OPERS to make extra deposit in Connector HRAs
The Ohio Public Employees Retirement System will reimburse qualified medical expenses incurred through the OPERS Medicare Connector beginning in January. In order to make the transition flow more smoothly, OPERS will furnish enrolled retirees with an additional $300 deposit to these accounts once annually for the next three years.
The additional deposit means that retired OPERS members participating in the Connector will have more money in their accounts to cover out-of-pocket expenses that they’ll incur as they transition to their new health care plans and as new reimbursement arrangements are established.
As we’ve said in recent months, we will use a Health Reimbursement Arrangement to provide funds to Connector participants. The first regular allowance deposit should arrive in participants’ accounts within a few weeks of their initial sign-up. This deposit can be used only for reimbursement of expenses incurred in 2016 or later, including January 2016 plan premium payments.
The additional, $300 deposit will arrive no later than Jan. 8. Regular monthly allowance deposits for the remainder of the year should arrive at the beginning of each month.
OPERS is introducing the Connector for eligible retirees enrolled in Medicare Parts A and B. They will choose a Medigap plan or a Medicare Advantage plan and a prescription drug plan on the individual health care market. The medical expenses that qualify for reimbursement include premium payments, spousal health care premiums and prescription drug costs.
The HRA will allow OPERS to provide tax-free reimbursement funds for eligible health care expenses through the Connector.
Current and surviving spouses will not receive the additional deposit.
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 figure out what your organization is doing. I work full time and a side job on the weekend. I don’t have time to go thru all your info. I’m trying to figure out how to get my mother health care by the end of the year. Can you direct me through all your postings to finally see these new market place plans ? Thanks.
Walter,
You can help your mother set up the plan this fall. The full plans are not available right now. Click here OPERS Connector readiness to be directed to the Connector section of our website for more information. Also, we will be mailing out our second Connector Readiness Kit in June to all eligible participants. We suggest that you read through this kit as well.
–Ohio PERS
Mike,I have two questions. Passed 2018, will retires get a HRA deposit and how much? Also if I retired December 30, 2010, will I get the three percent cola indefinitely?
Malcolm,
Connector participants will certainly continue to receive their allowances beyond 2018. That amount isn’t known at this time. Members who had retired before the effective date of the recent pension legislation (Jan. 7, 2013), are not affected by the change in the COLA.
–Ohio PERS
I am responding to the response from PERS saying the amount of the HRA after 2018 isn’t known at this time. I got a letter from PERS in my Connector Readiness Kit telling me the amount of my allowance after 2018. Now you say the amount of the allowances is unknown. What is correct? Why did PERS give me a definite amount for my allowance and you are now saying the amount after 2018 is unknown? Why are you trying to confuse everybody with inconsistent information?
Diane,
We gave potential participants in the Connector information on their allowances through 2018. Not beyond 2018. The question from the other member was regarding the allowance beyond 2018, which we did not describe in the last kit.
–Ohio PERS
Wow! My allowance for 2016 is more than 2017 which is more than 2018. It says that the amounts reflect how my allowance will transition between 2016 and 2018. I thought that meant that the 2018 amount was the final amount that I would always get. It could be increased for inflation but not necessarily. I would at least get that amount forever. Now I guess I won’t. I might not get anything at all after 2018? Is that what this means?
Diane,
The 2018 allowance is the base amount you will continue to receive after 2018. It could be adjusted (increased) for inflation, subject to review by the OPERS Board of Trustees. The exact amount for 2019 will be determined closer to that date. That’s what we meant when we said the amount for 2019 has not been determined.
–Ohio PERS
I hope this connector is easy to understand because I am so confused as if I am going to get anything towards my insurance premiums. It is ashamed we have to go thru this at our age we are supposed to be enjoying it jot worrying about it. I have received nothing on this plan
Kay,
We’ve been communicating the switch to the Connector for well over a year, and we’ll continue to provide lots of communication this year. OPERS Connector website section to go to our website and find out more. OPERS Connector allowance blog that contains a video explaining the Connector allowances.
–Ohio PERS
How do you know if you are eligible for the Connector. I am very confused as to what the Connector this is all about. I have Medicare Part B but not A. Could you tell my if I am qualified for the benefits?
Corliss,
Give us a call at 800-222-7377, and we can help you with that question.
–Ohio PERS
Responding to a posting yesterday – just because you have been communicating the switch to Connector for over a year does not mean we understand it or will. I have watched the videos many times and I am not sure what happens when I get a doctor bill. I PERS keeps saying it saves money in the long run – but for whom? This is very sad that we are so confused and befuddled at this time in our life.
Are spouses entitled to receive “some or partial” compensation for health insurance for the next year or two?
Michael I ask this question based upon the response to the previous question where you state, “Current and surviving spouses will not receive the additional deposit.”
