Open enrollment for the Ohio Public Employees Retirement System (OPERS) health care program in 2025 is now underway. OPERS has started distributing enrollment materials to all eligible benefit recipients, ensuring everyone has the necessary information for this important period.
This guide provides key details about the 2025 OPERS health care open enrollment, helping you navigate the process smoothly. It’s essential to understand the timelines and changes, whether you are a Pre-Medicare or Medicare retiree.
Key Dates for 2025 OPERS Open Enrollment
It’s crucial to note the distinct enrollment periods based on your Medicare status:
- Pre-Medicare Open Enrollment: November 1 – December 15
- Medicare Open Enrollment: October 15 – December 7
- OPERS Vision and Dental Open Enrollment: October 15 – December 15 (applies to both Pre-Medicare and Medicare recipients)
Make sure to mark these dates on your calendar to avoid missing important deadlines for your 2025 health care coverage.
Understanding Your Health Reimbursement Arrangement (HRA)
For those eligible for the OPERS Health Reimbursement Arrangement (HRA), your open enrollment statement will detail your monthly HRA deposit for 2025. The OPERS Board of Trustees has approved significant adjustments to the HRA base allowance:
- Medicare Retirees: The base allowance is increasing from $350 to $400 per month, effective January 2025, and is projected to remain at this level through 2030. This increase provides enhanced financial support for Medicare-eligible retirees’ health care expenses.
- Pre-Medicare Retirees: The base allowance will remain at $1,200 per month through 2030, contrary to a previously scheduled reduction. This ensures continued robust support for Pre-Medicare retirees’ health care needs.
It’s important to remember that the “base allowance amount” represents the maximum basis for your monthly HRA. The actual amount you receive is a percentage of this base, ranging from 51% to 90%, depending on your age and years of service at retirement.
What to Expect in Your Open Enrollment Packet
If you are opted into the HRA, you will receive a comprehensive open enrollment packet containing crucial documents:
- Personalized Statement: This statement outlines your specific 2025 monthly HRA deposit amount and the premium rates for OPERS vision and dental plans, giving you a clear financial picture for the upcoming year.
- 2025 Opers Health Care Program Guide: This essential guide (2025 OPERS Health Care Program Guide) provides detailed information about health care program eligibility, the OPERS HRA, Medicare requirements, and the OPERS vision and dental plans. It is your go-to resource for understanding all aspects of the program.
- Vision/Dental Open Enrollment Change Form: Use this form (Vision/Dental Open Enrollment Change Form ) to enroll in, modify, or cancel your OPERS vision and/or dental coverage for 2025.
Specific Guidance for Pre-Medicare Benefit Recipients
Pre-Medicare recipients should pay close attention to these key actions during open enrollment:
- Review Medical and Prescription Drug Plan Details: Carefully examine the 2025 plan details provided by your plan administrator or insurance carrier. Look for changes in premiums, plan design, and prescription drug formularies. This information may arrive by mail or be available on the administrator/carrier’s website.
- Via Benefits Consultation (Optional): If you are enrolled in a plan through Via Benefits and have questions, you can contact Via Benefits between November 1 and December 15. Scheduling a phone appointment with a Benefits Advisor is optional but recommended if you need personalized guidance on your 2025 medical plan options.
- Evaluate Your HRA Funding Decision: You have the flexibility to change your HRA funding decision annually during open enrollment. Any changes will take effect on January 1 of the following year. Manage your funding election through your online OPERS profile under “Your Funding Decision” between November 1 and December 15. Remember, opting into the HRA is separate from having medical insurance and provides valuable funds for qualified medical expenses without reducing your pension benefit.
Key Steps for Medicare Benefit Recipients
Medicare recipients need to focus on these points during their open enrollment period:
- Medical and Prescription Plan Review: Examine the 2025 medical and prescription drug plan details from your plan administrator. Be aware of any changes to premiums, plan design, and drug formularies. Contact Via Benefits if you have any uncertainties or questions about your 2025 medical plan.
- Via Benefits Enrollment and Changes: Contact Via Benefits (Via Benefits) between October 15 and December 7 to enroll, make changes, or cancel coverage. You can schedule a phone appointment with a Benefits Advisor for personalized assistance in choosing your 2025 Medicare medical plan. Note that selecting a Medigap plan might involve medical underwriting.
- Maintain Medicare Enrollment for HRA: To continue receiving HRA deposits, ensure you are enrolled in a Medicare medical plan through Via Benefits. This is a mandatory requirement for HRA eligibility.
OPERS Vision and Dental Plan Options
Open enrollment is your annual opportunity to adjust your OPERS vision and dental coverage for 2025 for yourself and eligible dependents.
- Automatic Continuation: If you are satisfied with your current OPERS vision and dental coverage and require no changes, your enrollment will automatically continue into 2025 without any action needed.
- Enrollment, Changes, or Cancellation: To enroll, change, or cancel vision or dental coverage, use the form in your open enrollment packet. Alternatively, you can contact OPERS directly between October 15 and December 15 to modify your plan level or cancel coverage. Importantly, cancellation of OPERS vision and/or dental coverage is not automatic; you must actively take steps to cancel if you no longer desire coverage.
- Review Dual Coverage: If you have vision and/or dental coverage through both OPERS and Via Benefits (or another provider), assess your needs to determine if dual coverage is necessary. Enrollment in OPERS plans is for the full calendar year and cannot be changed until the next open enrollment period.
- Plan Service Details: For specific details about plan coverage for services, visit metlife.com/opers or call MetLife directly at 1-888-262-4874.
For convenient premium reimbursement, OPERS automatically sends your vision and/or dental premium information to the OPERS Connector for HRA reimbursement. Manage your automatic reimbursement preferences by logging into your account (log into your account) and selecting “View Accounts” under “Funds & Reimbursement,” or contact Via Benefits at 1-844-287-9945.
This guide aims to clarify the essential aspects of the 2025 OPERS health care open enrollment, ensuring you can make informed decisions about your health care coverage. Refer to the 2025 OPERS Health Care Program Guide for complete details and take action within the specified open enrollment periods.
