(A) For the purpose of this rule:
(1) "Age and service retirant" shall mean a
former member that applied for and was granted retirement benefits as described
in section 5505.16 of the Revised Code.
(2) "Benefit recipient" shall mean an age and
service retirant or disability retirant that is receiving a pension benefit as
described in division (A)(1) of section 5505.17 of the Revised Code that
qualifies for health care coverage pursuant to paragraph (D) of this rule.
Benefit recipient does not include a member participating in the "Deferred
Retirement Option Plan."
(3) "Dependent" shall mean a spouse as defined in
this rule.
(4) "Disability retirant" shall mean a former
member that applied for and was granted retirement benefits as described in
section 5505.18 of the Revised Code.
(5) "Eligible dependent" shall mean a dependent
that qualifies for health care coverage pursuant to paragraph (F) of this
rule.
(6) "Health care service credit" shall
include:
(a) Credit earned as an
employee as defined by division (A) of section 5505.01 of the Revised
Code;
(b) Military service
credit purchased pursuant to division (D) of section 5505.16 of the Revised
Code;
(c) Credit granted under
section 5505.201 of the Revised Code; and
(d) Years of
participation in the deferred retirement option plan pursuant to section
5505.51 of the Revised Code.
(7) "Health reimbursement arrangement plan" or
"HRA" shall mean the HPRS amended and restated health reimbursement
arrangement plan, effective November 1, 2023, from which the reimbursement of
qualifying medical expenses may be made. The HRA may have component plans as
determined by the HPRS board. The text of the HPRS health reimbursement
arrangement plan shall not be incorporated into this or any other rule of the
Administrative Code.
(8) "Member" shall have the same meaning as
division (I) of section 5505.01 of the Revised Code.
(9) "Monthly health care allowance" or
"monthly allowance" shall mean the monthly amount that is allocated
to each individual enrolled in the health reimbursement arrangement plan. 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 the plan.
(10) "Retirant" shall mean an age and service
retirant or disability retirant.
(11) "Spouse" shall mean a wife or husband of a
retirant or member as set forth in a statutorily-valid
certificate.
(B) Except as provided in this rule, the rights of an
individual participating in the health reimbursement arrangement plan to a
monthly allowance or to reimbursement, including eligibility and coordination
of coverage, shall be governed exclusively by the provisions of the HPRS health
reimbursement arrangement plan.
(1) All provisions of this rule are subject to current
health care contracts and amendments.
(2) The board may implement cost control measures as it
deems necessary.
(C) Notwithstanding any other provision of this rule, any
benefit recipient or eligible dependent that is or becomes employed by the
state highway patrol in any capacity shall be ineligible for health care or
prescription coverage.
(D) The following benefit recipients shall be eligible for
health care:
(1) Except as provided in paragraph (D)(3) of this rule, a
benefit recipient that began receiving a pension pursuant to division (A)(1) of
section 5505.17 of the Revised Code, or deferred retirement under section
5505.16 of the Revised Code, or elected to participate in the deferred
retirement option plan pursuant to section 5505.51 of the Revised Code before
November 1, 2023;
(2) Except as provided in paragraph (D)(3) of this rule, a
benefit recipient that began receiving a pension pursuant to division (A)(1) of
section 5505.17 of the Revised Code or elected to participate in the deferred
retirement option plan pursuant to section 5505.51 of the Revised Code on or
after November 1, 2023 shall be eligible for health care coverage only if he or
she has twenty or more years of health care service credit;
(3) A benefit recipient granted a disability pursuant to
section 5505.18 of the Revised Code.
(E) The board may require documented proof of marriage,
guardianship, or parenthood. The board reserves the right to deny or cancel
coverage if the benefit recipient or dependent does not comply with the
board's request for documents.
(F) After the death of a retirant or member, dependents may
become eligible for health care coverage, subject to the following
conditions:
(1)
(a) If the retirant or
member was or was eligible to be a benefit recipient, and was eligible for
health care coverage under paragraph (D) of this rule, at the time of death;
or
(b) If the retirant or
member was not eligible to be a benefit recipient at the time of death, the
dependent becomes eligible the date on which the member would have been
eligible to enroll pursuant to paragraph (D) of this rule.
(G) An individual who receives benefits in accordance with
section 5505.16, 5505.17, or 5505.18 of the Revised Code may be reimbursed for
medicare part B premiums upon the receipt of evidence of coverage, up to a
maximum amount established by the board.
The reimbursement amount for calendar year 2017 and each year
thereafter shall be zero.
(H) Any person eligible to receive a monthly allowance or
reimbursement under the health reimbursement arrangement plan 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
plan.