Gary,
Yes, spouses both in the Connector and in the OPERS plan will follow the allowance schedule set out in our health care redesign of 2012. For 2016, that means the first real reduction in the allowance — 33 percent of the 2015 percentage. The allowance will be reduced by another third in 2017 and another third in 2018 when there will be a zero allowance.
–Ohio PERS
Thank you for your quick response. Then please tell me how my wife and I can get the spouse allowances.
Both my wife and I are OPERS retirees so we individually have health care and will get our “own” allowance. If as you say “spouses” receive some allowance then please tell me how we will apply for that.
Gary,
Participants in our health care coverage can’t receive two allowances. We will default the participant to the highest allowance possible each year.
–Ohio PERS
I have been retired since 2005 and my husband since 2013. His company drop his insurance when he retired and I picked him up on mine. Now am I taking that as of January 2016 that he will no longer be on my policy and you are dropping spouses and he will have to get another insurance policy with someone else.
Brenda,
We are gradually eliminating allowances for spouses of members. But the allowance won’t disappear next year. They will be reduced by one-third. They’ll be reduced by another third in 2017 and then become zero in 2018. Spouses will be allowed to continue coverage then, but they’ll have to pay the full monthly premium.
–Ohio PERS
I do believe that the switch to the health care connector is going to be a benefit to both the retiree and opers. I do have a question regarding medical expenses that qualify for reimbursement. Will the spouse’s medicare, dental, prescription and supplement premiums qualify if the spouse is not enrolled in a opers plan?
Timothy,
Yes, those premiums will qualify even if the spouse is not enrolled in an OPERS plan.
–Ohio PERS
Michael, You helped me in a previous blog question. Hope you can help again.
To review: I am medicare age but my husband is still employed with group coverage from his employer, hence I have never used OPERS health care which has always been available to me. We now live in Pennsylvania. He will retire in August of 2016 and at that time I plan on signing up for a medicare plan with the help of the connector. (hopefully?) It will not be during an open enrollment period but from what I read this should still work. I have medicare A now and will pick up medicare B in time. QUESTION: Will I also receive the extra OPERS deposit in 2016 at the time of my later enrollment?
thank you in advance
Virginia,
We intend to provide the additional deposit within the first month of enrollment in the Connector for those who can’t sign up during open enrollment.
–Ohio PERS
I am a diabetic and my drug Januvia is 100% covered now. I cannot find any D plan that pays that in the markets. Will TW’s offerings cover diabetic drugs in full, as we have now? Our Humana plan now has only a 2-4% copay when visiting my doctors – will that be continued or will we now have large copays?
Bruce,
Our Connector administrator will be able to answer that during open enrollment this fall.
–Ohio PERS
My Connector packet received several month ago – I could not find any dollar amounts which reflect the benefit amount. I did receive an HR amount of $50.00 ???
Eugene,
Give us a call at 800-222-7377, and we can help you.
–Ohio PERS
Can the HRA deposit be placed in an account different from the one in which the pension checks are placed, and if the total amount of the HRA deposit is not used for medical expenses during a particular month, can it be used to pay for general expenses or be withdrawn and used to accumulate in investments?
Gary,
The HRA can be a separate account. Any amount left over carries over. The HRA is a Health Reimbursement Arrangement and can be used only for qualifying medical expenses.
–Ohio PERS
To elaborate on the previous answer to “can the HRA deposit be placed in an account different from the one in which the pension checks are placed” can this separate account be in a bank other than the one where the pension checks are deposited? Pension check goes to ABC Bank A. Can HRA deposit go to XYZ credit union? Please answer this. It is the second time I have asked. Thanks.
JA,
Yes, you can have the accounts at separate financial institutions.
–Ohio PERS
My husband died in Nov, 2014. He was retired and
received a monthly pension from Ohio Pers. I was covered under
His Ohio Pers insurance.
Regarding pension payments, he
Took a lesser monthly payout amount so I would continue to receive
His pension after his death for the rest of my life.
I have never worked (raised the kids) and have Medicare and Humana
And express scripts currently through you.
What is going to happen to me? Should I start looking
For my own insurance for 2016? Will I be responsible
For the total cost next year. I no longer live in Ohio.
Thank you for any help you can give me. Phyllis
Phyllis,
You’ll continue to receive the pension benefit. As for health care, spouses are gradually having coverage reduced. Beginning next year your allowance will be reduced by a third. In 2017 it will be reduced by another third. In 2018 and 2019 you may still be covered but OPERS won’t provide an allowance.
You can refer to the Comprehensive Guide to Pension and Health Care Changes for more information.
–Ohio PERS
This is the second time in the last six months that the OPERS Board has reallocated funds to the over age 65 retirees. Maybe it’s time to put money in HRA’s of the under 65 retirees.
Dean,
Just to clarify, the under-65 retirees do not have HRAs.
