OneExchange to waive some fees
OneExchange is waiving Connector fees for the first three months of 2016, OPERS Health Care Director Marianne Steger says in her monthly health care chat.
Members of the OPERS Medicare Connector won’t be charged manitenance fees of $2.33 for the months of January, February and March, Steger tells OPERS’ Michael Pramik in the March health care chat. She also addresses other issues regarding the Connector.
We’ve posted the video on our YouTube channel.
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.
I have been trying to get reimbursed for my prescription drug coverage since January. So far no luck! I have made four phone calls and talked to four different representatives for no less than 45 minutes each call. Each time I have been told the problem will be resolved in 3/5 days and here I am getting ready to go in to a new month and still nothing is resolved! I believe the issue revolves around the fact that my prescription drug premium is the same amount as my OPERS dental insurance. Shouldn’t be a problem but evidently it is and one that four different people can not get fixed! It’s not a large amount of money but it is my money and I am entitled to it! At this point, I do not know what to do. The last thing I want to do is call and talk to another rep and be put on hold and transferred around for another 45 minutes and then be told they will take care of it in another 3/5 days and nothing happens. Any suggestions on how to handle this would be appreciated!
Joy — A member of our Healthcare team will contact you.
– Ohio PERS
Who actually has possession of the money in the HRA accounts? Is the money being used while in the accounts? If so, who is benefitting from that?
Barbara,
The money stays with OPERS until it’s reimbursed to the member.
–Ohio PERS
Folks, if you’ll listen to the latest video, you’ll see that the funds are maintained by OPERS as they gather additional interest/investment income. Even tho so many of us are very unhappy with the performance of One Exchange, we can not deny them the $2.00/account that they received each month in the fervent hope that they will learn where the shortcomings are and strive to better train their associates. Many of us have been given wrong information. I hope all will take note of the name of the associates with whom they speak, then when errors in the information arise, you’ll be able to report the erroneous information along with the name of the associate who provided it.
I ALWAYS ask for the name of the associate I’m speaking to. I also note the date AND time of the call. That way you have all your “time stamp” so to speak. I even take notes so I can remember the information given to me. Just a thought.
Guess I’m the unlucky one. They have been charging me the fee. However I have been reimbursedoing just not till late in the month. No need to contact them, phone calls take at least a hour with no real answers. I just pray my bills get paid on time while I’m waitng. My insurance is good which I personally researched and ask for, the difficulty was getting them to sign it up and not take what they wanted me to take. Finally after a hour and half I got a really nice man that took over and knew what he was doing.
Emma,
Are you certain that you’ve had an amount of $2.33 per month taken from your HRA?
–Ohio PERS
There should be no fees, O.P.E.R.S. should be picking up these charges.
Thanks O.P.E.R.S.
Mike,
We are picking up the charges. We set the allowance amount at a level that the fees would be covered.
–Ohio PERS
Please do something about the windfall. I do not see any fairness in me being penalized for working hard all my life in two different jobs. I paid into SSI but now the Ohio Government is basically stealing my ssi from me. My neighbor worked in pers and retired and also retired from the railroad. As well as another worked as a truck driver and pers. No one steals what they paid. Why do you do this to me. Just not right.
Rich A Pica
Rich,
Do you think the state government or OPERS has something to do with the Windfall Elimination Provision? This is a federal rule, implemented by the Social Security Administration. We are working to have the WEP recalculated to be more beneficial to those who have worked in both the public and private sector. We have nothing to do with lowering your Social Security benefit.
–Ohio PERS
Joy, I have been having exactly the same problem. I told PlayFlex that I knew I couldn’t be the only one. On Friday I talked to a PayFlex supervisor (because I had already been working on the problem for a couple of weeks, did not want to explain it twice, and did not want it relayed through two people). She said it is because the “program” looks at the $ amount and not what the premium is for. This happened in February and in March. It thinks my recurring dental premium is my prescription premium and denies it. When I called PlayFlex last Monday and told them, by Friday they had deleted all of my recurring dental premiums for the year. During Friday’s call she said she reinstated my recurring dental, sent March prescription back for reimbursement, and put a notation on my file. Wait another 3-5 days. I do not have high hopes about all this. She told me I could turn off automatic reimbursement for my prescription and submit it as recurring. She said I could get a statement from SilverScript to submit, but that would not prove that I have paid it each month. I am totally frustrated.
I am so upset with the One exchange that I have been given. Especially the silverscripts. It is becoming so that you buy groceries or prescriptions. I am working two parttime jobs and 76 years old and my savings is going to buy medicine. What are the other 70’s plus that can’t work doing for the extra out of the pocket cost. I worked for 41 years at Ohio University and I always felt I was treated fair. But now that is a different story. You should have insisted on grandfather the elders when this change was decided. It is not fair to be in a conflict at this late in life. I am sure the upper board members are being treated fairly and don’t have to worry. This has been a terrible blow to our life. Icalled the Advocate patient assistance and I have to be under “Coverage Gap” which is having paid $4,850 during a year and then your out of pocket cost goes higher before you can get assistance. Everytime to call someone you end up getting transferred 3 0r 4 times and get different answers. There is no right to what you have done to the elder retirees.
I’d like to respond to Dorothy Gettle regarding her prescriptions or to any other senior retiree.
Many pharmaceuticals will help with medications. Talk to your doctor, they have a way to help. It takes filling out some paperwork, but if your doctor will work with you, it can be done.
I wish all seniors the best.
Same problem here, they bit off more than they can chew, obviously have a problem.
go for recurring monthly automatic reimbursement. that is what we had to do in order for them to reimburse us for my husbands health care.
I am having the same problem as above only it is my dental expense that was kicked out because it was the same amount as my silver script. Respond well as I have had one without res respond well as I have had conversations with one without resolution. Thank you. — Marie Bontempo
Marie: I had the same problem in February and March. March’s finally showed up in my checking account today after 5-6 e-mail and two phone calls to OneEx/PayFlex. I have no hope that it will not be messed up again in April.
I was paying double for my vision & dental for three months. I didn’t realize it till I got my letter in March (my retirement month), when I noticed the deduction from my pension check and I was also paying it thru OE. I called them, explained my problem and was told I’d have to wait till enrollment opened up again before I could do anything. Wow, that’s not till Oct, and yes I’d have to wait, and that I should’ve cancelled it when I enrolled with OE. I think the “expert adviser” should’ve mentioned that to me. I’m 82 and think that at my age, we should be reminded of some things that we need to do.
Well, I wasn’t going to wait but got on the internet & did some research and finally got it taken care of. I was disappointed that I had to pay $115 for that double payment and did not get it refunded even tho I did not use either of them. I guess the saying Live and Learn is true.
I had a similar situation with my Medicare reimbursement. Finally after 3 tries it was resolved. Can’t anybody over there read?
I’m not surprised that Towers Watson was denied an endorsement from the Better Business Bureau. Isn’t it just dandy to know they can’t consistently make timely reimbursements or properly handle phone calls; yet manage to get their monthly administration fees from us all sorted out. Can’t wait for next year. Nice going OPERS.
One Exchange should send us a fee for the hours and hours some of us have spent trying to fix the mistakes and oversights, and”computer problems” that have been made by them!
I am having the same problem as Joy Fisher, I try explaining to the rep that it is two different
claims with no luck. any suggestions
Alicia,
We are working with OneExchange on this. We’ll update you when the issue is resolved.
–Ohio PERS
One Exchange should WAIVE any Fees whatsoever due to complete & total Incompetence! Get Rid of Them…You are KILLING US here!! Going BROKE….
After working on it for over two weeks (5-6 e-mails and 2 phone calls), it looks like I may finally be getting my my March “automatic” prescription reimbursement. I have never worked so hard for just less than $20 in my life.
Will I have to pay twice, for both my husband and myself?
There is only one fee per account. Only if both retiree and spouse are OPERS retirees would there be two fees because in this case there would be two accounts.
– Ohio PERS
Thank you.
Patricia,
No, just once for each HRA account.
–Ohio PERS
If this matter of fees weren’t so serious it would be laughable.
I’m sure glad that you produced these three very informative guides, bulletins, and whatever. But it’s too bad that they weren’t delivered to most all of the disgusted participants. I have a stack of all mailed items, all PDF notifications that were mentioned in emails, and notes from meetings. I never heard of any of these three sources. Now I have downloaded and filed them along with all the others. I would presume that after the US mail was discontinued as a means of distribution, there was a severe lack of oversight to provide continuity of service.
Richard,
Do you understand the fact that we have covered the fee in the monthly allowance we provide?
–Ohio PERS
06April2016
Michael Pramik, I regret that you thought I was complaining about fees. I understand the mechanism. I am merely trying to explain how so many people weren’t aware that there would be a small fee. I was slightly disturbed, however about not discovering some of the mail/downloads that were available. Anyhow, I’m quite satisfied with my dealings with the One Exchange/Payflex mechanism.
My wife is on Medicare and I, the OPERS retiree, am not. I am upset that $300.00 was put into my HRA in error and now supposedly will be deducted. I put in a lot of time trying to get the $300.00 reimbursement from OneExchange and am now told “never mind”. The latest video does not even address this mistake, why it was made, and who made it! Also, my contacts with OneExchange have been maddening!! I am on hold at least 15 minutes when I call, some representatives are nice and helpful, but most are nice but not very helpful, to say the least.
We too find the phone calls maddening. Long waits, but mostly when we get someone, and they are told our story with questions, they say they will have to transfer me, and it starts all over again. We were on the phone the other day for over a hour, and talked to six different people, with little result.
Vince, my husband and I are in the same situation as you. I am on medicare and he did not qualify for part A. We just found out that he qualifies for part A as my spouse! What a nice surprise. This does require a personal visit to the local Social Security office to set the record straight.
Maybe other retired couples could benefit from this information!
My husband and I also had $300 taken from our HRA this month! What a shock it was! These people are handling our retirement money! Such incompetence is downright scary! OPERS claims it was perfectly clear in all their correspondence to us that ONLY the retiree was to get an extra $300. If it was so darn clear, why did One Exchange put the money into all our accounts??? No one at OPERS was taking responsibility for it this morning, and no one at One Exchange is taking responsibility either (I talked to both today)! This is so wrong! And not a single personalized letter of explanation! What I got was a one page letter from One Exchange (mass produced generalized letter) saying how bad their service has been, how they know they should do better, how they have heard our complaints, and just a little one line item about the $300. Do you think maybe- just maybe – someone at OPERS or One Exchange could have taken 20 seconds to write each affected person a personalized letter explaining there was an error and that unfortunately it would be corrected the next month? No, that would mean you actually cared about your retirees!!! When you are on a limited retiree’s income, you count on certain things. We counted on getting a reimbursement this month for our insurance premium we paid up front in January. Instead my account shows I am in arrears of $95 because of the $300 withdrawal! So that means next month we will also be shorted on reimbursement. I am so upset with OPERS and One Exchange. Their “not my problem” attitude is just shameful!
EXACTLY!! Total Incompetence!! They take the PREMIUMS Out very Promptly…yet, DELAY DELAY DELAY the Reimbursements!!! UGH
So whatever monthly allowance we get will also be eaten up by fees for a ‘service’ we had essentially no option but to accept!?
I didn’t know anything about any FEES, it’s funny how quick they are grabbing my money and how slow they are giving it back to us, suppose interest has anything to do with that??
We regret that some members are unfamiliar with this issue, so here is some more background on the fee. Each OneExchange account is assessed $2.33 per month to cover the costs of administering the account. When moving to the Connector, OPERS made sure that the HRA allowance would be sufficient to cover these costs and other eligible medical expenses.
In error, OneExchange did not charge this fee for the first three months of 2016. Instead of allowing OneExchange to charge these fees retroactively, we insisted they forfeit these charges. April 1 is the first date you’ll see a $2.33 fee charged to your HRA account.
We know that not everyone has experienced the level of service you have come to expect from OPERS and our partners and we apologize for that. OPERS will continue to work directly with OneExchange daily to solve any remaining customer service issues. We will not be satisfied until the process is running flawlessly.
– Ohio PERS
Since I obviously missed the information, published or presented, about Connector fees, all I really want to know is where this information was published or presented.
Michael,
The fee was mentioned in the 2016 Open Enrollment bulletin mailed last Summer, the 2016 coverage guide and the Connector Basics Guide. We also reference the fee in the September healthcare video and in answering member questions at that time.
– Ohio PERS
We really don’t begrudge the fee . . . We are just a bit upset because, under the previous plans where funds were in a Medical Savings Account, WE got Interest. Now, it is apparent that we do NOT get any interest on our funds, but do get to pay an administrative fee. I don’t object that the system is getting interest on the funds not yet disbursed, but I really think that we should be getting the interest on the funds in our account rather than OneExchange benefiting from what we do not spend!
Larry & Peggie,
OPERS actually pays this fee. We built the fee amount into the allowance we give to Connector participants.
–Ohio PERS
We have now received a letter of “apology” from One-Exchange that the monthly allowance was deposited early into our accounts. Why is One-Exchange doing the depositing ? It would seem to me the deposit should be coming from OPERS (and I’ve been told by an OPERS rep that it’s not) because if it’s not that means OPERS has given these people more than a month of deposit money IN ADVANCE ! How much money or rather how many months has One-Exchange been given ? If they are holding more than a month, there needs to be an explanation.
Ann,
OneExchange never controls the money in the HRA. That amount stays with OPERS until it is moved to your bank account.
–Ohio PERS
“Apology” letter was a farce! OPERS claims it was One Exchange that made the mistake by depositing it into the wrong accounts. That leads me to believe One Exchange is controlling our money, not OPERS. Yet OPERS says it controls the money. I think we are getting the run around! In any case, the error was handled poorly by both groups with no one taking ownership.
ONE EXCHANGE is contracted by OPERS, I don’t believe that their offices are located in USA. Researched this and did not apply for HRA because of this. SOOOO good people, whos grabbing the $$$
Sharon,
OneExchange is located in the United States. The telephone service center is in Utah.
–Ohio PERS
I would just like to state that I, the retiree, & my husband, a Lawyer, attended many of the One Exchange Informational sessions over the last 2 years in Toledo, Ohio. We also read the materials sent to us. When I “heard” about the One Exchange Maintenance Fee for our accounts in the last several weeks, I was surprised as I do not remember hearing or reading about this. I checked with my husband who verified that this information was NEVER brought up at any informational session.
Exactly. Why even deposit the money at all into an HRA? OPERS gives a subsidy in an HRA and then takes money back in order to implement its contract with One Exchange.
Exactly
WHY WEREN’T WE TOLD OF THESE FEES WHEN THIS ALL STARTED.
Cathy,
We disclosed the fee in several publications in 2015. Further, we are actually covering the fee because we made sure the allowance we’re providing was enough to pay the fee.
–Ohio PERS
I too, did not know about any monthly fees. It wasn’t mentione once during the sign up period !
I didn’t realize there would be fees either. What gives ? First they gradually dropping our health insurance….which, by the way, was promised as a “life long benefit” when I was first employed under the OPERS system, and now they are charging us “fees” ????
why is opers not paying for the “fees” all this was there doings
Maggie,
We are paying for the fees. They were built into the allowance we’re giving to Connector participants.
–Ohio PERS
I went to all the seminars & didn’t hear anything about fees! Trying to get help from One Exchange is a nightmare.
Rosemary,
We disclosed this fee in several publications last year, including our coverage guide and open enrollment guide for 2016. Further, we are actually paying this fee. We made sure that the allowance we give to our Connector participants covered it.
–Ohio PERS
Rosemary,
We mentioned it in the following publications:
We told you about the fee in at least the following documents:
* Understanding the Basics: Medicare and the OPERS Medicare Connector
* The 2016 Open Enrollment Bulletin
* The 2016 Coverage Guide — this is our main health care document of the year.
I’ve also discussed it in blog commentary.
–Ohio PERS
2.33 is a small price to pay per month. I submit claims online and save high postage costs. I have a source of answers to questions I may have (oh yeah, get straight answers from OPERS)
the twits forget to charge us for 3 months, so you want straight answers?
good luck!
You forgot to include the fee OneExchange gets from the insurance companies for selling their policies. They make way over $5 million selling policies to opers retirees and their so call support to us.
OneExchange does NOT get commission from Insurance Companies. How come you do not know this?
William,
Interest has nothing to do with it. OneExchange never has access to the money in your HRA. Also, we’re sorry that you didn’t see the information about the fee. We did include it in several publications, including our coverage guide although not all current retirees receive that.
–Ohio PERS
Now you have admitted not all retirees’ rec’d information regarding fees coming out of our money. This is very unfair and false information during the 2-3 hour phone call it took to change over, no mention of these fees, etc. I consider my opinion as rated POOR management..
Sandra,
No, I did not. All retirees received the summer Health Care Bulletin, which included information on the fee. Which we cover in the allowance we provide to Connector participants.
–Ohio PERS
It was NEVER made clear in all the materials I received regarding going to One Exchange. I agree with 145,000 retirees’ making $2.33 per each, per month is sure adding up to a lot of money for misconduct in managing phone call time spent, along with all the other problems us retirees are encountering. I am still awaiting my question on here to be answered. My husband is the retiree and I am the spouse. He is not eligible for Medicare and they automatically too him off Humana and put him on Med Mutual so he lost his doctor’s and hospital, along with the rise in prescription co-pay, doctors’ co-pays, not to mention breaking our bank in having to pay his % he has to pay after insurance pays. They are taking away elders’ being able to make ends meet. The contract was Spouses were covered under the spouse, the retiree had life time coverage (he had 31 year’s before retirement), and now look is what is happening. Not only for me as a spouse do they take out $104 from SS, I will lose any stipend come 2018. And with what stipend OPERS is offering this year has caused a lot of questions that still need to be answered, and now they want us to pay administrative fees to handle. Shame on them.
Sandra,
For the record, the number of HRA accounts is about 105,000, not 145,000.
–Ohio PERS
Shirley,
Willis Towers Watson’s headquarters are in London. That has no bearing on the company’s ability to operate a U.S. health care exchange. The company has operations in 38 other countries in addition to the United States.
–Ohio PERS
I totally agree with you. I heard nothing about any administrative fees being taken from us. This is a surprise to me.
I never saw anything about a monhtly fee….if it was in anything they sent us, it was very buried in some fine print.
Lee,
Most monthly allowances are in the $300-$400 range. The monthly fee is $2.33.
–Ohio PERS
Michael,
Could you tell me how many years service a retiree would need to qualify for a $300 monthly allowance? Does it depend on their age at retirement? If so, how exactly is it calculated?
