Health Care Program News

Open Enrollment for STRS Ohio Medical Plans Begins Nov. 1

The open-enrollment period for STRS Ohio’s medical plans is Nov. 1–23, 2021. This period provides benefit recipients the opportunity to change plans or enroll in a new plan for calendar year 2022 without a qualifying event. Board approved premiums resulted in lower premiums for nearly 90% of current enrollees for the upcoming year. Most plan features will remain the same; however, changes for the STRS Ohio Health Care Program for 2022 are outlined below.

This open-enrollment period is for medical plans only. It does not include the dental and vision plans. Members who have requested paperless delivery of open-enrollment materials received an email when the materials became available online. In late October, members who did not request electronic delivery received open-enrollment materials by mail in an STRS Ohio Health Care Program envelope. Medical plan information was included for current medical plan enrollees. If you now have medical coverage, your personalized letter included a list of plans and premiums. The medical plan listed on the front of the letter is the plan you will be enrolled in for 2022 unless you contact STRS Ohio. Additional plan options (if available) are listed on the back of the letter. To make a change to your medical plan, log in to your Online Personal Account and click “Health Care.” If you do not have a personal account, you can register for one here.

If you are not currently enrolled in an STRS Ohio plan and would like a personalized enrollment packet, contact STRS Ohio’s Member Services Center toll-free at 888‑227‑7877 to request these materials or contact STRS Ohio.

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2022 Health Care Premiums and Items of Note

Board-approved health care plan premiums for the 2022 plan year resulted in a monthly premium decrease for nearly 90% of plan enrollees. A complete list of premiums is available on the STRS Ohio website, or may be requested by calling the STRS Ohio Member Services Center toll-free at 888‑227‑7877. A sampling of the medical plan premiums is shown below.

Monthly Enrollee Premiums for 2022 — With Medicare

Benefit Recipient Years of Service*
(See requirements below.)
Aetna Medicare Plan (Medicare Advantage PPO)
Total Cost: $289
Medical Mutual Basic (Indemnity or PPO)
Total Cost: $326
AultCare PrimeTime Health Plan (Medicare Advantage HMO-POS) Total Cost: $288 Paramount Elite (Medicare Advantage HMO)
Total Cost: $328
30+ $107 $144 $107 $146
25 $137 $174 $137 $176
20 $168 $205 $167 $207
15 $198 $235 $197 $237
<15 $289 $326 $288 $328
Spouse $289 $326 $288 $328
Per Child $289 $326 $288 $328
Disabled Adult Child $289 $326 $288 $328

Monthly Enrollee Premiums for 2022 — Without Medicare

Benefit Recipient Years of Service*
(See requirements below.)
Aetna Basic/Medical Mutual Basic (Indemnity or PPO)
Total Cost: $1,144
AultCare (PPO)
Total Cost: $910
Paramount Health Care (HMO)
Total Cost: $873
30+ $423 $337 $323
25 $543 $432 $415
20 $664 $528 $506
15 $784 $623 $598
<15 $1,144 $910 $873
Spouse $1,144 $910 $873
Per Child $293 $257 $247
Disabled Adult Child $1,144 $910 $873

*Eligibility requirements

Members who retired before Jan. 1, 2004, with less than 15 years of service credit have access to coverage but pay the full cost of their premium.

Members who retire on or after Jan. 1, 2004, and before Aug. 1, 2023, must have at least 15 years of total service credit to access coverage.

IMPORTANT: Members who retire on or after Aug. 1, 2023, must have at least 20 years of total service credit to access coverage.

Health care items of note

  • All current enrollees, including those who change plans, will receive a new medical plan ID card.
  • Online enrollment — benefit recipients who want to enroll, cancel or change coverage can do so online during open enrollment through a secure online account. If you do not have an Online Personal Account, click here to register for one. You can also use your Online Personal Account to update contact information and communication preferences, register for webinars and meetings, view important documents and more.

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Health Care Plan Enhancements for Calendar Year 2022

Health Care plan changes for the upcoming 2022 calendar year include:

  • Moving to Express Scripts’ Premier Performance Formulary for Medicare enrollees and to the National Preferred Formulary for non-Medicare enrollees. This results in a three-tier drug copay structure with a new option for non-preferred brand-name drugs (in addition to the existing tiers — generic and preferred brand-name drugs). The copays for the non-preferred brand-name drug will be $75 at retail for a 30-day supply and $187.50 for home delivery for a 90-day supply.
  • Reducing the specialty copay for prescription drugs to the lesser of 8% of cost or $450 from the lesser of 13% of cost or $450 for 31-day supply.
  • Decreasing the drug maximum out-of-pocket limit to $5,100 from $6,500 for the Medicare plans — below the 2022 standard Part D limit of $7,050. The out-of-pocket limit for non-Medicare enrollees will remain at $5,100.
  • Maintaining the current $275 annual deductible for prescription drugs for Medicare and non-Medicare plans for brand-name and specialty drugs.
  • Delta Dental Premiums for 2022 will reflect a slight decrease to:
    — Benefit recipient — $29.48/month
    — Other adult (includes spouse or disabled adult child — $38.74/month
    — Children under age 26 — $22.10/month.

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Health Care Webinar Offers Details on Open Enrollment and Minimizing Costs

STRS Ohio is pleased to offer its popular Understanding Your Health Care Plan webinar this fall to help benefit recipients better understand their health care coverage. Join us for an informative webinar to learn about:

  • Preventive care benefits
  • Plan changes effective Jan. 1, 2022
  • Open-enrollment details and resources for 2022 medical coverage

These webinars will be held on Nov. 3, Nov. 8 and Nov. 11 at 10 a.m., 1 and 5 p.m. each day. For further details and to register, click here. A recording of the webinar is also available on demand in the Videos section.

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Health Care Assistance Program Available to Qualifying Benefit Recipients

STRS Ohio offers a Health Care Assistance Program (HCAP) to benefit recipients who are eligible. The program provides medical and prescription drug coverage for a $0 premium. Eligibility for the program is based in part on an annual family income limit of 175% of the federal poverty level for a family household of two persons ($30,170 for retirees currently applying based on 2020 tax returns) and a household liquid asset limit of $30,170 (a home is not considered a liquid asset). New HCAP applicants must be eligible for a subsidy under the STRS Ohio Health Care Program to qualify for HCAP enrollment. Benefit recipients, survivors and beneficiaries who are currently enrolled in HCAP are not subject to the subsidy requirement if they continue to meet all other HCAP requirements and remain continuously enrolled in the program. New and current STRS Ohio Health Care Program enrollees may apply. The application and additional program details are on the STRS Ohio website or by request from the Member Services Center (toll-free) 888‑227‑7877.

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