–Ohio PERS
Mike, correct me if I am wrong.The HRA deposit is a benefit that you wouldn’t get if you were just under social security?
Malcolm,
The HRA contribution is not a benefit at all. We use the term “benefit” to refer to the pension benefit that by law we must provide. The HRA contribution is a feature of our discretionary health care coverage for those participants over 65 who next year will use the OPERS Medicare Connector.
Having said that, you’re correct that Social Security does not provide this payment to those on Medicare.
–Ohio PERS
What will our spouse have to pay on this connector plan, compared to the insurance covered in a United Health care plan?
Barbara,
We can’t make comparisons to individual plans you’re referring to here. The exact amounts will be made available to you during the signup process, and you can choose the plan that’s best for you.
–Ohio PERS
Would it be possible to have an example of what exactly will be presented by OneExchange when the time comes, and how the HRA really works. I cannot picture this in my mind. I’d like to have an idea of which Health Insurance carriers we can chose from and a general idea of the cost of each even though it might not be correct at this time. We receive information from OPERS but it makes little sense until it can be applied directly to a plan.
Thanks, Marilyn
Marilyn,
You can click on this link to view the OneExchange OPERS portal. It may answer some of your questions. But you won’t be able to see exact rates for 2016 because they have not yet been released by the government.
–Ohio PERS
I read that only those retirees who have both Part A and Part B Medicare can qualify for the Connector. I have only Part A, can I pick up Part B by paying for it quarterly as OPERS has in the past?
Mary,
You can do that.
–Ohio PERS
Periodically I get a reimbursement account amount letter showing a figure that I am eligible to be paid for for. “SOMEONE” sent info to you indicating what I had done (medical/prescription/eyes/dental) that resulted in me being entitled to whatever amount and then you want me to send you receipts for it.
I don’t understand that. If the providers reported to you an amount I’m due why not just send me that instead of me having to come up with receipts. I have a considerable amount in the reimbursement account going back 4 years and don’t have some of those receipts, etc. I did not understand what it was about until here just recently. Will that money be lost? Why do I have to send proof?
Thank you.
Bettye,
The HRAs have not even been funded yet. This account, which is called a Health Reimbursement Arrangement by the IRS, will be in effect beginning in January for use with the Connector. Your funds in the Retiree Medical Account will not be affected.
–Ohio PERS
Michael,
I am a recent OPERS “group A” retiree who will turn 65 this month (September 2015). I am still working in the private sector and have health care coverage available at my place of employment, but I currently have spousal coverage through my wife’s employer’s plan.
The premium for this coverage is expensive and I am now eligible for Medicare. It is my hope and intent to utilize my OPERS health care benefit. Does my having this coverage available preclude me from being eligible for health care benefits through the connector? After speaking with OPERS representatives, it is my understanding I will be able to enroll in Medicare A & B then enroll in the Connector and receive my HRA commencing January 2016.
Thank you for your assistance.
Jim
Jim,
Yes, you will be eligible for the Connector. We recommend setting up an appointment with OneExchange to discuss your options. Go to medicare.oneexchange.com to do that. These options may include coverage for your spouse, because an individual plan for her might be more cost-effective than her employer’s group plan.
–Ohio PERS
My wife will not begin Medicare until March 2016, although we will sign-up in December 2015. It’s my understanding she will remain with Medical Mutual via OPERS through February 2016. Will we be able to sign-up for her health care coverage that will begin in March 2016 during the Oct-Dec enrollment period? If not, when and how will her enrollment through the Connector take place?
Don,
We will begin sending you information about that six months before your wife’s birth month. You will be able to sign up closer to the date she becomes eligible for coverage. There is no need for an open enrollment period if, as we say, someone “ages into” Medicare.
–Ohio PERS
Really really lost with this HRA.Please explain when and how this can be used and to when or why.Also please explain how we receive it. I am lost in this new deal with our hard earned money.Can drive you crazy. Please help us.
Jean,
The Health Reimbursement Arrangement is a process whereby OneExchange will reimburse you for your qualifying health care expenses. You’re eligible if you are enrolled in Medicare Parts A and B and if you choose a plan through the Connector. We provide a monthly allowance, and you’ll submit claims to OneExchange. Then, OneExchange will reimburse you from your HRA balance into a bank account that you designate. Click here to go to our website and read more information about the HRA.
–Ohio PERS
My wife and I are retired from the State of Ohio.
1. I have a career position with the State of FL that provides an employer sponsored HMO, prescription drug plan and other insurance for me and my family. Can I remain on my employer plans and set up a Medigap Part F plan in the Connector when I turn 65 in March 2016 if enrolled in Parts A & B?
