New police, fire pension fund health care benefit lacking for some

Dec. 23--PLAIN TWP. The Ohio Police & Fire Pension Fund's new health care plan provides a stipend and insurance options to retired firefighters such as Steve Teolis.

Teolis, who lives in Plain Township, said he, however, has neither under the new model. At 62, he does not qualify for Medicare and found few local physicians covered by available plans.

"I don't feel the pre-Medicare people were treated fairly," Teolis said.

The pension fund's board of trustees voted in the spring of 2017 to switch from group-sponsored health care to a monthly stipend for members, which begins Jan. 1.

Stretching funds

Ohio Police & Fire Pension Fund material states the change extends health care funding by seven years, allowing benefits to continue for another 14 to 16 years.

"These health care benefits are discretionary in Ohio," according to a pension fact sheet.

Pension fund spokesman David Graham, in an email, wrote about 64 percent of non-Medicare retirees registered for the stipend by the Dec. 15 deadline. That's greater than the 50 percent projected by the pension fund's partner, England-headquartered insurance company Aon.

Aon manages the stipend-funded health reimbursement accounts for members and the health care plans must be purchased through the Aon Retiree Health Exchange. Aon is paid by insurance carriers in their exchange and not the pension fund or members.

To address its "share of challenges" at the start of enrollment, the pension fund and Aon added staff and hours for appointments and have taken more than 64,000 calls since the enrollment process began. Graham acknowledged some areas have more plans than others, but the pension fund does not control the marketplace.

"Every retiree has at least one plan available to them," he stated. "If no plan is available on the marketplace in their area, they were able to select a plan on healthcare.gov and still receive our stipend."

Limited options

Teolis said he understands why the board of trustees changed health care benefits. The reality for pensioners, however, doesn't match what was promised.

"They told me I was entitled to this pension to help pay for my insurance, that's all I want," he said.

Teolis, who retired at 56 after 34 years at the Canton Fire Department, said there only were two options available to him through the Aon exchange. Both plans -- SummaCare and Medical Mutual -- were Health Maintenance Organizations (HMOs).

Graham, however, stated Ambetter and Molina also are available to retirees in Stark County.

Teolis said the plans would have covered primary care for him and his wife, and that's about it. None of the specialists or Aultman Hospital facilities they use were included.

"So, in my view, I didn't have a choice," Teolis said.

Mark Hill, spokesman for the Ohio Association of Professional Fire Fighters, said non-Medicare retirees across the state also have reported sparse offerings.

"Some areas around the state have a decent amount of choices, and some, there may be one or two counties that have no choices at all for retirees to get health care," he said.

Hill said he believes the pension board simply was "sold a bill of goods" by Aon, which hasn't delivered sufficient options.

Out of pocket

Ultimately, Teolis said, he forfeited his health care stipend and enrolled in an AultCare insurance plan.

"When I add it up, I'm going to spend less money going through Aultcare and not getting my stipend and paying for coverage all out of my pocket," he said.

The annual premium for Teolis and his wife through AultCare is about $20,300. He said their previous annual cost for the pension-sponsored plan was $11,700.

Had Teolis taken the stipend, he would've received about $12,900 a year to help pay for plans priced about $22,000. That would not have covered the $16,000 a year for one medication. In all, Teolis would have spent at least $25,000 using the pension plans.

"Medications on the other plans weren't covered like they were through AultCare," he said.

Future plans

Teolis said he would like a stipend without limitations or more insurance options.

"I'm not asking for anything extra," he said.

Unless something changes with the pension plan or his own situation, Teolis said, he doesn't expect to be able to use the stipend.

The pension fund expects the health care plan to continue to evolve.

"OP&F will always be reviewing the plan so we can offer whatever health care support we can with the resources available," Graham stated.

The Ohio Association of Professional Fire Fighters also is assembling a task force to examine health care options in the coming year.

"We are going to look into some alternatives outside of the pension board, and work with them, obviously, if we can," Hill said.

Reach Kelly at 330-580-8323 or [email protected]

On Twitter: @kbyerREP

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