(A) Each recipient of service, disability, or survivor benefits who receives health care benefits from the Ohio police and fire pension fund ("OP&F") and his/her enrolled dependents shall enroll in medicare part "A" and "B" at his or her first eligibility date. If a person covered under OP&F's health care plan fails to enroll in medicare part "A" or "B" at his/her first eligibility date, OP&F's appropriate third party administrators will process the claims of such person in accordance with the terms of OP&F's health care plan and reserves all rights to recover monies associated with a covered person's failure to comply with such provisions.
(B) For purposes of section 742.45 of the Revised Code, "satisfactory evidence of the payment for coverage" shall mean filing of the medicare part "B" reimbursement statement in the form approved by OP&F or the medicare billing statement, along with a copy of the applicant's medicare card or a letter from medicare in lieu of a medicare card. No retroactive reimbursement will be made. For any inaccurate or incorrect statement made on the medicare part "B" reimbursement statement, OP&F reserves all rights to recover monies associated with a covered person's failure to comply with such provisions.
(C) In accordance with divisions (C) and (D) of section 742.45 of the Revised Code, OP&F shall not reimburse the medicare part "B" premium to a benefit recipient who is receiving or should be receiving reimbursement for this premium from any other source and the member or benefit recipient shall be deemed to consent to the recovery of any overpayment by deduction from his/her monthly pension or benefit. If another Ohio retirement system is responsible to provide health care to such recipient, OP&F shall not be responsible to pay the medicare part "B" reimbursement. No retroactive payment shall be given.
(D) The recipient of the medicare part "B" reimbursement shall be deemed to consent to the recovery of any overpayment by deduction from his/her monthly pension or benefit. The monthly deduction shall be an amount equal to the greater of:
(1) The monthly amount determined by dividing the amount of the overpayment by the time period over which the overpayment occurred;
(2) The monthly amount of OP&F's medicare part "B" reimbursement on the month in which deductions are to commence; or
(3) The monthly amount agreed to in writing by the recipient.
(E) Effective January 1, 2002, the reimbursement of medicare part "B" payments made by OP&F to eligible beneficiaries under section 742.45 of the Revised Code shall not be considered "benefits" under division of property orders and child and spousal support orders since these payments are reimbursement of expenses incurred by such beneficiary.
R.C. 119.032 review dates: 03/01/2012 and 05/17/2017
Promulgated Under: 111.15
Statutory Authority: 742.10, 742.45
Rule Amplifies: 742.45
Prior Effective Dates: 07/15/94, 2/17/98, 1/29/01, 11/30/01 (Emer.), 2/22/02, 3/14/02 (Emer.), 5/31/02, 10/6/03, 12/23/04, 12/20/2006 (Emer.), 03/19/2007