Answers to Health Care 2022 questions

This month: Enrollment, Health Reimbursement Arrangement issues

By Michael Pramik, Ohio Public Employees Retirement System

Dec. 7, 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 the ins and outs of Pre-Medicare health care for 2022.

Q:  If I enrolled in a medical plan through Via Benefits during open enrollment, can I make a change or cancel that plan before open enrollment is over? What if money is taken from our checking account for the first premium?

A: Yes, you can make changes up until the end of open enrollment. Keep in mind that you’ll need to disenroll from the first plan you enrolled in to avoid paying two premiums. You will need to work with your insurance carrier to receive a refund if you’ve already paid your January premium.

Q: Do I have to return the dental and vision insurance enrollment form if I want to continue it and I am not making any changes?

A: No. There’s no need to return that form if you’re continuing the same coverage you have currently.

Q: I live part time in Ohio and part time in Florida. What do I do about scheduling my health care plan if I’m going to be moving soon?

A: Changing residences launches a Special Enrollment Period, during which you can enroll in a new plan. However, note that deductibles and other expenses start over when you do that. We recommend talking this through with Via Benefits.

Via Benefits covers this topic in depth in its Pre-Medicare Enrollment Guide.

Q: If I sign up for Pre-Medicare insurance outside of Via Benefits, do I have to inform Via Benefits of that choice? If so, how do I do it?

A: No, you do not need to inform Via Benefits of your choice. But you will need to opt in to the HRA to receive the monthly HRA deposit, and then submit the proper documentation from your carrier to receive reimbursement. The “Getting Reimbursed Guide” contains detailed instructions on what documentation you will need and how to submit it to Via Benefits.

Q: I just opted in to the Pre-Medicare Health Reimbursement Arrangement, selected my health care plan and paid my premium for January. When can I expect my first reimbursement?

A: Now that you have opted in to the HRA, Via Benefits will create your account and send you a “Getting Reimbursed Guide.” Once you receive this guide you can submit your January premium for reimbursement. Keep in mind if you received the $1,200 transition deposit, the only expense that can be reimbursed prior to January is your January premium amount. If you did not receive the transition deposit, you’ll need to wait to receive your January HRA deposit before seeking reimbursement for your January premium. Depending upon your submission method, it could take up to three weeks to receive your reimbursement if you submit it via mail or fax, whereas submitting it through your Via Benefits online account or mobile app would take only approximately a week.

Q: I’m an OPERS retiree, but my spouse is still working. I am covered as a dependent under the medical plan offered by his employer. Can I receive reimbursement from my HRA for the premiums we pay for his employer-sponsored plan?

A: Yes, but only if your spouse pays premiums post-taxes. Whether you or your spouse is the enrolled employee, all medical plan premiums must be post-tax in order be reimbursed from the HRA. Retirees also can use the funds within their HRA to be reimbursed for deductibles, co-insurance and other qualified, out-of-pocket expenses incurred through a spouse’s plan.

Q: Why doesn’t the Via Benefits phone app work?

A: The mobile app is working but it’s for HRA reimbursement only. Retirees cannot enroll in a health care plan or opt in to the HRA through the app. Please wait to download the Via Benefits mobile app until you have received your “Getting Reimbursed Guide.” Waiting to do so will ensure that your HRA has been set up within the Via Benefits system.

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

85 thoughts on “Answers to Health Care 2022 questions

  • December 7, 2021 at 1:49 pm
    Permalink

    On the Via Benefits page there is no information listed for my husband.
    Do I have to submit reimbursement forms for him for 2022 Medicare and Dental & Vision reimbursement or is that done automatically too?

    Reply
    • December 10, 2021 at 10:04 am
      Permalink

      Janice,
      The dental and vision coverage is automatically reimbursed through the HRA for recipients and their dependents as long as the member did not opt out of the dental and vision automatic reimbursement.
      Thanks,
      MS

      Reply
  • December 7, 2021 at 1:59 pm
    Permalink

    Who does the monthly administrative fee of $2.33 going up to $2.70 get paid to?

    Reply
    • December 7, 2021 at 2:37 pm
      Permalink

      Louis,

      The administrative fee is paid to Via Benefits for administering the Health Reimbursement Arrangement.

      Reply
  • December 7, 2021 at 2:07 pm
    Permalink

    I had my phone session with via and selected a plan on nov. 8, have paid my first premium but have not received any written info from via to set up reimbursement yet …what now??