Thanks.
Mary,
Monthly allowances are based on age and service. You can use the OPERS Retirement Planner to get a general idea of what your costs might be. Or, call us at 800-222-7377.
OneExchange has nerve to charge retiree’s any fees. I have tried to get an explanation about the rejection of a request for medical expenses. Their web site does not have any place where you can request additional information and if you go to the “talk to an expert” section you are given the phone number. Have you tried the phone number? Call early and you are told to call back. Call late and you are told to call back. Call mid-day and you are told to call back. Call all hours day after day and you are told to call back. Maybe I should try to call when they are closed and hope the cleaning people can help.
I agree. Thanks for the “laugh of the day.”
Somehow I don’t think that comment was meant as a “joke.”
I have to hand it to you, OPERS! I don’t recall anything about fees for One Exchange service. I went to all seminars & never heard a word about fees! One Exchange is a joke. They are not helpful, polite & wait times are horrible. It’s amazing how many times you get transferred & no one has the answer to your question. It’s like calling a government office. I never thought there could be an outfit worse than a government office. Exchange One, you nailed it!!
Charlene,
The fee was mentioned in the 2016 Open Enrollment bulletin mailed last Summer, the 2016 coverage guide and the Connector Basics Guide. We also referenced the fee in the summer 2015 Health Care Bulletin, an insert into the retiree newsletter.
— Ohio PERS
Charlene,
I’m not sure about the seminars, but we disclosed the fees in the following publications:
* Understanding the Basics: Medicare and the OPERS Medicare Connector
* The 2016 Open Enrollment Bulletin
* The 2016 Coverage Guide — this is our main health care document of the year.
I’ve also discussed it in blog commentary.
–Ohio PERS
When I call and am told to “call back later”, I ignore it and usually the call is answered within 5 minutes. I do agree that One Exchange is an incompetent organization. I had not heard of any “fees”, but the fact the OE ‘forgot’ to apply them for 3 mos. shows the level of incompetency. I
Does everybody expect OneExchange to handle our accounts for free? I, to, have encountered some glitches. However, everything has been resolved ( I hope!).
My wife received her letter from One Exchange on 3/28 (I’ve yet to receive mine) and we looked at each other and said: Connector fees? We’ve been to numerous OPERS/One Exchange seminars and don’t recall ever hearing anything about Connector fees. One other point: While I do get the quarterly Medicare coupons that Marianne Steger discusses, I receive no annual letter from Social Security.
yeah me too Michael. Got the letter the other day and said to myself…what fees..first I’ve heard of it.
Sorry, but this is continuing to be a confusing, frustrating, demanding process. Murphy’s Law certainly explains my personal experience. Unfortunately I have little knowledge of what is happening.
I think I would be helped with a written description of what is going on. Simple, structured, ie., No.1; No.2; No. 3 etc. What do OPERS, One Exchange, that is, ALL vested parties do each month? What am I expected to do and when? This should include a written description of my insurance benefits and obligations from my new insurance carrier. Please don’t repeat that it is complicated and a process
because that has been realized. Do in someway be definitive.
Ray,
The Quick Reference Guide found on the OPERS website may answer your questions. You can find it at https://www.opers.org/pubs-archive/healthcare/HRA-quickreferenceguide.pdf.
– Ohio PERS
To Opers Board, you all need replaced. You lost millions several years ago. You did away with medical insurance. Hired One exchange and placed some money into an account that lowers in the future. Now we all get letters that we must pay a fee for One Exchage to handle and reimburse our medical payments from. I can not wait for all of you to retire and get stuck with this monster you have created.
Mr. Bessinger — I agree that the OPERS Board of Trustees has some responsibility for what has become a nightmare for retirees. The following Board info is copied from the OPERS Website:
The OPERS Board of Trustees — the governing body of the system — is responsible for the administration and management of OPERS. The board meets monthly to review and formulate policies concerning the members, contributors and benefit recipients of OPERS, and the OPERS office staff.
The board members also authorize the investments made with the system’s funds. They receive no compensation for their service to OPERS, but they are reimbursed for necessary expenses incurred while serving the system.
Absolutely correct!
Why blame the Gov. for greed. Everybody knows where he’s coming from. How about the investment counselors at OPERS who recommended the investment? Are they still drawing their huge retainer fees? I’ll bet they are.
Remember Asst. Gov. Ms. Taylor supervises the State Insurance Dept. when she runs for office.
yes, the OPERS board needs to be replaced.
Kay: Sounds just like the CEO’s and their associates and our government officials does’t it! We all lost money during the recession a few years ago. Only OPERS said they were good. Let’s face it $2.33 is NOT a great amount and there was way more work to be done with this new system than any of them realized. Some One Exchange employees are more knowledgable than others. One of the calls I talked to 3 people (one was a supervisor!). The last person knew exactly the answer I needed and could not understand why the other 2 could not answer it!. I am fortunate because my issues have all been resolved. It is just a shame we give way more than $2.33 a month to our government and look at the mess it is in!
JulieGraham-Price; Can you tell me what pages that the fee was mentioned????
Kenneth,
We mentioned it in the following publications:
* Understanding the Basics: Medicare and the OPERS Medicare Connector (page 18)
* The 2016 Open Enrollment Bulletin (page 12)
* The 2016 Coverage Guide (page 20) — this is our main health care document of the year.
I’ve also discussed it in blog commentary.
–Ohio PERS
I am so tired of hearing about the $2.33 fee. For goodness sake people, be glad you have health care coverage. It could be worse, you could be paying the ENTIRE COST of your health care and have a humongous deductible like a lot of folks on obamacare. Count your blessings.
Dear Ms. Julian, I realize that health care coverage is not guaranteed and that you don’t understand why others are venting frustrations. I feel very sorry for those who have serious health issues and are having problems with the system. As you say, ‘it could be worse’.
I found it on page 12 of the insert of the Summer Newsletter.
this has been a nightmare trying to get reimbursted for my dental preiums workers there are giving wrong info there has to be a better way
Linda,
Although the fee was mentioned in the 2016 Open Enrollment bulletin mailed last Summer, we regret that not everyone saw the notice. Here is some additional information.
First, the $2.33 monthly fee is paid to One Exchange, not OPERS, to cover the costs of administering the account. When moving to the Connector, OPERS made sure that the HRA allowance would be sufficient to cover these administrative costs and other eligible medical expenses. When OneExchange failed to start the fee in January, we insisted that they forgo these funds. The fee will begin in April.
Second, the fee is deducted from your HRA – not your pension. OPERS’ first obligation is to pay pensions. We will continue to work hard to provide access to health care because we understand the importance of health care coverage for our retirees.
– Ohio PERS
I’m afraid to retire because of the One Exchange / reimbursement / health care fiasco. I think it will take years to get it all straightened out, and just about the time it does all start coming together, you’ll switch from One Exchange to another group that offers false promises and lower costs, and the fiasco will start all over again! Yes, I’m afraid to retire!
Nicely said Julie Graham Price…thank you for the detailed explanation! I think OPERS is very generous with the HRA accounts.
Oh my! Such discussion over a $2.33 administrative fee to process transactions of the HRA allowance deposits, incoming claims for health care & drug premiums/expenses and outgoing reimbursements for these expenses. Credit Union of OH has been charging my acct $2 per mo. starting 2016 just to receive a paper statement! The OneExchange fee sounds like a bargain to me. In addition, when I received notice of the amt of the HRA allowance that would be deposited,in Oct 2015, I noticed that it was exactly $2.33 more than what was quoted in the original Connector allowance info. So obviously the HRA allowance was bumped up $2.33 to allow for this fee. As I figure it, I’m not really paying the fee, OPERS is. Thanks OPERS. And although I agree that the health care changes that we retirees have had to deal with in the last 6 months have been at times tedious, time consuming, and frustrating, there has always been resources, and support to get us through. No system is perfect, but overall my experience has been very positive. And after working out a couple kinks, my electronic pmts for premiums and the subsequent reimbursements from my HRA are on track. Soap box removed!
Mary, my experience, as yours, has been tedious, and occasionally frustrating. Once I learned where to find supporting documentation and then convert to PDF format, all my claims for reimbursement have been completed satisfactorily.
I have also been successful submitting vision and dental premiums as recurring expenses for automatic monthly reimbursement.
Learning the process was time consuming, but committing that time to understand all the processes now frees me up to worry about other matters.
It would not surprise me if a number of retirees could use some one-on-one assistance. Old dogs can learn new tricks!
I have read so many negative comments, I would just like to say my experience with One Exchange has been pleasurable with no problems. I am thankful for the allowance PERS pays each month which covers my premiums and also has HRA that rolls over each month and each year. I went to a specialist in January and he received prompt payment and I have also received my direct deposit in a very timely manner. I may be the exception, but I will gladly pay the fee to continue having OPERS take care of their retirees.
Thank your lucky stars!
I am grateful to OPERS, as well, and certainly don’t understand what the big todo is about concerning the monthly management fee which isn’t coming out of our pockets. Folks need to remember that OPERS is not legally obligated to provide us with health insurance! Good heavens!! However, I would hope that OPERS would pass along our dissatisfaction with the poor performance to One Exchange. From sign-up and and on through many subsequent issues, I was given WRONG information. I don’t know if there might be a better company out there, but alas, it’s too late for OPERS to change the management company. Therefore, I hope OE will do whatever is necessary to properly train it’s personnel. OE might provide a way for us to notify supervisors when we’re given misinformation or have other problems with performance of OE personnel. An e-mail link, if nothing else. Their website is a mess, and appears to have been put together by someone with little or no understanding of what the business is all about.
Ms. Wagers, My first impression is that you are very lucky, my next thought is that I hope you continue having good luck and don’t end up like the rest of the folks who are so frustrated by a poorly run organization and a process that was poorly configured by all involved. And still, there seems to be no resolution to their problems.
I was told on Monday that it would take four to six weeks to come to a resolution as to why my husband’s (the retiree) pharmacy benefits for Jan/Feb/March haven’t been reimbursed. FOUR TO SIX WEEKS?
A member of the OPERS health care staff will contact you.
– Ohio PERS
I supplied my medicare information to One Exchange via a letter from Social Security. It was denied for the whole year. now I hear that they are now reimbursing that each month. Will they automatically start to reimburse me or do I need to contact them again. although I usually don’t get an answer to my questions that I feel are correct.
Dixie,
A member of our Health Care staff will contact you.
– Ohio PERS
I want to know the same thing. When I was on the line with PayFlex about another issue I asked about the recurring reimbursement for Medicare that I pay monthly as a withdrawal from my checking account, and that it was in the OPERS web series. She had no idea what I was talking about.
Since Exchange One gets this monthly fee, who gets the commissions from the sale of the insurance products we all are being advised to purchase?
Ina,
OneExchange is paid by the insurers. However, the benefit advisors have no knowledge of the commissions and they aren’t paid by commission.
–Ohio PERS
I am still a little confused by the HRA reimbustment. I have done something wrong because I don’t know how to use an HRA account. I thought it would help me with the Medicare I had to pay so much for because I have worked under OPERS most of my life.Need someone to explain it to me in terms I can understand???
Barbara,
A member of our Health Care staff will contact you.
– Ohio PERS
Barbara,
The HRA process is explained in the OPERS HRA Quick Reference Guide on the OneExchange/OPERS website. If you have further questions, post them here and we’ll answer them for you.
–Ohio PERS
I can tell you why so many retirees did not pursue the new system…..it is too confusing. My mother is 89 and finds it hard to keep her head above water with all the constant info thrown at her. It has been very stressful for her. Shame on pers for putting honest hard working people through this. What do people do that have no family to help them?
Trying to get help from any of the insurers is an horrific experience. HOURS spent being sent from pillar to post, waiting only to be cut off and when a human finally gets on the line they give incomprehensible answers. I have yet to know how the reimbursement process works and it is so frustrating I’ll probably just forget it to spare myself the misery of this mess. I will not be able to deal with this in a couple of years and have no one to sort things out for me. The USA needs a SINGLE PAYER SYSTEM like every other civilized nation has. There are not enough cuss words in my vocabulary to express my dissatisfaction with this crappy system. OPERS used to be the best but should have found us a better system for our “Golden Years.”
Kenneth,
A member of our Health Care staff will contact you.
– Ohio PERS
I am a spouse of a retiree and retired from a bank I have tried to balance the account and nothing ever adds up there is $450 that I do not where it went they may have paid my health care twice in one month.As far as getting any help from them forget it Most do not know and they reconnect you and then they disconnect you after waiting for and hour. This is such a MESS maybe if they could just give me the money I would pay the taxes this is just that BAD. This is new about the Fee which was never mentioned which should have been.I would just once love to balance my check book???????
I’m completely unhappy with my experiences with One Exchange. Everytime I’ve had to call, which is several, I’ve gotten alot of miss information. I’m on the phone for 45 min. At least transfered around. Then when I did what I was told to do in a letter I received from OPERS, on how to get my reimbursement for my SS part B and my Medical Mutal premium faster. They double paid my Medical Mutal premiums in Jan. & Feb. So now it’s been a hassle trying to get that straightened out. Then when I sent in receipts for prescriptions and a Dr. copay, they paid on those wrong. 3 of the perscription were on one receipt. They paid on 2 and not the third. Mind you they were all filled at the same time. Who ever did the entry as 3/14/15, instead of 3/14/16, these were all on the same receipt. I can’t believe the incompetence. This only part of the frustration at their service. I was given wrong info when I signed up and had to change doctors. Now I have to wait months to get care.
The problem I had so far is trying to understand some of the staff at One Exchange. I am hard of hearing I have a Caption phone and they can’t make out what the staff the saying. Need to have a good English speaking.
In 1 of the first videos One Exchange produced, we were told that we would be speaking with an advisor that may say “ya’ll”. Well if that is who I have spoken with most of the time, they say “ya’ll” in a language other than English. This particular bit of information was part of an explanation of how One Exchange would be operating, and who we would be dealing with for any questions about refunds, benefits, costs, reimbursements, etc.
Eventually we did get most everything straightened out, and for the most part it has been good. However, we are still waiting to hear anyone say, ya’ll have a nice day, and thank u’nns for calling One Exchange. Good ‘ol down home English speaking folk.
This is the first I have heard about this fee, it seems things change monthly and we have no control on any of these issues…
I think all of us should have some say in all issues..
I just learned yesterday I have to send a monthly re-ember segment form each month for my dental and vision in place of a continued form this sounds like a lot of unnecessary added paper work to me!
I can,t believe all the complaining people are making I have had no problem signing up or being rembursted for my bills Opers are doing you a good thing thru One Exchange they could have made you pay for all of your health care and no reminburstment why people are so greddy and expect something all the time makes me mad take care of your self and not expect the government handout I am 84 yrs old
You are one lucky lady hope you don’t have problems like all of us. Don’t consider myself greedy I worked hard for these benefits!! I pay my bill and it takes a whole month to be reimbursed.
You are one lucky lady hope you don’t have problems like all of us. Don’t consider myself greedy I worked hard for these benefits!!
So I’m lucky also? Because I followed all the directions and had minimal problems? The few whiners here may not have followed the explicit directions it sounds like to me. And we don’t know that you “worked hard” for these benefits.
I agree with Mary Lee. I have not had a problem with one exchange.
I agree with Guylene, however, as we get older, having to hold so long on the phone is an issue. Also, I missed the info regarding reimbursement for Part B (a lot of info thrown at our brain that can only comprehend a small amount without getting confused). When I do talk with One Exchange, it has been very pleasant, just wish I was told my co-pays on medications with them pickicky my prescription plan were accurate meds quoted as co-pays are higher than told on the phone. Otherwise, very thankful.
I have no problems with One Exchange the CSR I spoke with was very helpful and answered all my questioms
GOOD JOB!
I am surprised at this video. It sounds like OPERS has helped some members, yet when I called with my problems, I was told that OPERS does not “intervene.”
I have been trying for over a month to get my Medicare A problem resolved and the last time I spoke with someone at the Columbus SSA, I was assured that I would receive the information I need by the March 31st deadline. Not in the mail today!!
In addition to many hours on the phone, I was told I had to go to the Xenia office to settle a problem.
Frustration does not begin to explain my feelings. Supposedly I am to get in touch with One Exchange starting April 1 but what can they do for me since SSA has not finalized my Medicare A situation.
I would appreciate any assistance I can get.
Mary Lou,
It’s unclear what issue you’re having with Medicare Part A coverage. If Social Security promised you documentation, we can’t help you with that. It seems like your issue is with Social Security.
–Ohio PERS
Time for a favorable comment. Fee of $2.33 is less than $30.00 per year. I feel this is very reasonable for the servces provided. I have been very satisfied with program In my case everything is running very smoothly, thank you.
I agree!
When I have a question for OneExchange I use their email system and they answer my email the same day.
I knew nothing about the fee until two days ago when I received a letter. This should have been made known more than it was to avoid members feeling ripped off. Also, to get enrolled with One Exchange was a nightmare, spending hours on the phone & getting wrong info. numerous times.
We are being over come of mail from Humana which entails dubicatiion with six pages saying the same thing. Cut out this waste would more than cover the fee charge of $2.33. Like the goverment always a fee.
How was it determined as to how we were to be reimbursed for medical charges? Has a debit card ever been concidered? Filling out paper work and waiting is just to much. I’m not being reimbursed as fast as I’m being billed.
Joy,
A reimbursement card is not available at this time.
– Ohio PERS
I too had overlooked the information pertaining to the administrative fees. So today I looked at the summer bulletin and in the insert on page 12 it is explained as Ms. Graham-Price stated. I did have some problems with the method of payment for the prescription plan with the carrier I chose but have now resolved that. I agree not all of the representatives with One Exchange have all of the answers but they do give you the opportunity to answer a survey at the end of your phone call, which I did, and a manager called me to be sure my problem had been taken care of.
I am 84 I have no trouble with signing up ur having my bills rembursted to me What is a small fee going to hurt you to pay for One exchange service we are lucky we didn’t have to pay everything ourselves but instead we do get some help by a RMA so quit complying and don’t expect the state or any government help for free all the time One Exchange employees Are great when helping you if you let them and have Paitient so again quit complying
I agree Mary. In a couple years from now we will lose all reimbursements and our RMA account will be zero.
When the government took over our healthcare system promising lower health insurance costs I new it was a lie.
