of this change in policy anywhere and are interested when and how this decision was reached without the members knowing. Happened to stumble on this today!

    • Mark,

      Our goal with Health Care 2022 is to stabilize the Health Care Fund so that we can continue to provide access to meaningful health care to current and future retirees. Over the last few years, we’ve had to make some tough health care-related decisions that impact spouses and children. This means that any child over the age of 26, regardless of status, will no longer be eligible to enroll in OPERS dental and vision coverage. We recognize that not everyone will be happy with these decisions, but we hope that our retiree population can appreciate why we are making these changes. Please understand that you may work with Via Benefits, our administrator of the Pre-Medicare and Medicare Connector, to explore individual dental and vision plans that may be right for your child.

  • I’m a pre-Medicare retiree…I thought HMOs and PPOs were going to be offered through VIA Benefits. I only see options for HMOs when looking for a plan on their website. I have emailed them and called them twice and have not been able to talk with anyone to get an answer. Are PPOs not being offered?

    • Kim,

      The majority of individual and family medical plans offered through the OPERS Pre-Medicare Connector are Health Maintenance Organizations (HMOs) – all plans secured through healthcare.gov for Ohioans are HMOs. HMO plans offer lower premiums and deductibles and typically require a referral from a primary care physician to see a specialist. They also require services through a specific network of providers and hospitals. Remember that because the Pre-Medicare Connector is an open HRA, you are not required to sign up for a plan through Via Benefits or healthcare.gov.

  • Via Benefits seems overwhelmed. Their Benefits Coordinator basically only asked, “what plan do you want to sign up for?” No counseling or advice. I have been trying to get my mobile app to work for the last week. Finally got through to VB’s IT team …apparently there is a “know issue with the app if you are using Android” as it will not let you even sign in. Why is OPERS or VB not telling us that, letting us become more frustrated every day. It seems to me VB is only a link to Obamacare. There apparently other plans like BC/BS of Michigan that are nationwide PPO plans accepted in Ohio, that include most area Drs./hospitals, and that have low deductibles/maximum out of pockets. VB does not offer choices or mention anything other than Obamacare and OPERS is not telling you where else to look. Disappointed in VB and OPERS.

    • David,

      Yes, there is a known issue with the Via Benefits phone app, and that company is working on a solution. Also, remember that Pre-Medicare retirees have an “open HRA,” meaning you are not required to use Via Benefits to elect a medical plan. You are free to enroll in the plan of your choice.

    • I made my appointment in October for today with Via Benefits, still on hold for over 2.5 hours past my appointment time.

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