OPERS video: Open enrollment via the Connector
The 2017 open enrollment season for the Ohio Public Employees Retirement System officially kicks off Oct. 15.
For Medicare-eligible retirees, it means reviewing current medical/prescription drug plans and assessing if change is necessary. If you are keeping the plan you selected for 2016, you do not need to contact OneExchange. Your 2016 selections will automatically carry over into 2017.
Tune in to a new video as OPERS Health Care Project Manager Gretchen Feldmann discusses things to think about when considering change and what to do if change is or is not on the horizon. She also reviews the different roles each OneExchange subject matter expert plays in the enrollment process.
This video also can be found on the OPERS YouTube channel.
In addition to this video and the personalized open enrollment material currently being mailed, OPERS will hold Tele-Town Hall meetings in October to share details and answer questions about open enrollment and OneExchange. If OPERS has your phone number, you’ll be notified 48 hours in advance of when a Tele-Town Hall will take place for you.
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.
When will information be coming from insurance companies regarding premiums.
Good afternoon,
You will want to visit medicare.oneexchange.com/opers to check for 2017 rates. CMS releases this information in the beginning of October. Check back often for the new rates.
thanks,
Ohio PERS
What about people that don’t have computers. My form asks for proof of payment and if my rates change how can I send proof of payment. I don’t have anything with proof now because I have auto deduction and reimbursement. I even find the form confusing in some areas. Are we supposed to mark it as “new” each year thus voiding the proof of payment?
Thanks for reaching out. If you are referring to the HRA manual request, in order to be reimbursed for your monthly insurance premium, you must first pay your premium to your insurance carrier. Then, you need to send your completed reimbursement request form and supporting documentation to OneExchange. Acceptable documents include itemized receipts or premium statements from your insurance carrier and a cancelled check, credit card statement or a bank authorization showing proof of payment. You should be able to contact these places of business for the appropriate document copy.
-Ohio PERS
I participated in the 1:00PM teleconference today. I was using a good quality, land line speaker phone and had difficulty hearing some of the speakers. Speakers need to speak directly into the microphone. Some of the speakers had a list of issues to consider. These lists should be published on the website or the facebook page. The call that I was on lasted less than 30 minutes. I was aware of all of the issues discussed, but many were not. Sixty percent of the participants did not know that they had to renew their recurring requests for reimbursement every year.
That is the same problems I had with it. You could not hear the speakers clearly.
Maybe this is a stupid question but I’m a little confused about renewing our recurring requests for reimbursement every year. Is that for the reimbursements from OPERS that we get for our premiums we’ve paid? How do we do that, where do we get the forms, or will this all be answered in the packet we get via U.S. mail? This whole thing is very frustrating. Thank you.
Ellie,
Recurring reimbursements are for regular expenses you incur that are not your main insurance premiums. For instance, Medicare Part B reimbursements, dental reimbursements, etc.
If you had those automatically reimbursed last year, you’ll have to fill out a new recurring reimbursement form. That will be good through calendar year 2017.
Go to the OneExchange/OPERS website and scroll down to “Health Reimbursement Arrangement.” There are several helpful documents there, including the “Getting Reimbursed Guide” as well as the forms.
–Ohio PERS
I have found all that information but it requires Proof of Payment–where do we get that “proof”. The only thing I need is Dental. I’m wondering how many people are not going to be getting their reimbursements. We never had to do this prior to this year.
The proof is the Premium Reduction Letter, also referred to as Premium Receipt, and is available through your online account or you can call OPERS and we will mail you a copy.
Thanks,
Ohio PERS
This video says December 7th is the deadline but the booklet says you have til the end of December. Which is it? I already have an appointment for my enrollment set for November but I was just wondering about the confusion with the dates.
Stephen,
Open enrollment ends on Dec. 7.
–Ohio PERS
I would like to enroll for the 10/17/16 seminar in Mentor, Ohio. Please advise. Thank you!
You can register for OPERS seminars in two different ways:
1) Online with your OPERS online account. Once logged in click on “Tools and Resources” and then on “Seminars and Counseling” to select a seminar.
2) Calling OPERS at 1-800-222-7377
Hope to see you there,
-Ohio PERS
Can I add dental to my plan and if so what will it cost
Great question. you will be able to enroll in the OPERS dental plan during open enrollment, beginning October 15th. Open Enrollment materials are currently mailing, and contain a personal allowance statement with cost details. Included within the packet of information are details about dental plan as there are two options: high and low. If you have further questions, please do not hesitate to call OPERS at 1-800-222-7377.
thanks,
Ohio PERS
Think I’m ok so far. Thanks. MMN
If I don’t change my plan do I have to change my premium payment or can I keep it as is .?
Thank you
Sue,
If you want to keep your current plan, you do not need to do anything during open enrollment regarding your premium payment and premium reimbursement.
–Ohio PERS
Sue,
You can keep your plan, but the actual premium charged is up to the insurer. The payment will still be made automatically if that’s the way you set it up last year.
–Ohio PERS
Thank you this makes a lot easier I love Humana I will continue to stay with this company .