I truly respect the fact that you are 84 years old and have navigated the OPERS healthcare system in a superior manner, but out of respect for our other retired brothers and sisters, the system seems very flawed — they are simply airing their frustrations while trying to make things better in the future. I am not yet retired and pretty much afraid to retire because of this new healthcare process. Seems to be making so many struggle during their retirement years.
I do not see anywhere on my bank statement that I was reimbursed for the January payment I made and thought I was to receive the reimbursement by mid February. It is one day away from April and I sure could use the money returned to me through my bank account.
One exchange takes health care cost out of my checking account the first of the month. Tell me why it takes them TWO to THREE WEEKS to deposit the reinbursement back into my checking account.. I called one exchange was told that Humana has to notify them payment was received before they deposit $ back into checking account, MAKES ME WONDER WHY IT TAKES SO LONG the fees they are assessing us is a joke!
I just finished reading all the above comments and thought I would respond. I haven”t had any problems with One Exchange. It did take very lengthy phone calls to get it all set up but everything is going smooth now.
All payments and reinbursements are automatic. The prescriptions and other medical and glasses receipts have been taken care in a very timely manner. So far, so good. By the way, I don’t mind paying the 2.33 a month.
Boy am I glad to read a few positive comments on here. I have been an OPERS retiree since 2008 but will be 65 in October so I’ll have to deal with OneExchange soon. I hope my experience is a positive one.
OPERS standard reply to our concerns is “a member of our health care team will contact you.”
I don’t want a contact from a member of OPERS health care team. —- I want one exchange and OPERS to be honest, straightforward and do their jobs.
Do they really expect us to believe that One Exchange somehow “didn’t notice” they weren’t getting two or three hundred thousand dollars each month in administrative fees? Do I believe my insurance carrier is to blame (as I was told by One Exchange) for my still not receiving premium reimbursements? Are we expected to believe One Exchange’s so-called licensed benefit advisors had the training or knowledge they needed before our scheduled phone calls? NO, NO, and NO! We were inundated for over a year with mailings, seminars, and you tube videos, even calendars with stickers, crossword puzzles and other “fun” activities to prepare us for the changeover to One Exchange. What we needed was simple, straightforward, honest information. What we STILL need is simple, straightforward, honest explanations of what went wrong, and how OPERS and One Exchange intends to solve all these problems.
Is holding up reimbursements for retirees premiums and healthcare expenses, now for three months, planned inefficiency, or fraud? I would think the Ohio Attorney General would be concerned about these issues, since it concerns not only his, but all Ohio state employees futures.
I appreciate this latest video regarding issues with One Exchange. Several folks I know got the letter Marianne mentioned earlier this week. I have not received it but hope that it will show up soon. In my dealings with One Exchange, I’ve found that many of their associates are either misinformed or not sufficiently trained. During enrollment I was led to just one policy and told that none of the policies covered Silver Sneakers (very important to me). The following day, I received a flyer from Humana mentioning that they covered Silver Sneakers, so I immediately called to change my policy. The Humana policy for the same coverage was nearly $15./month less than the one policy my advisor offered! The change in my policies (both medical and Rx) led to a whole string of problems. So many additional problems that have occurred with reimbursement have been real headaches, but I appreciate Marianne’s reassurance that problems we’ve experienced will be ironed out soon. Thank you for that!
Why can’t the notifications that come from PayFlex indicate if the payment amount is for the retiree or the spouse? When amounts are the same for each, there’s absolutely no way to tell which person the reimbursement is for. Without that information, I have to (1) receive, download, print and save the PayFlex notification, (2) log on to One Exchange, (3) go to” my reimbursements” to see if the payment was for me (spouse) or the retiree, but that information isn’t on that page! To gain that important piece of information I have to make yet another call to One Exchange with my printed notification in hand so I can have the necessary information to make the inquiry. And I can’t talk to anyone in One Exchange’s disbursements department without first giving the reason/necessary information to the person who first answers and then I get to sit on hold for ten minutes or so while that person calls disbursements to gain the information. It’s a frustrating scenario.
In our case, the problem is because they have reimbursed me (the spouse) but not my husband (the retiree!). I have to check every month to see if they’ve made the payment. The pharmacy company payment system shows the date they charged our credit account, and the date they transferred the funds to One Exchange, yet One Exchange is three months’ behind on reimbursements for the retiree’s pharmacy coverage.
Same, same, same, I am a spouse, they won’t talk to me, have to have my wife’s permission, I take care
of finances, it’s taken a dozen calls to get even with the board thru February, according to the people who pay the claims, service reps are without a clue, recurring claims get paid 4 to 6 weeks after the premiums are paid. OPERS said it would be a few days, Yeah 45! I have to keep a journal to keep track of premiums and for who’s claim it was paid. They don’t want to talk to me but it’s pretty hard when they
mix my wifes and my claims on the same payment. They also won’t tell me if the claims are paid on the same day of the month, we have 3 bank accounts envolved, overdrafts a definite possibility. Also just because OPERS sends out something, doesn’t mean we pay attention since, these fees were asked
about @ several seminars and it was always kicked down the road, Health Care was always promised
since people took small raises each year to insure hat benefit, now they lost a fortune in 2008 and they
have to cover all the existing employees, using medicare as the vehicle and very few had their own
part A, so that expense comes out of opers funds and spouses are kicked to the side of the road
especially after they are 70 years old plus, and we have to go on the market to find health care. Yeah,
OPERS is piece of work, I agree the board should be reconstituted so the bankers and politicians
are in the minority. I think that spouses shold be represented since there are plans of retirement that
only go to spouses if the member passes away.
And then the government, ObamaCare, took over in 2009 on the promise of greatly reduced healthcare insurance costs for everyone. And what did we get with ObamaCare? We got higher healthcare insurance costs, higher prescription prices and higher healthcare prices. This is the fault of voters who voted for ObamaCare….twice.
Oh you are so right! Have MUCH to say about THAT/HIM! Don’t get me started on politics or the blog would end up being shut down! ha!
You aren’t alone in your disgust. I’m glad I’m old, but sorry for our kids who will continue living the nightmare he has created
You can’t blame the voters about Obama Care.. It was passed by politations that were not able to read it before it was passed. Nancy said pass it and then we will read it. Just another thing that was forced upon us. I was not aware of the monthly fee being charged to us. I often wondered how One Exchange made their money. It was not clear to me what would be reimbursed and how. What happens when the funds dry up? What happens to my wife after I am gone? When I singed up years ago I was under the impression that my wife would be taken care of. I too have questions, but some times it is hard to get to a live person to talk to. I guess I will have to wait till December so I can make changes to my coverage.
You can’t blame the voters about Obama Care.. It was passed by politations that were not able to read it before it was passed. Nancy said pass it and then we will read it.
Ken, those who voted for Obama in 2008 and 2012 are directly responsible for the healthcare disaster we are now experiencing. The Democrats promised free healthcare for the poor and greatly reduced costs for the rest of us. NONE of those promises came true.
I am so sick of hearing from all these witless republicans that everytjhing–EVERYTHING–is the fault of OBAMACARE ! Perhaps OPERS wouldn’t have needed to throw the retirees health care overboard, if George hadn’t wrecked the economy..
The Affordable Care Act (Obama Care) did not promise healthcare for everyone. The act created state based marketplaces for insurance for citizens that did not have health care insurance. People eligible for medicare have health care insurance and are not effected by the Affordable Care Act (https://www.medicare.gov/about-us/affordable-care-act/medicare-and-the-marketplace.html). The medicare supplemental insurance market was complicated before President Obama became president.
Ed.
Unfortunately, President Obama PROMISED that with ObamaCare the average reduction in healthcare insurance premiums for everyone would be over $2,000! Moreover, average family premiums for workplace coverage didn’t decline by $2,500, but increased nearly $3,800 from 2010 to 2015 — a burden split between families and employers. And the many ObamaCare State Co-Ops that have failed have left hundreds of thousands of families without their insurance.
According to that promise we should have free Medigap insurance premiums by now.
OPERS even lobbied Washington to stop the ObamaCare ‘Cadillac Tax’ that that would affect retirees under the age of 65. Since ObamaCare needs to tax OPERS healthcare plans to help fund healthcare insurance subsidies for low income people, how does OPERS feel that the lost Cadillac tax money can be made up to fund ObamaCare subsidies? OPERS doesn’t care where the needed money for ObamaCare will come from now right?
OPERS admits that healthcare costs have skyrocketed since ObamaCare was implemented. ObamaCare affects our Medigap insurance plans and Medicare insurance.
And now United Healthcare, the most popular Medigap insurer used by OPERS Medicare retirees is in trouble because of ObamaCare. Here is a newspaper clipping from April 9, 2016 in the Cleveland Plain Dealer:
“UnitedHealth Group Inc., the largest U.S. health insurer, has decided to call it quits in two state Obamacare markets, in the latest challenge to President Barack Obama’s health care overhaul. The insurer won’t sell plans for next year in Georgia and Arkansas, according to state insurance regulators. Tyler Mason, a UnitedHealth spokesman, confirmed the exits and declined to say whether the company would drop out of additional states. Many insurers have found it difficult to turn a profit in the new markets created by the Affordable Care Act, where individuals turned out to be more costly to care for than the companies expected.”
ObamaCare affects everyone who uses Medicare, Medicaid, Medigap and Advantage insurance plans because ObamaCare has it’s hands almost every aspect of healthcare now.
We have been dropped, added back, and left in a state of confusion, to muddy up the process, we moved, our bank changed ownership thus the routing codes changed so we now get mail at two locations even though every time we contact customer service we are told the correct address is in the system, the amounts have not remained the same for two months in a row and the reimbursement has yet to be the same nor has the part “B” amount been consistent . We expected a mess and were not let down, now how long is it going to be before all of this is resolved without us getting screwed.
Many of these posts criticize OPERS, OneExchange, etc. I instead, appreciate and commend OPERS..
I didn’t want to go through the change either, as it was so easy before.
Vision & Dental – yes or no. Medical high, medium or low plan.
Very simple to choose. Now, all kinds of decisions. Bummer.
But I went to some seminars and read the information and survived the experience.
BTW I’m 71 in a few weeks.
OPERS stated many, many times, MEDICAL INSURANCE IS NOT GUARANTEED !
But OPERS offers it because they are managing funds quite well.
Even with the the economy downturn and the investment loss mentioned in a post.
How did your portfolio do ?
The OneExchange fee was mentioned before, it’s not new.
And remember the extra $300 OPERS initially deposited?
That covers over 10 years of the fee, so you aren’t really directly paying it.
Yes, $4m is a lot of money but OneExchange needs revenue to pay staff.
Most people don’t work for free.
In my opinion, groups to slam should be:
Politicians: To keep their hands off OPERS money.
Insurance companies: For driving costs up to skim the cream.
And a few others, on other subjects.
Don’t forget to ‘slam’ ObamaCare!
We were PROMISED lower insurance costs, lower prescription costs and lower healthcare costs in 2009! We got NONE of those promises.
Very well said, Bob!
I totally agree with Bob Neeper. I am grateful to OPERS for attempting to keep post retirement medical insurance available to all of us. I did as Bob did, and studied all the information sent to us as well as attending seminars when I could get registered for them. One Exchange was not all as ‘billed’ in that the employees are not well-trained, giving out erroneous information. But I do not blame OPERS for the short-comings of this exchange. I’m hoping that One Exchange stands by their promise to improve, that they have ‘heard’ us and are working to improve service. In addition, I was given erroneous information by one of the insurance companies, that they would NOT be forwarding proof of premium payment, and this lead to problems of overpayment to me. I corrected this in one instance by sending a check to One Exchage as instructed, but that caused so many additional problems with One Exchange that I’m reluctant to try to correct other errors. Maybe next year, we’ll get it right. The fee One Exchange is deducting is not out of pocket money, but from our allowance granted by OPERS. Thank you, OPERS…and please get your act together, One Exchange!
Bob, you say you go to seminars and learn about the changes etc. Congratulations, I’m glad you have no health issues that prevent you from doing that. You seem well spoken and mentally sharp, again, congratulations.
Consider this, everyone isn’t as fortunate as you. At a time of life when we are less able to deal with complicated and diverse options we are saddled with them. The choices used to be simple and not at all worrisome. I wish it were still that way for the sake of we who have physical problems that are confining and are less cognitively able to deal with these critical matters. It seems that OPERS never considered these points.
WELL…I certainly have found out I’m not alone in my anger, frustration, disappointment, amazement at the whole One Connection debacle! I, too, don’t recall reading/hearing a thing about fees and now we are supposed to be impressed that they waived the first few months that they “forgot” to collect? REALLY? Holy moley! How dumb do they think we are?
Without going into the details because I’m very sick of repeating them, I want to share with the others how i was FINALLY able to get reimbursed for my husband’s Medicare premiums…well, at least it looks like we will be reimbursed monthly–who knows? The recurring reimbursement was denied because OC said they could not accept the benefit letter we submitted because even though it was dated January 2016, in the body of the letter it only referred to “beginning December 2014…” then gave his benefits. They had the audacity to tell me that I had to tell Social Security to write a more current letter! Finally, I searched online for a name of a CEO from OneConnection (and in so doing stumbled upon a Better Business Bureau site with 66 complaints against OC) in New York City. There are dozens of offices worldwide–I picked and address. Then I wrote out a detailed account of the craziness I had encountered with copies of all documents. My husband was going to mail it the next day. He forgot. Being in a good mood I called OC one last time and in a very calm, determined voice I told them that the letter was written and stamped and would have been mailed had my husband not forgotten it, and that a copy was going to OPERS. I said if the denial was not reversed in 3 days, I was mailing it. WELLL…guess what? The supervisor I spoke to assured me it would be paid and added, “Social Security did NOT update their benefit letters in 2015 and we have been told to accept letters, like yours referring to 2014”. I then very calmly told her this was the 5th time I had been told my documentation was acceptable and 4 other times, the denial arrived 3 days later. I said I did not believe her, but that SHE could TRUST ME–I would mail the letter to the CEO if I received one more denial. Two days later the money was in my account!!
BUT…I intend to request that I can go before the OPERS Board in May (I have eye surgery in April) and at that time I WILL take the information to the OPERS Board in person because you need to protect people who are not as able to fight the system as I am.
So, now we are supposed to be impressed that 3 months of fees have been waived. Now we get to pay $2.33 a month while they hold onto our money by denying legitimate reimbursements and collec the interest??? This is shameful.
OneExchange does not hold the money, PERS does. Listen to the video.
OneExchange does not have your money, they only handle electronic transfer of funds from PERS. PERS is earning interest on our funds.
Tom,
These funds belong to OPERS until your premiums are reimbursed.
–Ohio PERS
How does it save OPERS from taxes, specifically the Cadillac tax, if it maintains the funds for our healthcare? Thought that was part of the reason behind all of these changes?
BJ,
If we offer a plan that has a value above the threshold that’s set in the ACA, we have to pay a tax.
–Ohio PERS
Just to follow-up . . . I had the same problem with the Social Security (SS) letter not being accepted and my claim for my Medicare Part B reimbursement denied. In addition, I never received notification the claim was denied — I discovered it on my own via my online OneExchange (OE) account. I, too, was told by the OE “customer service” rep to contact SS to issue me a correct letter. The problem is/was: since there was no SS Cost of Living Allowance (COLA) increase for 2016, the letter sent in December 2015 (for 2016) stated the monthly benefit amount set in December 2014 (that was applicable for 2015) would remain in 2016. In addition, the letter (applicable for 2016) stated, “The benefit amount shown is current as of the date of this letter.” I wrote a very detailed letter to Marianne Steger, copied Karen Carraher (OPERS Executive Director), three OPERS Board members and the CEO of Willis Towers Watson (the parent company of OE). As a result of my letter a Willis Towers Watson Senior Client Support Specialist contacted me and personally followed the progress of my claim, which I was asked to resubmit. The issue was eventually resolved, and just today I received a letter of response from Marianne Steger acknowledging my concerns, noting the actions taken to resolve my problems, and listing details of the corrective results I received. I very much appreciate her personal response, especially in light of all with which she must be dealing to resolve the problems folks are experiencing with this OneExchange conversion. Minus this singular problem I am, so far, very pleased with this change to my OPERS health benefits. The HRA amount is very generous and I appreciate the opportunity to have more control over the choice of insurance plan, along with the premium price and the benefits I will receive. But, I’m a Type A, so that’s most likely why. I also must say I was employed by an Ohio state college; one of the benefits was a tuition-free education for myself and for my dependents. What a wonderful, tax-free benefit the State of Ohio provided for me and my children. In addition, due to my college education, I was able to advance my employment position to one private college and then to a public college system in another state. Neither of these systems provided post-retirement health benefits to their employees. As for the $2.33 monthly fee — OPERS is providing each retiree the funds to pay this fee! Most of the complaints stated here pale in comparison, on any level, with what folks are experiencing with Obamacare!!! AND, have you read what’s happening to the Teamsters retirees — the percentage pension reductions they are about to receive???
Mary,
We’re sorry that you didn’t read the information about the fee. It appeared in the following OPERS publications last year:
* Understanding the Basics: Medicare and the OPERS Medicare Connector
* The 2016 Open Enrollment Bulletin
* The 2016 Coverage Guide — this is our main health care document of the year.
I’ve also discussed it in blog commentary.
–Ohio PERS
I really, am not upset about the fee being charged, even though I find it odd that I and so many others have no recollection of it being mentioned. What upsets me is to be charged a fee for horrible, rude, possibly illegal service. THAT;s what really irks me. I want to know why I was told I could not keep the same policy I had with Anthem in 2015 even though it was an option. Why was I told I could not keep it?
Could it be that One Connection would not collect first year commissions if we kept our previously issued policies?
Mary,
It’s illegal to keep the same policy while receiving your allowance without going through the Connector. It’s a process called “churning,” and it’s not allowed.
–Ohio PERS
Michael,
Hate to beat a dead horse, but I’ve looked through the material that I’ve received from OPERS, as has my wife who is also an OPERS retiree, and have been unable to find “Understanding the Basics: Medicare and the OPERS Connector” or “The 2016 Coverage Guide.” Were these sent to all OPERS retirees? Were they tucked into an issue of OPERS News like the “2016 Open Enrollment Bulletin” was?
Michael,
The fee was mentioned in these publications. The bulletin was sent to all retirees. The others are posted on our website.
* Understanding the Basics: Medicare and the OPERS Medicare Connector
* The 2016 Open Enrollment Bulletin
* The 2016 Coverage Guide — this is our main health care document of the year.
