Tips for solving Connector reimbursement issues
The Ohio Public Employees Retirement System uses a reimbursement process administered by OneExchange to help participants in the OPERS Medicare Connector pay their expenses. This mechanism requires specific actions to receive reimbursement.
We realize that the process can become frustrating. It requires participants to first pay their health care costs, then apply to OneExchange for reimbursement from their Health Reimbursement Arrangement accounts. We fund these accounts each month.
While we chose OneExchange to administer the Connector, we are still your advocate. To help resolve issues you might have with your reimbursements, here are some tips. Keep in mind that it’s important to protect your financial privacy, and OPERS wants to make sure your personal information remains confidential.
- Call OneExchange at 844-287-9945 and select option 3 to be connected to the OneExchange funding department if you have reimbursement issues such as incorrect amounts, delays or denials, especially ones involving specific dollar amounts.
- Use the customer help tab on the OneExchange/OPERS website. Here you can get answers to general questions, submit a question to OneExchange or provide feedback directly to OneExchange.
- If you have issues with OneExchange customer service, or you need help escalating the issue with OneExchange, we want to know about it. Please send us a message through your OPERS online account or call us at 800-222-7377 to share your general concerns. If you require action on a specific personal issue, call OneExchange for immediate attention.
Over the next few weeks, OPERS will post a series of blogs that will illustrate how to pay for coverage and other items, and how to be reimbursed through your HRA account.
The series will address:
- Medical and prescription drug premiums for plans enrolled in through OneExchange
- OPERS medical, dental and vision plan premiums
- Medicare Part B premiums
- Out-of-pocket expenses
For additional information regarding the HRA, refer to the following materials that are available online:
- Frequently Asked Questions
- HRA Quick Reference Guide
- Get HRA Ready brochure
- Getting Reimbursed Guide
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 just want you to know that One Exchange has always applied excellent customer service any time I called. They directed me to appropriate areas, guided me through the process of filing claims and was very courteous at all times. They are very patient and explain things clearly and precisely. I have never had any problems.
Sincerely,
Linda Constantine
Thank you for being responsive to our need for advocacy and for specific information on the topics you propose to cover. There is a pervasive sense of frustration, and often a resignation to futility or confusion that leads some retirees to give up and “eat the loss” for what they’ve paid.
Good Morning. I am pleased to see this email with reference to reimbursements. I have consistently sent in my documentation for reimbursement, especially those for Medicare payments, as we were told in those meetings that we may have to pay for only the first month. This is the 4th month that I have paid the payment, and have sent in for reimbursements every time, to date, I have received nothing back except the fee for my monthly insurance coverage. Retirees have worked long and hard for some peace in their golden years. Folk have given up with this system. It is not working. Not every elder has computers, much less computer skills. Exactly what are we supposed to do? Thank you.
Eugene,
We will ask OneExchange to contact you soon.
–Ohio PERS
I received a call today in response to my query and I thank you. The lady on the phone said someone would call within 1-3 days. If I happen to be away from home when you do call, please ensure a message is left as to where and to whom I should return your call. I know for sure that I will be out volunteering in the community on Tuesday until about 3:00 p.m. Thank you.
I write to advised that after several attempts, I was directed, very patiently, by 2 One Exchange personnel about a procedure that finally worked for me. I kept every invoice, sales receipt, EOB’s, went to the bank for copies of my cancelled checks, if there was an electronic transfer, I waited until I had proof of tgat, copied my credit card if paid that way (don’t forget to blackout your CC number), and anything else to prove payment. Filled out the reimbursement forms, attacked proof of payment. After months of trial and error, IT FINALLY WORKED!! Within less than 2 weeks I received my reimbursement. It was trial and error, but it worked. I did not give up. I complained, but I did not give up. Keep trying, I urge you. Thank you One Exchange, my reimbursement came just in time to pay my Medicare for the next quarter. Much appreciated.
Since the very beginning dealing with OneExchange, I haven’t had any problems. I get reimbursed very quickly each and every month. I even did a scan and uploaded the RX info for reimbursement and only problem I first had was to do with my computer but they even helped me with that and I was able to send the info that way. I think they are all very friendly and helpful with any questions I did have and were kind and courteous to me. I think they are doing a wonderful job.
Apparently OneExchange appears to have solved some major issues and I commend them for doing so. However, the poor initial experiences endured by OPERS retirees due to OneExchange employee lack of accurate knowledge and poor communication regarding the reimbursement process left a bad taste. It cannot be denied that it caused a great deal of confusion. It will require time for the rebuilding of trust in the changes now made in the system. We all know that gross errors made in the beginning should never have occurred and that OneExchange was not properly prepared. One still wonders how they were allowed to begin a process with so many ill-trained employees.
