Health Care 2022

OPERS, at its core, is a pension fund and protecting pensions is our priority. However, we believe retirement security should include access to health care coverage and we’re committed to preserving the program. The changes adopted by the OPERS Board of Trustees effective Jan. 1, 2022, will allow us to continue offering access to health care coverage to current and future retirees.

Whether you are retired or considering retirement in the next several years, it’s important to understand the structure of OPERS health care coverage and the changes effective Jan. 1, 2022.

Medicare-Eligible Retirees Pre-Medicare Retirees Active Members

Medicare-Eligible Retirees

Eligibility for OPERS Medicare Coverage

Eligibility requirements will only change for those retiring on or after Jan. 1, 2022. If you’re currently retired and eligible (or retire and are eligible prior to Jan. 1, 2022) to participate in the OPERS health care program, you will continue to be eligible after Jan. 1, 2022. However, you will be impacted by changes to your Health Reimbursement Arrangement (HRA) allowance.

If you are receiving a disability benefit with an effective date of Dec 1, 2021 or prior you are still under the eligibility rules that were in place based as of your benefit effective date.

Health care eligibility requirements will change for new retirees with a benefit effective date on or after Jan. 1, 2022, see the Active Member section for details.

Health Reimbursement Arrangement Allowance

Effective Jan. 1, 2022:

  • The base allowance percentages and monthly HRA deposit amount for Medicare-eligible retirees will be reduced from $450 to $350 per month.
  • Allowance amounts will range from 51 percent ($178.50 per month) to 90 percent ($315 per month) of the base amount.

Step 1: Determining Your Allowance Percentage

To determine your allowance percentage, compare the table below to the following:

  • Your age when you first enrolled in the OPERS Health Care Program
  • Your qualifying years of service credit at retirement

Use age 60 if you were, or plan to be, under age 60 at first enrollment; use age 65 if you were, or plan to be, over age 65 at first enrollment. Partial years of service credit are not rounded up to the next year.

Notes for those retired and enrolled prior to 2015:

  • If you had less than 20 years of service, your allowance percentage will be reduced from 75% to 51% effective Jan. 1, 2022.
  • If you had 20 or more years of service, your allowance could change. This impacts retirees who, using the table, had an allowance percentage less than 75%, but were grandfathered at 75% in 2015. Your allowance will be reduced to between 51% and 74% based on your actual position on the allowance table effective Jan. 1, 2022.
Health Care Allowance Percentage
Years of
Service / Age
60
and under
61 62 63 64 65
and over
20 51% 54% 57% 60% 63% 66%
21 53% 56% 59% 62% 65% 68%
22 55% 58% 61% 64% 67% 70%
23 57% 60% 63% 66% 69% 72%
24 59% 62% 65% 68% 71% 74%
25 61% 64% 67% 70% 73% 76%
26 63% 66% 69% 72% 75% 78%
27 65% 68% 71% 74% 77% 80%
28 67% 70% 73% 76% 79% 82%
29 69% 72% 75% 78% 81% 84%
30 71% 74% 77% 80% 83% 86%
31 73% 76% 79% 82% 85% 88%
32 75% 78% 81% 84% 87% 90%
33 76% 79% 82% 85% 88% 90%
34 77% 80% 83% 86% 89% 90%
35 78% 81% 84% 87% 90% 90%
36 79% 82% 85% 88% 90% 90%
37 80% 83% 86% 89% 90% 90%
38 81% 84% 87% 90% 90% 90%
39 82% 85% 88% 90% 90% 90%
40 83% 86% 89% 90% 90% 90%
41 84% 87% 90% 90% 90% 90%
42 85% 88% 90% 90% 90% 90%

 

Step 2: Determining Your Monthly HRA Deposit Amount

To determine your monthly HRA deposit amount, compare the table below to the following:

  • Your allowance percentage from the table above
Monthly Allowance
Health Care
Allowance Percentage
Medicare
($350 base allowance)
51% $178.50
53% $185.50
54% $189.00
55% $192.50
56% $196.00
57% $199.50
58% $203.00
59% $206.50
60% $210.00
61% $213.50
62% $217.00
63% $220.50
64% $224.00
65% $227.50
66% $231.00
67% $234.50
68% $238.00
69% $241.50
70% $245.00
71% $248.50
72% $252.00
73% $255.50
74% $259.00
75% $262.50
76% $266.00
77% $269.50
78% $273.00
79% $276.50
80% $280.00
81% $283.50
82% $287.00
83% $290.50
84% $294.00
85% $297.50
86% $301.00
87% $304.50
88% $308.00
89% $311.50
90% $315.00

 

View Calculation examples

Re-employment
Federal rules have recently changed regarding re-employed retirees and HRAs. These changes may provide more options than currently exist. We’re evaluating options and the impact of these recent changes on those re-employed in an OPERS-covered position. We’ll share more information as it becomes available in the coming months.

What's Next

Attend an education event
We know you have questions, which is why we're offering interactive webinars designed specifically for the Medicare and pre-Medicare populations.