Thanks for the short video regarding the 2017 Enrollment. This time will certainly be much easier and less stressful regarding the enrollment.
Was wondering if there is going to be for 2017 a reduction in the amount reimbursed for the medical coverage for widows, spouses and dependants, as noted in the past may happen. Please advise. Thank you
Allowances for spouses, including surviving spouses, will continue to be incrementally reduced to $0 by 2018. For an exact allowance amount, please refer to your personalized cost statement that was included with your Open Enrollment Guide, mailed earlier this month.
thanks,
-Ohio PERS
One exchange came in to existence the beginning of 2016 for reimbursement for our medical premiums, and in order for me to activate my prescription coverage with Humana thru AARP I had to prepay my January 2016 premium in December 2015 and when I submitted my premium for reimbursement i was denied because i paid the premium in December 2015. I’m trying to understand the theory in this as it was a requirement of AARP to prepay the previous month to activate the account. Can you please help with this issue?
Thank you
Plan premiums are the only expense type that was reimbursable prior to 1/1/16; based on the information you provided, you should not have been denied. Please call OneExchange to discuss further.
-Ohio PERS
I will be out of town for a couple weeks in October. Will there be make up sessions for the tele town hall meetings if I am not available when called?
Dave,
In addition to the tele-town halls already announced, we’ll be doing one at 1 p.m. on Thursday (Oct. 20).
–Ohio PERS
I watched this video after listening to the town hall meeting today.There are other reasons a person needs to go through the open enrollment period not mentioned in the video or the town hall meeting.’
I answered the polling question that I was changing plans this year. I did not plan to change plans, however we received letters last week that we would not be covered next year as our plan was not being offered this year. There I do not have the choice of not going through open enrollment this year.
Needless today, I am very disappointed. Thank you for listening.
So did we. The stupid letter fro Meadow Gold just dropped us. No offer for an alternative plan, several 800 numbers and none of them we Meadow Gold or Tower Watson. We called Meadow Gold and was unofficially told that not enough people signed up for our plan so they just dropped us., period, now the video Pers if you like your plan you can keep your plan. More stress like in 2016.
I will be turning 65 in Feb. 2017 when do I need to sign up with the connector?
Prior to your 65th birthday, you will receive a packet of information in the mail with detailed instructions such as the importance of signing up for Medicare Parts A and B, when to contact OneExchange, how to set up your online account and more. If you are interested in learning more about OneExchange, you can visit medicare.oneexchange.com/opers and also visit opers.org.
-Ohio PERS
why when i call to complain about one exchange was told you have nothing to do with them. and being on phone for 2 1/2 hrs with 3 different people in the end that all you want is to get off phone give me anything. also called them last month was told could not talk till November 17,
I would very much appreciate having a manual authored collectively by OPERS and One Exchange that outlines the typical requirements that each retiree needs to address on a yearly basis. It should also include the forms that need to be submitted for reimbursement of expenses, for the automatic monthly payments, and monthly reimbursement, etc. I believe it could greatly reduce the calls to both OPERS and One Exchange, as long as these same forms can be accessed from the respective websites. Additionally, the manual should outline the documentation required to accompany the form submitals. Certainly, this will require some effort on the part of OPERS and One Exchange, but the ultimate benefit will be realized by both parties. It should reduce the waiting time for retirees to hold for a representative to address their calls to each of these two agencies, because a well conceived manual will reduce the need to make the calls.
Thanks you for your feedback, we love to hear from retirees as to how to make this process better. We are actually working on a piece of communication now that will house information such as what you describe. Please also know that forms are currently available online at opers.org and through OneExchange at medicare.oneexchange.com/opers.
thanks,
-Ohio PERS
I strongly endorse Lawrence R. Gillen’s recommendation for a collaborative instructional manual. Retirees and the people helping them with their health care paperwork need a single, comprehensive, up to date resource.
The online manual (printable for those who need a mailed hard copy) should pull together information from brochures, videos, conference calls, and the web (OPERS, One Exchange, Medicare).
Retirees also need more detailed, step by step instructions for each HRA topic. To be most helpful, please provide very specific instructions for reimbursement, such as real life examples with completely filled out sample paper forms and sample acceptable receipts. Please also include examples with completed computer screen shots showing how to file common claims online.
Please ask retirees to review the draft instructional materials.
Thank you for your efforts to enhance the process.
We appreciate any feedback that can make the process easier to follow. Have you visited medicare.oneexchange.com/opers? This website features much of the information that you speak of, all located in one place. It houses the OneExchange Guides pertinent to getting ready, enrolling and the HRA process, videos and forms. opers.org houses most of this information within the Healthcare/Medicare plan pages. We also have a Resources section within the Health Care pages that houses videos specific to health care topics such as HRA and enrollment for 2017.
OPERS will share your feedback with OneExchange to further develop these tools. Thank you again for your thoughts.
