OPERS and Medicare: HRA, Via Benefits Connector, and Your 2026 Options

The OPERS Connector model

OPERS used to administer its own group health plans for retirees. That changed several years ago when OPERS shifted to a Connector model: instead of running a plan, OPERS partners with Via Benefits (a national retiree health-benefits administrator) to help you shop the individual Medicare market, and OPERS funds an HRA to help you pay the premiums.

The Connector handles two distinct populations:

• Pre-Medicare retirees — under 65 (or not yet Medicare-eligible). Via Benefits Pre-Medicare line: 1-833-939-1215. You can shop the ACA Marketplace or buy any individual plan you want; the Connector helps with side-by-side comparisons, including whether the federal Premium Tax Credit beats the OPERS HRA in your situation.
• Medicare-eligible retirees — 65+, or Medicare-eligible due to disability. Via Benefits Medicare line: 1-844-287-9945. You select an individual Medicare plan — either a Medigap (Medicare Supplement) policy paired with a stand-alone Part D plan, or a Medicare Advantage plan that bundles both.

Both lines are staffed by licensed benefit advisors. You can schedule a phone appointment, and the call is not a sales pitch — Via Benefits is paid by OPERS to run the Connector, not by carriers selling plans.

How the HRA works

An HRA is a tax-advantaged account funded by your former employer (in this case, OPERS) that reimburses you for qualified medical expenses. With the OPERS HRA, you typically pay your health premium and other expenses out of pocket and then submit for reimbursement — though Via Benefits will help you set up automatic premium reimbursement so the carrier and the HRA talk to each other and you don't have to file every month.

The dollar amount OPERS deposits each month depends on two factors:

1. The age you first became eligible for the HRA. Earlier eligibility (retiring at 55 with full service credit, for example) yields a smaller percentage of the base allowance; reaching the HRA at a more typical retirement age yields a higher percentage.
2. Your qualifying years of health-care service credit at retirement. More qualifying service credit increases your allowance percentage.

The percentage range is 51% to 90% of the OPERS base allowance. The base allowance itself is set by OPERS and reevaluated based on funding and market conditions — OPERS updates it periodically rather than annually. You can see your own monthly deposit in your OPERS online account; if you're not yet retired, the OPERS retirement estimator will model it.

Reimbursable expenses are broadly defined under IRS Publication 502 and include the Medicare Part B premium ($202.90/month standard in 2026), your Medigap or Medicare Advantage premium, your Part D premium, dental and vision plan premiums (including OPERS's optional vision and dental plans), and out-of-pocket costs like copays, coinsurance, and prescriptions not covered by your plan.

Pre-Medicare vs. Medicare-eligible

If you retire before 65 with an OPERS pension, you're in the Pre-Medicare phase. Pre-Medicare benefit recipients are not required to enroll through Via Benefits — you can buy any individual plan you want and still potentially receive HRA deposits (the rules differ slightly from the Medicare-eligible closed HRA). Many pre-Medicare OPERS retirees actually do better with the federal Premium Tax Credit on the ACA Marketplace than with the OPERS HRA, depending on income. Via Benefits walks you through a side-by-side decision.

When you become Medicare-eligible — either by turning 65 or qualifying through disability — OPERS sends you transition information well in advance. You must notify OPERS and Via Benefits within 30 days of receiving your Medicare eligibility notice from the Social Security Administration. Updates to your HRA are made prospectively only, not retroactively, so a late notification can cost you weeks or months of deposits.

Choosing a plan through Via Benefits

At your Via Benefits Medicare appointment, the licensed benefit advisor walks you through your options based on your ZIP code, doctors, prescriptions, and travel patterns. In broad terms, you'll be choosing between two structures:

• Medigap (Medicare Supplement) + stand-alone Part D. Medigap policies sit alongside Original Medicare and cover most or all of what Medicare leaves behind. Plan G is the most popular new-enrollee choice in Ohio. You add a stand-alone Part D plan for prescriptions. This combination tends to have higher monthly premiums but very low out-of-pocket costs at the doctor and hospital, plus broad provider freedom (any doctor or hospital that accepts Medicare).
• Medicare Advantage. A private plan that bundles A, B, often D, and frequently extras like dental, vision, hearing, and gym benefits. Premiums are often $0 or low, but you trade network restrictions and prior authorization for those extras. Ohio's MA market is competitive — Anthem, Aetna, Humana, Medical Mutual, UnitedHealthcare, Wellcare, Devoted, and CareSource all sell statewide or in major regions.

Selecting a Medigap plan may require medical underwriting if you're outside a guaranteed-issue window — Ohio does not have a Medigap "birthday rule" like California, so plan switching is harder once your initial Medigap Open Enrollment Period closes. See our Medigap in Ohio guide for what's underwritten and what isn't.

Open enrollment timing

OPERS Connector open enrollment mirrors Medicare's Annual Enrollment Period: October 15 through December 7. This is when most plan changes are made for the following January 1 effective date.

Two important nuances:

• Medigap plans can be changed any time of year — you don't need to wait for AEP. But changes are subject to medical underwriting outside of guaranteed-issue windows. Call Via Benefits during open enrollment only if you're unhappy with your current Medigap.
• Medicare Advantage and Part D plans can only be changed during AEP (or during the Medicare Advantage Open Enrollment Period, Jan 1 – Mar 31, if you're already in an MA plan and want to switch once). The MA-OEP doesn't apply to people switching from Medigap into MA, only between MA plans.

Re-employment and the HRA

If you retire from OPERS and then accept another OPERS-covered position, you enter re-employment. The HRA rules for re-employed retirees are specific:

• HRA deposits accumulated during re-employment are placed in a separate Re-Employed Accumulated HRA, with a $2.60 monthly administrative fee per month accrued.
• You can use those accumulated deposits to reimburse expenses incurred before the re-employment period or after it ends — but not expenses incurred during the re-employment period itself.
• Your re-employment period begins the first day of the month employment started and ends the last day of the month employment ends.
• To continue receiving HRA deposits during Medicare-eligible re-employment, you must stay enrolled in a Medicare medical plan through the Connector.

Common mistakes

The patterns we see most often with OPERS retirees:

• Buying a Medigap policy directly from a carrier or independent agent. The plan may be perfectly good, but if it wasn't enrolled through Via Benefits, your HRA deposits stop. Always confirm the enrollment is being processed through the OPERS Connector.
• Adding a second Part D plan. If you have a Medicare Advantage plan that includes drug coverage and someone signs you up for a stand-alone Part D plan, the carrier will disenroll you from the Advantage plan — and you may not realize until you try to fill a prescription.
• Missing the 30-day notification when you receive your Medicare eligibility notice from SSA. Adjustments to your HRA are prospective only.
• Assuming OPERS pays your Part B premium. OPERS doesn't pay Part B directly — you pay Medicare (or have it deducted from Social Security), and you can use HRA dollars to reimburse yourself tax-free.