2. If so, will the unspent funds in the OPERS tax free account be allowed to accrue year to year?
3. Can my wife continue on my insurance as well and set up a Medipap Part F plan in the Connector and see her unspent funds accrue in her OPERS tax fee account year to year as well if enrolled in Parts A & B?
4. Medicare allows for my Part B premium to be taken directly from my bank account if I delay taking my Social Security while employed. Is that a problem for the Connector?
5. Once on Social Security, can the Part B Premium be taken directly from the tax fee OPERS account or must it come from the SS check? If not how long will the reimbursement from the OPERS account take?
thank you
Ernest,
You can remain on an employer plan and set up a Medigap plan through the Connector. You can accrue funds in the HRA, but first you have to meet the health care eligibility requirements to receive the HRA allowance. Your wife can have her own Medigap plan and any allowance would be deposited into your HRA. Those funds would roll over.
Call us at 800-222-7377 for more information. And please refer to OneExchange for your question about the Medicare Part B premium. Those premiums have to come from your Social Security check, not directly from the HRA — although once paid you can request reimbursement from the HRA.
–Ohio PERS
Will the OPERS contributions to the Health Reimbursement Account appear on the 1099 pension disbursement at the end of the year – either in 2015 or 2016?
Carlton,
No. HRA contributions will be deposited into a banking account that you designate.
–Ohio PERS
I need to know how to have HRA delivered directly into a bank account and most importantly, how to not get medical bills direct but paid automatically from my account …. thank you.
Jacqueline,
After you choose a plan through the Connector, you will receive a “Getting Reimbursed Guide” from OneExchange that will detail exactly how you can apply for reimbursement of your expenses. In the meantime you can refer to our Get HRA Ready guide for general information.
However, you will still have to pay premiums and other expenses first, then apply for reimbursement. You will be able to set up auto-reimbursement, so that you need only submit documentation once and your premium reimbursement is sent automatically, but you will have to pay it first.
–Ohio PERS
Question: I am learning quite a bit about Medicare Part D coverage. I am a diabetic using both lantus and Humalog. For the last two years these have been covered at 100% and am researching the “donut hole”. How was insulin paid at 100% under P.E.R.S. ? Did opers pick up the balance? Because now, I will reach the donut hole by February, 2016. OSHIP calls insulin the “budget buster”. Thanks for your help.
Jean,
For detailed questions about specific drugs, call us at 800-222-7377.
–Ohio PERS
I’m the surviving spouse of a disability retirement recipient. I’m curious as to the following: Due to the massive increase in premiums, (OPERS is far higher than some of the insurances offered elsewhere) if I choose to leave OPERS Health and find something on Obamacare’s exchange and in 2 years (or whenever) if that should not exist, can I come back to OPERS?
The way my deceased husband explained his insurance was that I would be covered for life. I see that’s not the case. Is there anyone pushing for a change in this legislation? It appears that OPERS is trying to get out of the insurance business all together and push everyone to get their own insurance/get on the exchange.
Laura,
As long as you have proof of creditable coverage, you can go to the exchanges and then come back to OPERS coverage in the future.
–Ohio PERS
I just read all the questions & answers, which helped a little. But what if the balance in my HRA isn’t enough to reimburse me for a bill that I paid. And, what if a person can’t afford to always pay the bill first & then get reimbursed? Thank you
Pat,
Balances will be paid as funds become available in the reimbursement account. We are providing $300 up front to help participants with paying their initial premiums.
–Ohio PERS
Now that OneExchange has started and I’ve received Open Enrollment Guide for 2016, it states that my HRA monthly deposit is X amount but nothing is mentioned about the $300 annual extra deposit. I am under 65 and receiving disability benefit. Why do I not see any information regarding this extra deposit? The information is not listed in my OneExchange account either. I receive both Medicare Part A and Part B.
Cassandra,
We said back in the spring that the $300 deposit will arrive in your HRA account no later than Jan. 8, 2016.
–Ohio PERS
Does my doctor bill me directly and then I pay him?
Is that correct?
Then I send receipts to my provider for reimbursement.
Is this correct?
John,
You will send receipts to OneExchange. Shortly after you sign up for coverage, we will send you a Health Reimbursement Arrangement guide that will spell out exactly what you’ll do to receive your reimbursements.
–Ohio PERS
I just finished my phone appointment with OneExchange. I was a little nervous about it going in, but the lady I talked with was very helpful and calmed my anxiety.
She answered every question that I could possibly ask, and if she didn’t have the answer at hand, she dug until she found it. I didn’t have any idea of what Connector plan I needed. She ask a few questions and came up with a plan that fits me personally.
The key for me was, reading the ‘2016 Enrollment Guide’ that was mailed to me. I read it page by page and laid out the cards and documents that OneExchange would be asking information from, during my phone appointment.
Don’t be nervous. Take all the time on the phone, that you need. I was on the phone for 2 hours, but I’m satisfied with the outcome.