-Ohio PERS
thank you for info
I THOUGHT SPOUSES WERE NOT TO BE COVERED IN THE COMING YEAR.BUT YOU ARE SAYING IF WE LIKE THE PLAN WE HAD IN 2016 WE NEED NOT DO ANYTHING.IF SO WILL THE REIMBURSTMENTS STILL BE THE SAME FOR BOTH OF US?PLEASE RESPOND TO MY EMAIL. THANKS VERY MUCH ///RON SCHULTZ
Great question. Your open enrollment materials (currently mailing) contain a personalized allowance statement with premium costs and HRA amounts noted for each qualified individual. Regarding spouses, pre-Medicare dependents will see a considerable premium increase and as such we have included additional resources for spouses to turn to; Spouses (including surviving spouses) enrolled in Medicare Parts A and B over age 65 can enroll in an individual Medicare plan with the help of OneExchange. Allowances for Medicare-eligible spouses will continue to be incrementally reduced to $0 by 2018. However, many retirees will find they have sufficient allowance dollars remaining to pay for a spouse’s premium. If interested, there are resources for Medicare-eligible participants to learn more about plans available outside of the Connector. Please visit opers.org for more information.
Watch your mailbox if you have not already received your Open Enrollment materials as it includes more detailed information.
-Ohio PERS
It would be very helpful to have my 2017 packet in front of me before these tele-town hall sessions but I guess that will not be the case.
One Exchange was an absolute nightmare last year trying to get the health insurance set up for me and my husband. I filled out the profile on the website thinking that would help a lot with the procedure. The person I talked to did not even look at my profile, said she didn’t need to. When are we going to get information concerning our health insurance (such as are the premiums going up, what will the coverage be). Back to applying – I got disconnected twice and then got a different person when I called back, got put on hold several times and waited and waited for someone to come on the line. I hope I don’t have to make any changes this and TRY TO TALK TO ONE EXCHANGE AGAIN!!
Martha,
By now, you should have received your open enrollment kit for 2017. It will contain information about your health insurance costs. If you haven’t received it, call us at 800-222-7377.
–Ohio PERS
Sorry for your experience but glad to see others have the same or similar interactions with OE and OPERS says you must talk to OE. What a vicious circle we end up in.
I only got to hear 11 minutes of the conference call. Everything went dead — I still had a dial tone so I don’t think it was my phone – don’t know. Anyway, I would like to address Ed Bell’s statement above where he says “Sixty percent of the participants didn’t know that they had to renew their recurring requests for reimbursement every year. I don’t even know what that means. Can you please enlighten me.
Thank you.
Donna Toy
Donna,
OneExchange has a few types of reimbursements. The one that’s most common is the “automatic reimbursement” of your main insurance premium. You likely set this up during your initial enrollment call. If you have it, and you keep the same plan you have this year, you do not need to fill out any forms. You’ll keep being automatically reimbursed.
OneExchange also has “recurring reimbursements” for other expenses, such as your Medicare Part B premium or perhaps a dental or vision premium. They’re only active through the calendar year in which you set it up. If you set one of these up last year, you’ll need to do so again for the 2017 calendar year.
You can actually do that right now at the OneExchange/OPERS website. Scroll down to forms and look for the recurring reimbursement forms. There’s a specific one for the Med B premium.
–Ohio PERS
Michael’s explanation is, as always very useful. I would like to add that one the reasons that recurring reimbursement forms need to be updated every year is that the amount often changes. I haven’t received my medicare part b statement yet and I won’t have a statement with the new dental and vision rates until I get the documentation from OPERS in my online OPERS account. I will have to wait for the documentation before I can update my requests for recurring reimbursement.
My Premium for medigap and prescription coverage is automatically deducted from my checking account on the 1st for one and on the 4th for the other. It is not deposited back into my checking account until the 22nd or later. Why is there such a long wait until my premiums are deposited back into my bank account.
The turnaround time for reimbursements will vary by the method reimbursement is being requested. The Automatic Reimbursement feature will have a 4-6 week turnaround time from the time the premium payment is made. When faxing in a manual claim, the documentation can take up to 48 hours to be scanned and loaded into the system. Thereafter, the turnaround time is 3-5 business days to process and approval. Also, we must take into consideration of when the Benefit Recipient’s financial institution will release the funds to the account after OX has transferred payment, as this may take up to 72 hours depending on the financial institution.
thanks,
Ohio PERS
Thank you, the reminder and infromation
How & when are the requests for recurring reimbursements made????
Will forms for these be mailed to us.??
Great question. If you haven’t already, I recommend looking at the OPERS Open Enrollment webpage as it includes information about the reimbursement process. The forms are also available online through opers.org and at medicare.oneexchange.com/opers
thanks,
Ohio PERS
So many people, especially older folks, don’t have computers or access to one and can’t access the information or copy the forms.
Understood. The option to call for forms to be mailed is always there. Please call OneExchange at 1-844-287-9945 and they will be happy to mail the appropriate forms. If the forms that are needed are OPERS related, we are able to do the same.
OE does not like to mail forms, tell you to print them off from the web site, and if you insist on having them mailed to you they say they can only mail one and you have to contact them again to get more forms. I had to get with a supervisor to get three forms sent at one time and even then it takes 2-3 weeks to get them so call way in advance of when you will be needing them.
