Formerly sleepy TRS trustees are considering “big changes” to TRS ActiveCare because member districts are threatening to leave to establish their own health plans. Competition, for the first time, is clearly at play here (Texas School District Challenges TRS ActiveCare Plan Mandates).
The TRS solution? Eliminate community rating so some districts can pay more and utilize narrow networks so all districts have less choice……………………..
SOURCE: TSTA.ORG
The Teacher Retirement System (TRS) is considering a new approach to health care plans as a means to turn around the declining enrollment numbers in TRS Active Care. TRS Active Care was established by the Texas Legislature in 2001 with the intention of offering affordable health insurance to districts, especially smaller districts with few other options. While larger districts are not required to participate, those with fewer than 500 employees were. Since 2001 the cost of health insurance has continued to rise, causing districts that participate in TRS Active Care to reconsider their participation in the state plan. Not helping matters: the state provides a $75 monthly insurance allotment per educator, leaving the remaining costs to be covered by districts and educators. In Texas, a teacher pays an average of $1,121 a month for coverage, compared to $546 nationally.
TRS understands the level of dissatisfaction with Active Care and is looking to make drastic changes, specifically, the system is looking at a never-before-considered option: restructuring Active Care with a potential regional health care plan system, as opposed to the state-wide system.
Representatives from TRS have publicly noted that there are clear pros and cons with this possible approach. While a regional plan may allow for a better deal financially, it could be very limiting in terms of coverage within the system. Katrina Daniel, Chief Health Care Officer of the system, discussed the plan with the TRS board’s compensation committee. “We know, if we go in that direction, some employees might be dissatisfied,” Daniel said. “Some might want to go to another facility in the area. But if we work closely with school districts—and school districts agree to move in this direction—it might help with some of the dissatisfaction among employees.”
TRS will be having 22 meetings in 13 cities with school districts throughout the month of October. After these meetings, a preliminary methodology will be developed to be presented to the TRS board at its meeting in February. Then, the board will vote on final rates and benefits at its April meeting.
The idea of using regional networks with limited partners has the potential to provide better outcomes and coverage for educators. With 482,000 enrollees, the TRS system has the largest purchasing power of any employer in the state. Hopefully, this kind of leverage will see better outcomes.
TSTA will continue to monitor and report on future developments.
