Premiums

The premium you pay for SERS’ health care coverage includes medical and prescription drug coverage.

Premiums are based on:

  • Years of qualified service credit
  • Eligibility for a premium subsidy
  • Health care plan selected

If you enroll in dental and/or vision coverage, you will be charged additional premiums.

SERS automatically deducts the premiums for you and any dependents from your monthly payment.

If your payment is not enough to cover your premiums, SERS will bill you for the remaining balance each month.

 


Premium Subsidy

SERS helps reduce health care premiums by providing a subsidy to those who qualify.

To receive a premium subsidy, you must have at least 20 years of qualified service credit, or be receiving a disability benefit. In addition, at the time of retirement, disability, or separation from service, you must:

  • be eligible to participate in the health care plan of your last school employer, or
  • have been eligible to participate in the health care plan of your school employer at least three of the last five years of service

Spouse premiums are based on the qualified service credit of the service retiree, disability recipient, or member.


2024 Medicare Plan and Premiums

Plan

Service Area

Premiums

Medical Plan Coverage

Prescription Drug Coverage

Preventive

Aetna Medicare Plan (PPO)

SERS.AetnaMedicare.com

United States

Premiums

Plan Summary

 

Over-The-Counter Health Solutions Product Catalog

Express Scripts Guide

 

Express Scripts Medicare Formulary

Preventive Screenings

 

Preventive Vaccinations


Health Care Premium Discount Program

To apply for the Health Care Premium Discount Program, at least one family member must be enrolled in a SERS Medicare plan, and you must qualify based on your household size and income.

A 25% reduction in your monthly SERS health care premium for medical and prescription drugs is available if your total household income falls at or below qualifying income levels. The discount does not apply to dental and vision premiums.

To receive the discount, your total household income must be at or below the following levels:

Household Size

Qualifying Income

1

$25,515

2

$34,510

3

$43,505

4

$52,500

5

$61,495

Call SERS at 1-800-878-5853 to request an application through the mail.


2024 Non-Medicare Plans and Premiums

Plan

Service Area

Premiums

Medical Plan Coverage

Prescription Drug Coverage

Preventive

Aetna Choice POS II

AetnaResource.com

United States

Premiums

Summary Benefits and Coverage

 

Plan Benefit Booklet

Express Scripts Guide

 

Express Scripts Non-Medicare Formulary

Preventive Screenings

 

Preventive Vaccinations

AultCare PPO

AultCare.com

In Ohio: Ashland, Belmont, Carroll, Columbiana, Coshocton, Guernsey, Harrison, Holmes, Jefferson, Knox, Mahoning, Medina, Portage, Richland, Stark, Summit, Tuscarawas, and Wayne counties.

Premiums

Summary  Benefits and Coverage

AultCare Pharmacy Services

Preventive Screenings

 

Preventive Vaccinations

Aetna Traditional Choice

AetnaResource.com

This plan is not available for optional enrollment. SERS determines when enrolllment is appropriate.

Summary Benefits and Coverage

 

Plan Benefit Booklet

Express Scripts Guide

Preventive Screenings

 

Preventive Vaccinations

SERS Marketplace Wraparound HRA Brochure

SERS Marketplace Wraparound HRA

SERS offers a Health Reimbursement Arrangement (HRA) option as an alternative to SERS’ non-Medicare group plans.

How it Works

You first select a health care plan from the Health Insurance Marketplace with the assistance of a counselor from our plan administrator, UMR.

The counselor will help you review the Marketplace plans that are best for you, and assist you in signing up for a plan. The counselor also will tell you whether you are eligible for a federal subsidy to help you pay your Marketplace plan premium.

The SERS Marketplace Wraparound HRA will then provide reimbursement for eligible expenses such as deductibles, co-pays, and other costs. Reimbursement is capped at $2,100 per participating family, per calendar year in accordance with federal limits.

To participate in the SERS Marketplace Wraparound HRA, you MUST complete the Health Insurance Marketplace enrollment process through UMR. You would then be responsible for paying premiums directly to the Marketplace plan that you selected. There is no additional premium for the SERS Marketplace Wraparound HRA.

You are eligible for the Marketplace Wraparound HRA when you are eligible for SERS’ health care coverage.  This option is NOT available when you:

  • Waive SERS coverage
  • Are eligible for Medicare
  • Are enrolled in Medicaid, or
  • Will have a family member enrolled in a SERS Medicare Advantage Plan.

For more information, review the SERS Marketplace Wraparound HRA brochure and Cost Comparison.

Before You Call: Answers to Frequently Asked QuestionsCLICK HERE