I find it remarkable that some retirees did not have a poor experience; that is a wonderful thing.
It is good and necessary that OPERS offers assistance to their retirees during the upgrade of the OneExchange process. There have been definite and better changes made to reduce confusion and allow for more timely reimbursement. I encourage retirees to seek help offered and never “give up” until they are completely satisfied they understand and are able to accomplish their entitled reimbursements.
My frustration with OneExchange is that they answer e-mails quickly, but usually not with a real answer or any followup. My husband’s prescription drug premiums have never been auto-reimbursed even after four months of payments. I finally had to go to the bank to get copies of cancelled checks and submit manually. This is an unreasonable burden. I don’t understand why OneExchange cannot follow up with the insurer if they are not getting the information that they need to auto-reimburse. In the case of our Medicare B premiums, CMS will not always send a receipt when we have to pay in a lump sum. The bank cannot supply copies of the cancelled checks because CMS submits them electronically. Why does this need to be so complex. I am able to fight this through. Bet there are a lot of older more frail retirees who just won’t get the reimbursements that are due to them.
Penny,
Have you tried submitted a copy of your bank statement showing these payments. You can just white out all other items listed on the statement. Even if you don’t get a paper statement, you can always go online to your bank account and print one off.
Did you submit a recurring reimbursement form for both the RX plan and part B? I’m not sure if you are paying your part B on your own (rather than having it deducted if you receive SS) that you can use the recurring form or not.
Mary
Almost 5 mths, and reimbursement is STILL an issue? I really dread the changeover to Medicare and One Exchange. What about folks that have to pay a Medicare A premium too? Will we have to give up our entire pension checks w/NO money back for weeks? Some people live check to check; what about them? OPERS you have really done us older, (sometimes very sick) retirees that were SO LOYAL to OPERS, and TRUSTED you with ours and our loved ones (who we happily worked for) lives, a real disservice. So much for trust and loyalty…
Alexander,
OneExchange is aware of the issues that it has had with the timeliness of reimbursements. They are working on these issues. The fact is that many people are getting their premiums reimbursed on time every month. If we can help, call us at 800-222-7377.
–Ohio PERS
I believe that I was told in that first conversation I had with an OE rep on Dec 10 that it was being (or might be) recorded. I really wish I could hear that conversation played back. I am fairly sure that I was told that the $396 I was to receive each month would be deposited in the account of my choice. At least I know that I supplied my checking account number. I remember asking if I could pay my health insurance and prescription premiums out of that money and was told that I could – that it was my money.
So, why do I have to pay the premiums out of my pocket and then wait weeks to be reimbursed? Could it really take 6 weeks? How do these agencies communicate – by carrier pigeon? I am sorry to sound so sarcastic but I really am terribly frustrated. I has caused me many sleepless nights.
I read your comments about wishing to have the conversation played back. I was pretty leery about this as well, so I downloaded an app on my Ipad and recorded the entire conversation with the speaker on on my phone. Worked really well!!
Luckily I have not had to use it, but I did listen to some of it to make sure it worked so I could use it again for any conversation I might need to have recorded.
The One Exchange website to submit prescriptions, claims, etc. for reimbursement has been unavailable since Friday last week. I emailed them and they replied they are aware of the problem and are working on this. How can a technical issue take this long to fix?
Ginny,
OneExchange tells us that this problem was resolved yesterday evening. We’re sorry you had to wait to use their website.
–Ohio PERS
Thanks, I was able to submit claims today.
An HRA is a health reimbursement arrangement. Just by the nature of what it is, you have to pay first and then be reimbursed for your premiums, prescriptions, etc. OPERS set it up this way so that we would not have to pay taxes on the money in our HRA’s. If they gave us the money up front, we would have to pay taxes (federal and state) on the money, which would eat up a good portion of the HRA and leave us with less to use for our health expenses.
How long will the Funds and R
eimbursement site be down? It has been down for 3 days that I know of.
Patricia,
We regret that Connector members had difficulty accessing their online Connector accounts. OneExchange had technical issues with their payment processor for the last several days. We were informed yesterday at about 5:30 p.m. that the issues had been resolved.
–Ohio PERS
So happy I found this page! I’ve been struggling with the One Exchange/PERS medicare reimbursement. And I’ve been made to feel that it’s just ME. What a relief to know there are others with the same problems. Ive thought about writing AG Mike Dewine since he’s on the board of PERS..I believe the One Exchange people contracted for services they were unable to deliver and what they did deliver has been inaccurate info, just plain wrong info, etc. It’s almost May. I’m still not being reimburssed completely.
