TRS ActiveCare’s Hostage Taking Strategy Under Attack

“He who has data wins. He who has good date wins a lot. He who has real time data wins all the time.” – Author Unknown

There is a movement afoot by member TRS ActiveCare districts to offer employees a commercial health plan option.

However, school districts considering TRS-ActiveCare alternatives have been at a disadvantage because TRS ActiveCare has refused to provide member districts with claim data which is needed by insurance companies to evaluate risk in the best possible and accurate manner.

This industry standard underwriting process is called experience rating.

The refusal of TRS officials to provide claim information is intended to make it difficult for districts to procure competitive alternatives.

Those districts that have succeeded in offering a TRS ActiveCare alternative have done so through various underwriting methods. These may include health questionnaires and/or risk analysis using established data sets as a benchmark. A technology firm we are familiar with, in conjunction with stop loss carriers, has the ability to evaluate risk within an average 10% margin without requiring health questions of individual members.

However, nothing beats experience rating for best underwriting practices. TRS ActiveCare officials know this. So do all of us.

No one likes being held hostage.

But this may all change if the following bill is passed this legislative session:

Relating to the provision of certain historical claims data and other information to school districts and other participating entities in the Texas school employees uniform group health coverage program.