–Ohio PERS
Michael,
I hope OPERS realizes the issues such online postings raise for those retirees who are technologically challenged and still live in a paper-based world. (I’ve got a feeling that there might be a few of us.)
I have a question? WHY was I not allowed to keep the Anthem coverage that I had purchased on my own when a similar product (probably the same one) WAS offered by One Connection. When I requested to stay with Anthem, I was told it was not legal–it was called “churning”. I’ve since investigated this (I was a paralegal and know how to research terms). I found out this is not true.
Could it be that if I didn’t change insurance companies, One Connection would lose out on getting their commission for “selling” me the new policy? Tell me, OPERS–is that legal?
I don’t believe that! All you have to do is call the individual company you chose and ask them (as a new customer) how much your premium will be. I found this out when I called, but AFTER I chose a plan. The amount quoted me was $24/ FEWER per month than it was getting it through One Exchange! So they ARE skimming that extra off the top because we picked a plan through them. That’s a crime!
I am sure One Exchange receives a healthy reimbursement from the State of Ohio for Administering this Healthcare Reimbursement system. Why didn’t they include the $2.33 fee amount in their Request For Proposal instead of putting the fee on the Retirees? Also, I am sure this fee will continue to increase year after year. As someone else stated, we did not ask for this new system, it was thrown upon us and now we have to suffer the consequences of Incompetence, which always comes with Privatization. As always, the rich get richer and the working class and lower middle class, who carry this country, get shafted
I would fault ObamaCare for increasing our insurance costs, prescription costs and healthcare costs even though Obama promised in 2008 that all those costs would be GREATLY reduced if we voted for him.
Tom, I’m tired of hearing you bash Obama Care. We are talking about One Exchange here, not Obama Care.
Hooray for those few who have had good luck with One Exchange and can’t believe how some are venting their frustrations. All I can say is count your lucky stars, and I wouldn’t criticize those who are venting. Your good fortune may end, and you could be next to have issues with One Exchange! Support each other — currently, OPERS isn’t doing such a great job doing so.
Thank you, Patricia. When oh when are people going to quit blaming Obama for everything????
Yes, Tom, please give your Obamacare rant a rest and stick to the subject at hand.
I agree with Tom. Had obamacare not been enacted, should say, forced on people, I don’t think OPERS would’ve had to make the decision to have retirees purchase their own health care plan. I, for one, am glad they didn’t just dump us and make us fend for ourselves. They are even making it easier on us by the HRA. Be grateful for what you have and count your blessings.
Bibliogirl,
OneExchange is not paid by Ohio for administering the Connector. OneExchange receives commissions from insurers, although this commission structure is not shared with the advisors who work with customers. Further, OPERS actually pays the $2.33 monthly fee. We made sure that the allowance we provide to Connector participants included the $2.33 fee.
–Ohio PERS
I understood that there would have to be a substantial increase in medical premiums for retirees but the increase in paperwork is overwhelming. Prior to 2016 the medical, dental, vision premiums were just deducted each month from our pension. I just had one entry in my bank account to track. There was a max of $150 (I think that was the amount) for the year entered into my Retiree Medical Account. I sent in the premium for my LTC and got back $150. Life was manageable. Now, although I am grateful for the HRA allowance, the paperwork is overwhelming. I have to track numerous entries each month in and out of my HRA, in and out of my bank account, and keep sending in requests for various claims. PERS should be ashamed that they have placed this burden on elderly retirees many with no computers, copiers, etc. I can also agree with the many comments about One Exchange. Service is terrible – long waits and then bad/incorrect answers.
Keep in mind that after 2018 we get ZERO money deposited into our RMA accounts.
Considering that healthcare, prescription and insurance costs are continuing to increase every year, despite the Affordable Care Act of 2009, I would keep as much money as possible in your HRA account so it lasts as long as possible. Huge federal government programs, like the Affordable Care Act of 2009, always seem to hurt the people they say they are trying to help.
Retirees continue to get money put into their HRA’s monthly. The spouses will not starting in 2018 but any excess from the retirees account can be used for the spouse.
After 2018 we get nothing? Where did I miss that one? Same place I missed the administrative fee?
I agree with the woman who commented on You Tube after the presentation for April…..I would rather get this information in print because then I could read it and digest it in a minute or so. It would be there for me to look at later if I had a question pop into my head in the middle of the night (-:
I would much prefer this — as she stated so aptly — than listen to an 11 minute presentation digging for some kernel of information.
So — after 2018 — nothing?????
I thought they were going to look at health care costs and make adjustments in our allowances. Probably not going to give us a raise, but to give less…I didn’t think it was all going away.
Thank you for the head’s up!
BTW — my suggestion for One Exchange is to get a telephone system whereby we get a call back — IN A SPECIFIED AMOUNT OF TIME LIKE OPERS AND CINCINNATI BELL GIVES — not like the call back on Turbo Tax which just says you will be called back…..maybe this week, maybe next, maybe never….. (-:
Why isn’t this being addressed?
Several times I have suggested it. OPERS always says it is a good idea.
Only the spousal part of the HRA will phase out in 2018.
Mary Ann Steger mentions in a very recent video a “coupon” as a documentation source for Medicare Part B Reimbursement from OneExcange. Since my wife and I are having a terrible time getting straight answers from OneExchange on what constitutes Medicare premiums payment documentation, we called OPERS today. The OPERS rep. had no idea what was the “coupon” mentioned in the video. He switched us to a OneExchange rep. who, also, had no idea what a coupon was for documentation purposes. We wasted over an hour getting frustrated all over again and never making any progress.
The coupon Ms. Stegner referred to is actually the monthly/quarterly statement Medicare sends out. You will use a recurring reimbursement form ONE Time for the amount e.g. $89.99 after I deducted the amount Opers reimbursed monthly.
Make sure to put Jan 1, 2016 to Dec. 30, 2016 in the date column. Include copy of your bank statement or receipt to show you paid the amount due. This covers the whole year…no more paper work for Medicare reimbursements. One exchange will reimburse you monthly.
Next year, you will need to complete a new recurring reimbursement form with January 2017 statement and copy of receipt.
I hope this helps.
I have never received a monthly statement from Medicare indicating that I paid a premium. I know that my monthly amount was reduced but I did not receive anything indicating what my actual monthly payment is. Do I need to go to my local Social Security office to obtain this?
Rose: Did they approve and accept this for recurring for the year 2016?
My interactions with One Exchange have been infuriating and disgusting. You battle through a myriad of prompts and if you get an operator they are reading from a script. I have asked for a supervisor and they refuse the request. They blame the other providers and always say if will take a month or two. At this point, I am investigating calling an investigative unit on this company. I’m sure other have the same problem in this chess game. Wish we had an alternative to this sloppy company with awful customer service.
I retired with PERS , but having less than 10 years service, I was not eligible
for any health benefits through PERS. After reading about all the problems
with the PERS/ Connector, I’m glad not to have this frustration.
I’m the opers retiree and my wife will be going on medicare beginning July 1, 2016. Regarding getting my wife’s on-line profile set up with One Exchange I have some questions.
Does my wife need to set up her own individual account, including her own “Username & password”, with One Exchange in order to fill out her personal profile information? If not, does she fill in her profile through my account, and how do we start this? If both my wife’s profile & mine are on the same account how do we know which person’s medicare information we are viewing when we log in?
I’ve already submitted to OPERS proof of my wife’s eligibility for parts “A & B” with medicare and I believe the next step will be for my wife to complete her personal on-line profile on One Exchange’s website.
Thank you for your assistance.
Greg
Greg,
Your wife does not set up an individual account. The reimbursement of any of her costs will go through your HRA account. She can, however, set up a profile through your account. Go to
Greg,
Your wife’s reimbursements will occur through your account. She does not set up her own HRA, although you can enter her profile in your account.
–Ohio PERS
update! just got a call from TW Representative cause she read my blog above, wanted to know if she could help, then proceeded to give me the same BS I had gotten before, no solutions, but said I did have a reimbursement to my account today ( April fools day ) course went and looked, guess what
not there, It’s past 3PM eastern time, no business day till Monday. HA HA pretty funny joke on an old man for April fools day, Looks like we are all fools for believing OPERS
If OneExchange could be reached by email or phone without long waits on hold, gave correct answers to questions, and handle problems efficiently, a management fee of $2.33 monthly would be a bargain, but none of those things are true. Because of their poor performance it is time consuming for their representatives and for OPERS retirees who must deal with them. Watch those fees escalate next year!
I was on the phone 47 minutes today trying to correct a problem related to Medicare premium reimbursement which I thought had been resolved Mar. 14th. It occurred because I submitted my Medicare B premium for automatic reimbursement in Jan., was billed for Medicare D in Feb. with no information except the amount, filed a claim for the additional amount to be added to my monthly reimbursement, was billed in Mar. for a different amount for Medicare D and realized the previous bill intended to recoup the previously unpaid Medicare D. I could find no way that I could correct my “reimbursement history” to stop payment of the incorrect amount and file a claim for the correct recurring amount. I called Mar. 14 and spent nearly an hour with a OneExchange “expert” who eventually appeared to understand the problem and said she would stop payment on the Medicare D amount and for me to wait a week and file a claim for the new correct amount. I did that, and yesterday was informed that my April payment included BOTH Medicare D premium claims. The representative I spoke with today was able to access the notes of the person I spoke with Mar. 14 but did not know why the reimbursement department did not make the correction. She promised to follow up and get back to me in a week. Now that I have received double reimbursement for Medicare D I seem to have their attention. There are clearly internal issues at OneExchange between phone representatives and the reimbursement staff. When we are forced to deal with OneExchange by phone we have no written record. I am careful to note what time I called and who I spoke with but I always have to start over at the beginning to describe my problems. I am 81 years old but I am computer literate and could deal more efficiently by email, but was told this is not allowed because of “security.” This seems very odd to a person who has paid bills online from a checking account for several years and deposits checks with my cell phone.
If OPERS would allow me direct access to my HRA, I would happily document expenditures monthly to anyone you designate without a management charge! Dealing with OneExchange is like trying to type while wearing mittens!
When my husband retired in 1988 he was told he would get free insurance during his retirement. Why didn’t OPERS just give the money to each person to pay for their own insurance? Most people are responsible enough to keep insurance. When they stop paying will my husband still have to deal with One Exchange or directly with the insurance co? How will that work? One exchange’s accounting is off, no matter how I count the money it is always different than what they have. The paperwork is to much. Simple plan. Doctors file claim for service insurance pays, you pay co-pay out of your account.
I too, was suprized to learn about the monthly $2.33 monthly One Exchange administration fee. Also all the paperwork retirees receive from One Exchange adds to the expense of the program. This program has proven to be so much more complicated than needed. I very much appreciate the health insurance that retirees have had under OPERS and certainly missed the former system
Overall, interaction with One Exchange has been positive with one exception: trying to get reimbursement for my spouse’s insurance premium for January because automatic reimbursement was not turned on for him although we were assured that it had been. We are on the third set of papers to be sent to them. I have empathy for those who do not have someone to help them through this process. It can be overwhelming. I hope that with time it will become easier for all although by then it will be time to decide on our options for 2017. I, too, missed the information about the administrative fee.
I have/continue to experience many of the same problems others have relayed here. The problems seem to be at One Exchange and their lack of appropriate training, and a lack of consistency with no accountability. I call, go through repeating my problems over and over again, get calls dropped, transferred and then given direction which I follow only to find out that what I was told was inaccurate which caused denials do reimbursement.
Right now, I am trying to get my husband’s health care premium reimbursed (at least I think it is my husband’s premium) as I was told that since our premiums are the same amount, they can’t distinguish which one has not been paid for March. What I believe now is the problem is that we signed up for auto reimbursement but when my premium was reimbursed the first month and my husband’s was not, I called One Exchange on 1/29/16 and they said that auto reimbursement works for the retiree but not the spouse so was directed to fill out a recurring reimbursement form for my spouse which I did and I thought all was well because reimbursements were received for Jan and Feb but then not in March. I called three times in Mar to find out why and at first was told it was for my premium and they had not received notice yet from the carrier that I paid, the second time, they said they received the notice and it would take 6 – 8 bus. days to process and finally, on the third call, was told that they denied it because I had signed husband up for auto reimbursement and recurring reimbursement and it was considered a duplicate and so they denied paying at all. When I explained that was what they had told me to do in January, they said that was wrong information and they could not fix problem. I now have to resend the recurring reimbursement form and ask to cancel and then submit a reimbursement request for the denied premium…..it is all so confusing, but for the retiree to have to undue and try to fix problems caused by their inexperienced, untrained staff is wrong. I am not at all confident that my problem is being addressed. I have been receiving other denials in amounts I do not understand as they are not for anything I submitted and the last rep I asked about it, did not know either!!!
Whole process has been confusing and frustrating.
My view of OneExchange. OneExchange was low bidder on this change over. Once they received the contract, they hired a group of inexperienced people, but did not adequately train them. Phone calls usually last an hour or more, individual account information is not always available or the agent cannot access all of the information in your account. A question usually results in a hold, so the agent can ask someone else the answer to the question. Then if you ask a follow-up question, you again go on hold and wait and wait and wait. The problem may or may not be solved. OPERS must apply pressure on OneExchange’s management to correct this problem.
After viewing the video re: the status of the transition I find I’m less than confident that all my reimbursements are set up correctly. I’m particularly unsure about the Vision and Dental premiums, but I’m also unsecure regarding the Part B premium reimburse “annual” requests being in place. I do receive a monthly SS benefit that covers the premium, but I want to be confident that I’m receiving what I am due. I’m also very unclear about the status of the medical expenses spending account, how to check its balance, abd how to submit recipes for payment. This was quite clear with the previous account from Aetna, but not clear to me under the bew regime.
I too was not aware of any administrative fee that was going to be charged. I have not had a good experience at any time dealing with Tower Watson employees. I have cancelled my call when I can’t understand the person on the line and numerous times I have gotten different answers on the same issues. I feel the complete program has not been user friendly and feel sorry for the elder retirees who do not have assistance. Just today I was checking why our prescription payment which is deducted from social security had not been paid for March. I was told it can take several months to get reimbursed. I was then reviewing my bank account and noticed that my premium was reimbursed 3/18/16 but the customer service agent had no idea as the website did not even indicate that it had been paid. What’s up with that. Isn’t the site updated daily. Whoever sold the OPERS board this program did one heck of a selling job. Maybe the board should have researched a little better.
I have experienced none of the frustration or negativity with One Exchange or OPERS. After sending the necessary paperwork to One Exchange, every month the reimbursement for health insurance premiums, prescription drug premiums and Medicare premiums are in my bank account. I am thankful that OPERS provides us with a health reimbursement account. Very few retirees from other companies receive any reimbursement for health care premiums or are provided with health insurance.
People get over it, the old way is gone. I have filed 3 reimbursements and was paid back in 2 days.
$30 bucks a year will not bankrupt anyone. Ask your friends who pay hundreds a month for Insurance. Good job PERS & One Source
Just wondering, what was paid to whom on this deal–did OPERS pay OneExchange to take all of us (pensioners), or did One Exchange solicit and pay OPERS?
My dealings with One Exchange have been a nightmare. When I retired, it was a pleasure to deal with OPERS–straight, accurate information and in a very prompt fashion.
Barbara,
OneExchange receives commissions from insurance carriers, but the licensed benefit advisors are unaware of the commission structure. So they have no incentive to steer participants to any one product.
–Ohio PERS
I am not happy with One Exchange. After 2-3 hours, I thought all was worked out with choosing what plan I took along with my prescription. I have been mislead on what my prescription co-pays would be for some of my meds, I do not see reimbursement for the money I have taken out for prescription drugs out of my stipend, and I still have not rec’d answer to how I can receive part of my $104 they take out of my SS check each month. This is April 5th. What happened to the money we had to pay in December for our plans. I don’t see where we are reimbursed for the entire 12 months, saying it takes time to start, but I am keeping watch to see if I am reimbursed for 12 months for what I am being charged for supplemental insurance and prescription automatically taken out of my checking account. Easy to see as my bank keeps records of each month’s statements. Now come January 2017, let me look back and figure in the amount they took out December 2015 through December 2016, to see if full reimbursement was rec’d for both!
Sandra,
This document on the OneExchange/OPERS website explains how to be reimbursed for your Medicare Part B premiums.
–Ohio PERS
Regardless of what is said in this video, as of 4/1, One Exchange still insists that I submit my Medicare Part B premium and payment each and every month. They will NOT consider this a recurring payment for reimbursement.
I submitted other one-time claims for other medical services in early March. One Exchange suggested I continue to wait for these reimbursements for another “week or two” since they are so far behind. However, they cannot even tell me if they’ve received them.
I need help.There have been several issues that started from the beginning of sign up till know.
I have dealt with individuals that were totally incompetent,they have no business at all working on a project that means so much to our members.
Your keep making these video tilling the members that things are getting better, and for me that is absolutely not true.
Here are my problems :
1) I processed all of the correct paperwork that’s needed for my wife’s monthly medicare payments. From January 1st till the present time.
2) I processed all of the correct paperwork that’s needed for both my wife’s and myself Dental and Vision reimbursement.From January 1st till the present.
3) I also processed the billing for my medicare payment of $ 69.00 monthly. From January 1st till the present time.
4) My wife and I relied on( we thought there professionalism )these individuals who work for this company
About the type of insurance would be better for us,but as of right know,it’s not.
5) I have talked to supervisors that have told me that they were going to work on thease issues and that they would get back to me,but they all totally lied. I’ve had to really push a supervisor to help me get reimbursement for my medicare payments of $104.80.
I would like to have someone who actually knows what there doing contact me at ASAP.
So we can get these issues resolved.
Please contact me by email.
jrocco1952@yahoo.com
Joseph R.Marchi
Joe — an OPERS healthcare staff member will contact you.
– Ohio PERS
I had been paying double for my vision and dental without realizing it till I got my letter from OPERS with my new pension payment in March, at which time I was told that I should’ve cancelled it from OPERS when I picked my new policy. I thought the person at OE should’ve told me to do that, but didn’t. Geesh, I’m 82 and didn’t realize it. I finally got that straightened out, but am out $115 of over payment for three months. The reason I didn’t realize this was because my retirement date was March 1st and that was when I got my letter stating my new pension amount. I guess I should count my blessings that it was taken care of by the cancelling the OPERS part but I sure could’ve used the $115. Oh well, we live and learn.
one exchange is the worst company I HAVE EVER TRIED to get correct answers from. WAIT WAIT ON HOLD, Different answers from operators. They were not ready for this job Who ever hired this company should be FIRED YEA FIRED .