I must say something very positive about the transition to selecting your own heath care coverage. As a Power of Attorney over my mother’s health matters, I sat with her and called the OneExchange number. The kind gentleman who handled our call was VERY patient and offered simple explanations with examples. I will say that due to my mother’s language barrier, she would not have been able to do this without my help, he made it easy for me, and she trusted my decisions. It did take about 2.5 hours on the phone, but we got everything accomplished, including signing up for an AARP Medigap plan and enrolling my mother in AARP (she had let her membership lapse). We are VERY satisfied with the selections, coverage, and cost. The entire coverage, including a Medigap plan and a prescription drug plan (and adding vision to the OPERS benefits) will still cost her less per month than currently.
I agree with Roger’s comment above – “Don’t be nervous. Take all the time you need on the phone.” Ask and re-ask questions, if you need.
The thing most confusing for my mother was that she will have to pay her own health premium. She said she didn’t do that before. What she didn’t know how to accept was that she is getting a benefit amount in her health savings plan to cover that premium, AND THEN she pays it with her own check.
We opted for automatic reimbursement, so that after the initial 60 days she won’t have to submit requests for reimbursement. Her health savings plan will reimburse her checking account for any monies that need to be given back to her.
It appears that this question has been asked before, but not really answered. Can doctors send bills directly to One Exchange for payment or must it come to us first? Submitting receipts for reimbursements seems like a giant step backward to days old when that’s how such payments were handled. It seems that in the 21st century there would be a more efficient process.
Bob,
Some expenses may be reimbursed without participants having to send receipts, but generally not “doctor bills.”
Insurance premiums are available for automatic reimbursement if the provider participates.
Medicare Part A and B premiums are available for recurring reimbursements. These are automatic reimbursements for expenses that are the same amount each month and occur every month during the year.
For the reimbursement of other non-recurring expenses, such as co-pays and co-insurance, Connector participants need to file their own requests. This can be done online, by fax or through the mail. If you want to do it online, you may need a tool to scan your receipts, such as a smartphone or scanner.
You’ll receive the “Getting Reimbursed Guide” from OneExchange after you enroll. It explains how to be reimbursed from your HRA.
–Ohio PERS
I have been reading other members questions and have been enlightened by some of the answers. This change is frightening for us as we never had to deal with putting our money out there for our health. There is a matter of the deductibles and out of pocket cost before the insurance kicks in which is a bit confusing. Also what if our premium is small ie, $50 monthly and meds $4. Does the moneies in the HRA keep building up and if so is there a limit as to how much can accumulate in this account?
1Valori,
Yes, the money in your HRA account rolls over without limit if you don’t use it.
–Ohio PERS
If I don’t use all my HRA allowance in a calendar year will it roll over into a following year?
Barb,
Yes, it will roll over to the next year.
–Ohio PERS
I have a question about a person in a nursing home and is on medicade. How will she pay her ins. bill?
John,
She will have to sign up for a plan through the Connector. It would be good if someone can help her with this. She also can have a power of attorney act for her.
–Ohio PERS
She lives there and the nursing home takes all of her assets. Will connector pay direct to ins co.?
John,
Someone will have to set up automatic reimbursements for her for what can be covered that way, such as monthly premiums. Other expenses require applications for reimbursement. The Connector does not pay directly to insurance companies; rather, it reimburses costs that were already paid for by the insured.
–Ohio PERS
Above I see that Linda Cooperstock stated that her mother was set up with an AARP Medigap plan and the person from One Exchange helped set her up for automatic reimbursement. I was told that AARP does not qualify for automatic reimbursement by the person who set my husband up. She told me that we have to pay the January premium and then send in a physical application to be set up for automatic reimbursement. Which is true?
Jenette,
Some insurers request that you send in a form to request automatic reimbursement. Either way, it sounds like you can set it up. In the meantime, you can do manual requests for reimbursement.
–Ohio PERS
who would have ever thought that we would work for the State and paid into OPERS for 30 years and end up jumping through hoops like this. We pay our premiums and get reimbursed. We pay our DR. Bills and get reimbursed, Heaven forbid that we forget, and not remember to send it in. I signed up but don’t like any of this at all.
I understand that OPERS retiree spouses are eligible for an allowance toward their insurance. Does this mean that the retiree’s allowance is reduced or is the spouse allowance in addition to the regular retiree benefit. It seems that if it is in addition then OPERS retirees are being treated unfairly. Funds for health insurance for OPERS retirees should be divided among retirees only, not spouses.
Jean,
OPERS retirees’ allowances are not reduced because we provide a spousal allowance. We had been doing this for years. The spousal allowance is being transitioned to zero over three years beginning in 2016.