    Reply
    • December 10, 2021 at 10:30 am
      Permalink

      Lori,
      If you have not received the getting reimbursed guide from Via Benefits you can access the Via Benefits website and view the guide.
      Thanks MS

      Reply
  • December 7, 2021 at 2:50 pm
    Permalink

    Thank you Michael for answering my reimbursement question.

    As a heads up to members, you DO NOT need to enroll in a health plan through Via Benefits. If you enroll directly through the insurance company (i.e Medical Mutual) instead it is usually cheaper. I signed up for a plan directly through MM for almost $200 less per month than what Via was quoting me for the exact same plan.

    Reply
    • December 8, 2021 at 1:41 pm
      Permalink

      I thought we had to enroll through VIA Benefits or we wouldn’t get our HRA deposit.

      Reply
      • December 9, 2021 at 6:53 am
        Permalink

        Patricia,

        The Pre-Medicare Health Reimbursement Arrangement is a open HRA. That means you have to opt in to receive it, but you don’t have to enroll in a plan through Via Benefits to receive reimbursements from the HRA.

        Reply
  • December 7, 2021 at 3:02 pm
    Permalink

    I’m enrolled and have selected a carrier for health insurance, my account shows I have funds that can be distributed. But I can not access them? I would very much like to get my funds paid by the January 1st due date. But I’m being denied access. Why is that?

    Reply
  • December 7, 2021 at 3:14 pm
    Permalink

    I just wish that we still had the medical plan that we had when I retired in 1998. I did not have to do anything. I miss that.

    Reply
  • December 7, 2021 at 3:26 pm
    Permalink

    When Will we get the paperwork to show how much we pay for Medicare part A so that offers covers it?

    Reply
    • December 10, 2021 at 2:20 pm
      Permalink

      Babba,
      The Medicare premium due notice comes from Medicare not OPERS. If You are referring to the Medicare part A certification form from OPERS they began being mailed on 12/8/2021.
      Thanks, MS

      Reply
  • December 7, 2021 at 3:30 pm
    Permalink

    If new retires are getting $1200.00 why isn’t current retires getting this allowance in our HRA? Thank you.

    Reply
    • December 8, 2021 at 8:06 am
      Permalink

      Donetta,

      Current retirees who have HRAs are in the OPERS Medicare Connector. The $1,200 is a one-time deposit for Pre-Medicare retirees to help with initial signup, much like the $300 transition deposits that OPERS made into Medicare HRA accounts in 2016, 2017 and 2018.

      Reply
      • December 9, 2021 at 9:14 am
        Permalink

        I understand the “one-time” $1200/300 deposit logic. What I’m trying to understand is: on what basis the decisions were made to provide a monthly base allowance of $1200 for current, and also for the retire/rehire group of employees? MANY in these groups already have reasonably priced employer subsidized plans at very favorable rates, that is, nowhere even NEAR $1200 in cost to the employee. Now consider that at the same time, OPERS is reducing the base allowance for Medicare eligible retirees from $450 to $350?? That is a huge cut for this group. While grateful for ANY amounts directed to my HRA, this action still seems very unfair. There has to be a better explanation given for this severe cut in benefits for one group (Medicare eligible), other than OPERS simply pointing out that some Medicare eligible retirees have “positive balances” in their HRA’s. That is not an adequate explanation in my humble opinion.

        Reply
        • December 9, 2021 at 12:55 pm
          Permalink

          Joe,

          Medicare is the primary insurer (80 percent) for those in the OPERS Medicare Connector, and thus that HRA allowance typically goes toward a gap plan, which is much cheaper than Pre-Medicare coverage. The $1,200 base allowance you mentioned, for Pre-Medicare retirees, is actually a reduction from the previous allowance of $1,380, which was the cost of the group plan when the Board passed health care changes in January 2020. At that time, the OPERS Health Care Fund was at risk of becoming insolvent within 11 years. OPERS still is not able to contribute any of the employer contribution toward health care, and that also weighed significantly into the health care decision.

          Reply
          • December 28, 2021 at 11:11 am
            Permalink

            “The $1,200 base allowance you mentioned, for Pre-Medicare retirees, is actually a reduction from the previous allowance of $1,380, which was the cost of the group plan when the Board passed health care changes in January 2020.”

