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OPERS Vision and Dental Plans

Anyone receiving a monthly OPERS benefit payment qualifies to enroll in the optional OPERS vision and dental plans, even if you don’t qualify for the Health Reimbursement Arrangement. However, your net monthly benefit payment must be enough to cover the full premium amount.

You may also enroll the following eligible dependents:

  1. The spouse of a primary benefit recipient
  2. A biological or legally adopted child of the primary benefit recipient who is under the age of 26 (regardless of marital status) or the minor grandchild of the primary benefit recipient if the grandchild is born to an unmarried, unemancipated minor child and you are ordered by the court to provide coverage pursuant to Ohio Revised Code Section 3109.19.

Benefit recipients of a deceased retiree or member

If you receive a monthly benefit from OPERS, you may enroll in the OPERS vision and or/dental plans. You may also enroll only those dependents who would have been eligible dependents of the deceased retiree or member as defined on this page.

It is your responsibility to notify OPERS, in writing, within 30 days of the date your dependent fails to meet eligibility requirements. Failure to notify OPERS could result in overpaid claims or reimbursement for which you will be responsible to repay.

When can I enroll in the vision and/or dental plan?

You may enroll only prior to or within 30 days of receiving your first benefit payment or during the annual open enrollment period. Outside of open enrollment, you can also enroll if you have experienced a life change (or a qualifying event). A qualifying event can be a divorce or an involuntary loss of coverage from another source. You must tell us of such an event, complete an enrollment application and provide supporting documentation of the qualifying event within 60 days. If OPERS does not receive the required supporting documents within 60 days, you cannot be enrolled. Contact OPERS to request a copy of the enrollment form.

After you enroll, you (and any enrolled dependents) must stay enrolled until the next open enrollment period unless you have a change in family status, including a divorce, death or a child reaches age 26. You must notify OPERS immediately if you have a change in family status.

If you are enrolled in a vision and/or dental plan with both OPERS and another insurance carrier, take some time to review your coverage needs to determine if both plans are needed.

When can I enroll eligible dependents?

If you are enrolled in OPERS vision and/or dental plan, you may enroll eligible dependents in the same plan, and at the same level option (low or high), when you first enroll or during open enrollment. Outside of open enrollment, you can enroll eligible family members if they have experienced a life change (or a qualifying event). A qualifying event can be a new marriage, a new child (birth or adoption), or an involuntary loss of coverage from another source with whom dependents were enrolled. You must tell us of such an event, complete an enrollment application and provide supporting documentation of the qualifying event within 60 days. If OPERS does not receive the required supporting documents within 60 days, eligible dependents cannot be enrolled. Contact OPERS to request a copy of the enrollment form.

How will premiums for the OPERS vision and dental plans be paid?

Your net benefit payment must be enough to cover the full premium amount to be enrolled. Your premium cost for the plan(s) in which you are enrolled will be deducted from your benefit payment each month. If a change occurs and your net benefit payment is not enough to cover the full premium, ALL enrollments will be terminated. If you are receiving a monthly HRA deposit from OPERS, your premiums will be automatically reimbursed monthly from your HRA. If you do not wish to have your premiums automatically reimbursed from your HRA, you can contact OPERS by phone to opt out. The change will take effect the following month.


Aetna Vision Plan MetLife Dental PlanCertificates of Coverage

Aetna Vision Plan

Aetna Vision Preferred, administered by EyeMed, is a vision coverage option available to you and your eligible dependents. If you choose to enroll in a vision plan, the entire premium for this coverage will be deducted monthly from your OPERS benefit payment. With a recent change to procedures impacting European nations, vision coverage is no longer available to our participants residing in European Union countries.

Aetna Vision
1-866-591-1913
aetnavision.com (link opens in new tab)

For more detailed information about covered services and limitations, call Aetna.

Plan Features

  • A comprehensive eye exam. Not only can eye exams detect serious vision conditions such as cataracts and glaucoma, but they can also detect the early signs of diabetes, high blood pressure and many other health conditions.
  • Savings of around 40 percent. There are two plan options to choose from both offering a significant savings on eye exams and eyewear.
  • Your choice of leading optical retailers including LensCrafters, Target Optical, most Sears Optical and Pearle Vision locations, as well as thousands of private practitioners.

Added Benefits

  • Eye Care Supplies. Receive 20 percent off retail price for eye care supplies like cleaning cloths and solutions purchased at network providers (not valid on doctor’s services or contact lenses).
  • Laser Vison Correction. Save 15 percent off the retail price or 5 percent off the promotional price for LASIK or PRK procedures.
  • Replacement Contact Lens Purchases. Visit contactsdirect.com to order replacement contact lenses for shipment to your home at less than retail price.

Plan Options

You have two options of vision coverage to choose from: High or Low. If you use an Aetna vision provider, you will have less out-of-pocket expenses. If you don't use an Aetna vision provider, you'll need to submit a claim form for reimbursement.

Aetna Vision Plan for All Plan Participants

Aetna Vision Plan Options
Note: Coverage is available for lenses and frames - OR - contact lenses, but not both.

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Next: MetLife Dental Plan

MetLife Dental Plan

Dental coverage administered by MetLife is optional for you and your dependents. If you choose to enroll in a dental plan, the entire premium for this coverage will be deducted monthly from your OPERS benefit payment.

MetLife
1-888-262-4874
metlife.com/mybenefits (link opens in new tab)

For more detailed information about covered services and limitations, call MetLife.

Plan Highlights

  • Choose a dentist within the MetLife network to help reduce your costs1. Negotiated fees apply to in-network services and may apply to services not covered by your plan and those provided after you've exceeded your annual plan maximum2.
  • You can also choose an out-of-network dentist, but your out-of-pocket costs may be higher. There are more than 410,000 participating Preferred Dentist Program dentist locations nationwide, including over 96,000 specialist locations. It is encouraged to have your dentist provide a printed 'Pre-treatment Estimate' prior to having services rendered.

Plan Options

  • You have two options of dental coverage to choose from: High or Low. Once enrolled you can view your Certificate of Coverage for additional details. These certificates explain the dental options available in the High or Low option dental plans.

Claims Details

  • Dentists may submit your claims for you which means you have little or no paperwork. You can track your claims online and even receive email alerts when a claim has been processed. If you need a claim form, call MetLife at 1-888-262-4874.

1MetLife's negotiated or preferred Dentist Program fees refer to the fees that dentists participating in MetLife's Preferred Dentist Program have agreed to accept as payment in full, for services rendered by them. MetLife's negotiated fees are subject to change.

2 Negotiated fees for non-covered services may not apply in all states. Plans in LA, MS, MT and TX vary.

Please call MetLife for more details.

MetLife Dental Plan for All Plan Participants

MetLife Dental Plan Options

Like most group insurance policies, MetLife group policies contain certain exclusions, limitations, exceptions, reductions, waiting periods and terms for keeping them in force. Please contact MetLife for details about costs and coverage. Dental plan underwritten by Metropolitan Life Insurance Company, New York, NY 10166

* Negotiated Fee refers to the fees that participating Preferred Dentist Program dentists have agreed to accept as payment in full, subject to any copayments, deductibles, cost sharing and plan maximums.

** R&C fee refers to the Reasonable and Customary (R&C) charge, which is based on the lowest of (1) the dentist's actual charge, (2) the dentist's usual charge for the same or similar services, or (3) the charge of most dentists in the same geographic area for the same or similar services as determined by MetLife.

✝ Applies to Type B and Type C services

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Next: Certificates of Coverage