Epic Battle of The Blues

File this under “You Can’t Make This Stuff Up”

TRS ActiveCare officials are set to announce benefit changes and new rates next week. The battle to win Texas public school business will be off and running as districts gear up for school year 2023-2024.

Blue Cross of Texas will be competing with Blue Cross of Alabama and Blue Cross of Texas.

Wait a minute, how can Blue Cross of Anywhere compete with another Blue Cross of Anywhere? Aren’t they the same company?

Blue Cross of Texas is competing against Blue Cross of Texas. Both are the same companies. TRS ActiveCare’s provider network is with Blue Cross. TML-TASB is competing against TRS ActiveCare and they too are using the Blue Cross network.

The Battle of The Networks

Which network has the best discounts? That’s important because claims drive 90% of plan costs, the better the discounts the lower the cost.

Is Blue Cross renting their network to TML-TASB and taking a cut of the savings thereby reducing cost effectiveness? Landlords don’t rent out for free.

Who’s doing the repricing?

Blue Cross of Alabama, through their proxy 90 Degree Benefits (formerly Caprock Health Plans), is competing against TRS and TML-TASB but, bless their cotton picking heart, they are using the Aetna network.

Did you ever imagine in your wildest dreams that Blue Cross and Aetna would partner up to capture business? What does CVS think about this? Who’s gonna be the PBM?

How does Aetna’s network discounts compare to TRS-Blue Cross and TML-TASB-Blue Cross discounts? Didn’t TRS ActiveCare fire Aetna several years ago in favor of the Blue Cross network citing better discounts and more savings to plan members? Was TRS right, or wrong in their assessment?

The loser in all of this is TRS ActiveCare. The one they brought to the dance left with another.