These sessions focus on the health care changes and their impacts as well as health care tips to consider now and during Open Enrollment. Common questions concerning the HRA will also be addressed.

We'll also continue offering small group, hands-on HRA workshops to help you better utilize your HRA.

Check your mail and inbox

Read all communications from OPERS. In the coming months, we will be providing more detail and creating scenarios to show how the changes will affect all segments of our retiree population. We will also be providing more information on education opportunities.

Pre-Medicare Retirees

Eligibility for Pre-Medicare Coverage

Eligibility requirements will only change for those retiring on or after Jan. 1, 2022. If you’re currently retired and eligible (or retire and are eligible prior to Jan. 1, 2022) to participate in the OPERS health care program, you will continue to be eligible after Jan. 1, 2022. This includes those who retired prior to Jan. 1, 2022 with 20 years of qualified service and currently are not in our health care program, you will still be able to enter at age 60. However, effective Jan. 1, 2022, all retirees will receive a monthly Health Reimbursement Arrangement (HRA). Medicare-eligible retirees already receive an HRA, but this will be new for pre-Medicare retirees.

If you are receiving a disability benefit with an effective date of Dec 1, 2021 or prior you are still under the eligibility rules that were in place as of your benefit effective date.

Health care eligibility requirements will change for new retirees on or after Jan. 1, 2022, see the Active Member section for details.

Health Reimbursement Arrangement Allowance

Currently, as a pre-Medicare retiree, you receive an allowance from OPERS to offset your monthly premium for coverage in the OPERS Retiree Health Plan administered by Medical Mutual.

Effective Dec. 31, 2021, OPERS will no longer offer a pre-Medicare group plan. Instead, effective Jan. 1, 2022, eligible pre-Medicare retirees will begin receiving a monthly Health Reimbursement Arrangement (HRA) allowance.

In addition to receiving a monthly allowance, you'll no longer pay a medical premium through OPERS, and your monthly benefit amount will increase by the amount currently deducted for that premium.

Step 1: Determining Your Allowance Percentage

To determine your allowance percentage, compare the table below to the following:

  • Your age when you first enrolled in the OPERS Health Care Program
  • Your qualifying years of service at retirement (Partial years are not rounded up to the next year.)
Health Care Allowance Percentage
Years of
Service / Age
60
and under
61 62 63 64 65
and over
20 51% 54% 57% 60% 63% 66%
21 53% 56% 59% 62% 65% 68%
22 55% 58% 61% 64% 67% 70%
23 57% 60% 63% 66% 69% 72%
24 59% 62% 65% 68% 71% 74%
25 61% 64% 67% 70% 73% 76%
26 63% 66% 69% 72% 75% 78%
27 65% 68% 71% 74% 77% 80%
28 67% 70% 73% 76% 79% 82%
29 69% 72% 75% 78% 81% 84%
30 71% 74% 77% 80% 83% 86%
31 73% 76% 79% 82% 85% 88%
32 75% 78% 81% 84% 87% 90%
33 76% 79% 82% 85% 88% 90%
34 77% 80% 83% 86% 89% 90%
35 78% 81% 84% 87% 90% 90%
36 79% 82% 85% 88% 90% 90%
37 80% 83% 86% 89% 90% 90%
38 81% 84% 87% 90% 90% 90%
39 82% 85% 88% 90% 90% 90%
40 83% 86% 89% 90% 90% 90%
41 84% 87% 90% 90% 90% 90%
42 85% 88% 90% 90% 90% 90%

 

Step 2: Determining Your Monthly HRA Deposit Amount

To determine your monthly allowance, compare the table above to the following:

  • Your allowance percentage from the table

The base allowance amount for pre-Medicare retirees will be $1,200 from 2022 through 2024. The base allowance amount will then be re-evaluated based on market conditions and funding. Allowance Percentages and monthly HRA deposits will range from 51% ($612.00 per month) to 90% ($1,080.00 per month) of the base allowance amount.

Monthly Allowance
Health Care
Allowance Percentage
Pre-Medicare
($1,200 base allowance)
51% $612.00
53% $636.00
54% $648.00
55% $660.00
56% $672.00
57% $684.00
58% $696.00
59% $708.00
60% $720.00
61% $732.00
62% $744.00
63% $756.00
64% $768.00
65% $780.00
66% $792.00
67% $804.00
68% $816.00
69% $828.00
70% $840.00
71% $852.00
72% $864.00
73% $876.00
74% $888.00
75% $900.00
76% $912.00
77% $924.00
78% $936.00
79% $948.00
80% $960.00
81% $972.00
82% $984.00
83% $996.00
84% $1,008.00
85% $1,020.00
86% $1,032.00
87% $1,044.00
88% $1,056.00
89% $1,068.00
90% $1,080.00

 

View Calculation examples

Re-employment
Federal rules have recently changed regarding re-employed retirees and HRAs. These changes may provide more options than currently exist. We’re evaluating options and the impact of these recent changes on those re-employed in an OPERS-covered position. We’ll share more information as it becomes available in the coming months.

