Ruf v. Ohio Pub. Emps. Retirement Sys.

2021 Ohio 4389
CourtOhio Court of Appeals
DecidedDecember 14, 2021
Docket20AP-330
StatusPublished
Cited by2 cases

This text of 2021 Ohio 4389 (Ruf v. Ohio Pub. Emps. Retirement Sys.) is published on Counsel Stack Legal Research, covering Ohio Court of Appeals primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Ruf v. Ohio Pub. Emps. Retirement Sys., 2021 Ohio 4389 (Ohio Ct. App. 2021).

Opinion

[Cite as Ruf v. Ohio Pub. Emps. Retirement Sys., 2021-Ohio-4389.]

IN THE COURT OF APPEALS OF OHIO

TENTH APPELLATE DISTRICT

Christine S. Ruf, :

Relator-Appellant, : No. 20AP-330 (C.P.C. No. 19CV-1684) v. : (REGULAR CALENDAR) Ohio Public Employees Retirement : System, : Respondent-Appellee. :

D E C I S I O N

Rendered on December 14, 2021

On brief: Oberholtzer & Filious, L.P.A., and John C. Oberholtzer, for appellant. Argued: John C. Oberholtzer.

On brief: Dave Yost, Attorney General, Isaac Molnar, and Mary Therese J. Bridge, for appellee. Argued: Samuel A. Peppers.

APPEAL from the Franklin County Court of Common Pleas SADLER, J. {¶ 1} Relator-appellant, Christine S. Ruf, appeals a judgment entered by the Franklin County Court of Common Pleas denying appellant's request for a writ of mandamus ordering respondent-appellee, Ohio Public Employees Retirement System ("OPERS"), to stop withholding payments from her retirement account and to refund any monies withheld. Because appellee is statutorily required to recoup overpayments arising from appellant's son enrollment in the incorrect OPERS health care plan, appellant is not entitled to the requested writ and we affirm the trial court judgment. No. 20AP-330 2

I. FACTS AND PROCEDURAL HISTORY {¶ 2} Appellant began receiving an OPERS retirement benefit in 1999. At that time, appellant's adult, permanently disabled son was eligible for health care coverage through OPERS as her dependent, and appellant enrolled him in the "OPERS Health Care Plan." (Cert. Record at 7.) Appellant does not dispute that her son was then enrolled in Medicare, beginning in 2001. (Appellant's Brief at 8, 18; Reply Brief at 9, 15-17.) {¶ 3} By letter dated April 4, 2014, appellee asked appellant to validate her son's eligibility in the OPERS Health Care Plan. In response, appellant sent appellee a letter stating that her son "is still disabled and receiving Social Security Disability benefits" and that he had been eligible for those benefits since 2001. (Cert. Record at 44.) Appellant attached to the letter two statements from the Social Security Administration dated November 2008 and April 2013 showing the cash benefit her son received, and two notices dated December 2003 and March 2012 from the Social Security Administration finding her son's disability "continuing" and explaining that benefits recipients could work during a "trial work period(s)" and continue to receive disability payments as well as "[c]ontinuation of Medicare" coverage. (Cert. Record at 48-50, 53-55.) Appellant additionally attached a page from what appears to be a 2014 notice or statement from the Social Security Administration explaining an adjustment to her son's benefit amount. (Cert. Record at 48, 53.) The 2014 document states, in pertinent part: How much Will I Get And When? ● Your monthly amount (before deductions) is $850.00 ● The amount we deduct for Medicare medical insurance is $0.00 (If you did not have Medicare as of Nov. 14, 2013, or if someone else pays your premium, we show $0.00.) ● The amount we deduct from your Medicare prescription drug plan is $0.00 (If you did not elect withholding as of Nov. 1, 2013, we show $0.00.)

