Enrollment and Withdrawal in OPERS Health Care
If your retirement is quickly approaching and you're unsure about the enrollment process such as when to enroll, if there are perks to waiting to enroll, and if there is opportunity to enroll at a later date, read on.
Understanding Your Responsibilities
Participants in the OPERS Retiree Health Plan receiving a monthly benefit as the surviving spouse or beneficiary of a deceased retiree or deceased member may only enroll those dependents who would have been eligible dependents of the deceased retiree or member as defined on this page.
It is the retiree's responsibility to notify OPERS, in writing, within 30 days of the date his or her dependent fails to meet eligibility requirements. Failure to notify OPERS could result in overpaid health care claims for which the retiree will be responsible.
You have two choices when deciding when to enroll in OPERS health care coverage:
- Enroll at the time of retirement
- Defer enrollment until a later date
Enrolling at Retirement
If you choose to enroll in OPERS health care coverage at the time of your retirement you must submit a Health Care Coverage Application with your retirement application.
When does coverage begin?
Coverage begins the later of :
- The first day of the month in which OPERS receives your retirement application
- Your benefit effective date
Failure to apply
If you don't meet the application deadline, you cannot enroll until the next open enrollment period.
Waiting to Enroll in OPERS Health Care Coverage
If you are under age 65, waiting to enroll may have its perks.
Each retiree has an allowance percent amount that applies to health care.
- If you are pre-Medicare, this percent determines how many dollars you pay toward your monthly premium.
- If you are enrolled in Medicare Parts A and B and enroll in an individual Medicare plan through the Connector, the percentage determines how much money is deposited into your health reimbursement arrangement account each month.
Because your allowance amount is based on your age when you enroll, your premium allowance amount could increase by 3 percent for each year you wait to enroll.
See the Health Care Allowance page for more details.
How to enroll
To enroll after delaying enrollment, you must submit a Health Care Coverage application during an enrollment period:
- Annual open enrollment period.
Within 60 days of the involuntary cancellation of your health care coverage by another health care plan. You will need to include proof of credible coverage from your employer or plan administrator with your application, as it confirms the involuntary cancellation. Coverage will begin on the first day of the following month.
Cancelling OPERS Health Care Coverage
You can cancel your OPERS health care coverage at any point during the year and re-enroll at another time.
To cancel coverage, you must either:
- Call us at 1-800-222-7377
- Complete and submit the Health Care Cancellation form to:
Re-enrollment after cancelling coverage
If you voluntarily choose to cancel OPERS health care coverage, you can re-enroll:
- During open enrollment; or
- If you had a qualifying event, such as marriage, birth or adoption of a child, or experienced the involuntary cancellation of your coverage by another health care plan.
Required documents for re-enrollment
- Proof of creditable coverage in another health care plan.
- Documentation from your plan administrator or employer confirming your cancellation.
Plan coverage begins the first day of the month following OPERS' receipt of all required documents.
Although OPERS understands the importance of offering health care coverage, our board has the discretion to review, rescind, modify or change our health care coverage at any time.