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OPERS Healthcare Coverage Changes

by | 1 Sep | health care, OPERS, Retirement Planning & IRAs

Men and women who retired as members of the Ohio Public Employees Retirement System, commonly called OPERS, need to be aware of a change that may affect their healthcare coverage.

OPERS retirees who are not of Medicare age will need to opt in during an upcoming open enrollment period in order to receive monthly payments to purchase health coverage. This is required, as the current OPERS group healthcare plan will be terminated at the end of the year.

In early 2020, the OPERS Board of Trustees voted to end the group plan effective in 2022, in order to switch to a model where it will instead provide monthly subsidies for pre-Medicare retirees to buy coverage on the open market.

This health reimbursement arrangement (HRA) will be administered by Via Benefits, a vendor OPERS selected as the OPERS Pre-Medicare Connector to help move retirees into new plans and manage the reimbursement payments.

Open enrollment runs Nov. 1 to Dec. 15. During this time, pre-Medicare retirees will have to opt in to the HRA with Via Benefits in order to begin receiving subsidy payments.

According to a blog on the OPERS website, this move will not necessarily cost retirees more money. Depending on their HRA allowance and the plan chosen, some retirees will find the HRA covers their entire premium and they will have extra funding to pay for out-of-pocket costs. Further, money can accumulate from year to year in the HRA to be used for future health care expenses.

All retirees will have choice and flexibility in plans, as some retirees may find they like the additional choices and are better off financially, while others may find that they will have to pay more in premiums and/or out-of-pocket costs. This will depend on the available plans in your county.

As a result of the decision to end the group plan, pre-Medicare retirees will no longer have group plan premiums deducted from their monthly pension, so their monthly benefit payment will increase by the amount they are currently paying for coverage. OPERS urges retirees to earmark these additional funds toward out-of-pocket health care costs. Premiums for vision and/or dental coverage will still be deducted from your monthly benefit if enrolled.

Retirees who choose not to enroll in a plan and just pay for expenses out-of-pocket, will still receive HRA deposits. Enrolling in a medical plan is not a requirement for pre-Medicare retirees to receive HRA deposits. Pre-Medicare retirees only need to meet eligibility guidelines and opt-in to receive the HRA deposits.

The move may also affect retirees re-employed in an OPERS-covered position.

OPERS requires all re-employed retirees to choose coverage offered by their employer if it is available to them. However, if employer coverage is not available, re-employed retirees may enroll in a separate, OPERS group plan that closely aligns with a current plan for pre-Medicare retirees. Retirees pay a premium which is offset by the OPERS-provided allowance. For Medicare retirees, the allowance replaces monthly HRA deposits during the re-employment period. Participants are subject to new deductibles and co-insurance.

For more information on this transition, visit the OPERS Healthcare 2022 page.

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