            Mr. Pramik– I’m STILL trying to understand the disparity in the revised “base” allowances between the pre-Medicare (AND, by the way, the retire/rehired group as well) and the Medicare eligible groups. That is, $1200 versus $350. I cannot place enough emphasis on the fact that the cut from the $450 base to $350 in CY2022 is going to hurt a lot of Medicare retirees. In my humble opinion, the base allowance should have remained at the $450 level for this group. To explain, I would be surprised if there are ANY pre-medicare, OR retire/rehired folks currently working in OPERS covered positions, that would justify the base allowance of $1200. That is, folks that will be actually paying out-of-pocket, anywhere near that allowance amount. If there ARE, I would like to hear from them in this blog. However, I do know MANY in the Medicare eligible group that will now be paying amounts well in excess of their allowance (myself included) going forward in CY2022 and beyond. Full disclosure–In my case, based on years of service. my revised “net” allowance is going to be $269.50. My premiums alone are: Medicare Part-B $148, Medicare supplement is $190, and my Medicare Part-D is $12.90. That is a total of $351 monthly. That does not include any actual prescription drug costs. Maybe I’m missing something here, but the current allowances seem very unfair to the Medicare eligible group?

          • December 30, 2021 at 10:25 am
            Permalink

            Joe,

            Thanks for your comment.

            Offering health care coverage has become increasingly expensive as health care rates have risen dramatically and member demographics have shifted. To preserve the OPERS Health Care Fund for current and future retirees, OPERS took a careful look at all aspects of the health care program to identify impactful changes. Keep in mind that the HRA allowance was never intended to cover the full amount of costs that a Medicare retiree may incur.

            The biggest disparity in the allowance amounts is the fact that Medicare already covers 80 percent of participants’ health care costs, and that OPERS provides funding for secondary coverage (or an Advantage plan). Pre-Medicare retirees pay for total coverage.

  • December 7, 2021 at 3:35 pm
    Permalink

    I was told that the one time $1200 would be deposited into my account within 2 weeks of opting in. It has now been a month and still no deposit. When can i expect it?

    Reply
    • December 10, 2021 at 2:30 pm
      Permalink

      Linda,
      The transition deposit is generally deposited into the HRA approx. two weeks after the member opts in to the HRA. If a member is re-employed the transition deposit will be deposited into the accumulated HRA.
      Thanks, MS

      Reply
  • December 7, 2021 at 3:41 pm
    Permalink

    I asked via benefits a question some five weeks ago, no reply bas yet. I asked via about Summa insurance showing the max out of pocket of $350 a month for my prescriptions in 2021 (donut hole) when actually it was $554 a month. They know my perceptions, why the difference. Can you help OPERS

    Reply
    • December 10, 2021 at 2:34 pm
      Permalink

      Jack,
      The questions will need to be answered by Via Benefits, you can contact them at 844-287-9945.
      Thanks, MS

      Reply
  • December 7, 2021 at 4:14 pm
    Permalink

    Just retired Nov 30th. Have one month of med mutual thru opers that I’m paying for in dec. Looking at the pre-medicare policies and was offered cobra from employer i just left. My question is can I use my HRA to pay cobra monthly premiums. I’ve been told both yes and no by VIA and requsted answer from OPERS and still haven’t gotten response…need an answer soon as running out of time.

    Reply
    • December 10, 2021 at 2:41 pm
      Permalink

      Gary,
      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 their HRA.
      Thanks, MS

      Reply
  • December 7, 2021 at 6:22 pm
    Permalink

    If someone is reemployed in a PERS position and has opted into the HRA, will they be able to see the balance in their HRA account even if they do not have access to it while reemployed? Also, when should they receive the initial $1200 if they opted in on November 2?

    Reply
    • December 10, 2021 at 2:52 pm
      Permalink

      David,
      Once a pre-Medicare re-employed retiree opts into the HRA OPERS will receive the opt in file from Via Benefits within two weeks of the selection. While re-employed the HRA allowance and transition deposit will go into the accumulated HRA that will be visible through the OPERS online account starting in the beginning of 2022.
      Thanks, MS

      Reply
  • December 7, 2021 at 7:06 pm
    Permalink

    I am pre medi care and retired from the state in 2014. I went back to work for the state and have both OPERS and state health insurance. Do I need to enroll in the HRA marketplace even though I will continue to have my state insurance. If I sign up will the HRA pay anything towards my state health insurance premium? Thank you

    Reply
    • December 10, 2021 at 2:58 pm
      Permalink

      Heidi,
      The pre-Medicare HRA does not require the member to be enrolled in a health care plan with Via Benefits to receive the HRA allowance, they are required to opt in to the HRA to start receiving the HRA deposits. While re-employed with an OPERS covered employer the HRA deposits will go into an accumulated HRA until the member terminates employment. Once employment has ended the funds in the accumulated HRA will then be deposited into the HRA with Via Benefits where the member will have access to be reimbursed for health care qualifying expenses. They will not be eligible to be reimbursed for expenses that occurred while re-employed.
      Thanks, MS

      Reply
  • December 8, 2021 at 6:58 am
    Permalink

    I’m currently working and opted to take my employer’s Ins. If was to quite or go part time part way through this next year will I be able to enroll in a plan through via for insurance.

