OPERS Medicare Connector Health Reimbursement Arrangement

A Health Reimbursement Arrangement, or HRA, is an account funded by OPERS that provides tax-free reimbursement for qualified medical expenses. The monthly allowance deposits can accumulate from month to month and, unlike most flexible spending accounts, the balance will roll over from year to year. Via Benefits ™ administers the HRA.

How to use your HRA

The HRA is provided to eligible retirees for reimbursement of qualified out-of-pocket medical expenses incurred by you or your qualified dependents.

For example, you may seek reimbursement of premiums (e.g., individual Medicare Advantage or Medigap (Medicare Supplement) plan, Medicare Part B, dental and vision) and other out-of-pocket expenses as defined by the IRS including medical and prescription drug copays and co-insurance.

Questions about your HRA?

Consider registering for an OPERS How to Use Your Health Reimbursement Arrangement seminar near you.

It's the perfect way to get the HRA information you need straight from OPERS professionals.

Eligibility Requirements for the Health Care Reimbursement Arrangement

To be eligible to receive the HRA, you must be:

The HRA administrator sets up the account after the retiree is enrolled in a medical plan through the Connector.

How much is deposited into my HRA?

The monthly amount deposited into your HRA depends on your years of service and age when enrollment in the OPERS health care plan first takes place.

Individual allowance amounts range between $229 and $405 with more than 90 percent of current retirees receiving $337 or more per month.

You can check the amount in your HRA at anytime by logging into your Via Benefits™ Online account.

Submitting Claims for Reimbursement from your HRA

The HRA will reimburse you up to the extent that there is a balance available in your account.

Understanding Your Reimbursement Options

Via Benefits offers different types of reimbursement. You can decide what works best for you when using your HRA.

Below are the types of reimbursement and the benefits of each type.

There are two different ways to receive reimbursements from your HRA: automatic and manual.

Automatic Reimbursement

You may like Automatic Reimbursement for the following reasons:

  • As long as Automatic Reimbursement is offered by your insurance company, you can select this option at enrollment or enroll at any time after. It is the preferred method for receiving reimbursement (providing your insurance company offers it) and it requires less paperwork and effort on your part.
  • Once set up, Via Benefits will process and automatically send your reimbursement to the bank account that you have on file with them. After completing the initial set-up, you don’t need to do anything. There are no forms to complete – just set and forget.
  • Your preference for automatic reimbursement will continue year over year without requiring you to take any action – even if premium amount changes – unless you enroll in a different plan.
  • Can be used for the following premiums:
    • Medical and prescription plans that offer this service
    • OPERS dental and vision plans
    • Part B

Keep the following in mind when using Automatic Reimbursement:

  • It will take two to three months to receive your first reimbursement. Following your initial reimbursement, you’ll receive a reimbursement every four to six weeks.
  • Timing of these payments may vary slightly from month to month, as they are dependent on when the insurance carrier sends Via Benefits this information.
  • Via Benefits cannot reimburse you until we receive payment from your insurance company.
Manual Reimbursement

Recurring Reimbursement

You may like Automatic Reimbursement for the following reasons:

  • Once set up, Via Benefits will process and send your reimbursement without requiring additional requests for the rest of the calendar year.
  • Consistent timing of payments - you will be reimbursed at the same time at the beginning of each month. The timing is more consistent than Automatic Reimbursement.
  • Can be used for the following premiums:
    • Medical and prescription plans
    • OPERS dental and vision plans
    • Part B
  • This is a good option if Automatic Reimbursement is not offered by your insurance companies. However, this option requires more paperwork on your part.

Keep the following in mind when using Recurring Reimbursement:

  • This reimbursement method doesn’t continue year over year – you must submit a new request with each plan year or if your premium amount changes during the year.
  • The initial request will take about 10 days to process.

One-time Reimbursement:

You may like One-time Reimbursement for the following reasons:

  • Most useful for qualified out of pocket expenses
  • The reimbursement is paid one time
  • Can be used for the following expenses:
    • Medical and prescription plan premiums
    • OPERS dental and vision plan premiums
    • Part A premiums
    • Part B premiums
    • Out-of-pocket expenses

Keep the following in mind when using One-time Reimbursement:

  • Timing of these payments is based on the time to process the reimbursement

The following premiums can be reimbursed automatically:

The following premiums can be reimbursed manually:

Submit claims online

Claims may also be submitted through your online Via Benefits™ account or Via Benefits Mobile app. For step-by-step instructions, refer to the Via Benefits™ Getting Reimbursed Guide (pdf opens in new tab).

Reimbursement Forms

Reimbursement forms are available through the retiree's Via Benefits™ online account and by phone at 1-844-287-9945. Each form includes a personalized barcode specific to the retiree's HRA as well as a check list detailing the required documentation needed with each claim type. Personalized barcodes eliminate the use of social security numbers to identify accounts and increases accuracy and efficiency when Via Benefits™ processes reimbursement requests.

To be granted full control of the Health Reimbursement Arrangement

To manage full activity of the account when you are no longer able to do so, a Power of Attorney or Guardianship of the Estate document must be on file with Via Benefits™.

This document can be obtained with the assistance of an attorney and should be mailed or faxed to Via Benefits™.

Assisting someone who has recently passed

If you are assisting someone who recently passed away, you will need to notify OPERS (1-800-222-7377) and Via Benefits™ (1-844-287-9945) that the OPERS benefit recipient is deceased.

You will also need to inform medical and pharmacy carriers to stop charging monthly premiums.

More Information

More information for caregivers can be found within A Guide for Caregivers and Families.

Did you know?

Medical expenses after a retiree passes away

Any outstanding, qualified medical expenses in the retiree’s name can be submitted to the retiree’s Health Reimbursement Arrangement for reimbursement up to 24 months following the retiree’s death.

Eligible spouses and dependents can also submit qualified medical expenses to the HRA for reimbursement until the funds in the HRA are exhausted. The balance of the HRA will be forfeited into the OPERS health care fund after 24 months of inactivity on the account.