Utterly confused here! My recurring reimbursement is the payment One Ex makes monthly for my Medicare Plan B, sponsored by AARP and underwritten by UHC. So — you are saying I have to re-request this even though it has been auto reimbursing all through 2016?
If so, how do I re-request it?
I respectfully ask that you not tell me what a great question this is! That is too perky for the task at hand. This is a horrible experience — it was last year and it is again this year. Not meaning to sound nasty, but doing this brings out the absolute worst in me (and in others too, I guess.)
It isn’t as if I don’t have other things I want to do during October and November! Others too! Thanks, tho…
Recurring reimbursement is separate from automatic reimbursement.
If you are not changing carriers and you set up automatic reimbursement for premiums in 2016, you DO NOT need to set it up again as those arrangements will automatically continue.
If you set up recurring claims for Medicare Part B, OPERS vision and/or dental premiums, you WILL need to resubmit this information as it DOES NOT carry over.
Forms are located at opers.org, and medicare.oneexchange.com/opers.
If you have further questions, please call OPERS and we can further walk through it with you.
I was disconnected from the teleconference. Wasn’t originally connected until 1:06. Didn’t even
hear 10 minutes on conference.
Thank you for reaching out. The information shared in the teletown hall meeting is an abbreviated message of what was shared in the Health Care Open Enrollment Bulletin and the Health Care video that posted yesterday. This same information plus more detail is included in the Open Enrollment Guide which just recently started to mail. The main message is that if you are NOT making changes to your Medicare insurance plan(s) for the 2017 plan year, you DO NOT need to call OneExchange. Opers.org is another resource that contains information pertinent to the open enrollment season, such as important dates and action steps to take in regards to claim and premium reimbursements.
thanks,
Ohio PERS
My concern is what is our monthly HRA going to be? If I understood correctly, it’s going to drop $300.00.
I do understand we are to receive the 2nd annual payment of $300.00. It sounded to me that after 3 years the HRA will be very low if at all. Please clarify.,
Great question. The 2017 OPERS Open Enrollment material is currently mailing. Included with the guide is a personalized allowance statement which states your 2017 monthly HRA amount. Along with the monthly deposit, retirees will also receive the $300 annual deposit in January. Additionally, any funds you have remaining in your account in 2016 will roll over to 2017. After 2018 the OPERS board will re-evaluate the annual $300 deposit. In regards to the HRA dropping, retirees will see a decreased amount compared to 2016, and will experience it again in 2018. At this time, there are no further plans to decrease it further after the 2018 plan year.
thanks,
Ohio PERS
After reading the Health Care Open Enrollment Bulletin and your comment to Ms. Bradford about the HRA decreasing in 2016 and 2018 I am left confused. How much is the HRA decreasing and why? Thank you.
Thank you for reaching out for clarification. This is a two part answer. First, if you recall, in January 2015, your HRA received a one time annual deposit of $300. This was in addition to your personal allowance amount, which on average was around $337/month. The annual $300 deposit will continue in January 2017 and again in January 2018. The OPERS Board will re-evaluate at that time, if the annual deposit should occur and if so, in what lump sum.
The second part of this answer is around the personal allowance amount that is deposited each month (refer to your personal allowance statement, included with your October Open Enrollment materials for your personal amount.) As part of the changes that were adopted in 2012, we steadily decreased the allowance amount by 1/3 each year to 2018. 2018 will reflect your ending amount.
-Ohio PERS
The tele townhall call was already in prgress when I got connected so don’t know what I might have missed and certainly there was no time or option to ask questions. Even after the call there was an option to leave a voicemail but it went to a busy signal and disconnected. Shame OX didn’t have sufficient staff/call centers to handle the initial signup instead of now when the largest percentage of people are not needing the service.
If one of the reasons OPERS cut the retirees out of the promised health care coverage offered to others was to save money (supposedly for OPERS and the retirees) then why don’t they take some of the HRA funds not being used by individuals lucky enough to have obtained plans that cost less without higher out of pocket and other expenses who have money left over every month? Quarterly those funds could be distributed into the accounts of others who cannot meet their medical expenses due to the HRA not being sufficient to cover them? The purpose is not for people to make money from their insurance plan/coverage/reimbursement and there are those who have such high drug or other related costs that are beyond their control and HRA is not sufficient to cover them. Some people are really hurting as a result of this change, medications being placed into higher tier levels every year, and those like myself who are not 65 but had to retire on disability and not eligible for supplement plans which are cheaper with better coverage.
BJL,
Sorry to hear you had some technical difficulty with the Tele-Town Hall. The content is what is in this video and in the open enrollment kit we sent to you.
As for taking some of the HRA funds from some members and distributing it to others, that is not the way the system is set up, and we would be in no position to make that kind of judgment.
–Ohio PERS
Don’t know why not when you made the decision to change our health care and OX has everyone’s account totals.
I don’t have any carry over HRA funds and I am sympathetic with your medical situation, but the left over HRA funds belong to the retiree for their future medical expenses. Clawing back the HRA remainder and redistributing the funds before the death and end of medical expenses of the retiree and their family is not and should not be an option.