I’ve spent a lot of time actually crying while trying to deal with these people. I too feel like I gave my work life to PERS and as a retiree I was always treated with respect..but not any more . Life is difficult at times, and I’ve spent almost a year trying to fix all this. I don’t understand it. The government SS office was very helpful though.
Elizabeth,
Thanks for reading the PERSpective blog. FYI, the attorney general is not on the OPERS board, although a staff member from the AG’s office routinely attends our board meetings.
–Ohio PERS
When I mentioned Mike DeWine, attorney General it is because on your web site it says according to Ohio Law the attorney general is the OHIO PERS BOARDS LEGAL ADVISOR.
Therefore, he should know what’s going on with all this mess. True he’s not a voting member, but isn’t his responsibility to acknowledge that the One Exchange has done a terrible job.. I would think he would be able to offer some legal advice as to how to get out of this contract you’ve signed with One Exchange.
just a suggestion!
my 2nd posting. I just spent an hour reading all the comments about the One Exchange problems. And I think I understand that if I choose not to go thru the connector to purchase coverage then I won’t be reimbursed for my medicare costs & any supplemental plan. But I’m not getting my reimbursement money anyway, and spending hours trying to deal with it all. I’m assuming that in October 2016 we will all receive booklets to choose insurance for 2017. So I’m enrolled in Medicare A & B and will have to pick another plan or continue with the one chose for this year….it seems so simple. I’m wondering if I should “hire” someone to try and figure all this out. A family member purchased insurance thru a broker. Maybe a broker would be able to deal with the One Exchange people. Anyway…thank you everyone for sharing your troubles. I hope PERS will fix this for us. It’s so overwhelming. Thank you for being out there people!
Elizabeth,
We are forwarding your concerns to OneExchange. We expect them to contact you soon to review your case.
–Ohio PERS
One Exchange called me today, said that this call was being recorded. And I said “Good, please do record it”.
Supposedly my problem has been moved to a high priority list. I thanked the representative, but said I would wait and see.if I rec’d a call, if anything was actually solved, etc.
pardon my cynicism and lack of trust,
I submitted a reimbursement claim for the parking fee at the Cleveland Clinic in March. Within days, I received notification that the claim was denied. It was denied because I did not provide mileage or shipping cost information as part of the claim. I appealed the denial and submitted the mileage information that they asked for even though I did not claim the mileage. This appeal was filed on April 1 and to date I have not heard a word from OneExchange about the status of the claim. If I look at the claim online, it still shows as being denied. So much for OneExchange improving their communications.
I WANT ALL TO KNOW THAT I HAVE “NEVER” HAD A PROBLEM WITH ONEEXCHANGE REGARDING “AUTOMATED” REIMBUSEMENTS EACH MONTH. ALSO, EVERY “MANUAL” REIMBUSEMENT REQUEST.THAT I HAVE SUBMITTED, HAS BEEN PROCESSED QUICKLY AND EFFICIENT. I AM GIVING ONEEXCHANGE ASSOCIATES CREDIT FOR A TERRIFIC JOB DEALING WITH “US RETIREES”!
Seems you are the lucky one!
I sent in a claim in March, 6 weeks later I called and waited 15 minutes, they couldn’t find it . Put me on hold 5 minutes later I got a busy signal. I just gave up. There has got to be a better system.
I have had very negative experience with One Exchange. Their customer service department is definitely designed to deflect customer problems as opposed to resolution. People answering the phone are not able to answer any question and forward your concern. Return calls, if they occur, are at the convenience of One Exchange. My complaint has been under consideration for two months. OPERS hired this company but seems unwilling/unable to intervene. I certainly have been disillusioned.
I would think after 6 months the glitches should have been fixed BUT this month my HRA deposit/allocation from OPERS did not get deposited into my HRA at One Exchange but my spouse’s allocation did. I was on the phone for an hour with One Exchange and all they did was write up a trouble ticket. Since then they have contacted OPERS at least twice but OPERS has not responded. I can’t get a straight answer from either company. One Exchange said that sometimes these problems take 4-6 weeks to resolve?? Meanwhile I still have to find a way to pay out over $600 a month in premiums!
I have 2 questions re a quote from Michael Pramik’s reply to Patricia on April 28, 2016 at 7:27 am –
“One Exchange had technical issues with their payment processor for the last several days.”
1. Does this mean that One Exchange has sub-contracted all or part of their IT processing?
2. If yes, how many sub-contractors has One Exchange hired and will OPERS provide a list of these sub-contractors to retirees?
Fred, thank you for your question. OneExchange has not subcontracted all or part of their IT processing.
thanks,
-Ohio PERS