Luckily I am a healthy person and don’t have to visit health care providers except for a yearly checkup therefore I don’t need to send in claim forms. I was going to wait for several months to send in for SS Part B reimbursement but with others comments, I think I better start now.
I signed up for auto reimbursement for healthcare and prescription. Automatic reimbursement to me means that once the premium is withdrawn then a reimbursement is issued. I have no problem getting the reimbursement for the healthcare premium which normally comes within 4-5 days but the prescription doesn’t happen for 2-3 weeks. I called One Exchange and they told me that the carrier needs to inform them that they have received the payment. I don’t understand why it takes 2-3 weeks for this when I’m sure this is all done electronically by a file which needs to be downloaded on the One Exchange end. I don’t accept the answer I got from One Exchange and was hoping it would get better but it seems like it’s getting worse. I keep track of when the premium is deducted out of my bank and watch each day for the reimburse.
After being surprised for our Medical Mutual premium reimbursement in January (for January), we have not received another reimbursement for that premium. We were told, when we contacted One Exchange that we could expect both February and March’s auto reimbursement around the 17th of March. Now, it is April 1 & still no catch-up funds received…and we will be due April’s premium, too.
Anyone else have this problem?
Since January I have requested 6 times for the forms for Reimbursement, everytime its a long process of waits and getting passed around, Ive gotten nothing but excuses and more excuses and empty promises they would be mailed out ! Even the quality control people dont follow up, its gets old hearing they are sorry they are not up to their high standards. Its apparent they are not up to the job and OPERS should terminaye the contract.
Marc,
You can find a variety of forms on the OneExchange/OPERS website.
–Ohio PERS
I am behind one month’s reimbursement towards my pharmacy account. I received reimbursements in Feb. and March but not in January. Is it correct that OPERS will not be putting money in our RMA as of 2018? If this is true, how are we going to survive?I agree that it takes a long wait to get questions answered by One Exchange and some times after waiting you are disconnected and have to start all over. This is very frustrated.
I have been trying to get reimbursed for Medicare too. 3 times was told mine should not have been denied and sent to be reviewed. It is still denied. I have called at least 15 times to be told something different each time. They want verif I can’t get. I give up. I will just continue paying my own premium as I have been doing. They want us to jump through hoops to get what is ours. I am too old for hoops.
I don’t understand a thing going on about fees. This is the first time I saw anything about a fee.
I am now paying out of pocket for my prescriptions that I will soon have to stop taking medication. I am a diabetic and the cost of my high blood pressure and insulin has taken to much of my income to continue.
I worked for 41 years under PERS I am 76 and working at two part time jobs to live. I was told by one person at silverscripts to send in my receipts of purchase of medication. Then I was told by another person not to send in receipts because we have record of what you are purchasing. You send Smart Reports and I don’t understand anything about all these payments, etc. I never in my 16 years of retirement have I ever been so confused. It is sad to think you reach a time in your life to have this confusion when you have worked and should have a peace of mind in your old age.
Dorothy,
Here are a few places that we told Connector participants about the administrative fee:
* Understanding the Basics: Medicare and the OPERS Medicare Connector
* The 2016 Open Enrollment Bulletin
* The 2016 Coverage Guide — this is our main health care document of the year.
I’ve also discussed it in blog commentary.
–Ohio PERS
When I signed up last year, I was told that each month an amount would be taken out of my checking account to pay for my Medicare Supplement premium. So far the money is being taken out of my account, but I have not had ONE reimbursement. This will the fourth month, which adds up to approximately $800.00. I have called One Exchange at least six times, and I have been told everything from the appropriate supporting documents were not with my records to “your check is in the mail” I resent the documentation, but still nothing. The last time I spoke to a customer Service rep, I was told that the section that handled my issue couldn’t be reached by the person that I was talking to. Everytime I called I was assured that It wouldn’t take long for me to be reimbursed. It’s April now, and i have an overdraft in my checking account. The documentation was faxed, but no one notified me to let me know that they had not received it. Am I the only one with this problem? I have also run out of patience pills.
I would gladly pay give the $2.33 to OPERS monthly to reinstate our old system that worked very well. I’ve heard from employees of other government agencies that tried One Exchange and only stuck with them a year because they ended up in such a mess, which resulted in costing the system more money.
One exchange connector was unnecessary. Reps were and are not helpful , make sure you have half a day to stay on phone to talk to several people , some are rude , you are lucky to get answer to your questions . Choosing healthcare was not a rocket science project . As a matter of fact reps were least helpful , trying to push cheapest HMO and prescription plans .
Is it too hard to manage our own accounts that we need connector to send us statements of with drawl/deposit of premiums .
Now , there is a monthly fee . One exchange is so charitable to waive 3 months fee.
From all of the negative comments I am dreading going on the exchange in 2018 when I turn 65. I called OPERS to see if I should get on one of the webinars this year because I can’t get to the seminars in person because they are the days I work (yes, I work even though retired from the State) in order to maintain expenses. The customer service representative said I could wait until 2017 to get to a webinar or seminar as things may change by then. I also asked him about whether I am correct that I would get a stipend to help pay for my wife’s insurance once I lose PERS health insurance because she is a spouse and will have no insurance once we lose the plan. He said there is nothing for her and she would have to go on insurance with no stipend. She will be totally off any insurance as of January, 2018 but I can remain on what I now have until I turn 65 in May, 2018. I’m just checking if this is correct.
With the amount of misinformation I am seeing on the comments I’m not sure which customer service representative I can believe.
Fact: In many cases, the reimbursement system is unnecessarily complicated, frustrating, and time consuming.
Serious suggestion: Give directly to each retiree the money that would be held in their HRA. Let each of us manage our own expenses. True, we would have to pay tax on it, but I would gladly pay a little to avoid all the existing complications.
I look forward to OPERS’ and my fellow retirees’ reaction to this suggestion.
I agree that we should receive an amount to be used for medical expenses either as a lump sum at the beginning of the year or so much per month. The medicare.gov web site has a program to evaluate various insurance offerings very much like the one we used on One Exchange. It would seem to me that such a program would make life a lot simpler for the retired person and for OPERS.
I definitely do not want to pay taxes on my HRA money. It would eat up a good part of the HRA, and obviously make the HRA I can use much smaller. I am grateful that OPERS chose to do it this way to save us from having to pay taxes on the HRA money. Way to go, OPERS!
I don’t get all of the fuss over a small reasonable fee to cover business overhead. So far I have gotten prompt reimbursements. I make copies of credit card receipts and canceled checks; bills from providers; insurance account details; OPERS allowances and deductions; Social security part B deduction and use a highlighter on the recoverable amounts. I also include a summary of the individual claim amounts for myself or my wife with the date of service and provider or the month if a recurring deduction. I fill out and sign the HRA claim form and write “see summary” for the claims section. This goes into a manila envelope and mailed to OneExchange. Reimbursement is credited in about a week. I agree with the complaints about not getting satisfactory (or any at all) replies to telephone questions.
Try to get someone at opers to address your problems, we were told call One Exchange. We got a letter stating oops we messed up and didn’t charge you fees, from one exchange, and we wont charge you for the first three months. She sounds like they are being generous, I wonder what opers pays them on top of our administrative fees?? it took three months to get reimbursed for Medical insurance, that amounted to a tidy sum, and opers said they couldn’t help us, call the exchange. As for Medicare, this is the first I knew we could get reimbursement for that.
So we retirees didn’t pay much attention to the fee! WRONG. It was never mentioned. In fact, the October 2015 OneExchange/OPERS letter states: “OneExchange’s services are FREE for you and your eligible spouse”. – So OPERS, you’re washing your hands of your retirees by making them pay for being dumped by you. You should pick up the cost.
Robert,
We told you about the fee in at least the following documents:
* Understanding the Basics: Medicare and the OPERS Medicare Connector
* The 2016 Open Enrollment Bulletin
* The 2016 Coverage Guide — this is our main health care document of the year.
I’ve also discussed it in blog commentary.
–Ohio PERS
Sad I went to the seminar and absolutely no mention of a fee was mentioned. You continue as you have to say bend over and take it, we can do what ever we want. I would no recommend anyone work for the state of Ohio. The promises they made to me when I was hire and when I retired were empty words.
I must be one of the few that WAS informed about the 2.33 fee charge and so far no problems with refunds. However, I do have a suggestion and did also send this suggestion in an email to Marianne Steger. Issue HRA credi/debit cards as some businesses now do. These cards can be loaded automatically the first of the month and when a refund is due. . They can only be used at health care (ie hospitals, doctor office, pharmacy) facilities. No over the counter would be allowed. I am not sure how businesses handle all of this, but it could be checked into and might alleviate some issues, or, cause more. I will leave all of this up to OPERS/ONE EXCHANGE
Sorry, Patty. Reimbursement cards are not available at this time.
— Ohio PERS
I certainly empathize with all of the retirees who have had, as well as I, frustrating experiences with the new Connector. When I retired I had money in three systems, Sers, Pers and Strs. Because I was under Pers the longest, they pay my pension. I have been satisfied for the most part with PERS. At this time I think I understand the process of HRA. Now my only problem is not to submit bills for more money than my monthly allowance. I have large dental bills this year. The $2.33 was taken out for the past three months but the people I spoke with regarding it, never told me what it was. Now I know. I am pleased that I get the small reimbursement amount for my Medicare part B. that is taken from my Soc. Sec. check. Yes. I worked from age of 16, and had 40 qtrs of Soc. Sec. but because I get a pension I don’t get the entire benefit. In addition, Affordable health care is not a bad program. It has helped many people who otherwise would have no health care at all. We are blessed that we get health care through PERS even though when I retired I thought it would be free forever. Count your blessings. I do.
Seems like a lot of complaining over $2.33 a month. Someone
has to pay expenses. Better to share these costs.
First, I want to make it clear that I am convinced that this whole process (discontinuance of group coverage and implementation of Medicare Connector) was put into place with the best of intentions and that everyone who has worked very hard to implement it has had the same “best of intentions” (with which the road to hell is famously paved!) so I am not “complaining”. And I realize that it has been a massive undertaking, etc. However, I think this is the best argument I can think of for a so-called SINGLE PAYER SYSTEM. (I realize that it would very likely have similar, and possibly worse, “problems”). And I appreciate One Exchange’s “philanthropy” in foregoing three months of their fees, to the tune of something of $1 million; this gives a hint of how lucrative this contract must be for them, so I can’t shed too many tears for them. My point is, nevertheless, that to this day, i.e. well into the implementation, I have a very hard time keeping track of what I am receiving in the way of an allowance, how much I am made to pay for Medicare, how much for Prescription Coverage, what my “reimbursement” amounts to–and probably more that I am completely unaware of. (And incidentally, calling the monthly benefit a reimbursement, to the point of labeling it as amount claimed or words to that effect, is just plain incorrect because, in fact, I have not filed a claim. I have also had difficulty in setting up automatic monthly withdrawal of the charges for both coverages. Still don’t know whether it is working or not and have to rely on overdue notices to keep things current. And all this before I have had a single actual claim for a specific health care treatment! The previous system was downright benign by comparison.
When we signed up thru the wonderful connector we were given bum information about coverage, co pays etc by numberous personnel at the connector. this is stressful enough without having to deal with people that lie to us about what our coverage will be like. amazing pers would do this to us. prescription info was bum also, amazing. this program stinks.
the info is in the main text. they were terrible to try and work with to conclude our coverage. then, a lot of the wonderful info they gave us were false. good work pers.
Will this 2.33 fee be deducted from my checking account and then reimbursed like my insurance premiums are ? Or the 2,33 be deducted directly from the HRA account? Or perhaps they will send me a bill in the mail?
The $2.33 fee will be deducted from your HRA account.
Ohio PERS
Thank you. That bit of
information will help keep my checkbook balanced.
we were told @several opers/1xchg seminairs and thru opers mailings that there would be an adm. fee. I 4got this but when I received THE letter, understood what was going on. I enrolled with 1xchg early in Oct 1915 and did not have any problems. I understood that that the fees would come out of my checking acct. and the ins. co. would let 1xchg know that they got paid for that month and THEN I would get reimbursed. I did have problems getting reimbursement started for my husband, then 1xch double pays for two months of health fees for the both of us. I finally had to ask for a supervisor in reimbursement to use the double payments for our Feb. and March fees. It has taken 7 weeks but my account is now up to date and correct. If everyone would keep track of credits and debits on a note pad they may understand all of this better.
When you send in for the reimbursement for your medicare premium you have to show proof how you paid for it.. Not just the coupon. Mine was denied. I had to show my checking account or on my charge card that it was paid. I think this is invasion of privacy. I paid the premium in January and will not get all my money reimbursed until April 1st.
OneExchange has to guard against fraud by PERS retirees; or they will get sued.
I’m surprised. Throughout the conversion to the Medicare Connector, I read all the printed information and watched all of the videos and don’t recall seeing/hearing information regarding the monthly fee.
Seems like it could have been much better communicated.
How often can we expect this fee to change? When and how frequently will this fee increase?
Paul,
We told you about the fee in at least the following documents:
* Understanding the Basics: Medicare and the OPERS Medicare Connector
* The 2016 Open Enrollment Bulletin
* The 2016 Coverage Guide — this is our main health care document of the year.
I’ve also discussed it in blog commentary.
–Ohio PERS
After signing up with OneExchange on Nov. 16, 2015 we have had nothing but problems getting our HRA account set up for reimbursement. On or about Feb. 25th OneExch. Advised OPERS we did not sign up with them for health insurance! We indeed did sign up and we have confirmation numbers for both health insurance and part D coverage. After many hours on the telephone the problem appears to be between Humana and OneExc.as to who is agent of record. Humana does not list OneExc. as the agent of record. We have compiled with OneExc. request to email Humana to change agent of record to OneExc. with no response. We do have insurance with Humana which we are paying out of pocket with no reimbursement since we have signed up. In summary we have no HRA and have lost Medicare reimbursement on my pension check. We desperately help from someone.
If the $2.33 is truly an administrative fee, then I would assume that this fee encompasses the cost for postage and handling of all of the communication that OneExchange sends to us. This would include mailings for EOP, claim denials, claims received, requested forms, etc. Because I do all of my communication with OneExchange via their website, I should not have to pay the full cost for these administrative fees. If the fee was reduced, it may encourage people to use the internet for their communication with OneExchange. This method is probably more efficient for them and therefore should cut down their cost not only in postage but also in stuffing envelopes. Is this something that can be explored by OPERS?
The admin fee was mention in OPERS Health Care, 2016 Open Enrollment Bulletin. Here is the link to that bulletin. https://www.opers.org/pubs-archive/retirees/2015/Q3%20Newsletter%20Insert.pdf (if this does not work for you, copy and paste into your browser). See page 12, upper right column. I too have had issues with OneExchange, but now that the issues have been worked out, everything is working smoothly with reimbursements. This was a huge undertaking for OPERS and I think they did an outstanding job. Remember, health care is NOT a guaranteed benefit. They have worked very hard to assure that the funds that are available are used in the best way possible to provide health care benefits for RETIREES of OPERS as long as possible. We were blessed to have our spouses covered for a long time, but if a spouse did not work for OPERS, this was a gift, not a right. I commend OPERS for the outstanding job they have done. They have provided many, many written communications, videos, etc. What more could you possibly ask for? Take time to read the materials sent. View the videos. There is a ton of information on the OneExchange web site also that provides all the information you need. You just need to take time to learn about your own health care. We were spoon fed for a long time. Now you just have to put some effort into learning about a new way of getting healthcare. The information is readily available. I also found it helpful when I called OneExchange, to ask for another person if I found the first person to not be helpful after 2 or 3 minutes. I was quickly transferred to another staff member. Saved a lot of time and frustration. Thank you OPERS for the outstanding benefits you provide to retirees.
I also did not read from OPERS where OneExchange was charging an adminstration fee of 2.33 per month to administer our HRA account. With OneExchange enrolling over 100,000 retirees, they are getting a very large commission from us! We also had trouble enrolling, as we had to enroll 2 separate times (total of 3 1/2 hours) before OneExchange got it correct! The people they employed were not trained enough to enroll us and could not answer our questions! If they could have answered our questions maybe they wouldn’t have had to call us back to do another enrollment. They told us it was a “computer glitch” when they really had us living in two different counties, thus the reason for two different rates when we took the same exact policy! Hopefully we are all set now!
Like so many others who have expressed troubled feelings about One Exchange I too cannot believe the headache in dealing with them. The coverage we had under OPERS was clean-cut, easy to understand and made life a bit kinder to us seniors. Connect One has put a shameful burden on us with long waits, confusion and no clear answers. I have hearing difficulties & often the persons I speak with are very hard to hear. It makes me feel more upset than before I called.
People should not be ashamed of the company they work for but your employees cannot feel good about their jobs. I pity them when they retire & have to deal with the same garbage.
02/April/2016
Michael Lucas et. al.
.
The 2012 edition titled “Comprehensive Guide to Pension and Health Care Changes”, page 3, paragraph 6, states “You will use your health care allowance amount from OPERS to purchase this plan.” The plan refers to OPERS Medicare Connector.
I was surprised to get the letter this week about the $2.33 monthly fee for our reimbursement account. Knowing myself as a stickler for reading everything I receive about our Health insurance I can only guess that some of my mailings were missing a few pages. We also never heard any mention of it at the seminars. I have even wondered how One Exchange is being paid for their services but had not until now seen this issue addressed. The fee is not so high , it is the fact that I am being charged a fee I knew nothing about and have no say in accepting. I handle our finances carefully and pay no fees. I pay no credit card fees, no interest, and I keep a minimum deposit so as to avoid bank fees. In past videos were these fees actually explained clearly or just alluded too? I cannot say that we have had any major trouble getting our re-imbursements to this point but I am very vigilant. Seems like a lot of confusion to always be on guard against.
Page 12 of the insert in Summer 2015 newsletter shows the statement pertaining to the fee. So easy to overlook, I had to re-read all my material to find this. We were bombarded with too much information too early in the change!
Please return all of us, the OPERS employees and retirees to our former coverage………obviously all of us have had major problems………..how can we eventually change plans and not have all the above mentioned issues??
Evidently I hope all of the above is settled…but if not, I suggest making improvements for everyone…
Just wondering if you can tell me what percentage of my medical insurance allowance is used for the one exchange fee on a yearly basis. I am interested not only from the point of view of my personal account, but what that figure comes to for the total program. Is it negotiable annually dependent on actual members participating in the system? I was pleased to see the outcome of your getting the first three month’s funds cancelled. Kudos to you all.