    Reply
    • December 14, 2021 at 9:07 am
      Permalink

      Dave,
      Please reach out to Via Benefits to get additional information on the special enrollment period.
      1-844-287-9945 Medicare
      1-833-939-1215 Pre-Medicare
      Thanks, MS

      Reply
  • December 8, 2021 at 10:11 am
    Permalink

    When can I expect to get the Getting reimbursed guide?

    Reply
  • December 8, 2021 at 10:59 am
    Permalink

    I am retiring 12/31/21 and will go on my wife’s health-care plan in January thru her employer. I set up my ViaBenefits profile and will be receiving $948/mth in my HRA. Do I still need an interview with ViaBenefits? TIA.

    Reply
    • December 14, 2021 at 10:03 am
      Permalink

      Mac,
      OPERS does not require the pre-Medicare recipients to enroll into a medical plan to receive the HRA deposits monthly, they would be required to opt into the HRA to start receiving the allowance monthly. You can verify that you opted into the HRA by signing into your Via Benefits online account and verifying your funding option.
      Thanks, MS

      Reply
  • December 9, 2021 at 10:50 am
    Permalink

    I paid the January premium when I signed up for a plan through via benefits but did not get a receipt with the start date for the premium therefore was denied reimbursement by via benefits.

    Reply
    • December 9, 2021 at 1:26 pm
      Permalink

      Karen,
      Please reach out to Via Benefits with any questions about reimbursements from the HRA.
      Thanks, MS

      Reply
  • December 9, 2021 at 1:10 pm
    Permalink

    Do we still need to submit the Recurring Premium Reimbursement Request form for dental and vision again this year? Thank you.

    Reply
    • December 9, 2021 at 3:09 pm
      Permalink

      Linda,
      In 2021 we started sending the dental and vision file to Via Benefits so the members are not required to complete a reimbursement form unless they have opted out of the automatic vision and dental reimbursement. In 2022 the dental and vision reimbursement process will remain the same.
      Thanks, MS

      Reply
  • December 9, 2021 at 3:07 pm
    Permalink

    I have paid my first month premium. Can I request reimbursement now or do I have to wait until Jan.1?

    Reply
    • December 10, 2021 at 9:56 am
      Permalink

      Terry,

      That question is addressed in the blog: “Now that you have opted in to the HRA, Via Benefits will create your account and send you a “Getting Reimbursed Guide.” Once you receive this guide you can submit your January premium for reimbursement.”

      Reply
      • December 13, 2021 at 1:56 pm
        Permalink

        Except, Via is telling me, and other members, our funds are not available until Jan 1, 2022. We can submit for reimbursement now, but will not receive the funds until some time in January. So who do we believe??

        Reply
        • December 17, 2021 at 2:22 pm
          Permalink

          Brian,

          Pre-Medicare retirees can submit a request for reimbursement of the January premium from the $1,200 transition deposit now. The reimbursement will be made faster if the request is made online through the Via Benefits online account.

          Reply
  • December 9, 2021 at 4:13 pm
    Permalink

    OPERS Member Services directs us to reach out to Via Benefits when we have questions about reimbursements from HRA. After reading the pre-Medicare retirees OPERS/Via Benefits guide on HRA Reimbursements, I called Via Benefits a couple times for clarification on acceptable documents to submit when applying for a reimbursement.( I will need to submit my documents by mail since I don’t have a smartphone and cannot scan documents to a computer. ) I’m trying to figure out exactly what documents are acceptable so I can send the correct materials when applying for reimbursement of the “binder” first month’s 2022 health insurance premium I paid in after my November enrollment appointment and for applying for reoccurring reimbursements. Each Via Benefits rep in the reimbursement department gives me a different answer as to what documents are required. One said a premium statement was sufficient. Another said the particular health insurance premium statement I had wasn’t acceptable because it didn’t have the word “medical” printed on it, yet the statement contained the name of the insurance company, specific plan name, start date, and monthly cost; this is the exact plan name given to me by the original Via Benefits rep when I selected this health plan. Now the reimbursement department won’t recognize that plan name as medical insurance! One rep said I needed to supply a copy of my health insurance card, which the insurance company will not send out until late December. The rep also said I needed to send a Proof of Coverage Letter from the Insurance Company; when I called the insurance company to request such a letter, the insurance person explained the premium statement I already received should be sufficient documentation. Feel I’m getting the royal run around. Not getting consistent answers as to exactly what documents we need to supply. Very concerned about where to obtain accurate information. Plus while I paid my January 2022 premium in November; the HRA reimbursement guide says the transition funds already deposited by OPERS into my HRA will not be available until January 2022.