–Ohio PERS
I will retire in April 2016. OPERS will deposit into my HRA for myself and for my spouse through 2017. We currently have no health insurance through OPERS but we both have a Medicare Advantage plan that we pay for personally. I have enrolled for 2016 through OneExchange in preparation for the HRA, but it would be more advantageous for my spouse to remain with his current plan. Can I use the HRA money for my spouse’s premiums and medical expenses even though he is not enrolled through OneExchange?
Bonnie,
Yes, you can use HRA funds for a spouse’s premiums for coverage purchased outside the Connector.
–Ohio PERS
I found using the Connector quite stressful. I have signed up and paid the first month’s premium. My question is will I need to wait until January to have that money reimbursed?
Mary Lou,
The HRA accounts will not be funded until January, so yes, that’s when the first reimbursement will take place.
–Ohio PERS
Will our dental and vision coverage automatically be continued?
John,
If you did not make any changes during open enrollment, then yes.
–Ohio PERS
where is the form you need when they pay out of pocket and you want to get that refund back to the retiree, cannot find it on forms page
Julie,
You should file for reimbursement at the OneExchange portal. You will find instructions beginning on page 8 of the Getting Reimbursed Guide. OneExchange sends you that guide after you choose coverage, or you can find it on the OneExchange/OPERS portal.
–Ohio PERS
I have set up a different checking acct. which will be for just my medical reimbursement. Do I give my routing no. to the oneexchange during my phone interview or is there paperwork I need to fill out.? I still want to receive my monthly retirement check in my current checking acct.
Barb,
You can set up automatic reimbursement during your enrollment call or afterward, by going through your online account or by calling OneExchange. In addition to the account information you mentioned (routing number and account number), please make sure that the account is set up for direct deposit.
–Ohio PERS
What happens to the balance in the HRA when a member dies? If there was a spousal benefit election made at the time of retirement, what will the surviving spouse be entitled to after the member’s death?
Marge,
When the pensioner dies, no new deposits will be made through the HRA. However the remaining balance is available to an OPERS dependent, who could be a spouse or underage child. A claim must be made within 24 months of the retiree’s death. If no claim is made during that 24 months, the money will be forfeited.
We can’t say what every surviving spouse will receive without knowing the retirement plan option that was chosen. You can read about those in our Benefit Recipient Handbook.
–Ohio PERS
Enrollment went fine for auto-reimbursement for Supplemental and Prescription. I filed a recurring form for the OPERS annual Dental and Vision premiums, the costs of which were sent to me in the enrollment package from OPERS. I have had no response regarding the enrollment and was wondering if something can be done by OPERS to minimize this enrollment process by providing the correct/updated information to One Exchange to avoid the individual having to continue to contact them to verify the correct information and expedite the enrollment process? Thank you!
Bill,
Some insurance carriers provide policy information and ID cards in a couple of weeks of enrollment. Others take up to six weeks. Sorry if it seems like it’s taking a long time.
–Ohio PERS
I am the PERS retiree and on Medicare. My wife is also on Medicare. We have both enrolled in Medi-Gap with the same company, but we have enrolled in different Part D prescription drug supplementals. We have always kept separate checking and savings accounts and have nothing in a joint account.
How will this be handled when OPERS reimbursements start? Can I use my HRA reimbursements to defray some of her costs?
I’m having a lot of trouble seeing how the mechanics of all this is going to take place.
Martin,
The reimbursement will be made to the member’s account. You can submit your spouse’s premiums for reimbursement.
Please read the HRA reimbursement information that OneExchange was scheduled to send to you after your enrollment. You also can find that info on the OneExchange/OPERS website.
–Ohio PERS
What happens to our coverage through United Health Care if the company folds and withdraws from the market, as reported last week in Bloomberg?
follow up: http://www.foxbusiness.com/industries/2015/12/07/obamcare/
Jane,
The company hasn’t said a thing about “folding.” And you’re not participating in Obamacare, so your question is really irrelevant.
–Ohio PERS
A representative from One Exchange told me today that the annual extra deposit of $300 will be paid by check to me and arrive in the mail. However, in the info above it seems to state that this be deposited into my HRA account. Which is correct? Thank you
Marijo,
The payment will be deposited into your HRA.
–Ohio PERS
I understand that our vision care will stay with OPERS. Will I receive info on the plan and the cost?
I have automatic withdrawal for my healthcare premium, do I have the same for my perscriptions or do I have to set that up separately?
Barb,
You should have received information on the vision plan in the open enrollment materials we sent out this fall.
We can’t tell you through the blog what you have set up for prescription medication payments. Call us at 800-222-7377.
–Ohio PERS
A second clarification, please: representative from One Exchange one could submit paid expenses from prior to 1/1/16 (rollback is what she termed it). The above article states that the $300 can only be used for expenses in 2016 – is this true for all expenses to be reimbursed from my monthly allotment? If I have a $100 prescription from Aug., 15, can I submit it after 1/1? Thanks so much.
