Puff The Magic Dragon – The TRS ActiveCare Rebellion Gains Traction

At the stroke of midnight, August 31, 2020 as much as 5% of TRS ActiveCare membership may vanish……………

By Bill Rusteberg

More Texas school districts are challenging TRS ActiveCare’s mandate prohibiting member districts from offering employees a commercial comprehensive health plan option.

The first Texas School District To Challenge TRS ActiveCare Plan Mandates was the Raymondville Independent School District in deep South Texas followed by the El Paso Independent School District.

Now that the dust has settled, and TRS officials have taken no action to quell the rebellion,(Sleepy TRS ActiveCare Trustees & Clueless Texas Legislators) districts statewide are feeling emboldened to cross the minefield where others have tread before them.

Firms including FBS and First Financial, long involved in providing Texas school employees voluntary benefit products, have seized this opportunity to offer Texas educators yet another “voluntary” product, i.e, a competitive alternative to the aging TRS ActiveCare program.

From our perspective this is an easy sale. Texas educators are not generally happy with the TRS ActiveCare program nor can many of them afford the premium rates.

These insurance administrators have long term established relationships with many Texas school districts with contracts already in place to sell and administer insurance products. Adding another voluntary, optional product does not necessarily require a public bidding process especially when procured through an established interlocal purchasing agreement.

One insurance administrator is expecting to pick up 15,000 to 20,000 employee lives effective September 1, 2020 but will not know until August 15 if their efforts prove out. We understand some of the participating districts include Angleton ISD, Clint ISD, Palo Pinto ISD, Beaumont ISD, Texarkana ISD, South Texas ISD, Dripping Springs, Abilene ISD, Lockhart ISD, Childress ISD, Paris ISD, Splendora ISD, Jim Ned CISD, Calallen ISD, Red Oak ISD and many more too numerous to list here.

First Financial, long active in the Texas school market, is offering expertise and assistance to districts interested in exploring TRS ActiveCare alternatives. (First Financial Offers Assistance in Exploring TRS ActiveCare Alternatives)

Take Command Health is another vendor offering Texas educators a unique health plan option as a TRS ActiveCare alternative.

The TRS alternative has taken care of our family, even when Jack spent a week in the hospital, they were right there with prayers and financial support. Read the Hoopers’ Story – Jack & BrittanyThe Hooper Family

A competing firm, FBS has designed an attractive benefit package for Texas educators and is pressing forward with full steam marketing efforts, promoting their offering with apparent success.

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From the FBS website:

FBS presents an excellent avenue for all districts (regardless of size) to offer additional medical plan(s) for their employees. Our established relationships with major health insurance carriers and providers boasts plan options that will reduce premiums, provide out-of-pocket savings, and offer enhanced plans to district employees. (fbsbenefits.com/fbs-medical-consulting/)

TRS-ACTIVECARE HISTORY

The Texas School Employees Uniform Group Health Coverage program (H.B. 3343) was passed by the 77th Texas Legislature.  TRS was given the authority to begin plan management of TRS-ActiveCare with coverage effective on September 1, 2002.  It required districts with less than 500 employees to participate in the health plan unless they were self-funded or part of self-funded cooperative.

Districts that participate in TRS-ActiveCare may not discontinue participation (Texas Administrative Code 41.30).  There are currently over 900 participating entities in TRS-ActiveCare.

AMENDING YOUR DISTRICT OF INNOVATION (DOI)

Resources: DOI Overview | What is a District of Innovation? | Sample DOI Amendment | Sample Letter to Commissioner Amendment

EL PASO ISD DEVELOPMENTS

El Paso ISD, as a District of Innovation (DOI), amended its Local Innovation Plan so that they could offer their employees two additional plan options alongside the TRS-ActiveCare.  These plan options provide employees with an upfront premium savings of 10-15%, and are comprehensively better in most areas than TRS-ActiveCare plans.  The new plan options also provide a lower out-of-pocket cost to the employees of 20 – 40%.

El Paso ISD notified TEA on May 15, 2019, regarding their amendment to the Local Plan and enrolled employees in August offering TRS-ActiveCare and the additional plan options beginning September 1, 2019. For additional insight, please view the links below.

DISTRICT OF INNOVATION: EL PASO ISD

Overall Plan

Executive Summary  2/12/2019 | Executive Summary 5/14/2019

EPISD DOI Amendment: Resolution | Proposals Plan Amendment | Final Plan Amendment | Notice of Adoption

Steps to Join

SUBMIT AN FBS BROKER OF RECORD 

RISKMANAGERS.US COMMENT: In the past there has been some question as to whether a school district may employ a Broker of Record. “Because the use of a designated broker of record will necessarily limit the number of companies from which the district may purchase insurance, it may foreclose the district’s access to the most advantageous rates and terms. (JC-205, Page 2” www.tdi.texas.gov/bulletins/2007/cc41.html)

A Broker Of Record (BOR) must be submitted to FBS to begin our medical broker services. For your convenience, FBS has attached our BOR Agreement here to include on your district’s letterhead which can be emailed to: medical@fbsbenefits.com.

TSHBP REVIEW AND PROPOSAL

We will contact you and present to your district a proposal for your group health medical needs. This will include medical rates specific to your region and district. FBS will also work with you to provide information to amend your District of Innovation Plan if needed.

https://fbsbenefits.com/fbs-medical-consulting/

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More insurance vendors have joined the The TRS ActiveCare Feeding Frenzy with more expected to join the rebellion next year.

Districts considering offing a TRS ActiveCare alternative should be cautious. A short term solution may prove attractive for now but long term goals may be elusive if the program is not structured properly.

The problem we see with these new “solutions” is basic – Replacing a PPO Plan (TRS ActiveCare) with another PPO Plan will not solve the problem of eroding benefits and increasing costs. The definition of insanity is doing the same thing over and over again and expecting different results.

There are other proven methods such as the strategies adopted by Raymondville ISD. TRS officials would be wise to adopt those strategies too, but they won’t.

RiskManagers.us is a specialty company in the benefits market that, while not an insurance company, works directly with health entities, medical providers, and businesses to identify and develop cost effective benefits packages, emphasizing transparency and fairness in direct reimbursement compensation methods.
 
Industry news & updates @ www.RiskManagers.us   

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