    Reply
    • December 13, 2021 at 9:59 am
      Permalink

      Lynn,

      We recommend following the reimbursement process in the Via Benefits “Getting Reimbursed Guide.” For instance, on page 21 the guide states, “If you haven’t turned on Automatic or Recurring Premium Reimbursement and you want to be reimbursed for your plan premiums, you’ll need to provide a Proof of Coverage letter or premium statement from your insurance carrier.”

      Reply
    • December 30, 2021 at 6:23 pm
      Permalink

      I experienced the very same thing and have the employee names and dates to prove from recorded phone conversations that Via says it keeps. Inconsistencies abound and nearly cost me an incorrect and costly decision to a far inadequate health plan over a superior plan. Very, very concerning.

      Reply
  • December 10, 2021 at 10:08 am
    Permalink

    I’m all signed up with Via Benefits. I am a pre Medicare retiree. My first premium payment is due by Dec.31. Does that 1st payment come out of my checking account or does it come out of the HRA??? And how do I set this premium up as a re occurring payment. And how do I set my vision and dental as a re occurring payment as well?

    Reply
  • December 10, 2021 at 10:59 am
    Permalink

    Just received my Medicare B invoice for jan. feb. and March. Do I need to send a copy of this plus a reimbursement form to via benefits since the price has increased?

    Reply
    • December 14, 2021 at 11:03 am
      Permalink

      D. Carter,
      Please contact OPERS through the online message center or by calling our Member Service Center at 800-222-7377.
      Thanks, MS

      Reply
  • December 13, 2021 at 6:41 pm
    Permalink

    Michael: why is an OPERS retiree’s HRA reimbursement for premiums only allowable if the spouse’s employer-sponsored insurance is paid post-tax? And, as a practical matter, aren’t most employer-sponsor plans paid pre-tax anyway? Thank you.

    Reply
    • December 17, 2021 at 2:23 pm
      Permalink

      Mark,

      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 dollars.

      Reply
  • December 14, 2021 at 6:18 pm
    Permalink

    I submitted proof of payment to ViaBenefits a week ago on the 7th for my January 2022 premium and no reimbursement yet….it’s “under review”.

    It’s too bad that OPERS made a deposit into my ViaBenefits account and the money has been sitting there and is not being released in a timely manner.

    Having a $1200 hole in my checking account right before Christmas is not appreciated.

    The Via Benefits rep said I might have the reimbursement by the 23rd…This is NOT a good way to start the new health care system for pre-Medicare retirees with ViaBenefits. Very disappointed.

    Reply
  • December 16, 2021 at 2:46 pm
    Permalink

    Are the people that decided to cut our HRA elected , or appointed, and do they get paid for their position?

    Reply
    • December 17, 2021 at 2:32 pm
      Permalink

      Edward,

      The decisions made in January 2020 to preserve OPERS health care were made by the OPERS Board of Trustees. The Board is a combination of elected and appointed members, none of whom are paid for their services.

      Reply
  • December 16, 2021 at 3:55 pm
    Permalink

    In preparation for my planned March 1, 2022 retirement I would like to have some idea of the monthly out of pocket cost for my pre-Medicare health care premium. Can I or should I sign up for my Via Benefits account at this time or do I need to wait until I am certain of my retirement date and have submitted my OPERS information and fully committed to retire in 2022?
    Assuming it is possible to establish a Via Benefits account at this time, will I be able to research available plans and view monthly costs? Thank you!

    Reply
    • December 17, 2021 at 2:35 pm
      Permalink

      Tony,

      We recommend that members who are planning to retire soon set up a session with one of our counselors. You can do that through your online account, or by giving us a call at 800-222-7377.