As many others I was unaware that there would be a fee and agree the very subtle reference in a one time voluminous information brochure was inadequate and was bound to cause consternation by many who already were not happy with the change in heath care coverage. Although this new system presents many more problems for individuals, especially those of us who are older, to handle their health care finances I am grateful for all that has been done to continue to provide health care for many of us who are living on limited incomes…and your ongoing work on working through the problems that were probably inevitable on such a huge (HUGE as Sanders would say and for so many of older retirees would echo!) transition.
Also I can’t help but mention how dependent we are on OPERS’ investment strategies for its continuous good work in keeping our health funds solid. Thank you all!
Leona King
warrenCounty
I requested from One Exchange a recurring monthly reimbursement for my under age 65 spouses medical premium. I was told by them that OPERS discontinued that on 3/18/16 and that I will have to request it every month. With all of the other misinformation going on, is this true?
Kevin,
That’s not true. Spouses can have their premiums reimbursed on a recurring basis.
–Ohio PERS
Why didn’t O.P.E.R.S. tell anyone about the fee?
My friend had the fee charged in February on a drug reimbursement.
They now are saying the were waived. Just another case of Miss Steger not knowing whats going on.
The real joke is calling in to One Exchange.
Thanks
O.P.E.R.S.
Mike,
OPERS disclosed the fee in the summer 2015 health care insert to our member newsletter. We’ve also discussed it in this space. We’re sorry if it wasn’t made as clear as it might have been.
–Ohio PERS
I’am glad to see you disclosed this charge in the one insert sometime in the summer of 2015. One would think in the mountain of literature that has been mailed,it would have been mentioned. Apparently The Connector missed it too during the first quarter.
Thanks O.P.E.R.S.
Mike,
We hope you noted that we included enough in the monthly Connector allowance to cover this fee.
–Ohio PERS
I was an administrative secretary for many years so I consider myself a reasonably intelligent person. I, too, was not aware of a monthly fee but I would be willing to pay it if all of the other problems could be resolved. During my first phone call way back in December, I was told that the monthly amount (in my case) of $396.00 would be deposited in the account of my choice each month. It would be my responsibility to pay my insurance premium and prescription premium. I was also under the impression that I would be receiving a one-time payment of $300.00. None of this turned out to be true. Instead the money goes into the HRA and it seems nearly impossible for me to have access to it.
I, too, have had many hour-long telephone conversations with various people and, after reciting my name, S.S. number and zip code numerous times, have ended up feeling totally frustrated. The last one was on April 1 and when I hung up, I was in tears. I had made an insurance premium payment and expected that I would be reimbursed but that did not happen. The girl said that it could take as long as six weeks. Really?? Most of the people I have spoken to have seemed like nice people but apparently do not understand how the whole thing works.
I agree with the comments made by Ed Valeska.
I’ve read as many comments as I could before I became cross-eyed! My experience with One Exchange has for the most part been positive. As directed by OPERS, I did my homework before I made the initial call to OE. I researched health insurance companies and drug reimbursement companies. My first contact at OE was Mr. Marvin Evans, a “licensed benefit adviser”. True, I had to wait about 45 minutes on hold to reach anybody (my biggest complaint). Mr. Evans guided me through the sign-up process and advised me which of the companies would best fit my needs. We were able to set up automatic deposit and withdrawal (insurance premium) to and from my checking account. Pharmacy insurance reimbursement was not available at the time, so I set that up with a credit card.
My second call did not go so well. I was transferred about 5 times because nobody could answer my question about how to get my medical bills reimbursed. I finally insisted that I be connected to Mr. Evans. I was told OE had no employee by that name. I kept insisting that “yes you do”. Finally, one of the”helpers” said “Oh, you mean a licensed benefit adviser.” Ergo,I was connected to Mr. Evans who again helped me with my question. I now need to call OE again to set up Medicare, Dental and Vision reimbursement. I have decided to save all of my prescription and medical bills and submit them to OE on a quarterly basis (thankfully, that’s not much).
I cringe after reading some of the problems my fellow retirees are having with OE. So far, I’ve used Skype for all 800 calls so the wait time doesn’t come off my cell phone minutes. I no longer have a land line.
I have no doubt that we (retirees) were apprised of the $2.33 fee from OE. I don’t remember reading about it. But given the voluminous amount of paperwork we’ve had to wade through, I’m not surprised I missed it.
I wish OPERS and OE good luck in solving all of these problems and appreciate the explanatory videos that have been sent.
Thank you.
Given the fact that nearly all OPERS retirees are receiving $340 or more month, $2.33 is a rounding error. This is paid from funds provided by OPERS. There is no way that this can be construed as something being taken away/deducted from our money. Continuing to cast aspersions on OPERS staff is non productive and unfair. When I was working, (37 years public employment) I did not appreciate remarks and unfair characterization of public employees or their work, did you? OPERS staff are doing their job, and doing it well in my estimation. In my years of public employment I never had this much information and resources for insurance choice and enrollment as has been provided by OPERS. I agree that Oneexchange was not prepared and was deficient in many areas. We should continue to point out Oneexchange problems to OPERS staff and Trustees. However this must be done in a civil and responsible manner. If you think bullying and snark will result in better benefits or procedures, you are wrong.
So where are we now before/after.
Before-One size fits all medicare supplement plan
After-Choice of many plans so that I can pick the best one for me.
Before-Did not have to worry about cost because we never had to write a check.
After-Need to do research and make responsible choices. We have subsidy for purchase of supplemental coverage.
Public employee retirees in Portsmouth VA received a whole $1400 annual subsidy for insurance purchase. “A group of retirees had been speaking up about the cut to their benefits, worth $1,400. . . . . . . . reinstate it and give retirees an extra year of the health insurance reimbursement account (HRA).” Could you look any of these people in the eye and tell them what we are receiving from OPERS as a subsidy?
AMEN!!!! When I see what has happened to so many seniors, not only in Ohio, but around the country, who have not only lost all their health benefits, but are taking major cuts to their pensions, I can only thank God (and OPERS) that our pensions are still intact, and OPERS has made some tough decisions, for our benefit, to provide a generous allowance for us to purchase health care insurance for 2016.
What on earth are the blank white busts of a person covering half of the words of the posts made my people on this array of complaints I have tried to read????? Please some one tell me what’s going on!!
Ann,
Those are “avatars.” We didn’t realize that in some browsers they would act to cover the comments. We’ve turned them off.
Thanks for bringing this to our attention.
–Ohio PERS
What fee? Why didn’t we know about this? I have been on the phone with OE several times. Each time was very frustrating. Long wait times and being transferred from one person to another with absolutely NO resolution. The cost of my health and Rx is taken out immediately at the first of the month but it takes a month or longer to be reimbursed. I’m still looking for my March reimbursements (it’s April 3). When I call, they say that it takes that long for them to compile their report and that’s just the way it is. Also, I had selected a zero deduction Rx plan but was steered away from it by a representative from OE. Now, I’ve been paying a big price for my insurance and they have paid NOTHING yet. It will be at least June/July before my deductible is met. The so called expert at OE said this was the best plan for me but it’s not. My Rx bills have increased five fold. How could you (OPERS) do this to us? Retirees should have been ‘grandfathered in’ to the old plan. Totally discussed!
I thought I was responsible for not being aware of the administrative fee until i read all of these complaints. When it comes to requesting funds from your customers, those terms should be reiterated in all future letters and documents that are regularly sent until it becomes effective. My question is will there be an increase in this fee? If so, when and how much? Always remember, when you inform your customers about your process and mention it once six months in the past then tell them they have to pay you, it looks suspicious ( as if you are hiding something). Please be careful about your communication process if you want your customers to trust you. That is what this is about…trust. you have broken this in the manner in which you handled this “administrative fee process”. Hopefully, you can and will correct this problem. Place yourself in the position of these disgruntled customers and ask if this is how you want business handled.
I am turning 65 this year. From all the negative comments, I am reluctant to use OneExchange to help find my best Medicare and prescription options, especially if there is a monthly fee. What other options do I have to get me through this process which is very confusing from what others have told me. Thank you.
Linda,
In order to receive a health care allowance from OPERS you have to choose a plan on the Connector through OneExchange if you are over 65.
–Ohio PERS
Linda,
I suggest that you do a lot of research on your own before making a decision about which plan to choose. Don’t rely on One Exchange, or anyone else for that matter, to make the decision for you. Use medicare.gov (make sure you are on the correct website, as there are many other medicare websites that are not the .gov one) and also the OE website to learn about the different plans.
You will first have to decide whether you want regular Medicare and a medigap plan or a Medicare Advantage plan. The Advantage plans usually have a lower monthly premium, but you generally end up paying more when you use the benefits. Also, some Advantage plans include prescription plans, where most Medicare/medigap plans do not, so you have to buy a separate prescription plan (Part D).
As for the medigap plans, they are all the same no matter which insurance company you go with (Plan F is the same with Medical Mutual as it is with Humana, etc.). The difference is the cost of the premium (again, it’s the same plan, but each insurance company charges differently) and also which company you would need to deal with if issues come up. They also raise premiums at different rates, but that’s not as easy to determine ahead of time.
On both websites, you can enter your current prescriptions and dosage and be able to compare Part D (prescription) plans. Look at the annual cost – not just the monthly premium and deductible. The plans also list review ratings.
I would try to make a decision ahead of time about what you want to sign up for, but you can always ask questions to OE and then call back later to actually sign up for the plans. Some insurance companies and plans listed on medicare.gov are not available thru OE, but I know at least one (Unitedhealthcare AARP) is available, but just not listed. So, if you are interested in a plan thru that company, you have to ask the OE rep about it.
Just make sure that when you decide on a plan, that you sign up thru OE. Otherwise, you will be forfeiting your HRA.
Around September or October, the company you have your prescription plan thru is required by law to send you a letter stating any changes to the plan for the following year. Many companies added deductibles of $250+ this year. Even with that though, they sometimes are a better choice (depending on which medications you are taking) because the annual cost for the year is sometimes still cheaper. So, it’s important to research prescriptions plans every year during open enrollment to determine if you should stay with that plan for the following year or switch to another.
Linda: I advise you to do your homework before you call OneExchange. Know what insurance company, what plan, and what pharmacy company you want before you call. And decide if you are going to stay with OPERS dental and vision or switch. Don’t depend or expect the people at OneEx to make the best choice for you. Besides that, make sure your phone battery is charged up before you start. I had to switch to a land line because my cordless was about to go out. Luckily I have one to switch to.
Linda,
I suggest that you do a lot of research on your own before making a decision about which plan to choose. Don’t rely on One Exchange, or anyone else for that matter, to make the decision for you. Use medicare.gov (make sure you are on the correct website, as there are many other medicare websites that are not the .gov one) and also the OE website to learn about the different plans.
You will first have to decide whether you want regular Medicare and a medigap plan or a Medicare Advantage plan. The Advantage plans usually have a lower monthly premium, but you generally end up paying more when you use the benefits. Also, some Advantage plans include prescription plans, where most Medicare/medigap plans do not, so you have to buy a separate prescription plan (Part D).
As for the medigap plans, they are all the same no matter which insurance company you go with (Plan F is the same with Medical Mutual as it is with Humana, etc.). The difference is the cost of the premium (again, it’s the same plan, but each insurance company charges differently) and also which company you would need to deal with if issues come up. They also raise premiums at different rates, but that’s not as easy to determine ahead of time.
On both websites, you can enter your current prescriptions and dosage and be able to compare Part D (prescription) plans. Look at the annual cost – not just the monthly premium and deductible. The plans also list review ratings.
I would try to make a decision ahead of time about what you want to sign up for, but you can always ask questions to OE and then call back later to actually sign up for the plans. Some insurance companies and plans listed on medicare.gov are not available thru OE, but I know at least one (Unitedhealthcare AARP) is available, but just not listed. So, if you are interested in a plan thru that company, you have to ask the OE rep about it.
Just make sure that when you decide on a plan, that you sign up thru OE. Otherwise, you will be forfeiting your HRA.
Around September or October, the company you have your prescription plan thru is required by law to send you a letter stating any changes to the plan for the following year. Many companies added deductibles of $250+ this year. Even with that though, they sometimes are a better choice (depending on which medications you are taking) because the annual cost for the year is sometimes still cheaper. So, it’s important to research prescriptions plans every year during open enrollment to determine if you should stay with that plan for the following year or switch to another.
Mary
All Plan F are the same but all insurance companies are not. Some, like Humana, are “attained age.” Before choosing a company you want to do a little research on this. I went with United which costs a few $ more but is not attained age.
My United Plan F goes up on my birthday.
My husband’s plan (which is attained age) actually went up at what I guess would be considered the renewal date of the policy. It did not go up the month of his birthday (October), which is what we were expecting. His insurance went into effect on February 1, 2015 and the increase went into effect on February 1, 2016.
Question #1: If the retiree dies, does the spouse still have access to the HRA account to withdraw what is left in it to cover doctor bills for either the deceased retiree or the spouse? If not, it does not make sense to let it accumulate.
Question #2: Can you eliminate the icon that covers the first part of every question seen above on this website? Thank you.
Joan,
If a retiree dies, an additional HRA may be established for the survivor benefit recipient as a mechanism to continue receiving the respective allowance through the end of 2017. The retiree’s original HRA will stay available to the survivor benefit recipient and other eligible dependents to use for a rolling 24-month period. In this situation, there would be two HRA accounts.
Regarding your other question, we’re not sure what you mean. We do not see any icon that covers any part of a question.
–Ohio PERS
#1: Does that mean that final medical bills for the deceased cannot be reimbursed by the HRA, that only spouses or dependents can finish up that account for their own bills?
#2: For the first time today, the icons appearing on top of the first several lines (about 2″ into the text of each comment) have disappeared. Maybe it was just a glitch on my computer if no one else had it happen.
Joan,
Final qualifying medical bills can be reimbursed. And we turned off “avatars” on our blog, so that made the shadowy figures go away. Thanks for telling us about that.
–Ohio PERS
I have read the posts from my fellow OPERS retirees. It is sad to find out that all of the many long phone calls, submitted forms, and the long waits for representatives from One Exchange to finally answer my calls and questions have been experienced by so many retirees. If in my professional career life I would have treated people like this I would not have been employed very long. I think OPERS was either promised more than this company could deliver or One Exchange was unable to deliver on the promises made to OPERS. The Board of Directors of OPERS should completely rethink continuing with this company and should streamline the insurance issue for retirees. There has to be a better way for this problem to be resolved.
I completely agree with you……OPERS needs to streamline the process. Find a solution to this mess, please!
My husband is the retiree but I have been totally involved in the whole process of picking our own insurance for the first time ever. Our experience was less than stellar, to say the least. OPERS assured us that One Exchange employees were highly trained and knew what they were doing. NOT! We had so many problems from not being able to understand several people to them not knowing the answers to our questions to not turning in our application for Part D.. The wait time was always long. And now we learn there is an administration fee! Why was this NEVER once mentioned? I don’t object the the amount, it is reasonable, but to the fact that we were not told of the fee.
Carol,
We did disclose the fee in several health care publications last year. I mentioned it in blog comments. But we understand that not everyone saw the fee mentioned. We did include money in your allowance to cover the fee.
–Ohio PERS
The administrative fee is not a big deal for me, but I was never aware of it until I started reading these comments today. And I consider myself an “Information junkie”.
The Administration fee is no big deal because it is free for us. OPERS pays it by including in our monthly deposits.
I have read all comments made here in the past few days. I agree the amount of the monthly fee is not a big deal. But the “surprise” of the administrative fee, has been the straw that broke the camels back, and all of our frustrations have come pouring out. I am so glad we finally have this forum to voice our concerns and complaints, so we can each now know we are not the only ones who have major problems with One Exchange. Misery loves company, they say, and many, many of us are finding that dealing with One Exchange to be a miserable, frustrating experience.
Granted there are a lot of us for them to deal with, but the “licensed benefit advisors” were obviously not trained, nor did they have access to information they needed to answer our questions. I wonder how and from whom these employees obtained their so-called licenses. Once my husband and I suffered through the nearly five hours of phone calls and got our applications made, I assumed things would work as promised. Instead I am still waiting for reimbursement for January and February premiums, in spite of many e-mails and phone calls. I am signed up for automatic reimbursement but when that wasn’t working I sent the paper reimbursement form with policy information and bank statements showing our payments. Received a letter denying my claim! So still waiting……..
I’m not going ro repeat all the problems because it sickens me that we have been treated like this by a company located in Texas. It bothers me that instead of finding a company in Ohio to assist and help us we looked outside this state. My husband retired from AT&T, which has way more employees, and should he need assistance, he receives professional assistance from the qualified associates working for AON, which has an Ohio presence. AT&T enrolled in this a year before OPERS, and I listened and learn, and thought this was going to be okay. My experience turned into a nightmare. I attended the seminars, which always was a repeat session with, generally, nothing new added. Never appropriate time for questions and their normal response give me your name and phone number and we will call you. Also, watched videos. Enough said!
I am POA for my mother who is a widow of a OPERS retiree. Since she lives in an assisted living facility, I needed help selecting a Part D provider who is mandated by the facility. One Ex rep told me after checking with his supervisor that I had to go with a more expensive provider even though the one I was going to choose had better coverage. She now pays $14.30 more a month for less coverage. Her out of pocket costs have gone from $50 to $110 per month.
I didn’t call One Ex because of the problems my wife was encountering with her own OPERS/One Ex nightmare. Our experiences with One Ex leaves a lot to be desired. I am totally stunned by OPERS poor poor choice of a connector who is so unprofessional and overwhelmed.
One Exchange posted a reimbursement on March 1 prior to their Contribution also posted March 1. The debit being first placed my account in a negative balance. This resulted in a request to me to reimburse the HRA account for the negative reimbursement. Please notify One Exchange to post their contribution before any other postings at the beginning of each month. I also my object to providing my social security number to many strangers, during the sign up and now when I call One Exchange with questions. I recommend you find another identifier between One Exchange and retirees. I ALSO OBJECT TO THE SERVICE FEES. Would love to research the whole process to determine the cost to the State of Ohio.
