Ohio Administrative Code
Title 145 - Public Employees Retirement System
Chapter 145-4 - Health Care Coverage
Section 145-4-27 - Health reimbursement arrangement
Universal Citation: OH Admin Code 145-4-27
Current through all regulations passed and filed through December 16, 2024
(A) As used in this rule:
(1)
"Health reimbursement arrangement" or "HRA" means the public
employees retirement system of Ohio health reimbursement arrangement plan,
effective November 1, 2021, funded by the 115 trust or such other funding
vehicle or mechanism established by the retirement system, from which the
reimbursement of qualifying medical expenses may be made. The HRA may have
component plans as determined by the public employees retirement board. The
text of the public employees retirement system of Ohio health reimbursement
arrangement plan shall not be incorporated into this or any other rule of the
Administrative Code. The current version is available at
www.opers.org.
(2)
"Pre-Medicare health reimbursement arrangement" or
"PMCR" means the public employees retirement system of Ohio pre-medicare health
reimbursement arrangement plan, a component plan of the HRA, effective November
1, 2021, funded by the 115 trust or such other funding vehicle or mechanism
established by the retirement system, from which the reimbursement of
qualifying medical expenses may be made. The text of the public employees
retirement system of Ohio pre-medicare health reimbursement arrangement plan
shall not be incoporated into this or any other rule of the Administrative
Code. The current version is available at
www.opers.org.
(3)
"Medicare health reimbursement arrangement" or "MCR"
means the public employees retirement system of Ohio medicare health
reimbursement arrangement plan, a component plan of the HRA, effective October
1, 2015, and restated January 1, 2022, funded by the 115 trust or such other
funding vehicle or mechanism established by the retirement system, from which
the reimbursement of qualifying medical expenses may be made. The text of the
public employees retirement system of Ohio medicare health reimbursement
arrangement plan shall not be incorporated into this or any other rule of the
Administrative Code. The current version is available at
www.opers.org.
(4)
"Monthly health care allowance" or "monthly allowance"
means the monthly amount that is allocated to each individual enrolled in the
HRA. The monthly allowance shall be determined by the board and offered in the
form of a notional credit to the health reimbursement arrangement consistent
with the provisions of that plan.
(5)
"Qualified years
of employer contributions" shall mean years of employer contributions and the
years purchased or transferred under section
145.295,
145.2911, or
145.37 of the Revised Code that,
if earned or obtained in the public employees retirement system, would be the
equivalent of the years of employer contributions. Qualified years of employer
contributions do not include the contributions that are the basis of a lump sum
pursuant to division (I)(2)(b) or (I)(3)(b) of section
145.332 of the Revised Code,
unless the lump sum is issued pursuant to division (N)(3) of section
145.332 of the Revised
Code.
(6)
"Years of employer contributions" means the years or
portions of a year for which the member's employer contributed to the public
employees retirement system under section
145.302,
145.48, or
145.483 of the Revised Code,
section 3.02 of the combined plan
document, or article VI of the combined or member-directed plan document.
Beginning January 1, 2014, "years of employer contributions" means the years or
portions of a year described in this paragraph for which the member's monthly
earnable salary on and after January 1, 2014, is one thousand dollars or
greater.
(B) Except as provided in this rule, the rights of an individual participating in the PMCR or MCR to a monthly allowance or to reimbursement under the PMCR or MCR, including eligibility to participate and coordination of coverage, shall be governed exclusively by the provisions of the health reimbursement arrangement plans described in paragraph (A)(2) or (A)(3) of this rule.
(1)
Eligibility to participate shall be set by the board
and described in the PMCR and MCR and shall be based upon qualified years of
employer contributions, age, and medicare eligibility. The board shall set the
minimum required qualified years of employer contributions subject to the
following:
(a)
Except as provided in paragraph (B)(1)(c) of this rule, the
board shall require at least ten years of service credit, as described in
paragraph (A)(1) of former rule
145-4-06 of the Administrative
Code, for individuals with a benefit effective date prior to January 1,
2015.
(b)
Except as provided in paragraph (B)(1)(c) of this rule,
the board shall not set the minimum required qualified years of employer
contributions below twenty years of qualified years of employer contributions
for individuals with a benefit effective date on or after January 1,
2015.
(c)
The following individuals shall not be subject to the
requirements of paragraphs (B)(1) (a) and (B)(1)(b) of this rule:
(i)
A disability
benefit recipient with a benefit effective date prior to January 1,
2014;
(ii)
A disability benefit recipient with a benefit effective
date on or after January 1, 2014, who has been receiving disability benefits
for less than five years;
(iii)
A disability
benefit recipient that is eligible for medicare prior to age 65 on the basis of
disability.
(C) For purposes of determining eligibility, the retirement system shall aggregate years of employer contributions earned and purchased in both the traditional pension plan and the combined plan if both of the following apply:
(1)
The member is
eligible to retire independently from both the traditional pension plan and the
combined plan;
(2)
The member applies for retirement under both the
traditional pension plan and the combined plan with the same effective date of
benefits under both plans.
(D) Any person eligible to receive a monthly allowance or reimbursement under the PMCR or MCR shall inform the retirement system, in writing, not later than thirty days after the person no longer meets the requirements of the health reimbursement arrangement plans described in paragraphs (A)(2) or (3) of this rule.
Effective: 1/1/2022
Five Year Review
(FYR) Dates: 09/29/2026
Promulgated Under: 111.15
Statutory Authority: 145.09,
145.58
Rule Amplifies:
145.58
Disclaimer: These regulations may not be the most recent version. Ohio may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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