      Reply
  • December 18, 2021 at 10:30 am
    Permalink

    Re HRA base allowance change: I keep seeing “retirees who had an allowance percentage less than 75% but were grandfathered at 75% in 2015. Their percentage will be reduced , etc. I read this to mean if you retired before 2015 and received 75%, then you should receive 75% of the $350. I retired in 2010 with over 20 years of service but mine is being cut. How do you explain this?

    Reply
    • December 20, 2021 at 12:18 pm
      Permalink

      Patricia,

      The grandfathering you’re referring to was approved by the OPERS Board of Trustees in 2012. It called for those who retired in 2015 or later to be provided a monthly health care allowance percentage in a range from 51 percent to 90 percent based on age and service credit. All others were grandfathered to a minimum 75 percent allowance — for as little as five years of service credit. That created inequitable allowance levels between those who retired prior to 2015 and those who retired in 2015 and after. In some cases members with more years of service were receiving less support than those with less years of service.

      The changed the Board made in 2020 to maintain the health care plan resulted in an allowance chart for all members. (Grandfathering for health care eligibility did not change.) The chart begins at a 51 percent floor for those with 20 years of service. You can see the new allowance chart on the OPERS website.

      Reply
  • December 22, 2021 at 2:17 pm
    Permalink

    When will OPERS give VIA benefits the Dental & Vision premium amounts (the ones that are deducted from OPERS members monthly pension) to set up as Automatic Reimbursements in our HRA accts? Nothing is showing in my account yet. I asked VIA benefits last week if they had received the information yet from OPERS yet, but they have not responded.

    Reply
    • January 5, 2022 at 10:43 am
      Permalink

      Mariann,
      OPERS sends a file to Via Benefits on the first of every month with those who have opted in to the automatic reimbursement for dental and vision.

      Reply
  • December 30, 2021 at 2:46 pm
    Permalink

    I have vision coverage through opers/Aetna. I lived in Ohio originally, but now I’m living in Georgia. Can I use my coverage here in Georgia or must I change to a different plan?

    Reply
    • January 5, 2022 at 10:44 am
      Permalink

      Catherine,
      You may contact Aetna Vision at 1-866-591-1913 to inquire a list of in network providers in your area.

      Reply
  • January 3, 2022 at 10:27 am
    Permalink

    How long after we get our monthly retirement checks do we get reimbursed for our vision and dental since it’s an automatic reimbursement?

    Reply
    • January 5, 2022 at 10:51 am
      Permalink

      Cris,

      OPERS sends a file to Via Benefits on the first of every month with those who have opted in to the automatic reimbursement for dental and vision. As long as you did not opt out of the auto reimbursement for you dental and vision premiums you should be receiving that reimbursement shortly. Keep in mind if you have other claims that are pending those will get paid first.

      Reply
  • January 5, 2022 at 7:48 am
    Permalink

    I set up my medical through VIA last year ,I was getting reimbursed for my Medicare. B premium, somewhere my medical got disenrolled stating I had no insurance coverage I called via early in December to get explanation ,they stated they would fix it,still not corrected I called again on January 3,they said I was disenrolled by one of there employees, didn’t know why and because myy insurance is the same as last year and stilled covered,they didn’t know what happened,so in short someone there disenrolled me,it has not been fixed ,my Medicare b premium is deposited to my checking account the first week of January which I depended on and I have become very frustrated due to someone’s mistake there 2 months ago. So why can I not get immediate attention to this,the supervisor at via said up to 2 weeks from when I spoke to them before I could see even an answer, this is unacceptable.please fix my hard and get it turned back on!

    Reply
    • January 5, 2022 at 10:57 am
      Permalink

      Tina,
      Please forward your inquiry through our online message center in your online account, there we will be able to review your account specific information and respond to your question. If you do not already have an online account, you may register from the upper right-hand corner of the OPERS website. Once you have logged in, click on the my account tab, select message center from the drop-down menu, then click add new at the bottom of the page to submit your question or you may call 1-800-222-7377 to speak to a Member Services Representative.