Marijo,
The only expense that you paid in 2015 that can be reimbursed through the HRA is the premium payment for January 2016.
–Ohio PERS
I opened a new checking account specifically for my reimbursements. The bank was offering $150.00 free if you deposited $1,000.00 into the account. Will this mess up my reimbursement account as far as IRS is concerned. I will not touch the $1,000.00 that I deposited or the $150.00 they gave me. If it will then I assume I will have to open yet another account. I thought I was the only one who could not figure all this out. It’s very stressful because everything is new.
Helen,
As long as the account is open it will work for the HRA. If you have tax questions, contact the IRS.
–Ohio PERS
When my wife’s hra ceases after 3 years can I still get reimbursed for her expenses from my hra account?
Thomas,
Yes, you can use the HRA to reimburse qualifying medical expenses of a dependent. The dependent doesn’t have to be receiving HRA contributions.
–Ohio PERS
I am a surviving spouse. I chose a Medicare/Advantage plan,
I signed up for direct deposit of my HRA allowance into my
checking account. My OPERS monthly pension check is deposited
into this same account. Is this acceptable?
I have paid my first monthly (January) premium to the insurance company.
Will the pension and HRA reimbursement be one check or two separate checks?
Will the HRA deposit be my total monthly allowance or the amount of the Insurance premium?
Barbara,
It’s OK to have the same account for pension payments and HRA reimbursement. The pension deposit and health care reimbursement always will be separate. The HRA deposit will be the amount of the insurance premium you paid, but you can be reimbursed only with what is in your HRA. If your premium is more than the monthly HRA allowance, you would receive the monthly HRA allowance.
–Ohio PERS
When will we see the Healthcare reimbursement amount in our account? I read that the extra $300 should be in by 1/8. Will the vision and dental that are taken from our pension checks be automatically reimbursed, or will we have to set that up? Forms or link to submit claims?
Caprice,
Correct — by Jan. 8. You can set up dental and vision reimbursements as auto-reimbursements. See the OneExchange/OPERS portal for forms and more information.
–Ohio PERS
It would be helpful to have a little more information on exactly where to go on the OneExchange/OPERS portal for forms and information on how to automatically have vision and dental reimbursed. I did this, am reasonably technologically literate and was unable to find the forms or information. More specificity would be much appreciated.
Carlton,
Click on this link and scroll down until you see “HRA Information.” The forms are there – Recurring Claim Form, Direct Deposit Form, etc.
–Ohio PERS
I sent in a recurring reimbursement form on Monday, January 4. I sent it with a tracking slip thru USPS. However, on the 7th I noticed that the post office was informed to forward it from the PO box in Omaha, NE to an El Paso, TX address. I called One Exchange and they told me that all reimbursement forms were to be sent to El Paso, TX. However, when I clicked on the “Click on this link” in your previous email reply to Carlton, the forms still show the Omaha, NE address. What gives? And, how long will this stall them reimbursing my premiums????
B
B,
We pointed this out to OneExchange, and they are fixing it.
–Ohio PERS
I am an opers retiree and i elected opers pension coverage for myself and my wife.
I am on medicare and have elected for medigap coverage through the opers connector. I have received an HRA payment into my checking account for the cost of my insurance obtained through the connector. There is still HRA value in my HRA account because my insurance costs did not exceed the HRA amount that I’m entitled to.
My wife is not on medicare yet and we elected to stay with the opers health insurance for her that was still offered.
My question is, can the remaining value in my HRA account be used to cover my wife’s opers health insurance premium?
Tim,
Yes, you can submit a request for reimbursement for your spouse’s OPERS insurance premium.
–Ohio PERS
well, they just denied me, see below:
DATE OF SERVICE TYPE AMOUNT REIMBURSEMENT NUMBER DENIED ▼
01/01/2016 – 12/31/2016 Premium $4,940.16 404881854 $0.00 $4,940.16
Reason: Additional information required. Please submit the invoice from the insurance carrier billed directly to an eligible member or dependent indicating the type of premium and amount.
Claim Number 404881854
Date of service 01/01/2016
Payment date
Expense type Premium
Amount denied $4,940.16
i sent them a copy of the OPERS statement showing the medical and pharmacy deduction that OPERS subtracts from my monthly pension ($411.68) and a copy of OPERS open enrollment statement showing that my wife has a medical mutual monthly premium of $411.68 2016 coverage summary.
i faxed this information to them and their reimbursement form.
i don’t know what else to do. i don’t even get a bill from medical mutual, OPERS takes that amount out of my pension, and that is the information i sent Towers Watson.
