OPERS Medicare Connector Frequently Asked Questions
Below is a list of frequently asked questions, asked by you, our retirees.
Will the $300 annual lump sum Health Reimbursement Arrangement deposit continue beyond 2018?
The Health Reimbursement Arrangement annual lump sum deposit of $300 was originally approved by the Board for plan years 2016, 2017 and 2018 to help Medicare Connector participants pay for out-of-pocket prescription drug expenses, particularly those who had new expenses while in Medicare's Part D coverage gap (also known as the "donut hole"). Since it was announced that the coverage gap for brand-name drugs would close in 2019, the $300 lump sum payment will not extend another year.
Are retirees and/or eligible spouses required to use the OPERS Medicare Connector?
No one is required to use the OPERS Medicare Connector. However, retirees who do not use the Connector to enroll in a medical plan will not be eligible to receive an HRA allowance from OPERS.
Can an OPERS retiree use the OPERS Medicare Connector if he is not currently eligible for OPERS health care?
Yes. However, the retiree will not receive an HRA allowance from OPERS.
Can my spouse use the OPERS Medicare Connector now and once their allowance is phased out?
Yes. Spouses may use the OPERS Medicare Connector to access health care plans and use Via Benefits resources after plan selection is complete.
How will a retiree or spouse who worked in a public sector position for their full career and is not eligible for premium-free Part A be handled?
OPERS reimburses retirees at 100 percent for their Part A premium and at 50 percent for their spouse's Part A premium. Reimbursement also covers any penalties that may apply. The retiree must select a plan through the OPERS Medicare Connector to receive Medicare A premium reimbursement.
How is the Connector compensated?
The Connector receives commissions from the insurance companies whose product it sells. This is the model that's used in the Medicare individual marketplace in which 50 million people are enrolled. The Benefit Advisor does not know the commission structure so there is no incentive for the advisor to 'steer' retirees to one plan over another.