The intro says OPERS is still there for us as an advocate when we have issues with OX but when I contacted them they referred me to OX and stated they no longer deal with health care issues.
Thank you for contacting us. I’m sorry you had this experience. OPERS is here for you should you have issues with OneExchange. While we may not be able to answer questions pertaining to topics such as your HRA administration, we will work to get the answers for you.
-Ohio PERS
I listened to the phone call today and I thought I heard Marianne Steager say that Medigap F and C plans will be eliminated in 2020. Is that correct? What will happen to those of us on Medigap F plans? We will we have to select from the remaining plans or will there be a replacement?
First, thank you for participating in the teletown hall meeting yesterday, I hope you found it beneficial. OneExhange will be able to provide further information, however this is what we do know:
• If you choose a Plan F (or Plan C) this year, you will be able to keep your plan in 2020. All beneficiaries who enroll in a Plan F or Plan C prior to 1/1/20 can keep their plan after 1/1/20.
• It is too soon to tell if the new rule will affect your premiums. Plan F and Plan C are the two most popular Medigap plans, comprising over 6.5 million beneficiaries. Both insurance carriers and State departments of insurance will have strong incentives to ensure premiums remain stable as the policy takes effect.
• If you select a Medigap plan today, but do wish to change plans in the future, you will be able to enroll in a Medicare Advantage plan during the annual open enrollment that takes place each fall. You also may be able to switch into a different Medigap plan, although whether or not such a plan will be available on a guaranteed issue basis will depend on the state where you live and insurance carrier issuing the plan.
-Ohio PERS
Good to know that those currently enrolled in Medigap F and C plans will be able to keep their plan. Why are these plans being terminated? Medicare Advantage Plans do not work that well for folks who travel.
Wonderful question that OneExchange will be able to better assist with. What we do know is this:
• If you choose a Plan F (or Plan C) this year, you can keep your plan in 2020. All beneficiaries who enroll in a Plan F or Plan C prior to 1/1/20 can keep their plan after 1/1/20.
• It is too soon to tell if the new rule will affect your premiums. Plan F and Plan C are the two most popular Medigap plans, comprising over 6.5 million beneficiaries. Both insurance carriers and State departments of insurance will have strong incentives to ensure premiums remain stable as the policy takes effect.
• If you select a Medigap plan today, but do wish to change plans in the future, you will be able to enroll in a Medicare Advantage plan during the annual open enrollment that takes place each fall. You also may be able to switch into a different Medigap plan, although whether or not such a plan will be available on a guaranteed issue basis will depend on the state where you live and insurance carrier issuing the plan.
Thanks,
-Ohio PERS
Certain members of Congress (mostly Republicans) demanded an end to coverage for Part B deductibles (Plans F and C) as an incentive for seniors to use less medical care, http://www.elderlawanswers.com/congress-schedules-end-to-insurance-coverage-of-medicare-part-b-deductible-15094 .
Health care professionals agree that incentivising consumers to use primary care physicians decreases over all medical costs. Congress is wrong again and it will cost seniors money.
Interested in new insurance rates and renewing recurring reimbursements.
To view plans and new rates, visit medicare.oneexchange.com/opers. Also, please visit opers.org or reference your Open Enrollment materials or Open Enrollment bulletin for information about renewing reimbursements. Each source provides an overview of what to submit and when. Forms are also available at opers.org and at medicare.oneexchange.com/opers.
Please call OneExchange if you have any questions, 1-844-287-9945.
Thank you,
-Ohio PERS
If I want to keep the Medigap insurance I had last year I understand that I don’t have to do anything. Does that mean my premium payments will continue to be automatically withdrawn and monies will automatically be taken from my HRA and deposited into my personal banking account or do I have to do something to keep this process going?
Thank-you for your assistance
If 2016 auto reimbursement for plan premiums through OneExchange was previously set up and you do not change plans, arrangements will continue into 2017.
Recurring premium claim forms for 2017 Medicare Part B premium and OPERS vision and dental premiums must be resubmitted to OneExchange along with required documentation:
•Medicare Part B premium – Statement from SSA showing 2017 premium amount (available in December)
•Vision/Dental premium – OPERS Health Care Premium Receipt letter (available in January)
-Ohio PERS
I did not hear any information regarding medicare reimbursement and what we have to do to ensure we will continue to get reimbursed. Thank you.
If you set up automatic reimbursement for plan premiums in 2016, you do not need to set it up again as these arrangements will automatically continue. If you set up recurring claims for Medicare Part B, OPERS vision and/or dental premiums, you will need to resubmit this information as it DOES NOT carry over. More detailed information is available at opers.org, in your open enrollment materials (arriving soon if you have not already received them), in the winter retiree newsletter (also available at opers.org) and at medicare.oneexchange.com/opers.
