2025 OPERS Health Care Program Open Enrollment

Open enrollment for 2025 is under way and this means different things depending on whether you are a Pre-Medicare or a Medicare-eligible OPERS benefit recipient.

The OPERS Board of Trustees approved an increase in the Health Reimbursement Arrangement (HRA) base allowance for Medicare retirees and voted to maintain the Pre-Medicare allowance at the current level.

The current base allowance of $350 per month for Medicare retirees will increase to $400 beginning in January 2025 and is expected to remain at that level through 2030. The base allowance for Pre-Medicare retirees is currently $1,200 per month and was scheduled to reduce to $1,000 per month in January. Instead, the Pre-Medicare base allowance is expected to remain at $1,200 per month through 2030.

If you are eligible for the OPERS Health Reimbursement Arrangement (HRA) in 2024, you will receive the following:

If you are not eligible for the OPERS HRA but are enrolled in the OPERS vision and/or dental plan, you will receive the following:

Check your mailbox!

All eligible OPERS benefit recipients will receive a 2025 OPERS open enrollment packet. Packets mail early October.

Pre-Medicare-Eligible OPERS Benefit Recipients

Your HRA Funding Selection

  • Are you still in the right funding situation? You can change your funding decision each Open Enrollment Period and your new election will take effect January 1 of the following year. Sign into your Via Benefits online profile and select Your Funding Decision to make changes between Nov. 1 and Dec. 15, 2024. Remember, opting in to the HRA is not the same as having medical insurance. If you are eligible for the OPERS HRA and you choose not to opt in, you are essentially turning down funds that you could use to be reimbursed for qualified medical expenses. This is not something that is deducted from your monthly pension benefit.

Your medical plan for 2025

  • Review the 2025 medical and prescription drug plan details provided by your plan administrator and/or insurance carrier. Depending on the administrator and/or carrier, you may receive this information in the mail. If not, visit the administrator's and/or carrier's website. Look for changes in premiums, plan design and prescription drug formulary. If you are enrolled in a medical plan with Via Benefits and are unsure of any changes for 2025 or have questions, reach out to Via Benefits. Or, if you are enrolled in a plan outside of Via Benefits, contact your plan administrator and/or insurance carrier directly.
  • Enrolled in a plan through Via Benefits and have questions about your coverage in 2025? Contact Via Benefits (link opens in new tab) between Nov. 1 and Dec. 15, 2024. You can call Via Benefits at 1-833-939-1215 and schedule a phone appointment with a Benefits Advisor to review your medical plan details for 2025 during this period, but an appointment is not required.

Medicare-Eligible OPERS Benefit Recipients

  • Review the 2025 medical and prescription drug plan details provided by your insurance carrier. Look for changes in premiums, plan design and prescription drug formulary. If you are unsure of any changes to your medical plan for 2025 or have questions, reach out to Via Benefits.
  • Enrolling, making changes or canceling coverage? Contact Via Benefits (link opens in new tab) between Oct. 15 and Dec. 7, 2024. You can call Via Benefits at 1-844-287-9945 and schedule a phone appointment with a Benefits Advisor to discuss your 2025 medical plan, but an appointment is not required. Selecting a Medigap plan may require medical underwriting.

Remember, you must enroll or remain enrolled in a Medicare medical plan through Via Benefits to continue receiving HRA deposits.

OPERS Vision and Dental Plans

Open enrollment is your opportunity to enroll in, cancel or change OPERS vision and/or dental coverage for yourself and any eligible dependents for 2025. Enrolling, making changes or canceling vision or dental coverage? To terminate your OPERS coverage for 2025, you must complete and return the form within your open enrollment packet or call us no later than Dec. 15, 2024.

Automatic Reimbursement from your HRA for OPERS Vision and/or Dental Premium(s)

For your convenience, OPERS sends a notice of your paid premiums for all those enrolled in the dental and/or vision plan(s) to Via Benefits for automatic reimbursement from your HRA. To view and/or update your automatic reimbursement preference, log into your Via Benefits online account at marketplace.viabenefits.com/opers (link opens in new tab) and select View Accounts under the Funds & Reimbursement section or contact Via Benefits at 1-844-287-9945.

For answers to some common questions about the OPERS Vision and Dental Plans, please see these FAQs.

OPERS Open Enrollment Education

Now through the end of the open enrollment period, OPERS is offering seminars and webinars. Visit the OPERS Education for Retirees page to register for the Open Enrollment 2025 and Understanding Your HRA educational opportunity that works for you!