“It is a program without any sense of risk management, so this will continue to be the pattern until they kill it. One of the biggest issues is the consulting firm, which has worked with them forever and is not even located in the State.” – Insurance Consultant
SOURCE: TEXAS CLASS ROOM TEACHERS ASSOCIATION
On Friday, June 2, the TRS Board of Trustees adopted the ActiveCare, HMO and TRS-Care plan design changes and premium rates for the upcoming year. Enrollees selecting family coverage in the higher levels of the active insurance plan will be particularly hard hit, with premiums rising by 16.8 percent for family coverage under ActiveCare Select and 25.5 percent under ActiveCare 2.
IMPORTANT NOTE: The rates listed for ActiveCare and the HMOs are the full premium price and do not reflect the amount contributed by the state ($75/month) and school districts (at least $150/month, some districts contribute more). The actual amount paid by the employee will be at least $225/month less than the rates listed in the charts for ActiveCare and the HMOs.
The details below are excerpted from the presentation provided by TRS staff to the Board of Trustees.
ActiveCare benefit changes and premiums
Deductibles and out-of-pocket maximums will increase in certain categories, but no changes will be made in the prescription drug program. See below for plan design and premium changes for the upcoming school year (or click here or on each chart below for a larger view).
The First Care and Scott & White HMOs will continue; Allegian will be replaced by BCBSTX. The BCBSTX coverage area and benefits will be similar to those of Allegian. Click here for benefits and premiums for the three HMO plans.
TRS-Care benefits and premiums
Trustees adopted the plan design and premium rates as TCTA has described throughout the legislative process with separate plans for Medicare-eligible and non-Medicare-eligible retirees. Click here for more information about the significantly restructured insurance plans for retirees.
These changes are going to be very difficult for both active and retired educators to absorb, especially when retiree benefits are fixed and teacher salaries are likely to be stagnant in many districts due to the lack of new education funding from the state. TRS is unable to address funding issues except through premiums and plan design (only the legislature can increase state funding) and faces difficult choices in balancing benefit reductions with premium increases to accommodate rising health care costs.
Relief is unlikely until legislators can be persuaded that increasing state revenue and spending it on public schools and teachers is a politically prudent action. Educators concerned about their salaries and benefits should contact lawmakers soon and frequently to explain the difficulties that rising health insurance costs are causing not only in their personal lives but in the teaching profession as a whole. Until legislative priorities change – or more pro-education candidates are elected — school employee benefits will continue to be overlooked.