Texas legislators are considering gifting almost $10 million to pay for a new health plan benefit for approximately 550 plan members of the Texas state employee health plan. The “gift” is projected to cost 5% more each year due to medical inflation.
The “gift” would be extended to TRS ActiveCare members for another $10.5 million. It is estimated this will benefit less than 1% of TRS ActiveCare plan members.
“TRS estimates that the annual cost to ActiveCare, paid for out of School Employees UGIP Trust Fund 855, would be approximately $10.5 million beginning in fiscal year 2027, increasing to $12.1 million in fiscal year 2030.”
The cost would not go up for either government health plan if the state had adopted a indemnity plan back in the day instead of a managed care plan with provider reimbursement based on a percentage………. of a percentage……….of a percentage………. of a net discounted charge no one ever pays.
Proposed Texas House Bill 618 would “amend portions of the Insurance Code to require certain government health benefit plans to include coverage for outpatient expenses that arise from in vitro fertilization procedures to the same extent that those plans provide benefits for certain other pregnancy-related procedures.”
“The Employees Retirement System of Texas (ERS) estimates 550 women each year would be affected by the provisions of the bill, with an average cost per claimant of $17,500, resulting in an annual cost of $9.6 million to state agencies, community supervision and corrections departments, and institutions of higher education.”
According to Jerry McGinty, Director of the Legislative Budget Board the projected cost increase “may result in the need for higher contribution rates from the state, employers, or members.”
As of August 31, 2023, the Texas Employees Group Benefits Program (GBP), managed by the Employees Retirement System of Texas (ERS), provided health insurance coverage to approximately 559,285 participants. The TRS ActiveCare program consists of over 450,000 plan members. That’s over 1,000,000 people, half of whom are biologically identical.