Thanks,
-Ohio PERS
I received a call yesterday(Oct 6th) informing me that I would be connected to a teleconference Wed or Thursday. No time or date was specified and Wed had already passed. However, I stayed home all day Thursday waiting for the call. Shouldn’t the message give dates and time? Could they have meant next week, the 12th or 13th of Oct? It’s crazy that I should have to be waiting all day for to be connected and not receive a call.
This call was speaking to the teletown hall meeting held on both Wednesday and Thursday of last week. Because there were calls scheduled for multiple days and times, the automated message did not specify a time. We realize this was confusing to some and are making revisions to the message for future meetings. The purpose of the meeting was to state that if you do not have changes to your 2016 health plan selection through OneExchange, you do not need to take action as your plans will roll over. Another message reviewing the claims process as described in your open enrollment materials. If you have not received these, they are on their way.
Appreciate the feedback,
-Ohio PERS
Re: the auto call for the town hall – another glitch occured in that I did not receive any notice via any means, until about 1:00 pm, at the exact day/time of the call. I was able to make a connection about 1:08, but it was entirely happenchance. I didn’t even have time to gather a notepad for notes. Perhaps there were other notifications but none of them reached me. IF a notification call came via an unidentifiable phone number which didn’t leave a voice mail, I (and many others) delete those, especially in an election year.
What is the status of Dental and Vision coverage?
The vision and dental plans offered through OPERS are still available. If you have not received your open enrollment materials, they are on their way and include a personalized cost statement with these details. If you have further questions after receiving your guide, please call OPERS (1-800-222-7377).
Thanks!
-Ohio PERS
I would like to have my monthly Medicare amount deducted from my HRA. How do I have this done. Do I start with One Exchange or OPERS?
Automatic premium reimbursement allows you to obtain reimbursement for your monthly insurance premium without submitting a monthly reimbursement request form. You may activate this feature, if it is available for the insurance plans that you selected, in your OneExchange online account or by calling OneExchange at 1-844-287-9945 (select option 2). Once you have elected this option, you no longer will need to submit reimbursement requests for your insurance premiums; however, don’t forget that you will still need to make your monthly premium payments to your insurance carrier.
Establishing automatic reimbursement takes 6-8 weeks because connections need to be set up between OneExchange and the insurance carrier for each account. The carriers have to send OneExchange data showing that your claims have been paid, and then OneExchange has to set up the process on their side. Once the first month’s automatic reimbursement is completed you can expect your reimbursement around the same time each month. You can submit the first couple of month’s reimbursement requests manually to receive funds sooner while waiting for the automatic reimbursement to be completed.
In order to be reimbursed for your monthly insurance premium, you must first pay your premium to your insurance carrier. Then, you need to send your completed reimbursement request form and supporting documentation to OneExchange.
Acceptable documents include itemized receipts or premium statements from your insurance carrier and a cancelled check, credit card statement or a bank authorization showing proof of payment. A claim form may be obtained from the website or by calling customer service at 1-844-287-9945 (select option 3).
More information about this process is available at opers.org as well as on the Oneexchange/OPERS website
Please don’t hesitate to call OneExchange (1-844-287-9945) with any HRA questions.
-Ohio PERS
wasn’t able to listen in, but these comments have been very helpful. Thank you for helping us–non-internet people –the emails are a great help.
You say if theRe aren’t any changes, but than you also say we need to renew our reimbursement account ? Could you clarify this process for us ?
Thank you
No problem. If you are NOT making changes to your medical/pharmacy plan selection through OneExchange, you do not need to take any action to re-enroll as your enrollment will automatically continue.
Separately from your health plan selection, you have an HRA. If you set up automatic reimbursement for plan premiums in 2016, you do not need to set it up again as these arrangements will automatically continue. If you set up recurring claims for Medicare Part B, OPERS vision and/or dental premiums, you will need to resubmit this information as it DOES NOT carry over.
thanks,
-Ohio PERS
So you are saying here that if I have automatic deduction and reimbursements for my health care and prescriptions set up from 2016 that I do NOT have to send in a form each year? It’s confusing when you say we have to fill out a form for recurring reimbursements every year. So then it’s just for ‘claims’ and not premiums? Will this information be sent out in the mail. So many older folks don’t use the computer.
Thank you
This information is included in your open enrollment materials (if you have not already received them, they will arrive in the mail very soon), in the winter Retiree Newsletter as well as online at opers.org and at medicare.oneexchange.com/opers. Please give OPERS a call at 1-800-222-7377 if you need further information.
thanks,
Ohio PERS
I saw another comment on this but I don’t think that I understood the explanation. Medical Mutual takes the amount out between the 1st and the 6th but I am not reimbursed between the 22nd and 26th. I do not understand why it is taking so long.
Thank you!
The turnaround time for reimbursements will vary by the method reimbursement is being requested.
For example, if you selected Automatic Reimbursement it will have a 4-6 week turnaround time from the time the premium payment is made.
When faxing in a manual claim, the documentation can take up to 48 hours to be scanned and loaded into the system. Thereafter, the turnaround time is 3-5 business days to process and approve. Also, we must take into consideration of when the your financial institution will release the funds to the account after OX has transferred payment, as this may take up to 72 hours depending on the financial institution. If you have further questions, please call OneExchange at 1-844-287-9945.
thanks,
– Ohio PERS
None of the links for the video will work. Where else can I find it, and is there a written transcript of the video? Thanks.
