Ohio.gov  |   State Agencies   |   Online Services

        Benefits
        Open Enrollment
        May 15 - 26

 

All Employees

Important changes for the upcoming benefit year beginning July 1, 2017: 

  • Medical deductibles will be $250 for single and $500 for family in-network, and $500 for single and $1,000 for family out-of-network.
  • The copay for an emergency room visit will be $100, which is waived if patient is admitted as inpatient.
  • The copays for urgent care will be $30 for in-network and $35 for out-of-network.
  • The copay for specialist visits will be $25 for in-network
  • The out-of-pocket maximums for pharmacy benefits will be $2,500 for single and $5,000 for family.
  • Take Charge! Live Well! – Employees and spouses enrolled in the State of Ohio medical plan can earn up to $350 each again this year by taking the required actions to improve your health. However, some new criteria have been implemented to receive your reward. 
  • Healthways – Beginning July 1, 2017, due to new federal regulations, Healthways, the wellness program’s third-party administrator, will require either written or online approval to access the program via Well-Being Connect®, Healthways’ online portal for State of Ohio employees and spouses. Personal information on the Healthways portal is protected and confidential. Healthways does not share information or use information against the terms and conditions of the contract with the State of Ohio. 

    The Well-Being Connect portal for employees and spouses has been redesigned for a fresh, new look and a better user experience. Healthways will be performing updates from July 1 through July 17. During this time, Well-Being Connect will not be accessible.

Benefits Checklist

Check your Benefits Summary: login to myOhio.gov, click the Health and Benefits tab and click the Benefits Summary link.

• Enroll and/or make election changes from May 15-26.

 

Ensure required proof of eligibility for your newly enrolled dependent(s) is submitted timely. Coverage will not be provided for dependents until the eligibility documentation is received and approved.

• Refer to the Eligibility Requirements Matrix.

• June 1 – deadline for proof of eligibility in order for the newly added dependent(s) to be included on the medical and OptumRx ID cards effective July 1.

            NOTE: Anthem and OptumRx do not include the names of dependents on the card(s)

• July 31 – final deadline for proof of eligibility changes; replacement medical ID cards will be generated.

 

Review your confirmation statement when it arrives by mail in late May/early June.

• Contact your human resources office before July 31 if any information on the confirmation letter is not correct.

 

Look for new medical ID cards to arrive by mail near the end of June.

• Contact your agency human resources office if any information on your ID card(s) is not correct.

MyBenefits 2017 Open Enrollment Guide

Medical Deduction Rates

Open Enrollment Frequently Asked Questions

Open Enrollment Instructions

Part-time Permanent Employees

  • Part-time permanent employees’ premium tier will be determined annually rather than semi-annually.
  • The percentage that part-time employees pay toward their premium is based on the average service hours in an active pay status. Average service hours in an active pay status shall be calculated over a 12-month period (Standard Measurement Period), which starts with the first pay period in May through the last pay period in April.
    • All part-time permanent employees working an average of 30 or more hours a week (over a 12-month period) will be eligible for the full-time deduction tier, or 15 percent.
    • All part-time permanent employees working an average of 29.99 or less hours a week (over a 12-month period) will be eligible for the 50 percent tier.
    • All part-time permanent employees working an average of 19.99 or less hours a week (over a 12-month period) will be eligible for the 100 percent tier.
  • All part-time permanent employees will be notified at their mailing address of their eligibility.

Part-time Temporary Employees


  • The State of Ohio is required to offer medical care coverage only, per the ACA, to all part-time temporary employees who average at least 30 hours of service per week throughout a twelve-month measurement period (Standard Measurement Period)
  • Part-time temporary employees are those employees typically hired as interns, intermittent employees, and external interim employees. This does not include Americorps or contingent workers.
    • Existing employees who were hired before April 5, 2014, and who averaged 30 work hours or more will be notified by DAS of their eligibility for medical coverage. Those who elect medical coverage will have coverage from July 1, 2017, through June 30, 2018, or until they terminate their service with the State of Ohio.
    • Employees who are hired with a reasonable expectation of averaging 30 hours or more per week will be eligible to enroll for coverage upon hire. Coverage is effective the first of the month following the hire date and cannot be terminated until the 12 months expires or the employee leaves state service.
    • Employees who are hired with a reasonable expectation of averaging 29 hours or less per week will be not be eligible at the time of hire and will instead be measured over a twelve-month period. The twelve-month measurement period for all newly hired part-time temporary employees is called the initial measurement period.
      • The initial measurement period begins the first full pay period after the first pay period with one or more hours of service credited.
      • After the initial measurement period, if the average service hours are 30 or more per week, the employee will be offered the opportunity to enroll the first of the month following the end of the initial measurement period.