Open Enrollment 2018

It’s that time of year – open enrollment. As you plan ahead for 2018 health care coverage, it’s important to know key information, such as the open enrollment dates and action steps to take as a Medicare or pre-Medicare retiree.

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Check your mailbox!

Those eligible for OPERS health care coverage will receive a 2018 Personalized Health Care Open Enrollment Statement and Open Enrollment Guide by mid-October.

What's new in 2018

The following things have changed from last year:


Medicare-Eligible Retirees

Review your plan

You should review the 2018 plan details provided by your plan carrier and look for any changes in premiums and plan design.

Remember to evaluate the prescription drug formulary as these sometimes change from year to year. Some plan changes (Medigap) may require medical underwriting.

Want to keep your current plan?

If you have reviewed your plan details for 2018 and do not want to make any changes, no action is needed. Your plans will automatically carry over into 2018.

Retirees with End-Stage Renal Disease

If you are under age 65 with End-Stage Renal Disease (ESRD) and currently enrolled in the Humana Interim Plan, your coverage will automatically continue under this plan, under the new plan name, Medicare Re-employed Plan. Medical Mutual is the plan administrator for 2018.

Optional Vision and/or Dental coverage

If you would like to adjust optional vision and/or dental coverage, or drop a dependent for 2018, call OPERS between Oct. 15 and Dec. 7.

If you would like to add coverage for yourself and/or dependents, complete the Health Care Open Enrollment Change form included in your packet.

Spouses

While spouses (including surviving spouses) will no longer receive a monthly Health Reimbursement Arrangement (HRA) deposit, they will continue to have access to health care plans through the Connector.

Spouses will remain enrolled in their selected plan until the individual cancels the coverage. Should spouses choose to look into other coverage options, a list of resources are available on opers.org:

HRA Reimbursement Reminders

Automatic Reimbursement

If you previously set up automatic reimbursement for plan premiums and you do not change plans, these arrangements will continue into 2018.

Changing medical plan carriers?

Automatic reimbursement does not transfer over between carriers. Check to see if the new carrier offers automatic reimbursement. Note that reimbursement timing varies by carrier.

Recurring Premiums

Recurring premium claim forms for 2018 Medicare Part B and OPERS vision and dental premiums need resubmitted each year to the administrator. OPERS will mail a copy of your Health Care Premium Receipt in mid-December. This receipt needs submitted to establish recurring premiums that are deducted from your OPERS pension benefit.

Things to consider

  • Have you had a change in health or medications?
  • Is your primary care physician no longer included in your network?
  • Have you moved, or has your carrier closed your plan?
  • Are your current premiums outside of your budget?

If you answered yes to any of these questions, you may want to explore other available plan options through the OPERS Medicare Connector.

Other insurance companies and brokers will send materials and try to call you. Remember that you must maintain your current plan enrollment or enroll in a new plan through the Connector to receive your Health Reimbursement Arrangement.

Pre-Medicare Retirees

Continue your coverage

If you would like to continue your current coverage, there’s no need to take action. Current plans will automatically carry over into 2018.

Optional Vision and/or Dental coverage

If you would like to adjust optional vision and/or dental coverage, or drop a dependent for 2018, call OPERS between Oct. 15 and Dec. 7.

If you would like to add coverage for yourself and/or dependents, complete the Health Care Open Enrollment Change form included in your packet.

Re-employment

If you are pre-Medicare and re-employed in an OPERS-covered position, you will participate in the Pre-Medicare Re-employed Plan (administered by Medical Mutual), formerly known as the Medical Mutual Interim Plan.

Spouses

Spouses, including surviving spouses, who remain enrolled in the pre-Medicare plan will be responsible for the full cost of OPERS health care coverage.

As a result, some retirees may decide the premium to cover a pre-Medicare spouse is more than they can comfortably afford.

Open Enrollment Resources

Health Insurance Marketplace | 1-800-318-2596

Ohio Department of Insurance Consumer Services | 1-800-686-1526

Ohio Department of Aging | 1-800-266-4346

Ohio Department of Medicaid | 1-800-324-8680

Willis Towers Watson OneExchange | 1-844-287-9945

Open Enrollment Guide

The 2018 Open Enrollment Guide features plan information for the Medicare and pre-Medicare participants in OPERS Health Care.