Try accessing the video from the OPERS homepage. – Click on the YouTube icon, OneExchange Year 2 video.
-Ohio PERS
I am sorry I could not attend the Town Hall meeting. I live in Florida and preparing to evacuate as Hurricane Matthew was approaching. Reading the Blogs has been helpful.
Barbara,
Thanks for reading PERSpective.
–Ohio PERS
I am confused, Michael and sorry but have been unable to attend the meetings.
I have my Medicare Plan B, sponsored by AARP, underwritten by UHC auto paid from my One Ex Account this year and am happy. I want to continue it next year. It appeare I have to re-request it? I know how to select and de-select auto reimbursements. Do I have to wait until Jan 1, 2017 to select auto again?
And how do I make sure I get auto-reimbursed by One Ex — i.e. that the money they pay for my Plan B goes auto into my credit union account on file just like this year? Doesn’t this auto reimbursement and auto payment just transfer over?
Thank you. JA
JA,
Your AARP plan will roll over into next year, without any action on your part, if that’s what you want. So too will the auto reimbursement for that premium.
If you are also being reimbursed each month for your Medicare Part B payment, you will need to re-submit a recurring reimbursement form for that. This is not “auto reimbursement.” It is “recurring reimbursement,” and you do need to re-submit the “Recurring Part-B Claim Form.”
It is on the OneExchange/OPERS website, and you can fill it out now. You don’t have to wait until January.
–Ohio PERS
Last year I set up our medical/prescription plans via the One Exchange. website. This year the only change I have is to enroll in a new prescription plan in as much as my current plan is now under sanction by Medicare. Do I have to do that on the One Exchange site or may I do it directly with the compnay or on the Medicare.Gov site? The Medicare.Gov site is excellant and full of usefull information regarding coverage and costs of the various plans available. I also note that the premium costs of the plans I have been interested in are the same on both sites. Thank you for your help.
You can enroll outside of OneExchange, just keep in mind that your automatic reimbursement through the prescription drug plan that you enrolled in through OneExchange. As long as you remain enrolled in a medical plan through OneExchange, you will still have access to your HRA.
-Ohio PERS
Heather: Again, thank you. Donn
We did not receive notice about the tele town hall call?
All of the information shared during the teletown hall meeting is shared in your open enrollment materials, the health care open enrollment bulletin as well as at opers.org. The premise of the teletown hall was to reiterate that if you do not have changes to your OneExchange plan selections from last year, you do not need to take action to re-enroll in that carrier’s coverage as it will automatically renew. Another key message was discussion around the reimbursement process and what forms do need resubmitted each year. This is laid out in detail on the opers.org open enrollment webpage as well as printed in your open enrollment materials.
-Ohio PERS
I received my open enrollment packet. I read both the vision and dental coverage and it says “PER CALENDAR YEAR.” Is this correct and is this NEW? In the past I have been denied benefits from (hard to work with) Aetna because my yearly eye exam was 11 months apart.
Great question. If you are enrolled in OPERS optional vision coverage through Aetna, your coverage will change from a per calendar year system in 2016 to a rolling 12-month system in 2017. For example, if you receive a vision exam in July, you can schedule another vision exam the following July. Previously, you could have one exam between January and December of each calendar year. If you have questions, please contact Aetna Vision at 1-866-591-1913.
-Ohio PERS
If that is the system then tell it like it is! The brochure says ONCE PER CALENDAR YEAR not what you just said. Also as I said in 2015 I was DENIED a benefit because there was NOT 12 months between exams.
So are you saying there has to be 12 months between exams or are you saying that if I had an appointment on July 25 this year then I can have an appointment on July 12 next year?
Please clear this up!
Gary, you are correct. It is CURRENTLY 12 rolling months, and 2017 is moving to once per calendar year.
This is illustrated in your open enrollment materials.
Thanks for bringing this to my attention.
-Ohio PERS
It is the same way for women, they have to wait til it has been 12 months since their last mammogram. You being in politics should be even more aware of the rules.
I, for one, am not happy to see I have to deal with One Exchange again. They screwed up my selection last year, putting me in a different plan than I signed up for and had proof of, thereby costing me medical bills which I would not have had to pay for if they indeed put me in the Plan F that I signed up for and paid for. I have no confidence in their ability.
The OneExchange website shows available plans for my area indicating that there are 6 Medicare Advantage plans available. The site then lists these plans with the pertinent information on premiums, deductibles etc. The plans listed are from one company showing the different levels of coverage that are available. A banner at the bottom of the page has Humana in large letters and a statement:
“Plans from these companies are available, by phone: 1-844-287-9945 (TTY: 711) Mon-Fri 8:00am – 9:00pm Eastern”.
This is the number for OneExchange. This is very confusing and makes it impossible to compare available plans before calling OneExchange. I prefer to do my own comparisons but this makes it impossible. It would appear that one company may be getting an advantage because you are required to talk to a salesperson simply to get basic information? This same situation exists with Medigap offerings on OneExchange.
