June 2016

TRS ActiveCare changes for 2016–17

Plan benefits administration by Aetna for TRS ActiveCare, such as processing claims and network management, will not change for the next school year. However, members will see a change in plan premiums and benefits design for 2016–17. TRS ActiveCare is a statewide health coverage program that is self-funded—not an insured plan. This means that rates and benefits are determined by the TRS Trustees based on the claims activities of the plan, not by the vendors who administer the program.
 
TRS introduced TRS ActiveCare on September 1, 2002, and currently, over 460,000 employees and dependents participate in the program. Across the state, 1,245 districts and entities are eligible to participate, and more than 90 percent of those eligible do participate in TRS ActiveCare.

The following chart reflects the rates for Employee Only coverage for all three TRS ActiveCare plan options since 2003. ActiveCare 2 rates were mostly steady from 2003 through 2008 but have increased every year since 2008. Although ActiveCare 1-HD has only been around since 2009, its monthly premium increased almost every year until 2014 and again this year; and ActiveCare Select, only available since 2014, has increased its monthly premium every year since its inception.
 

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Teacher Retirement System of Texas Board of Trustees voted on 2016-17 TRS ActiveCare rates at their June board meeting. These new rates will go into effect on September 1, 2016. The board voted unanimously to implement the new rates as presented and recommended by the Budget Committee, and, with the exceptions of ActiveCare 1-HD, the vote resulted in yet another increase to employee health insurance.
 
According to the Budget Committee Booklet from the June 16, 2016 TRS Board meeting, this increase is largely because of the addition of seven full-time employees, which will cost approximately $500,000 to provide additional member support services, member-level accounting, and more efficient, streamlined healthcare procurement monitoring for both TRS-ActiveCare and TRS-Care plans.
 
TRS ActiveCare PPO plan premiums increased between 2.23 percent and 5.05 percent over last year’s premiums, and HMO plan premiums at an even higher ratio, between 5.02 percent and 12.82 percent. Unfortunately, the state has not increased its contribution of $75/month since TRS ActiveCare was implemented 14 years ago, and the required contribution amount from the state and district combined remains at $225/month. TRS ActiveCare PPO plan members also will see changes in benefit design such as an increase to their out-of-pocket maximum thresholds and copays, but individual and family deductible amounts did not change. HMO plan members will experience increases to their out-of-pocket maximum thresholds, copays, and deductibles, depending on which HMO plan they are enrolled.