Open Enrollment Bulletin

The Open Enrollment Bulletin, included in the Fall Retiree Newsletter includes high-level details of changes in plan design, Retiree Like Me scenarios (for Medicare and pre-Medicare), education seminar dates and much more.

Educational Seminars and Webinars

OPERS offers a number of in-person educational seminars, webinars, and recorded presentations tailored to the specific needs of OPERS retirees.

New this year: A HRA seminar focused on How to Use Your Health Reimbursement Arrangement

In-Person Seminars

Online Webinars

2018 Vision and Dental Plan Guide

The 2018 Vision and Dental Guide features vision and dental plan information for the upcoming year.

2018 Income-Based Discount

The OPERS Income Based Discount Program is designed to help qualified benefit recipients pay for their participation in the OPERS medical plan. More information about the program can be found in the 2018 Open Enrollment Guide.


Frequently Asked Questions

Why are premiums increasing?

The cost of medical services continues to rise and the use of these services continues to increase causing premiums to increase. OPERS retirees and spouses are experiencing the final year of the allowance transition which has a direct impact on how much of the monthly premium is paid by retirees and dependents.

If some retirees decide the premium to cover a spouse not yet eligible for Medicare is more than they can comfortably afford, there are a number of options available through the Health Care Marketplace, commonly referred to as Exchange plans. Another site that provides coverage and cost comparisons for a variety of carriers is ehealthinsurance.com.

Additionally, depending on income level, some may qualify for substantial help from the federal government to pay for a plan via the marketplace. If an outside plan is selected, you are still responsible for canceling OPERS spouse coverage as it will not automatically terminate. As you weigh your options, please keep in mind that while participants are being asked to share more of the costs, most of the plan costs will still be paid by OPERS.

How do I terminate coverage for a dependent or myself?
Retirees can complete the Health Care Open Enrollment Change Form or call OPERS to terminate medical, prescription drug, vision and/or dental coverage. The most efficient way to make these changes may be to call OPERS at 1-800-222-7377.
I enrolled in a medical plan through the Connector and receive an HRA. My spouse is not yet eligible for Medicare and enrolled in OPERS Retiree Health Plan. Can I reimburse her plan premiums from my HRA?
Yes, you can submit her plan premiums and you will be reimbursed up to the available balance in your HRA. You can also receive reimbursement for both your OPERS vision and dental plan premiums, if enrolled. Please submit a recurring HRA claim form (available through your HRA online account) along with an OPERS premium deduction letter (available through your OPERS online account).
What happens if I cease being re-employed in an OPERS-covered position?
OPERS must receive notification from your employer before we can officially change your status from re-employed to not re-employed.

Pre-Medicare
Coverage for those re-employed in an OPERS–covered position is identical to the OPERS Retiree Health Plan for those who are not re-employed. If you are enrolled in the Pre-Medicare Re-employed Plan, OPERS administratively adjusts your enrollment to the appropriate plan when your employer notifies us of your termination of employment, so no action is necessary.

Medicare-eligible
In order to receive your Health Reimbursement Arrangement (HRA) allowance, you need to be enrolled in a medical plan through the OPERS Medicare Connector administered by One Exchange.

To enroll, contact OneExchange at 1-844-287-9945.

As a spouse, will my OPERS Retiree Health Plan coverage automatically cancel for 2018?
No. Even though spouses (including surviving spouses) will no longer receive an allowance as of Jan. 1, 2018, they will remain enrolled in our plan. If you do not want to continue coverage for 2018, OPERS must receive a phone call or the open enrollment change form requesting cancellation of coverage.
As a spouse, can I enroll in a new Medicare plan outside of the Connector?
Choosing a plan outside of the Connector is an option. Remember, when you enroll in a plan through the Connector (administered by OneExchange), they provide ongoing support for online account management, carrier claim resolution and Medicare plan questions. Should you choose to enroll in a plan outside of the Connector, you will not have access to these services, nor will you have access to automatic or recurring reimbursements.

Please note that if you enrolled in a 2017 plan through the Connector, you will remain enrolled in that plan unless you cancel the coverage.
I am re-employed and transitioning from Humana Interim Plan to the Medical Mutual Medicare Plan . Will my premiums and coverage options change?
The plan coverage (plan deductibles, co-insurance, copays) for the Medical Mutual Medicare Plan will be identical to the current coverage offered under the Humana Interim Plan. Your open enrollment statement will provide information about any change in your monthly premium.