(Cert. Record at 57.) Based on the information provided, appellee confirmed appellant's son was eligible to continue coverage in the OPERS health care plan. {¶ 4} Effective January 1, 2016, a change in the OPERS administrative code required all benefit recipients and dependents to enroll in Medicare Parts A and B at the first eligible date and provide OPERS with evidence of the Medicare enrollment within 30 days. See Ohio Adm.Code 145-4-30(G). The benefit recipient's eligibility for Medicare disqualified him or her from receiving the OPERS Health Care Plan under Ohio Adm.Code No. 20AP-330 3

145-4-30 but the recipient could still receive a monthly allowance through a Health Reimbursement Arrangement ("HRA") account. Ohio Adm.Code 145-4-30(A) and (G); Ohio Adm.Code 145-4-60(C). {¶ 5} The 2016 OPERS health care open enrollment statement sent to appellant directed Medicare participants to review a section explaining the HRA. The HRA section explains that OPERS recipients and/or dependents enrolled in Medicare Parts A and B must enroll in an individual Medicare medical plan through the OPERS "Medicare Connector" to receive a monthly allowance from OPERS. In bold, it states, "[i]f you fail to enroll, you will not have any group medical or prescription coverage" for the upcoming year. (Cert. Record at 37.) In a chart describing coverage options, the document states, [p]articipants under age 65 and not eligible for Medicare will be enrolled in the OPERS Retiree Health Plan administered by Medical Mutual. Eligible participants (recipient, spouse and/or eligible children) who are enrolled in Medicare Parts A and B, excluding re-employed retirees and their spouses, will receive a monthly deposit into a Health Reimbursement Arrangement (HRA) account. This will only occur upon enrollment in a medical plan offered through the OPERS Medicare Connector administered by OneExchange. *** Note: *** ● In order to receive a monthly HRA deposit, a participant must be enrolled in Medicare Parts A and B and enroll in an individual medical plan through OneExchange. (Cert. Record at 38.) The document also noted that appellee's records showed that appellant would soon turn 65 and be eligible for Medicare Parts A and B, and that upon that occurrence she "must enroll in Medicare Parts A and B and select an individual medical plan through OPERS Medicare Connector in order to receive a monthly HRA allowance from OPERS" and that failure to do so would result in not having any group medical or pharmacy coverage available through OPERS. (Cert. Record at 38.) {¶ 6} A 2017 OPERS health care open enrollment statement showed appellant had enrolled in an HRA, but her son had not; he continued to be enrolled in a group health care plan through Medical Mutual. The document again states, "Participants not-yet-eligible for Medicare will be enrolled in the OPERS Retiree Health Plan administered by Medical No. 20AP-330 4

Mutual. Participants enrolled in Medicare Parts A and B * * * will receive a monthly deposit into an HRA. Enrollment in a medical plan * * * is required to receive an HRA allowance." (Cert. Record at 34.) The document further notes that a person enrolled in Medicare Parts A and B and enrolled in the corresponding OPERS medical plan and receiving an HRA allowance "will not be eligible for the OPERS group medical pharmacy/plan." (Cert. Record at 34.) {¶ 7} A 2018 OPERS health care open enrollment statement again showed appellant enrolled in an HRA and her son enrolled with Medical Mutual. The statement includes the same description of coverage as the 2017 statement, noted above. {¶ 8} By letter dated May 15, 2018, appellee asserted it had received information that appellant's son is eligible to participate in the Medicare program. Appellee required appellant to provide appellee certain information, including a Social Security Administration statement with her son's Medicare approval date and effective dates of coverage, to avoid termination of appellant's son's medical enrollment. Appellant provided appellee with a 2018 Social Security Administration statement that showed her son was eligible for Medicare beginning March 2001. {¶ 9} Based on the documentation appellant provided, appellee determined that appellant had failed to notify appellee of her son's enrollment in Medicare within 30 days of receiving coverage as required by OPERS rules. Appellee terminated appellant's group medical coverage, including enrolled dependents. The letter stated that such a termination would be "effective June 1, 2016." (Cert.

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Cite This Page — Counsel Stack

Bluebook (online)
2021 Ohio 4389, Counsel Stack Legal Research, https://law.counselstack.com/opinion/ruf-v-ohio-pub-emps-retirement-sys-ohioctapp-2021.