Health Care Documents
This page is designed as a resource for all OPERS health care guides and coverage booklets. Please click on the links below for more information regarding the OPERS health care coverage.
The Health Care Coverage Guide explains health care coverage that applies to individuals in the Traditional Pension and Combined plans who qualify for health care coverage at retirement.
This Medical Plan Description explains in detail OPERS' medical coverage for participants enrolled in Medical Mutual.
This guide reviews important steps to take for enrolling in Medicare and a medical/prescription plan supplement, addresses differences between Medigap and Medicare Advantage plans, provides detailed information about the reimbursement process and much more.
The Summary is designed to help eligible participants understand how the HRA works and describes the benefits available, advantages of a health reimbursement arrangement and key features of the HRA.
If an individual is receiving health care coverage from OPERS and would like to authorize a third party to receive personal health information related to the individual’s health care coverage, they must complete the HIPAA authorization form. The HIPAA authorization form will not authorize the release of confidential pension account information. For release of confidential pension information, the member/recipient must complete the Authorization for Release of Account Information (LL-2).
This guide explains OPERS' prescription coverage for Non-Medicare participants administered by Express Scripts.
This report explains OPERS health care operations.
This Summary Plan Description explains in detail the OPERS Humana Interim Plan for Medicare A & B participants and those who do not qualify for premium-free Medicare Part A.
This document provides a glossary of health coverage and medical terms required by the Affordable Care Act (ACA).
Summary of Benefits and Coverage
In addition to our existing OPERS communications above, we have included the OPERS summary of benefits and coverage booklets (SBC), which are required by the Affordable Care Act (ACA). The following links will provide access to each specific SBC broken down by the following plans:
Humana Interim Plan
2017 Humana Interim Plan
(This SBC includes medical coverage administered by Humana)
The OPERS health care plan for Medicare participants who are re-employed in an OPERS-covered position.
Medical Mutual (MMO)
2017 Non-Medicare PPO and Interim Plan PPO
(These SBC’s include medical coverage administered by MMO and pharmacy coverage administered by Express Scripts)
The OPERS health care plan for non-Medicare participants who reside within any Medical Mutual or affiliated provider network areas. To find network providers by ZIP code, visit medmutual.com.
2016 Retiree Health Plan OOA
(These SBC’s include medical coverage administered by MMO and pharmacy coverage administered by Express Scripts.)
This is an out-of-area OPERS health care plan for non-Medicare participants who reside outside of any Medical Mutual or affiliated provider networks. For more provider information, visit medmutual.com.