WE ARE PAYING DOUBLE FOR OUR VISION AND DENTAL INSURANCE BECAUSE WE DID NOT KNOW THAT WE HAD TO CANCEL THESE INSURANCES FROM OPERS. CONTACTED OPERS AND OE AND WERE TOLD SAME STORY THAT WE HAD TO WAIT UNTIL OCTOBER TO CANCEL OPERS INSURANCE. HOW IN THE BILLY H DID WE GET INVOLVED WITH SOMETHING THAT WE CANNOT CANCEL??? THANK YOU OPERS FOR TAKING $900.00 PLUS OUT OF OUR POCKET THIS YEAR. ACCORDING TO MARGERET JULIAN SHE FIGURED OUT A WAY TO GET HER INSURANCE CANCLED. IF ANYONE CAN HELP US WITH THIS PROBLEM PLEASE REPLY TO THIS COMMENT.
Get in touch with Ms Steger. They are working each case on an individual basis.
Don’t hope to be reimbursed for your double payments tho, I didn’t get mine back even tho I didn’t use either one. I guess they figured it was there if I needed it and that I was covered. The worst part was that I probably would’ve not been able to use both.
Good luck.
M. Julian
I signed up for a Medicare Supplement Plan F during the signup phase with One Exchange and received confirmation that I was accepted. I received a call January 15 from OE that Humana was withdrawing Plan F and I was put into a similar Humana plan for $32 more per month. OE said I had the Humana Plan F through the end of January. OE said they could sign me up for AARP United Health Care starting Feb.1 for the same amount I was paying for the original Plan F with Humana, which I did while talking to the OE rep. To my surprise I started getting medical bills from doctors for January. On calling Humana I was informed Plan F was pulled on January 2 and they informed a “third party”, which I assume was OE. The new plan Humana put me in was not a Plan F and I had a deductible now of $250. OE claimed they didn’t find out until mid January. Obviously, someone isn’t telling the truth. After hours on the phone with OE I was told the outstanding bills would be taken care of either by Humana or OE. Needless to say, it never happened and I continue to get bills from my doctor which would have been paid under my Plan F, which is the plan I signed up for and thought I had.
Patricia, there are other companies that offer Medigap F. The rates may be slightly higher. Because you were not notified until Mid-January, I believe that One Exchange owes you the favor of changing your policy to one YOU want. There was another Medigap policy that was nearly as good for a lower fee. Medigap D, E and G. You can find the information at the OPERS or One Exchange web site. I was sorry to hear Humana was no longer offering Medigap F (which I signed up for possibly earlier than you did) and I’m wondering whether they’ll grandfather it for those of us who were able to keep it. At least I hope we have been able to keep it. I haven’t heard otherwise. I wish you good luck.
I am not sure if OPERS is paying one Exchange for their services. If the only fee is a $ 2.33 monthly Adm. fee it does seem high to me. Although the total based upon 145,000 retirees seems a large amount just think that I receive 3 reimbursements per month and postage alone would use up half of the adm. fee. After this employees and all overhead needs to be met. Does OPERS pay additional fees to One Exchange? My problem was that it took 5 requests both on the phone and over the computer over a period of five weeks to receive a booklet that explained how reimbursements need to be handled. I was told three times booklets were mailed but did not receive them until late March. I received two on the same day! Although confused at first I am rather happy with the health plan at this time.
Stephen,
We do not pay additional fees to OneExchange.
–Ohio PERS
In the last video Ms. Steger pointed out this was “the largest transition of this type to ever happen in the U.S.” WOW! I wonder how many people are impressed with that.??…sure does not sound as if seniors are for the most part. …A FEW may be happy campers; however, when I hear all of these issues, I cringe at the numbers of senior citizens (self included) who are being forced to ‘ride a dead horse’ through this complicated process. I do not hear too many ‘atta boys’ (congratulations) on this new journey and the pride verbalized about this being “the largest transition of this type to ever happen in the U.S.” Could this big accomplishment be one of the most VICTIMIZING things to ever happen to such a large number of seniors? I pray this transition does not continue to put us in the category of “dependent patients” on a system that appears to be creating an unhealthy and stressful existence!!! We may be old, but we are not stupid!!!! It sounds as if the original intention was for us to assume responsibility for our health and healthcare… We can do that; however, we need more competent HELP with this….
I don’t know why so many people did’t know about the 2.33 fee it was stated so many times with all the material they sent last year. But I do agree about the time it takes to be reimbursed.
I don’t recall hearing about this fee in your meetings or web info. It might be my mistake, but I don’t think it was made clear.
My One Exchange account hasn’t had any flaws and Reimbursements for a Dental bill no problems as I followed the instructions. Setting up my 90 year Moms account was tedious but it worked for 2 months as she died Feb10,2016. I called One exchange in Feb to inform them of her death so no more Insurance premiums would be taken out and thought that the $600. dollars left in her account would be used after paying her medical bills to reimburse her estate. One Exchange informed my brother who is Executor of her estate the money is gone AND when account was closed THE $600. got sucked up into the ( TO BAD ,SO SAD ACCOUNT). This is just an FYI to all retirees to not close your spouses accounts upon their death so the balance of there accounts( which I informed my brother to submit bills to reimburse for her left over medical bills) would not disappear as my Moms did.
William,
We’re sorry for your family’s loss. Regarding the balance in your mother’s account, the HRA is funded by notional funds, meaning the money stays with OPERS until there is a valid health care claim that could be paid with these funds. So if there are are no dependents (that includes spouses) to make a health care claim, the money really can’t be withdrawn.
–Ohio PERS
I did see the the initial note about One Exchange’s fee of $2.33 a month for their service fees. Unfortunately One Exchange does not deserve on penny of it! We were told that One Exchange would adults that could communicate with the seniors calling from OPERS retirees. After making over 15 call if have yet to find a person that knows exactly what they are talking about and what Tower Watson actually does handle. My wife and I are both retirees with separate OPERS Benefits. We contacted One Exchange October 13, 2015 to sign up for new insurance through One Exchange. We both had existing Medicare Supplement “F” and “D” insurance for four years prior to contacting One Exchange. It took approximately 90 minutes to sign up for that insurance in 2011. We spent 4 hours with the One Exchange representative on October 13th to get signed up. My wifes insurance policy wehn through within days, mine did not. I contacted One exchange and found out that the company that they signed me up for would take and extra two weeks. I called back and they informed me that it would take more time and be patient. The Monday before Thanksgiving I contacted One exchange again and asked them to do some research on the my application delays. They contacted me back the next day to say that the insurance that they signed me up for they could not sell in the State of Ohio. So we started over with United Health Insurance and I completed their application with the One Exchange Representative on the line. United Health was to send me the application for me to sign. That did not come so I called One Exchange again and we called United Health together. They said that since we were trying to beat the Dec. 31st dead line to be signed up. that they used the electronic signature format instead of sending it to me. I got the application in the mail anyway and contacted One Exchange again to clarify. I signed mailed it back and Faxed it as well. No conformation occurred, so I contacted One Exchange again to find out that the application sent to me was sent before United Healthcare had signed the application requiring it to be sent to me again requiring my signature again. Which a course I did. Why was this necessary… well that was to make sure that One Exchange was going to get their kick back for Untied Health. Long and short of it that I carried my Original Insurance policy through January, was not reimbursed by OPERS for January since my United Health Care policy did not commence until Feb. 1st.
I am still trying to get proper reimbursement even though OPERS sends the funds to One Exchange. Today’s call only lasted two hours. It was in regards to why I don’t get reimbursed for the Part “B” medicare premium that is deducted from my social security benefits paid by Social Security. I had completed the One Exchange for twice correcting my original application which included Jan of 2016.
One Exchange informed me that I need a letter from OPERS stating that Part “B” medicare was acceptable to be reimbursed. Strange… since the One Exchange form required for request reimbursement has printed on it “OPERS” and includes instructions of back-up information that is acceptable for reimbursement. After a couple of hours the representative will request a review from One Exchange Review Committee concerning their rejection for this reimbursement.
Please explain who is benefiting from the interest on all this money that One Exchange holds from everyone? Why should they get paid a fee when they are making money from the interest of all the moneys that they hold??
Arden,
OneExchange doesn’t hold the money that goes into the HRA and thus gets zero interest on it.
–Ohio PERS
I have 2 questions/challenges for OPERS:
#1
The latest video has a statement that 85% of retirees are satisfied with the transition to One Exchange.
Question – Is that 85% of the 145,000 retirees and spouses?
I haven’t been surveyed and I don’t know anyone who has been surveyed.
Challenge #1 – Is OPERS willing to send an email survey to the 145,000 retirees and spouses re the transition to One Exchange?
#2
I have suggested twice in writing and twice via telephone (after a ridiculous wait time) to One Exchange, that they should adopt a telephone response system similar to the SSA.
When I call the SSA and they are very busy, you get a recoding stating that if you leave your telephone number someone will call you within a specified time, e.g. 20 minute, 35 minutes, etc.. SSA has ALWAYS returned my call within or less than the time they promised!
Challenge #2 – Is OPERS willing to meet with One Exchange and convince them to implement a responsive telephone communication system.
Fred,
It is not necessary to question each and every member of a certain population in order to receive a statistically valid response.
We agree that it would be better if OneExchange would have a virtual hold service, like we do. It’s a topic that’s worth exploring. If there are updates, we’ll tell all of our members.
–Ohio PERS
I have been trying to get reimbursed for my prescription drug coverage I have made three
phone calls and talked to three different representatives so far no luck with my reimbursement,
I agree with most of the comments from above, except that I was aware of the connector fees. My gripe is Why pay connector fees to a management group who cannot answer your questions when you call? I have been reimbursed for my premium expenses but not for my wife’s. When I called with the invoice number and check number for the reimbursement fee that I received, they could not tell me what or who the check was for! The customer service person excused herself from the phone at least 3 times to “check on something” and never did answer my question. When I answered a “post customer service call survey” I told how dissatisfied I was with the representative but never got contacted back to see why I was so dissatisfied! Seems to me if you’re bothering with a “post call survey” and the client served is unhappy, there should be some follow up. IF I’M GETTING CHARGED FOR THIS POOR SERVICE, I DON’T WANT TO PAY FOR IT!!!!!!!!!!
About the fees , it may have been told to us, but, I think the problem is that it is just so some information being shoved at us.
I never saw anything about a fee for this service. I think Opers should pay the fees and not the individuals or remove it from our accounts.. It was never mentioned at any of the seminars that I attended. Where was it mention? There would definitely been a discussion about this at any seminar. I would like to know how we can contest this fee.
Geraldine,
If you look at other responses in this blog, you’ll find links to three publications in which we mentioned the fee. We also have stated that when we set the allowance amount for our Connector participants, we took this fee into account. In other words, we gave you enough money in your allowance to cover the fee.
–Ohio PERS
Watch the video. If you didn’t see it, you should. It’s explained there.
I should have realized that I was not the only one who waited 2 1/2 – 3 hrs. for One- exchange to answer my “appointment” time, and then tried to sell me a policy I did not need….finally got through to someone a second time to cancel what One-e originally gave me to another Insurance company, after hearing the man with whom I spoke telling me about his medical problems,and I kept repeating that I was calling for my needs……it was frustrating and very unprofessional….
why do I have to co-pay and later get a bill for an additional amount…..why 2 separate transactions? I
have always felt that OPERS was doing an excellent job for us, but missed the mark when it came to dealing with One-Ex.
Thank you to Michael Pramik for his patient replies to our concerns. Thank you also to Beverly Barger and DP for their supportive feedback regarding the earlier suggestion that OPERS offer us the option of receiving an amount equal to our current HRA benefit with our monthly pension payment. Retirees could choose to continue with the current reimbursement system OR receive a predictable health care benefit at regularly scheduled intervals, and cover their obligations directly with medical providers and insurance companies. The upside for retirees?…no reimbursement hassles, less paperwork, less waiting for assistance or payments, less confusion. For OPERS?…members’ morale rises and peace of mind returns. For OneExchange?…a more manageable caseload. The downside for retirees?…direct payments would be taxable. For OPERS?…less unclaimed HRA money on which to earn interest. For OneExchange?…fewer accounts paying them a $2.33 monthly administrative fee. To me, the benefits far outweigh the drawbacks. What do you think?
Seriously, why can’t we opt for a taxable cash benefit added to our monthly pension check and forego the reimbursement route??
Ed,
By IRS rule, the money in our health care accounts can be used only to pay retiree health care. A taxable addition to a pension check is a pension enhancement, not health care. Pension enhancements can be granted only by law.
–Ohio PERS
My One Exchange Enrollment appointment was at 9:00 a.m. on April 1, 2016. I was perhaps one of the first new Medicare Part A recipients to be interviewed and I was very fortunate to be interviewed by a person who was very good at his job. Since I had reviewed all of the Plan F options in advance (and designed a spreadsheet that compared the options) I was fairly certain of my choice before making the call. Because we both understood the background information, we were finished with the interview in a very short period of time.
Possible issue for OPERS: My new card from Humana arrived today (less than a week after my interview) and I have a concern about that for OPERS to consider. The interim Humana card is to be used through June 30, 2016. The new card has no effective date on it, but the accompanying information says “Remember to carry your Humana I.D. Card with you and present it whenever you need healthcare services.” I suspect that many people will receive the new card and start trying to use it immediately, with the possibility of being rejected by the medical provider. I just thought OPERS might want to know about this possible issue.
Thank you OPERS for another informative video and I am deeply appreciative of OPERS’ offering insurance and reimbursement. My problem centers around OneExchange and their management of my account and their level of customer service. One specific problem I have had with OneExchange is with filing for recurring reimbursement for my Medicare payment that isn’t covered by OPERS reimbursement. I filed a claim for recurring Medicare reimbursement in January 2016. By March 2016 my claim hadn’t been posted in my account. I phoned OneExchange, and their answer was that they had no record that my claim had been received. I was advised to file again. I asked them very specifically about the requirements for claim application because I didn’t want to send a lot of personal information in the mail again only to get lost. I refiled my recurring Medicare payment claim again on March 23, 2016 and OneExchange received it on March 25, 2016 at 6:15 a.m. (I put a tracer on it this time). It is now April 8, 2016. Two weeks since OneExchange received my claim and still no indication on my online account my claim has been processed. Unacceptable. I will be calling again Monday April 11, 2016 but my expectations are low this will be resolved. My patience is gone and I’m not sure what the solution is to the problems with OneExchange. I feel weary and pessimistic from the whole process. Thank you.
I heard that UnitedHealth was the most popular medigap insurer chosen by OPERS, Medicare retirees. We have bigger problems than complaining about OPERS paying OneExchange monthly fees for us.
This article was taken from today’s Cleveland Plain Dealer. Next year they may drop Ohio.
UnitedHealth exiting two state markets
UnitedHealth Group Inc., the largest U.S. health insurer, has decided to call it quits in two state Obamacare markets, in the latest challenge to President Barack Obama’s health care overhaul. The insurer won’t sell plans for next year in Georgia and Arkansas, according to state insurance regulators. Tyler Mason, a UnitedHealth spokesman, confirmed the exits and declined to say whether the company would drop out of additional states. Many insurers have found it difficult to turn a profit in the new markets created by the Affordable Care Act, where individuals turned out to be more costly to care for than the companies expected.
Tom
Medigap policies are not part of the the Affordable Care Act (Obamacare) market place. UnitedHealthcare not participating in the ACA market place in Ohio does not affect their participation in the Medicare supplemental insurance market.
I am at the library and trying to listen to the YouTube presentation above. But after the ‘music’ ends I cannot hear what they are saying. What am I doing wrong? What settings should I be checking to hear them speak?
Thanks
Robert,
We’ve never had that comment before, so I’m not sure what happened. FYI, we now have closed captioning for that video. Click on the “CC” tab on YouTube and you can read the script as the video progresses. We’re going to continue to update our past videos until they all have the correct CC scripts.
–Ohio PERS
Hello All, Obama lied to all of us I can’t understand the posting from some of you who defend him you must not have been watching the press briefing when he said ” IF YOU LIKE YOUR HEALTH CARE AND YOUR DOCTOR YOU CAN KEEP THEM” I did watch that speech. If you noticed It’s now called the ACA he does not want his name attached to the changes.I think One Exchange will get the problems resolved and all of us who are OPERS retirees can enjoy our life.
Mr.Pramik – If you would to refer to Ms. Joy fisher – posted 3-29-16 at 1:24Hrs. (First post on this site)
Word for word is my same problem. I have called six times – dates and names available on request.
One Exchange has denied my Silver Scripts premiums for $19.60 even though it was set up and approved when I called in October. The reason is that my OPERS dental account is for the same amount of $19.60. It has been denied because it is the same amount. Please, please can you intercede on my behalf? Can OPERS change their dental fee to $19.59 or $19.61, or can One Exchange fix their computer program to recognize the same amount for different premiums?
Thanking you in advance for your efforts.
Jeanette,
OneExchange is working on this issue. Thanks for your comment.
–Ohio PERS
I made an appt for the first call for which I had prepared. It took 1 hour and I’m happy with the choices made. I had not prepared for the first Rx to be so expensive, but that was quickly reimbursed. I thought I had read everything but I didn’t know about the medicare reimbursement. I made a 10 minute call to request the form which came in 10 days. I returned it immediately with the proper documentation; the reimbursement was in my account in about 1 week. I didn’t know about the $2.33 fee but it seems reasonable and requires no action on my part. All of this is different and not easy;I am glad I have my wits about me (I think I do) but it is important to know not everyone is having a hard time..
Why isn’t the Medical Insurance and Prescription money taken straight out of HRA monies without have to wait a month to get reimbursed? Should be set up that way. I get 396 HRA monies so take the first of month the money for medical and prescription. Not that hard.
I also want to know why I have to pay out more for medicare to social security just because I didn’t pay into it. I still have to pay for the medicare each month. That seems like I am discriminated against for being old and worked where I didn’t have to pay out for medicare or social security. Shouldn’t be penalized. I should be able to not pay medicare but OPERS says I have to to get insurance.
Rhonda,
The system is set up this way because you have to first pay for a service before you can be reimbursed for it. The HRA is an IRS convention. You can read more about it on the IRS website.
–Ohio PERS
Jeanette,
Thanks for your comment. We haven’t heard much about that issue. We’ll forward it to OneExchange for review.
–Ohio PERS
Are you reading our posts Mr. Pramik? I and other people have posted on here with the same problem.
Judy,
Yes, I am reading every post. We are aware that OneExchange is not making some reimbursements because the amounts are identical to other claims. We’ll update you when they find a solution.
