It is not too late for Ohio Police and Fire retirees who have not enrolled in health care coverage for 2019.
Since one of the qualifying events for becoming eligible for the OP&F health care plan is the involuntary loss of group coverage, the end of the OP&F self-insured retiree plan counts as such an event. This creates a special enrollment period from Jan. 1 until March 1, 2019 for all members who were enrolled in the OP&F plan in 2018.
Although members will have a gap in coverage, retirees still can enroll until the special enrollment period ends and they may still qualify for a stipend from OP&F. This applies to both the Medicare and non-Medicare population. Call 844-290-3674 to enroll.
The OP&F Pension Fund says members who are having trouble accessing their stipend to pay for health premiums should be able to access money by the end of the month according to an OP&F spokesperson.
Members who signed up for coverage should have received a packet in the mail with paperwork to fill out to start the reimbursement process. If that paperwork was not filled out and sent in by now, reimbursement may take longer.
This only impacts retirees who are eligible for the stipend and have enrolled in a health care plan through Aon, and have a Health Reimbursement Account (HRA).
Meanwhile Aon will host webinars reviewing the healthcare reimbursement process and members can call in with questions. Here’s a link to that info.
David Graham, spokesperson for OP&F says more than 90 percent of Medicare eligible retirees have signed up for supplemental coverage and 67 percent of retirees under 65 have signed up. He couldn’t say how many are still without insurance because some may have jobs that provide it or they were able to go on their spouse’s insurance. However, the deadline for signup for those who still need it is March 1.
OP&F says about 70 percent of retirees under the age of 65 and 80 of retirees over the age of 65 have signed up for the new health insurance.
But some retirees are having difficulty getting access to their stipends to pay their premiums. It may depend on the coverage they signed up for. To learn more about how reimbursement will work, click here
The pension fund changed from a self-insured group plan to a system of stipends that allows retirees to buy their own insurance but only from within the insurers offered through the insurance broker Aon.
For some retirees, the change means the inconvenience of finding new doctors and new hospitals and many say they are paying much higher premiums and deductables.
The pension fund is not legally obligated to provide insurance but it has done so since the fund was formed in 1965. Many retirees say getting through to Aon to sign up or get the stipend activated has been difficult and frustrating.
Fund director John Gallagher blames the changes on the need for the fund to remain solvent, and on partisan bickering Washington over the Affordable Care Act. He says changing health insurance will keep the fund available for at least 10 to 15 years. Without the changes the money may have run out in about seven years.
In a letter to membership, Gallagher said:
I apologize for the problems our retirees had in enrollment, appointment
times, or plan choices available. However, the choice to make this transition was important and had to be done.
Our work is far from finished. Our staff and trustees will continue to work hard to address the shortfalls of the health care transition. This includes improved service from our health care partners and hopefully better plan choices for our pre-Medicare population. We still believe that the stipend we provide to eligible retirees is valuable and gives retirees significant purchasing power as they look for health care plans.
Diana Gunn is the wife of a retired Cleveland firefighter and sent the following letter to OP&F explaining how the transition impacted her and her husband:
Dear Mr. Gallagher, President of the Ohio Police and Fire Pension Fund,
I am writing this because my husband Kevin G. Gunn is not able to. He has Alzheimer’s. He served the city of Cleveland for 35 years as a Cleveland Firefighter. He served as Sergeant of Arms, Trustee, Secretary, Vice President and President of Local 93. He spent his career helping people, not only the citizens of Cleveland but also his fellow Firefighters. He was diagnosed with Alzheimer’s one year after retirement. There are two very important things a retired person needs; their pension and good health care which we thought we had both.
I have rheumatoid arthritis; I can barely walk or stand for any amount of time. I have to do everything for Kevin now. All responsibilities are on me concerning his finances, health and, daily care. He can no longer do any of this. He depends on me to take care of everything and I was up to the challenge. Now I don’t know how long I will be able to care for him.
This health care transition, crisis has destroyed me. I have been sick since the first week in November due to the chaos that you and your board have inflicted upon us. Never ever in my life, through child birth, surgeries, cancer, Kevin’s illness and my illness have I suffered such a gut wrenching, stressful, sense of helplessness trying to navigate the Ohio Police and Fire health care process. You made it almost impossible, from the lack of qualified help on the AON side as well as the e-health side. The Ohio Police and Fire Pension was no help during this time. We were forced to deal with AON even though you had knowledge that they were not doing the job that you hired them for. The health care plans that were offered to the under 65 firefighters are the worst. We are paying for insurance that we cannot use until we reach our deductible of 8,000 dollars. We cannot travel, not that me and Kevin can go far or often because of our illnesses but now we have no choice but to stay home or risk our life and our home because we do not have coverage outside of Cuyahoga County. Both of our expensive drugs are not covered. Kevin’s is $500.00 per month and mine is $4,165.00 per month. We will go without thanks to terrible coverage afford us. Without my drug I am not sure I will be able to continue to care for Kevin. This is truly not fair to a man who gave his life daily protecting others. Kevin dedicated his life to the Cleveland Fire Department and the citizens in Cleveland.
So let us move on, today January 2, 2019, I tried to access the HRA account to request our stipend. It will not let me access the account. We purchased two qualifying Medical Mutual Plans for a total of $1,536.67 dollars. The stipend amount is $1,074.00 that I cannot access. You would think after the fiasco that we all went through trying to purchase these plans that you would have told AON not to screw up this process, but again it’s obvious you did not. We need this money to pay for this month’s premium. Do I need an attorney, should I send this letter to a reporter? Tell me what I should do Mr. Gallagher! How do I get the monies promised to us? Was it all Lies?
You’re a business man, not a firefighter or a policeman. You never faced the daily danger associated with these jobs, or the health risks to their bodies. It only makes sense that they need good health care coverage in their retirement.
I don’t believe that this can be fixed at this late date. We are forced to live with a decision that you and the board put upon us. I know and so do you that you made a horrible decision on the health care for the under 65 retired members.
A great leader would stand up and admit he made a big mistake and try to fix this, and at the very least apologize profusely for his bad judgement in this matter. A great leader would not tell the press that for the most part; this went smoothly, knowing that it is not true. We are one example of many how very wrong the whole procedure went.
Sincerely,
Diana Gunn