One of the big promises of moving to an exchange is that information would be made available online. This seems to go against that premise.
One exchange seems to have greatly reduced insurance choices for next year. In category F I can only choose from 2 companies. Also it looks like I can no longer use my current carrier. Someone needs to inform people of this issue or many people may assume that they can keep what they have.
Thank you for your feedback. Carriers are responsible for notifying plan users as to changes such as not being available the following year. As you continue your research and develop more questions, please reach out to OneExchange. They will be able to listen to your concerns and help guide you to the best plan available in your area. When you speak to OneExchange, the subject of carrier roster is a valid concern and should be shared.
-Ohio PERS
An individual or a few individuals bringing problems to the attention of OneExchange through a telephone agent is a minor annoyance for OneExchange. OPERS, has the most power with OneExchange and could quickly get results on behalf of all OPERS retirees.
I just heard Marianne Stenger twice on the phone conference call clearly state, “if you like the plan you have, you don’t have to change.” Looking at the website, this in NOT TRUE at all. I have Medigap Plan F. My current provider, Mutual of Omaha is not listed. Even worse, there only 2 companies (3 plans) listed! Last year there were many more choices. Either Marianne is wrong or One Exchange is not providing accurate information. If my call had gotten through I would have asked about this. I am not happy with the lack of choice.
As far as other carriers missing from this year’s roster compared to last year, there are other plans from insurance carriers that were offered last year that aren’t being offered for 2017. It’s a carrier decision – not an OX decision. It’s a carrier decision, not a OneExchange decision as to if they will appear on the roster. Your enrollment in Mutual of Omaha wouldn’t change as you are enrolled with Medical Mutual of Omaha and not OneExchange, however, if you would like to evaluate whether Medical Mutual of Omaha is still right for you, call OneExchange (1-844-287-9945) to do a side-by-side comparison of your current Medical Mutual of Omaha plan against other plans that are available on the roster. The Licensed Benefit Advisor will have access to the plan design information for your current plan.
-Ohio PERS
The data that One Exchange needs to remit my reimbursement for my Gap coverage is sent on the 10th of each month, then lies around somewhere at OE until they feel like remitting to my account. Initially for the first four months, my reimbursement was in my account like clock work on the 18th of the month. Since 5/2016, OE has become progressively slower and slower. I have contacted my insurance carrier to verify. If the carriers can deduct my premium on the 2nd of the month and provide confirmation to OE by the 810th, why does it take OE another 10-11 days to get my funds into my account? We may be better off sending in manual or faxed requests; we would get it back quicker. We are living on fixed incomes and should not have to be inconvenienced in this fashion. Personally, I believe there is a bit of the lazies at OE. They used to do a little better.
I also found out today that the information given me at the time of choosing my Rx coverage that the information not accurate at all. Now I can understand why I’ve had a problem for most part of the year. Now it’s time to change (hope I got a knowledgeable one this. So OPERS, all is not what it seems. As well, I told them that I wold notify OPERS of my experiences, just so you know. From one who is very unimpressed and very disappointed with our representatives at OE. I don’t expect a response, but if you need to please respond via my email.
Thank u for allowing me to vent.
Thank you for sharing your concern. The delay is with the carrier. It all depends on when OneExchange receives the carrier file each month that determines timing of the deposits. If a carrier file is ever delayed, this causes a delay in the reimbursement process. OneExchange should monitor the timing and course correct if it becomes an ongoing issue. If you see this as a continuous issue, please contact OneExchange, 1-844-287-9945.
-Ohio PERS
-Ohio PERS
I used a recurring request for my prescription premium last year and got my reimbursement at the beginning of the month with my social security reimbursement. The easiest and fastest way to setup a recurring payment is to use the online option. You can fax in your documentation, but then they have to find the fax and match it with your claim. The more effective method is to create a jpeg or pdf file and attach it to your claim.
Know it doesn’t help much but you are not alone in dealing with OE in so many areas.
I called One Exchange today to find out the cost of my Medical Mutual Plan F for 2017. One exchange can give you prices for new enrollment in 2017, but not for a person currently enrolled.
I called Medical Mutual before calling One Exchange today, and they told me they cannot give me my rate until 30 days before the Jan 1st renewal date. That is not very helpful if open enrollment ends Dec. 7th.
I also lost my current coverage for next year. Called OE today, spoke with three representatives and was able to secure my new policy for next year in about 45-50 minutes for my wife and myself. I will have to say that all went smoothly. Will know in about two weeks if all is well!!!
With the onset of my mom’s dementia problems, I’ve been getting more directly involved with my parents healthcare. As most readers of this blog know, there is a steep learning curve when it comes to understanding healthcare. Getting simple questions answered definitively can often take a significant time investment. With that said, will OPERS cover health insurance premiums from plan not specifically offered by OPERS? Or is my Mom stuck? I have to say I’m REALLY disappointed in Aetna right now. Links to any documentation that spells this out would be really helpful.