      Reply
  • January 11, 2022 at 10:34 am
    Permalink

    per Mr. Pramik: “Offering health care coverage has become increasingly expensive as health care rates have risen dramatically and member demographics have shifted. To preserve the OPERS Health Care Fund for current and future retirees, OPERS took a careful look at all aspects of the health care program to identify impactful changes. Keep in mind that the HRA allowance was never intended to cover the full amount of costs that a Medicare retiree may incur.”
    ———————————————————————————————-

    Mr. Pramik, I understand that the HRA allowances were not intended to cover the full costs, but reducing the Medicare eligible group “base allowance” from $450 to $350 is a gross reduction of about 28%. That is a huge reduction for this group, and definitely qualifies as “an impactful change” for the Medicare retirees. Many in this group will be forced to dig deeper into personal funds to cover this reduction, a feat not so easily accomplished on a fixed income. As I stated in a previous post, MANY in the Medicare eligible group will now be paying amounts well in excess of their allowance (just for the PREMIUMS, myself included) going forward in CY2022 and beyond. In my case, based on 34 years of service, my revised “net” allowance for CY2022 is $269.50. My monthly premiums ALONE are: Medicare Part-B is $170.10 for CY2022 (up from $148 in CY2021). My current Medicare supplement is $190, and my Medicare Part-D is $12.90. That is a total of $373 monthly. Based on my current allowance of $269.50, that puts me $103.50 UNDERWATER monthly just on premiums alone. That is $1236 yearly that will have to come from somewhere else in my budget. I realize everyone has a different situation, but has anyone else in the Medicare group noticed how this severe cut in the base allowance will affect them?? At the risk of being repetitive, while I certainly appreciate ANY allowance amounts deposited into my HRA account, the current base allowance just seems very unfair ($350 for the Medicare group, versus $1200 for current employees AND the retire/rehire folks).

    Reply
  • January 11, 2022 at 12:47 pm
    Permalink

    I notice that premedicare retirees are in an open HRA but retirees have to go thru Via Benefits are there tax regulations or other laws that require this. In other words, they can go to the open market, but I , we can not, to get our reimbursement?

    Reply
    • January 11, 2022 at 2:06 pm
      Permalink

      Linda,

      We implemented a closed HRA for the Medicare population to ensure that we could account for each Medicare retiree who was enrolled in our group plan at that time. We knew that if we linked enrolling into a medical plan with our Medicare Connector (Via Benefits) to receiving the HRA, we could ensure that everyone had successfully enrolled into an individual plan, and we felt comfortable making the decision about the closed HRA because of how many insurance carriers and individual plans could be offered through Via Benefits. Additionally, implementing the closed HRA model allowed us to manage the Connector and the customer service experience and to prevent carrier steerage. On an annual basis, we evaluate all aspects of OPERS health care, and review/discuss future strategies with our Board.

      Reply
  • January 13, 2022 at 7:56 am
    Permalink

    I am a pre-Medicare retiree receiving the monthly HRA allowance. I currently have very few medical expenses, so that HRA balance will likely keep growing until I’m Medicare-eligible in July, 2025. Do I need to use all the money in that HRA before I turn 65/become Medicare-eligible. I’ve received three different answers from Via Benefits:

    > “Yes, you need to use all of the money in the pre-Medicare ViaBenefits HRA before your 65th birthday, or you’ll forfeit any unspent funds to OPERS.”

    >”No, once the money is in your ViaBenefits HRA, it’s yours forever until you “spend” it.”

    >I “I’m not sure, sir. Please check out OPERS.org, Healthcare, Healthcare 2022, Transition. Or, call OPERS.”

    I have the hard-copies of OPERS’s “2022 OPERS Health Care Program Guide” and “2022 Enrollment Guide, Your Pre-Medicare Guide To Funding and Medical Plan Options”. I don’t see where my question is addressed in either of those publications.

    Can you shed some light on this? Do I need to “spend” all of my Pre-Medicare HRA funds prior to my 65th birthday?

    Reply
    • January 13, 2022 at 8:24 am
      Permalink

      Robert,

      Thanks for asking. Once you become Medicare-eligible and enroll in a Medicare medical plan through the OPERS Medicare Connector, you will have access to the funds you accumulated in your HRA as a Pre-Medicare retiree. The previous HRA balance is co-mingled into one HRA that retirees can use for any expenses incurred after the effective date of their Pre-Medicare HRA.

      Reply
      • January 13, 2022 at 12:29 pm
        Permalink

        Wow, that was fast. Thanks for the quick response and the “great” answer. That’s quite a relief.
        rlm

        Reply
        • January 13, 2022 at 12:56 pm
          Permalink

          Robert,

          You’re welcome. No need to seek an alternative answer. The HRA funds as you describe them will carry over.

