Board Approves Health Care Premiums for 2020 — More Than 90% of Enrollees Will See No Premium Increase; Medicare Part B Reimbursement Extended for 2020

The Retirement Board approved health care premiums for the 2020 plan year along with several changes to the STRS Ohio Health Care Program for 2020. The approved premiums reflect favorable claims experience and result in little or no cost increase in most plans.A complete list of these premiums is posted on the system’s website or can be obtained by calling STRS Ohio’s Member Services Center toll-free at 888-227-7877. In 2020, about 92% of enrollees will have premiums equal to or less than their current premium. STRS Ohio staff works with health care consultants and actuaries to develop expected costs for the health care plans. As noted above, lower than expected health care claims during the review period for STRS Ohio’s self-insured plans had a positive impact on the 2020 premiums. For the fifth year in a row, board-approved premiums for the Aetna Medicare Plan — the plan with the highest number of STRS Ohio enrollees — have not increased. Below is a sample of monthly premiums for calendar year 2020 for a benefit recipient with 30 or more years of service.

Benefit Recipients With Medicare (30 or More Years of Service)
Plan Total Cost STRS Ohio Pays Benefit Recipient Pays
Aetna Medicare Plan (Medicare Advantage PPO) $340 $214 $126
Medical Mutual Basic Plan (Indemnity or PPO) $320 $200 $120
AultCare PrimeTime Health Plan (Medicare Advantage HMO-POS) $368 $214 $154
Paramount Elite HMO (Medicare Advantage) $364 $214 $150
Benefit Recipients Without Medicare (30 or More Years of Service)
Plan Total Cost STRS Ohio Pays Benefit Recipient Pays

Medical Mutual Basic Plan & Aetna (Indemnity or PPO)

$986 $587 $399
AultCare (PPO) $894 $532 $362
Paramount Health Care (HMO) $936 $557 $379

Board approves plan changes for 2020

Approved health care plan changes include:

  • Extending the current Medicare Part B partial reimbursement program for one year. Under this program, benefit recipients currently enrolled in the STRS Ohio Health Care Program and Medicare Part B receive $29.90 per month to reimburse a portion of the Medicare Part B premium. The reimbursement was set to be reduced to $0 beginning Jan. 1, 2020. This impacts about 85,000 benefit recipients.

  • Increasing the prescription drug maximum out-of-pocket limit to $6,350 from $5,100 for the Medicare plans to align with the 2020 standard Medicare prescription plan.

  • Modifying the specialty drug coinsurance for Medicare enrollees — changing the specialty drug coinsurance to the lesser of 13% or $450 per 31-day period from the lesser of 13% or $550 per fill. The cost for a 32–60 day fill will be the lesser of 13% or $900, and the cost for a 61–90 day fill will be the lesser of 13% or $1,350.

  • Adding SaveonSP manufacturer copay assistance program — manufacturer pays higher copay with a $0 balance to the enrollee and the net cost is lower for STRS Ohio.

  • Adding a 24-hour nurse line to the Medical Mutual Basic Plan for non-Medicare enrollees.

  • Requiring transplants to be performed at Organ Transplant Centers of Excellence for Medical Mutual Basic Plan non-Medicare enrollees.

  • Moving Medicare Parts A & B enrollees in the regional AultCare PPO plan to AultCare’s PrimeTime Health Plan.

Additional information about the 2020 health care program will be provided in upcoming newsletters and on the STRS Ohio website. In late October, all plan enrollees will receive personalized health care plan information in preparation for the fall open-enrollment period that will take place Nov. 1–26.