Step 3: Choosing Your Plan

Your Health Reimbursement Arrangement (HRA) allowance can be used to reimburse yourself for qualified medical expenses, including monthly premiums for the health care coverage medical plan of your choice.

This plan can be offered through:

  • The OPERS Pre-Medicare Connector
  • Healthcare.gov (The Affordable Care Act (ACA) health care marketplace)
  • A non OPERS-covered employer (yours or your spouse's)
  • Any private health care insurance carrier

OPERS will partner with a vendor to provide pre-Medicare retirees with assistance in identifying and enrolling in the health care coverage medical plan which best suits their needs. This vendor will be referred to as the OPERS Pre-Medicare Connector.

Once you know what your allowance amount will be, you can research private plans as well as plans on the open market offered through Healthcare.gov. Information on plans offered through the OPERS Pre-Medicare Connector will be available as we get closer to the 2022 open enrollment period.

The Affordable Care Act and Healthcare.gov
The Affordable Care Act (ACA) is a comprehensive health care reform law enacted in March 2010. The ACA requires that every state have an exchange, or marketplace, where consumers can buy individual health insurance policies.

The ACA also brought consumer protections to the individual marketplace including:

  • Coverage of all pre-existing conditions and essential health benefits such as prescription drugs, hospitalization and emergency services
  • Coverage for everyone regardless of health
  • Tax credits for lower income buyers 

Researching what's available in your area could help you prepare
Plans offered through healthcare.gov for 2020 are available for review. You'll be asked to answer a few questions about income and where you live, and then you can view 2020 plans in your area. Keep in mind that rates, plan options and carriers are likely to change each year.

All plans offered through Healthcare.gov for Ohioans are Health Maintenance Organizations (HMOs). HMO plans offer lower premiums and deductibles and typically require a referral from a primary care physician to see a specialist. Insurance carrier availability is based on ZIP code and there is coverage in all of Ohio's 88 counties.

The Ohio Department of Insurance is also an excellent resource for learning about insurance products and plans.

What's Next

Take advantage of our Educational Resources
We know you have questions, which is why we’re offering webinars designed specifically for the Medicare and pre-Medicare populations. We’ll also be offering an extensive education series for pre-Medicare retirees designed to help you transition to choosing health care coverage outside of the OPERS group plan.

Check your mail and inbox

Read all communications from OPERS. In the coming months, we will be providing more detail and creating scenarios to show how the changes will affect all segments of our retiree population. We will also be providing more information on education opportunities.

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Active Members

Eligibility for Health Care

Health care eligibility requirements for retirees in the Traditional Plan or Combined Plan effective Jan. 1, 2022:

  1. Age 65 with a minimum of 20 years of qualifying service credit
  2. Retirees under age 65 can qualify by meeting unreduced pension eligibility per their retirement group:
    • Group A - 30 years of qualifying service credit at any age
    • Group B - 32 years of qualifying service credit at any age or 31 years
      minimum age 52
    • Group C - 32 years of qualifying service credit and minimum age 55

Information to come for those who may become disabled with a benefit effective date of Jan 1, 2022 or after.

FAQ

If I retire between now and 2022, what are my options?

If you are considering a retirement date between now and when the changes become effective on Jan. 1, 2022, we strongly encourage you to attend an OPERS educational seminar or webinar (Ready to Retire Pension and Ready to Retire Health Care) as well as schedule a meeting with an OPERS retirement counselor to evaluate your individual options. In general, current health care coverage will continue through Dec. 31, 2021.

Will the base allowance amount stay the same after 2022?

We anticipate the $350 base allowance amount for Medicare retirees and the $1,200 base allowance amount for pre-Medicare retirees to remain from 2022-2024. After 2024, we plan to continue to offer an allowance at an amount based on market conditions and funding.

If I retire with 32.5 years of service, do I round up on the allowance chart to determine my allowance percentage?

You would use the 32 years of service row. Partial years are not rounded up to the next year.

Will you continue to reimburse Medicare Part A?

Yes. OPERS will reimburse retirees who don’t qualify for premium-free Medicare Part A for their premium and any penalty at 100%. Eligible spouses will continue to receive a 50% reimbursement.

How do these changes impact OPERS disability benefit recipients?

If you are receiving a disability benefit with an effective date of Dec 1, 2021 or prior you are still under the eligibility rules that were in place as of your benefit effective date. Additional information to come for those who may become disabled with a benefit effective date of Jan 1, 2022 or after.

Will OPERS still offer group dental and vision plans?

Yes. OPERS will continue to offer optional group dental and vision plans. All retirees can choose to enroll in these plans even if they’re not eligible for other parts of the health care program. Eligible dependents can also be enrolled. Participants will pay the full premium for these plans, just like they do now.

Will my dependent children also receive an allowance?

No. Eligible dependent children will not receive an allowance effective Dec. 31, 2021 when OPERS stops offering the pre-Medicare group plan. However, you’ll be able to use your HRA dollars to be reimbursed for qualified medical expenses on behalf of your eligible dependents.

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