          Reply
    • January 14, 2022 at 3:10 pm
      Permalink

      I am now retired and opted to use my husband’s benefits through his employment. They are extremely costly per month but needed due to past medical conditions. I applied for reimbursement through Via benefits monies with all required paperwork but was denied due to post-tax deduction. Is there a way to collect that money to pay our premium other than applying for other medical deductions? I don’t understand why that Money can’t be used for this As We Have to pay that bill monthly regardless. We would never utilize that deposit in full monthly as we have minimal deductions. Is there some way to do this? I hate to leave that Money sitting there when we can really use it! I’m sure I’m not the only person that has this same issue. Please assist! Thank you!

      Reply
      • January 21, 2022 at 10:17 am
        Permalink

        Joan, A Pre-Medicare retiree from OPERS can be enrolled in a medical plan through their own employer or a spouse’s employer and submit premiums for that plan for reimbursement from their HRA as long as those premiums were paid post-tax. If the premiums were not paid post-tax unfortunately you would not be able to receive reimbursement from your HRA for that premium. The only way to receive the funds from the HRA is to submit qualified out of pocket medical expenses and post- tax premiums for reimbursement.

        Reply
  • January 13, 2022 at 1:49 pm
    Permalink

    I’m considering retiring in two to three years, I’m 60 and have worked full time in a OPERS municipal since Jan. 2001 which means I have 21 years in the system. I’m trying to understand the statement on your website :
    “Group B – 31 years of total service with at least 20 years of qualified health care service credit” as to what 20 years of qualified healthcare service credit means. If you worked 20 years in the system, wouldn’t you have 20 years of Healthcare service credit ?

    Reply
    • January 20, 2022 at 1:59 pm
      Permalink

      Steve,

      Not necessarily. The monthly earnable salary threshold for health care credit is higher than it is for pension service credit. So, some members earn a full month toward their pension without a corresponding credit for health care. If you use our Benefit Estimator tool, available in your online account, you will see how much credit you have earned/will earn for both pension and health care.

      Reply
  • January 14, 2022 at 12:10 am
    Permalink

    Hello, I did receive the transition deposit and the 1st hra deposit, in november 2021. When will the next hra deposit be made?. Is there a schedule of when to expect these deposits on a monthly basis?
    thank you

    Reply
    • January 21, 2022 at 10:05 am
      Permalink

      Lee, The monthly HRA deposit will be visible in your HRA the first of each month.

      Reply
  • January 21, 2022 at 4:09 pm
    Permalink

    thank you!!

    Reply
  • January 22, 2022 at 12:44 pm
    Permalink

    I have 3 questions:
    1. Must you use Via Benefits as a Medicare connector in order to receive HRA funding from PERS?
    2. Must you use Via Benefits to purchase your health care insurance choices (supplement/advantage) plans or can you buy direct from providers and still retain access to continued HRA funding and expense reimbursement.
    3. When an OPERS retiree with the joint life plan passes, Does the surviving spouse retain HRA funding and access to Via Benefits.
    Thank you

    Reply
    • January 25, 2022 at 2:29 pm
      Permalink

      Don, Medicare eligible benefit recipients participate in a closed HRA. This means they must be enrolled in a medical plan through Via Benefits to receive monthly HRA deposits. If a Medicare eligible member does not enroll in a plan with Via Benefits they would not receive the HRA deposit. OPERS does not provide an HRA for spouses or surviving spouses. Upon a members passing a surviving spouse would not receive an HRA deposit however upon the members passing eligible dependents such as a spouse will have up to 24 months to spend down any remaining balance in the members HRA by submitting Qualified expenses incurred by the retiree prior to death and/or any qualified expenses incurred by the eligible dependent after the date of the retirees death.

      Reply
  • January 22, 2022 at 9:03 pm
    Permalink

    On January 11 I submitted to VIA Benefits all the necessary information to recieve recurring reimbursement for my healthcare premiums with Oscar Health and was turned down. Included in this was my welcome letter stating the start date of my coverage and what my monthly premium will be, along with VIA’s reimbursement request form. They claimed there was not suficient proof of payment. I hope this isn’t going to turn into a long term headache.

    Reply

Leave a Reply

dialog-information.png
We encourage your comments on the Ohio Public Employees Retirement System’s PERSpective blog. We can’t respond to every comment. Please be aware that we review all comments before they’re posted, and we reserve the right to edit, not publish or remove any comment that in our sole discretion does not further the purpose of the blog. For further details, please see our Comments Policy.
 

Your email address will not be published.