Retiree Medical Account

Retiree Medical Account
for traditional and combined plan health care participants
F
A
Q
As a participant in the OPERS health care plan,
you have the opportunity to receive monetary
incentives by participating and completing
qualifying wellness events. These incentives
are provided to you through a Retiree Medical
Account (RMA). Read below for commonly asked
questions regarding Retiree Medical Accounts.
What is a Retiree Medical Account (RMA)?
An RMA is a savings account where funds are
accumulated exclusively to pay for health care
expenses not covered by your health care plan
or other health care premiums. Once you or your
covered spouse have completed a qualifying
wellness event through OPERS and your health
care plan administrator, OPERS will establish an
RMA for you through Aetna. A deposit is then
made on your behalf or your spouse’s behalf
into your RMA. Deposits to the RMA can only be
earned through wellness program participation.
How does the RMA process work?
Eight to ten weeks after completing your initial
qualifying wellness event, you will receive a
welcome packet from OPERS and Aetna which
includes a reimbursement claim form. You can
use this claim form to request reimbursement of
the funds deposited into the RMA on your behalf.
For example, if you go to the pharmacy and pay
a co-payment for a prescribed medication, the
co-payment you pay can be reimbursed through
the funds available in your RMA account. Please
follow the instructions on the qualified medical
expenses form regarding how to properly submit
a claim. Aetna processes this reimbursement for
you.
As funds become available through your
continued participation in qualified wellness
events, you can submit additional claims for
reimbursement throughout the year.
What are qualified medical expenses?
Many different types of expenses can be
reimbursed by your RMA. Usually, qualified
medical expenses are the same kind of medical,
dental and vision expenses that can be taken as
deductions on your federal tax return. Examples
of these are post-tax health insurance premiums,
deductibles, many types of medical services and
even the money you might pay for transportation
to and from a medical care facility. Premiums for
some long-term care insurance may be covered.
For more details about qualified medical
expenses, please contact Aetna. You can also
find a complete listing of qualified health care
expenses at www.opers.org and IRS Publication
502 at www.IRS.gov.
How will I keep track of my account?
Your account will be tracked for deposits
and reimbursements and reported to you
periodically. Simple claim forms will need to
be completed for a reimbursement to be issued.
Aetna has partnered with OPERS to track all RMA
transactions. Aetna will keep a record of the
balance in your RMA, how much you have used
and how much interest your RMA has earned.
Once deposits have been made into your RMA,
you will receive a quarterly account summary
statement from Aetna. You will also receive an
Explanation of Payment each time you receive
reimbursement from your RMA. Additionally,
you can also visit www.aetnanavigator.com and
view your balance online.
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The Ohio Public Employees Retirement System • 277 East Town Street • Columbus, Ohio 43215 • 1-800-222-7377
RMA (08/14 valid through 12/14)
How do I file a claim?
Claims can be submitted for qualified medical
expenses for which you have received an
itemized bill. Aetna provides claim forms or
you can download the form at www.opers.org/
forms-archive/healthcare/GC-15731. Complete
the claim form and attach an itemized bill that
includes a description of the services received
and an Explanation of Benefits statement from
your insurer (if applicable). If approved, Aetna
will reimburse you from your RMA through
an Electronic Funds Transfer (EFT). Effective
November 2014, EFT will be the mandatory form
of disbursement. This process is similar to how
pension checks are deposited directly to your
bank account today.
Can I cover my dependents’ health care
expenses with my RMA funds?
Yes. As long as your dependent would qualify
for coverage under the OPERS health plan, claims
accrued by your dependent can be reimbursed
by your RMA. Please note that they do not have
to be covered under your OPERS health plan,
they need only be eligible for coverage.
Will my dependents have access to my RMA
funds?
If there are funds in your RMA at the time of your
death, your dependents may use that amount
to pay for qualified health care expenses. To do
that, your dependents (spouse, children) must
have been eligible for coverage under your
OPERS health plan (dependents are not required
to be covered by the OPERS plan). They only
need to have been eligible to have access to the
remaining funds in your RMA at the time of your
death and make a claim within one year of the
retiree’s death.
Will I lose funds in my RMA if I don’t use them
by the end of the year?
The funds in your RMA will roll over each year.
2015 changes
The OPERS Board of Trustees will be making
changes to the operation of the RMA effective
Jan. 1, 2015. We will keep you informed of the
changes as the time nears.
Website: www.aetnavision.com
Phone: 1-866-591-1913
Other available publications on www.opers.org
pers
Ohio Public
Employees
Retirement
System
277 East Town Street
Columbus, Ohio
43215-4642
1.800.222.7377
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opers.org
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RMA (08/14 valid through 12/14)

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