We know that OPERS tried very hard to get this new health arrangement, however, in my reviews of One Exchange, they are not affiliated with the Better Business Bureau. There have been a myriad of complaints on the REIMBURSEMENT issues and very poor service to the consumer. They hire students to talk to retirees with no compassion and bad attitudes. Not the fault of OPERS who have always been there for us. This is turning into a nightmare for many. Mistakes are being made due to poor organization. We are worried about fraud, since OE handles the “connector” ($$$$). If they are holding back in getting reimbursements to us, (1-6 months time), are they making money on our funds? First they say it will take a few months to get reimbursed, yet my first came in 9 days after they received my check? My spouse, however, is still waiting for reimbursement and we are nearly into next month, February. We wonder if he is insured. We have not even seen a bill for his premium,
yet we know they cashed his check. We hope this is a viable situation, not a fraudulent operation based on employee reviews of what is really going on behind the scenes. We, as senior retirees, need all the compassion we can get right now in our golden years. This is a hassle for us to change over, but we must TRUST or NOT TO TRUST, whatever the situation, but much of this is our “living money”, and we are not able to meet our bills if the reimbursements do not come in ON TIME. It was praised and outlined to us that this would be a smooth procedure, but it is appearing more skeptical day by day. The thought to an organization HOLDING our monies to gain interest is deplorable. IN time, I hope the insurance commission are made aware, and the Attorney General as well. If this is wrong practices involved, they need to be exploited. Just sayin’ (my thoughts)
Again, its not OPERS that is to blame, but their choice of an insurance broker taking over….
and has OPERS investigated OE’s reviews, references, credibility?
Lorene,
OneExchange doesn’t hold money related to the Connector. We do. So there is no threat that OneExchange is holding money for interest income.
There was a programming delay that has affected some of the early spousal reimbursements. That has been addressed, so the reimbursement process should be done on a more-regular basis in the near future.
–Ohio PERS
I don’t have any spousal reimbursement, but I still am experiencing a tremendous amount of difficulty with One exchange, with the website, with customer service, submitting claims, receiving funds, even talking to anyone who knows what is going on. Has anyone from OPERS tried any of these functions? I am computer literate and the site is terrible. I’ve been trying to upload a file for 2 days. No one has been at all helpful. I have called every week, with up to an hour of wait time.
Well it turns out I used the wrong pdf document (there are two types of reimbursement oneexhange documents, a recurring expense document and one that needs to be used for each expense, a spouse’s medical premium is not reimbursed as a recurring expense but has to be submitted monthly) when I first faxed my wife’s insurance premium information, and I didn’t use the Opers online document showing proof of that insurance premium. I originally used a scan of a mailed document that showed what my wife’s monthly premium is, (unacceptable by oneechange).
So on a second attempt I did use the Opers online document showing proof of that insurance premium, and the correct oneexchange pdf document, faxed all of that information to oneexchange and they eventually paid my hra into my checking account.
I just wanted to give an update, so that perhaps anyone else having problems getting their spouse’s insurance premium hra , may be able to figure out how to do it, considering my attempts.
Tim,
It has taken longer than anticipated to provide the initial spousal reimbursements, but they are available as an automatic reimbursement.
–Ohio PERS
Towers Watson and their subcontractors still have not reimbursed my wife’s automatic premium reimbursement. From some of the previous dialogue on this site, it appeared that the problem was solved. Just wanted you to know that it is not resolved.
Do you reduce our monthly benefit to put money in our HRA?
Linda,
No. HRA funds are entirely separate from pension funds.
–Ohio PERS
What is the advantage for a spouse to stay and shop with One Exchange instead of getting a plan from an independent agent? I have found that One Exchange has a limited amount of choices.
Mr. Hood,
When your spouse was receiving an HRA allowance they were required to be enrolled in a plan through OneExchange to receive reimbursement. Since your spouse is no longer receiving an HRA allowance this is not a requirement for them. Although you can submit for reimbursement, your spouse should consider the following items that they’ll lose if they dis-enroll from their plan with OneExchange.
• Choice – More plan options than what an independent broker can provide
• Objectivity – OneExchange brokers have no commission incentive to steer into certain plans
• Advocacy – OneExchange will not be able to conduct a 3-way call / provide support to an individual that has enrolled in a plan outside of their roster.
Julie, OPERS
From what I have read, my HRA will be calculated using number of years of service. Is there somewhere that gives more details (number of years = $xx)?
Thank you
OPERS pays a portion of the full cost of health care coverage based on your age when you first enroll in the OPERS health care plan and your years of service at retirement. We are in the middle of updating our website to add more information on the topic of allowance amounts. In the meantime, you can find the allowance percentages on the website at https://www.opers.org/pdf/healthcare/allowance-table.pdf. For example, if someone were to retire with 28 years of service at age 62, OPERS would pay 73 percent of the total premium cost and the retiree would pay the remaining 27 percent.
If you would like more information, please call us 1-800-222-7377 and we will be happy to walk you through it.