For all OP&F retirees eligible for a health care stipend, start by contacting Aon at 1-844-290-3674. To contact eHealth by phone, call Aon and request to be transferred to an eHealth representative familiar with OP&F.
Retirees are also encouraged to register online with Aon, where Medicare-eligible members can review plans available to them and pre-Medicare retirees can shop for health care plans.
A chart showing the stipend levels can be found on the OP&F website on the health care page here.
No, the stipend is not considered taxable income since the money is in a Health Reimbursement Account managed by our partner, Aon.
No, the stipend amount will not be added to a member’s monthly OP&F benefit. Instead, the stipend amount is deposited to a member’s health reimbursement arrangement (HRA) as a way for you to be reimbursed for certain health care costs that you and your eligible dependents pay out of pocket such as premiums for coverage and other eligible health expenses.
No, you may not rollover any amount remaining in the HRA to the following year. The stipend must be used for approved medical expenses that occur during that calendar year. There will be a window where reimbursements can be made for bills processed after Jan. 1 for expenses incurred before the start of the new calendar year.
Once enrolled, materials will be sent from Aon and include instructions how to pay for your health care and be reimbursed through your stipend-funded HRA. Depending on the plan you select, you may pay by electronic fund transfer or by coupon. This is up to the health care provider you select. Since you could select both medical and prescription drug (and potentially dental and vision also), there may be several transactions per month.
Also, if you are Medicare eligible, your Medicare Part B reimbursement will continue to be added to your monthly pension benefit.
The Aon Retiree Health Exchange is OP&F’s health care partner. They can directly assist OP&F members in selecting a health care plan. Aon will work with their partner, Alight Solutions, to manage the HRA, which will be set up specifically for eligible members and will be funded with the stipends from OP&F.
For OP&F retirees who do not qualify for a stipend, the Aon Retiree Health Exchange will still be available to help you select a health care plan if you wish to use their services. There will be no charge for this service.
For Medicare-eligible retirees, if you used the Aon Retiree Health Exchange to enroll in a medical or prescription drug plan for 2019, you remain stipend eligible for 2020. This group will remain eligible as long as they continue to enroll in medical or prescription drug plans through The Aon Retiree Health Exchange. If you did not enroll using the Aon Retiree Health Exchange, a qualifying event must occur to again become eligible.
For pre-Medicare retirees, OP&F has provided an exception to become eligible for the stipend for 2020. If you are not yet eligible for Medicare, you are eligible for the stipend in 2020 if:
For Medicare-eligible retirees, a wide variety of Medicare-Advantage or Medigap plans are available through the Aon Retiree Health Exchange. You can review these plans by logging on to your account with Aon or by contacting Aon to review your choices.
For pre-Medicare retirees, in 2020 OP&F will allow you to receive the stipend by enrolling in the following plans:
An employer’s plan, a spouse’s employer/retirement/COBRA plan are not eligible plans to receive a stipend.
If you experience life changes outside of the open enrollment period, you may qualify for a Special Enrollment Period. However, these qualified life events may be different for Medicare and non-Medicare plan enrollees. Qualifying life events include:
The Medicare Part B reimbursement program is not changing. Eligible members will continue to receive the reimbursement as a part of their benefit payments.
Aon Retiree Health Exchange, will assist you in finding a plan that you desire, which can include dental and vision coverage if you choose. The stipend can be used toward premiums for medical, dental and vision coverage too.
If you have health care coverage available from your employer, you are not eligible for the OP&F stipend. However, you can become eligible for the OP&F plan, and therefore the stipend, when you decide to leave your post-retirement job and therefore lose that coverage. This becomes a qualifying life event (involuntary loss of group coverage) that triggers eligibility for OP&F’s plan. You would have 60 days from the loss of group coverage to enroll in the OP&F plan.
For the 2020 plan year, eligible pre-Medicare retirees can purchase a health care plan either through the Aon Retiree Health Exchange or on the open market as long as the plan meets the minimum requirements set forth in the Affordable Care Act. A plan offered by a retiree’s employer and plans through a spouse’s employer, spouse’s retirement system or spouse’s COBRA are not eligible plans to receive a stipend.
Medicare-eligible retirees must go through the Aon Retiree Health Exchange and purchase either a medical or prescription plan to be eligible for the stipend.
A COBRA plan through the member’s former employer (even if it is not an OP&F employer) is eligible and these premiums are eligible for reimbursement. This change was made in the spring of 2019, so any eligible COBRA health care premiums after April 1, 2019 are eligible for reimbursement as long as the enrollment began after Jan. 1, 2019.
They can have dual coverage, however, if a member is covered through other insurance they will not receive a stipend from OP&F.
No. To receive a stipend, members who are Medicare-eligible must be enrolled in both Medicare Part A and Part B. There are no Medicare plans available unless the member has enrolled in A and B.
Yes, a member can receive a stipend if they are eligible and enroll in either medical or prescription drug coverage available through the Aon marketplace.
If a member and their spouse are eligible (meaning they don’t have access to group coverage elsewhere) and enroll in either a qualified medical or prescription drug plan the total stipend amount received by the member will increase. However, there will be only one Health Reimbursement Arrangement, regardless of the stipend amount and number of participants enrolled in a plan. The HRA will be in the member’s name, but all participants may submit claims.
The Affordable Care Act provides for guaranteed coverage and participants cannot be refused for pre-existing conditions.
Yes. OP&F will continue to offer additional support to families who can prove their household income meets the guidelines established by the OP&F Board of Trustees. A mailing will be sent each year from OP&F to those who began receiving the increase from September of the previous year thru Aug. 31 of the current year. This is because anyone who began receiving the discount in the fourth quarter of a year is automatically eligible for the discount the subsequent year. The Low-Income Stipend Increase Program increases the stipend 30 percent for those who qualify.
If a participant is employed and has access to any other group coverage, including employer or retirement coverage, they are not eligible for the OP&F stipend. Aon can still assist participants in selecting coverage options, however, the participant will not be eligible for stipend support from OP&F.
Yes. Members are not required to enroll in coverage provided through a spouse and can enroll in the OP&F plan and receive a stipend.
Aon benefit advisors will educate retirees on the plan benefits that are offered in their area and direct them to speak with their Tricare contact to assist in making a determination on which benefit or combination of benefits best fits their needs. Retirees may continue to participate in both Tricare and remain eligible for the OP&F stipend as long as the retiree enrolls in a qualified health care plan.
This additional feature to our health care program applies only to Medicare Part D (prescription) participants and provides up to $500,000 per year to help cover the expense of drugs that are used to treat certain illnesses and are extremely expensive (cancer drugs, for example).
No. A surviving spouse will receive a stipend of $685.00 per month (non-Medicare) for health care. There is not an additional stipend for dependent children of a surviving spouse. However, a surviving spouse may still select family coverage for a dependent child.
If you or your dependents are eligible for any other group coverage including employer or retirement coverage, they are not eligible for a stipend. However, if they leave that employer for any reason and do not have access to health care, this becomes a Qualifying Life Event (involuntary loss of group coverage) and they can then become eligible for the OP&F stipend program, provided they enroll within 60 days of the event. Please contact OP&F and Aon in order to become eligible for the stipend.