Size doesn’t matter when it comes to health care……….
But that’s not what all the experts say. They say size does matter. The bigger you are the better you can control costs, the better you can get lower health insurance rates, the more barking (bargaining) power you have. Size most certainly does matter the experts say.
We believe the experts. Surely large pools of insureds can get better health care pricing then smaller pools. A +400,000 employee life group can certainly get better health care pricing than a 15 life group. Right?
Not so it seems.
The TRS ActiveCare plan for Texas school districts has more than 400,000 plan members. Like almost every other group plan in the country costs continue to increase for plan members, with higher deductibles, higher cost and less choice.
64% of plan members are on a $2,750 deductible with no first dollar coverage (except preventive care). Maximum out-of-pocket exposure including plan member’s premium share can reach $30,000 and more depending on the plan chosen (members can pick between several plan options). Bear in mind the average Texas educator earns $55,000 per year
TRS ActiveCare plan members can barely afford the insurance, especially if they have to use it.
Members receive in-network benefits through the Aetna PPO network, the same network ABC Fence Company uses for their 15 employees.
A 15 employee member group gets the same Aetna negotiated health care pricing as a +400,000 Aetna member group.
Size doesn’t matter………………………….
