Problems plague new OPERS health plan

Retirees under 65 struggle with switch

Starting Jan. 1, Ohio’s largest public employee retirement system is downsizing the health care offered to retirees under age 65. And the sign-up for the new program has been rough.

Instead of providing group medical and prescription coverage, Ohio Public Employees Retirement System retirees will be given a monthly allowance to purchase their coverage. Retirees will pick a plan, pay costs upfront and seek reimbursement for qualifying expenses.

The monthly allowance amount depends on the retirees’ service and age when they started coverage. The pension fund deposited $1,200 into participants’ accounts to help with initial reimbursements.

OPERS is the largest pension fund in Ohio and the 11th largest in the nation. It has about $112 billion invested for 1.2 million employees, retirees and beneficiaries. The pensions are funded by employee and employer contributions and investment returns.

Long wait times, few answers

OPERS contracted with Via Benefits by Willis Towers Watson to help retirees look for coverage and figure out the reimbursement system.

Retirees have complained that they are placed on hold for hours and when they finally get to talk to someone, Via Benefits staff can’t answer their basic questions.

“It takes forever. The people you talk to know nothing,” said David Huber, who retired from a management job with Montgomery County Adult Probation a decade ago.

The new program is overly complex and offers few choices beyond the Affordable Care Act marketplace, he said.

“We’ve heard some of those complaints too about long wait times,” OPERS Member Operations Director Tonya Brown said.

This fall, Via Benefits lost about 20% of its 212 trained advisors assigned to the OPERS project, due mostly to labor shortages plaguing employers. Efforts have been made to remedy the staffing shortages and investigate reports of

other problems, she said.

OPERS contract with Via Benefits includes penalties when the company fails to meet monthly and quarterly performance benchmarks, Brown said.

Some of the problems reported to OPERS turned out to be tied to other insurance brokers – not linked to Via Benefits or the pension fund – reaching out to retirees on Facebook groups, Brown said.

Why did OPERS make the change?

The high cost of health care is driving the need for changes, according to OPERS. Without the changes, the OPERS health care fund was projected to run out of money by 2030. With the changes, OPERS estimates the fund will last another 23 years.

Retirees younger than 65 need to enroll in the new health reimbursement arrangement and pick a new coverage plan by Dec. 31. About 72% of 35,000 retirees in this category have already done so. Retirees already eligible for Medicare will face a different change: OPERS’ monthly allotment will drop from $450 to $350. There are just over 100,000 retirees in that category.

State law doesn’t require Ohio’s five public employee retirement systems to offer health care coverage, but OPERS has provided coverage since 1974. OPERS used to set aside a chunk of employer contributions for retiree health care but stopped doing so in 2018. Since then, all the contributions are earmarked for pension benefits, which take priority over health care coverage.

Huber said under the new system, he will pay more for inferior coverage.

“It’s just not the same coverage we had before and I think it’s a disservice to those who worked 30 to 40 years in public service,” he said. “How can your retire if you don’t have health care? You can’t.”

Laura Bischoff is a reporter for the USA TODAY Network Ohio Bureau, which serves the Columbus Dispatch, Cincinnati Enquirer, Akron Beacon Journal and 18 other affiliated news organizations across Ohio.