–Ohio PERS
I found this thread while I was waiting to talk to an OPERS rep to inquire about who to complain to about the horrible and frustrating service we are receiving from One Exchange for our reimbursements. Yes, I am grateful to be in a position to be reimbursed but for three months the time wasted waiting for folks who are being paid to to help us with problems that arise with the shoddy website for reimbursement…well, it is criminal. Last night I called to inquire why one of my reimbursement request was denied. The rep could see where it was a valid request per my documentation (it was the same amount as another receipt that must have flummoxed the receipt determiner!). She had no answer for me so I asked to speak to a supervisor. 20 minutes later she got back on to tell me that the supervisor refused to speak with me. I asked for the name but she said she didn’t catch it and she was not certain which of the three call banks she was from! There are no excuses for this. The service rep suggested I call back and ask to speak directly with a supervisor (51 minutes with no result was not long enough for one evening??) and then begged me not to use her name as she needed her job. People, it took me longer than 51 minutes to calm down after that “customer service”…………….
I am extremely grateful that OPERS is giving us a generous allowance in order to purchase health insurance and pay for health care. I take several medications, and I will be paying more for them than I had to pay when we had group coverage with Humana, but it is not reasonable for us to expect OPERS to keep paying for increasing health care costs. As for One Exchange, there were some glitches, but they have all been worked out for me. The long wait times for phone calls are a problem, but every person I have spoken with at One Exchange has been pleasant. Some advisors are better informed and more helpful than others, but that is probably true in most organizations. I also agree with everyone who says do your own research and figure out what kind of insurance you want (medicare advantage or medigap) before calling One Exchange. OPERS put on many seminars throughout the state and posted videos explaining the various insurance options for a medicare supplemental plans. Many of the dissatisfied comments from OPERS members are complaints about the insurance/drug plans that One Exchange recommended. Those of us who did our own research and made our decisions before-hand seem to have had better experiences. I am also very grateful to OPERS for figuring out a way for us to avoid paying taxes on our HRA money. If they simply gave us the money and we had to pay taxes, we would have a lot less money to pay for health insurance and health care. Thanks, OPERS.
Made my selection last week, and one of the plans offered to me was the Humana F Plan, this was not my selection, thank goodness, why are they still offering this plan if it no longer is available?
Humana Plan F is no longer being offered in Kentucky. I had to switch plans and incurred out of pocket doctor charges because I was put into another plan without my knowing, a Plan B. However, my friend in Ohio still has Humana Plan F.
I don’t understand all the angst on this blog. I was made aware of the $2.33 in last year’s publications. I understood OPERS would be paying for it from the monies they release to the HRAs. No big deal. I am one of those retirees who never qualified for free Medicare Part A, so I needed to arrange to purchase Part A out of pocket after January 1st. To be honest, dealing with Social Security and arranging the purchase, getting confirmation of coverage eligibility and future monthly payments, and obtaining a new Medicare card have by far been my biggest hassles. The delays in communication and follow up by both Social Security and Medicare are unbelievable. My experience so far with One Exchange has been hassle free and overall positive. I called them on April 1st to set up an appointment date. They told me I could speak to a licensed benefit advisor that very day if I was ready to make my selections. I was and I did. I had done my homework. I had previously created an on-line account and filled in all my information. I did my own prior research on various Medigap and Medicare Advantage plans. During my phone call, I selected the Humana Medigap and SilverScript plans that I felt were best for my needs. One Exchange first suggested another prescription plan, but given its limited network of retail pharmacies, I stuck with my original SilverScipt choice. The benefit advisor was fine with that. No hassle, no coercion, no problem. I also timed the length of my phone call. From dialing time to hang up was 51 minutes. And I was done. I received my new Humana ID card 5 days later. I received my new SilverScipt ID card 2 days after that. Perhaps I was just lucky this first go around with One Exchange. But I like to think that being proactive in both preparation and research can make a big difference. This, I believe, holds true whether you’re dealing with One Exchange, your insurance carriers, or Medicare itself.
The sound goes away on the above YouTube video – right after the music ends.
At the library’s computer, what setting should I be checking so I can hear what the people are saying?
thanks
Roberto,
It seems like the computer might be having issues. It’s likely that and not anything we control. Ask the librarian for help.
–Ohio PERS
Today I received a call from a representative of One Exchange. She called to see if she could help relieve some of my concerns. Fortunately, this morning I had received a reimbursement that I was waiting for so my stress level was much lower. I really appreciated the call. It shows that they are listening to us. I think, in time, the kinks may get worked out.
Thanks, Barbara.
I’m a little behind in watching this video, but I can tell you OPERS, I was quite surprised to see the $2.33 fee taken without any explanation. On my OneExchange account it says it’s a fee for a refund for Medicare Part B overpayment I had to give back to them because I did exactly what OPERS said to do about filling out the form and writing on the form that I receive the $31.81 on my check. I did not receive any letter from OneExchange explaining anything about any fees. They finally got the reimbursement fixed and I now receive it automatically, but the explanation on my account still says it’s overpayment refund fee. It was not my error, it was theirs. So is the fee actually for what the video says or overpayment refund fee? And how can I receive any future correspondence from OneExchange via email?
Cassandra,
The $2.33 fee is a monthly administrative fee that OneExchange charges to Connector participants who have an HRA account in their name. You can follow this link to contact OneExchange by email.
–Ohio PERS
Are you submitting an Explanation of Benefits or billing statement with a copy of receipt that it was paid to Silver Scripts? These documents will prove your case I should think.
My pharmacy premium is deducted from my checking account each month and it is supposed to be an automatic reimbursement.
Mr. Pramik, you would think that an EOB would do the trick but it does not. Oddly enough, they can handle several $4 entries but two, 11.21 entries, really throws them off. I have had one of the two denied with EOB. Have called many times, but the time the supervisor REFUSED TO TAKE MY CALL when the customer service rep could not help me…..well, I have all but given up. Sometimes I think that is their point of such shoddy customer service.
Becky Jaynes
Becky,
Thanks for letting us know about your experience. We are working with OneExchange to resolve the situation in which there are two claims for identical amounts and one is denied.
–Ohio PERS
I agree. They just simply will not PAY…they owe me over $700.00, Calls & Emails to no avail. My months old, HIGHLY DOCUMENTED Claims just sit there. I have many more to Upload, but why bother now.
Mr. Pramik,
THANK YOU !! Because of this opportunity to post my problem earlier, I BELIEVE my problem with
OE has been solved. I will not raise my hands and sing Hallelujah until next month to see if I get reimbursed for Silver Scripts $19.60 and Dental thru OPERS $19.60 for May. Due to this program a angel in the form of Mr. David Murray came to my aid and HOPEFULLY resolved my problem by contacting OE and speaking their language.
I believe that due to working with OPERS all those years, I have gotten spoiled by OPERS high quality service. OPERS would solve a problem before I even knew I had a problem.
I hope you never have to hear from me again,
BIG THANK YOU!!
Jeanette,
Thanks for the comment. We have been working with OneExchange on this issue. Let us know what happens in May.
–Ohio PERS
OPERS responses are very condescending and pretty much useless. People who are frustrated and trying to get a claim or other situation resolved do not need to hear their issue will be forwarded to OE when OE is the problem. Those providing responses to our concerns don’t seem to see the urgency of getting this system working correctly as it doesn’t affect them. When it is almost May and OE is still having basic issues that is unacceptable for any business and the contract would be cancelled due to the inability of the company to fulfill the requirements and meet expectations.
BJ,
We have an arrangement with OneExchange in which we suggest to them cases that could be escalated to require immediate problem solving. What specific issue are you having? We will forward your complaint to OneExchange and ask them to help you.
–Ohio PERS
Part of OneEx/PayFlex website has not been working since last Friday (4/22). Was supposed to be back up by noon on Saturday. I e-mailed on Monday and the response was that something was wrong with my computer and listed a bunch of hoops I should jump through to make it work. I e-mailed back and my response today was that they admitted that their website wasn’t working.
Another complaint that I have now that I can’t monitor my account on line is that when they deny a claim we are not notified by mail of the denial or a reason why.
Judy,
We regret that Connector members had difficulty accessing their online Connector accounts. OneExchange had technical issues with their payment processor for the last several days. We were informed yesterday at about 5:30 p.m. that the issues had been resolved.
–Ohio PERS
When they call you the number does not identify them as being One Exchange and if you do not answer they don’t leave a message and you cannot call them back directly. I called and another person said they would have them call but it never happened. I don’t answer calls from numbers I don’t recognize or are not identified because of so many scams.
They do not truly resolve the issues, only attempt to placate you, never apologize for troubles, and OPERS should discontinue the contract with them since they obviously are not sufficiently competent to handle the business they signed on to perform in a satisfactory manner. I have never seen such poor bookkeeping in my life and tracking it all is a nightmare.
BJ,
Thanks for the comment. We value our members’ input, and we have taken action to rectify flaws as we see them occur.
–Ohio PERS
Your agreement with One Exchange is that they contact us immediately… sure they contact us to say they will contact us in the next several weeks. Then when that happens the don’t have a clue of how to handle it. They leave a message to call them and once one does their not arround. What a run around!!!
The latest problem with One Exchange is – “Some account details are temporarily unavailable, for access to claims and balances. Please call back later or call for status.” Call for status – you have to be kidding – call and get disconnected almost every time. My opinion is that if they don’t know the answer they hang up on you.
I have not been able to get into my account for 6 days now. I need to be able to at all times because of this whole mess with One Exchange. This company is a joke. And a foreign one to boot. Shame Shame on you OPERS for letting this incompetent company manage our health insurance.
I receive $650 a month but the real cost to us is $689 per month. It will be worse next year and every year after (not including my husband losing coverage). Not only One Exchange but PERS is a joke regarding coverage. I realize that we were never guaranteed medical coverage,but this is hard to take after receiving coverage for over 20 years of retirement.
Michal,
We regret that Connector members had difficulty accessing their online Connector accounts. OneExchange had technical issues with their payment processor for the last several days. We were informed yesterday at about 5:30 p.m. that the issues had been resolved.
–Ohio PERS
Why does OPERS need a third party like OneExchange for the Health care management of member retirees? And why not make it optional to participate in the OneExchange program next year. My issue is not with the Associates I speak with because all those I had spoken with were very professional, polite, respectful and skillful. Personally, I just do not think it is fair to put us through such bureaucracy again after I survived 25-30 year bureaucracy working at my job. Now after retirement I will have to be fighting reembursement check. It is an unnecessary stress that I would prefer not to deal with. Why not give the members the $ 360 directly and they can manage their health care costs on their own, but any one who needs the financial management assistance of One Exchange may optin with them. I want to choose and pay my insurance directly. Thank you and God Bless OPERS. Amen
Elizabeth,
It currently is optional to participate in the Connector. We’re just not able to provide you a monthly allowance if you secure coverage outside of the Connector.
–Ohio PERS
It is not truly a viable choice when you tell people they can choose to not deal with One Exchange if they can’t get the reimbursement money.
One Exchange has to have told their employees to sign up a certain number of people to different insurance providers in order to get their percentage from them. Two times I spoke with them and two different insurance providers were recommended to me as the best for my needs when they had not even asked my for any information and then told me they could not help me sign up if I didn’t already know which insurance company and plan I wanted.
A supervisor was supposed to call me regarding an issue I was having but when he called the number didn’t identify it as being One Exchange and no message was left so I didn’t know he called. When another employee checked the log it showed he had called and the matter was resolved. Not likely, when you call and get disconnected, put on hold for extended periods of time, transferred back and forth between departments, and still do not get answers.
If there is so much confusion with the administrative fee, OPERS is actually paying the fee because it is figured into the “allowance” from which it is deducted, then OPERS should just go ahead and pay the fee directly instead of putting into our accounts.
The word “allowance” is demeaning like a child doing chores for an allowance. We worked for it, it was promised to us for life, and we deserve it.
BJ,
I wasn’t suggesting it was a “viable” choice, as in a practical choice. I just said that we are not requiring everybody to work with OneExchange. But they’ll have to if they’d like to get the allowance. Sorry if you don’t like that term, by the way. It is an “amount allowed,” thus the term “allowance.”
One thing I will point out, though, is that OPERS does not promise health care to any of its members. And regardless of interpretation, what really counts is what is stated in Ohio law: We are bound to provide pensions. While we want to help our retirees secure health care coverage, there is nothing in Ohio law that says we are under any legal obligation to do so.
–Ohio PERS
That is why it was for life until OPERS had the law / administrative rules changed.
BJ,
Not to belabor the point, but our recent changes to the health care coverage did not change the fact that offering coverage has always been something extra that we wanted to do, vs. something in the law that we had to do.
–Ohio PERS
I appreciate all the years of health care I have had through OPERS because I know that it is not guaranteed.
Thank you Pat Watson for reminding me that all of this is a gift and not required by OPERS. It occurred to me that too much complaining may get the program cancelled and we get nothing – pretty sure that the politicians in Columbus could figure out somewhere to spend the money they are giving us. As long as it lasts I will keep throwing claims at the OE wall, see what sticks and keep my mouth shut.
The OPERS folks have been beat up enough. Don’t make them mad. Worse things can happen. Trust me, I worked in civil service;)
PS And a tip about calling OE. Give up and submit things in writing. It is a lot easier on your nerves!
John,
Thanks for the comment. You don’t have to worry about making us mad, though. We welcome our members’ feedback!
–Ohio PERS
Whenever I write to OE it ends up with them telling me to call.
i have a question, I printed off all 28 Medicare plans available for my spouse that were picked by Exchange One since my husband takes 8 medicines. We listed all his prescriptions on line in his account. I talked to Exchange One for the first time and I was surprised that a lot of these plans, his doctors do not except, especially a couple of the Medigold and Medical Mutual plans. He had these doctors for a long time. We still need to research more plans but I know there are about 100 plans out there. Should I call Medicare to see if they can help us with the best plan first? I didn’t feel the representative with Exchange One was that knowledgable about the right plan for him with all his doctors. I didn’t know this was going to be a big problem and was really surprised about the high costs of a few of his drugs that are not covered with these Medicare plans compared to OPERS plans. Also, I attended the seminar with Exchange One and they did not mention the fees plus the information sent to me by Exchange One, did not mention it either.
Debbie,
I would use any available research to make that choice before calling OneExchange, including talking with my doctor, talking with Medicare, interviewing the insurers, etc.
–Ohio PERS
Thanks, I will certainly do that for sure. I did find out that my husband’s doctors do accept some of the plans that the Exchange One said weren’t covered. So, you do have to do your own homework. I do feel for some of the older retirees who probably need a lot of help. It can be overwhelming choosing the right plan.
Debbie,
You can call also call OSHIIP (Ohio Dept. of Insurance). They will help you decide on a plan:
https://www.insurance.ohio.gov/Consumer/Pages/ConsumerTab2.aspx
They will go over the various prescription plans also. Just have the medication list available when you call.
Mary
If you are looking at medicare advantage plans (those plans include health care and prescription medications as opposed to medigap plans which are health insurance only. You have to buy prescription drug coverage separately. With medigap plans, you are not limited to specific doctors. You can see any doctor you want. The premiums are more expensive for the medigap plans, but there are no co-pays or deductibles.) Anyway, on medicare.gov, you can enter your drugs and get an estimate of the cost for prescription drug plans and medicare advantage plans. However, I don’t think medicare can tell you which doctors are included in any specific medicare advantage plan. As you do your research, you should call OSHIIP. That stands for Ohio Senior Health Insurance and Information Program and is through the Ohio Department of Insurance. The OSHIIP people are very helpful in explaining the various medicare insurance plans and in helping you decide which to pick. However, I don’t think they can tell you which doctors are included in which medicare advantage plan. The only way to find that out is to ask the specific doctors or the specific insurance companies. The phone number for OSHIIP is 1-800- 686-1578.
For Debbie
Just wait until one of your doctors drops the insurance you picked and you have to find another one or you find out one or more of your medications is no longer covered or never was. I was assured all of medications were covered under the plan I chose but later found out differently.
I contacted all the doctors I was seeing before choosing a plan but one of them stopped taking the Humana plan I chose after the first of the year and another doctor who I had been seeing for over 25 years went in with the Mt. Carmel Group and sent me a letter telling me I may need to find another doctor as my new plan may not be accepted. I don’t think doctors or insurance plans should be able to change in the middle of the year as we can not change plans until the next year.
I have been on the phone with my insurance company while three of their employees were all on the same call and not one of them had the same answer as the others. It seems all of them are messed up. I have not yet filled one prescription through mail order and have been getting them filled at my local pharmacy which costs more because One Exchange assured me they were all covered.
I am on disability retirement but cannot get a Medigap or Supplement plan because of being under 65 so I am paying more for everything. Those retirees in the same situation I am were initially not included in this fiasco with One Exchange but later OPERS decided we would be kicked to the curb like all the other retirees stating their research showed we would “benefit” from the changeover. Boy did they speak with a forked tongue.
Was just told that it takes eleven BUSINESS days to process, approve and direct reimburse for a mailed claim to OneExchange. This seems like an extraordinary time frame, considering most insurance companies do the same process in one half the time. Is OneExchange understaffed? Is there anything that OPERS can do to accelerate the process?
Jim,
Thank you for bringing this to our attention. The 11 day time frame that was mentioned to you on your call included mailing time for the claim. This may have been misleading as the time frame is 3-5 business days from the time the claim is received. We have shared this feedback with OneExchange to ensure the proper timing is quoted by all associates.
–Ohio PERS
I must give credit to OneExchange. I submitted 5 Rx claims online on Monday, 7/11 and was just notified today, 7/13 that they have already been successfully processed. That’s great turnaround time! Of course, it was online so there was no extra mailing time involved. I would highly recommend doing it online if at all possible.
Don’t mail in your claim. File your claim online. I file all my claims on line. It is easy and fast.
I don’t think 11 days is such a long time. I have family working at Aetna and I can see how that time frame is pretty decent. There are thousands of claims that come in and various places that claim has to travel. It doesn’t just go to one person. Being patient is a virtue.
It takes four weeks to get reimbursement forms sent out. Even though this is not their busy time of year when you call there is a recording telling you about high call volume and call back. Can imagine what it will be like again this year when it comes to picking/changing insurance and the call volume increases. This company was and still is unprepared to do the job in my opinion. So I guess you are “lucky” to get your reimbursements so quickly.
I forget how to log in for the $50/month health purchases through OPERS and United Healthcare
Thank you for contacting us through our blog we can only provide general information as it not secured connection. Please contact OPERS at 1-800-222-7377 so one of our Member Services Representatives can further assist you.