Category Archives: healthcare

Why March 6 Matters: Healthcare

Early voting is underway NOW for the March 6 Texas primary elections, so we’re taking a look at some of the reasons why it’s so important that educators vote in this election! Today, we’re taking a closer look at healthcare for active and retired educators.

In our first post of this series we examined teacher pay, which lags behind the national average. While paychecks are a major concern, Texas also spends less than any other state on employee benefits, funding them only at about $967 per pupil, which includes the cost of health insurance. In fact, Texas spends less than our neighboring states Oklahoma and New Mexico, which are both under the national average as well but are spending $1,505 and $1,905 per pupil respectively, despite having significantly less wealth per capita than Texas (U.S. Census Bureau, Public Education Finances: 2014, G14-ASPEF, released May 2016).

The ever-increasing amount of money being taken out of educators’ paychecks for healthcare is primarily due to the fact that state funding and state-mandated district funding for health insurance, including the TRS-ActiveCare plan used by many districts for their employees, has remained unchanged since the program first began some 17 years ago.

When the Legislature first decided to subsidize teacher health insurance premiums back in 2001, the $225 contribution for each employee (made up of $75 from the state and $150 from the school district) was in line with what private employers were paying toward healthcare for their employees. Since that time, health insurance inflation generally has been between eight and ten percent per year, and educator premiums have increased more than 250 percent. Also during that time frame, many private employers have increased what they pay toward employee health insurance premiums, but Texas’s funding of the healthcare program for public school employees has fallen way behind.

Legislative inaction has now led to an insurance program for school district employees that is more burdensome than beneficial, and for many educators, it amounts to a pay cut year after year. Back In November 2014, the Teacher Retirement System (TRS) released its TRS-Care Sustainability and TRS-ActiveCare Affordability Study that was commissioned by the 83rd legislature. It outlined numerous options for lawmakers to consider in dealing with the looming healthcare crisis for educators. Despite those recommendations, the legislature has failed to address exploding healthcare costs for active employees.

One reason the legislature has neglected to address healthcare costs for active employees, including during the most recent 2017 legislative sessions, is the sad fact that the state’s health insurance program for retired educators, TRS-Care, is in even worse shape. After years of inadequately funding retirees’ health insurance, the legislature has now faced back-to-back sessions in which the program was at risk of running out of money and collapsing in on itself —a prospect that would leave hundreds of thousands of retired educators with no health insurance, dramatically limiting their access to healthcare when they most need it.

Back in 2015, the 84th Texas legislature opted not to address the funding formulas that determine how our state pays for TRS-Care. Instead, they made a $700 million supplemental appropriation to keep TRS-Care afloat for one more budget cycle.

By the time the 85th legislature arrived in Austin in January 2017, the TRS-Care shortfall had ballooned to $1.2 billion. Again, lawmakers were unwilling to address the underlying funding formulas, and they similarly declined to make even a one-time appropriation to cover the full cost. Instead, the Senate under the guidance of Lt. Gov. Dan Patrick and Sen. Joan Huffman, who chaired the Senate Committee on State Affairs that oversees TRS, pushed forward a plan that cut the cost of TRS-Care to the state by shifting more costs to retirees.

It’s worth nothing that retired educators have not seen a cost of living adjustment to increase their pensions for over a decade, during which time they’ve also had to endure dramatic reductions in their healthcare benefits as a result of restructuring of the health insurance plan. That combination of dwindling purchasing power due to the effects of inflation on stagnant pension payments and crushing new healthcare costs caused such an outcry from retired educators that by the time legislators came back to Austin in the summer of 2017 for a special session, they felt compelled to put a modest amount of one-time extra dollars into the system to temporarily soften the blow of the impending changes to TRS-Care. However, those additional one-time funds were only a short-term band-aid on a much larger problem that remains.

Even with the draconian measures taken by the 85th legislature, resulting in significant rate hikes for many plan participants, TRS-Care is projected still to have a funding shortfall that will have to be addressed by the 86th legislature. In other words, lawmakers must act in 2019 if TRS-Care is to continue to exist for retired educators

Finding real solutions to the crisis of access to affordable healthcare for the state’s active and retired educators is a complex and expensive task. It cannot and will not be achieved by legislators whose singular priority is creating the appearance of cutting state spending without solving the problems faced by our state’s more than 1 million active and retired school employees. The elections that will determine who occupies those critical legislative seats and will have the power to decide the future of healthcare funding for educators are happening right now. Active and retired public school employees who have dedicated their lives to serving and educating our 5.4 million young Texans have the power to shape the outcome of this battle simply by voting in the 2018 primaries.

Go to the CANDIDATES section of our Teach the Vote website to find out where officeholders and candidates in your area stand on school finance and other public education issues. Because voting districts in Texas are politically gerrymandered, most elections are decided in the party primary instead of the November general election. That’s why it is so important to vote in the primary election. Registered voters can cast their ballot in either the Republican or Democratic primary, regardless of how you voted last time.

Remind your colleagues also about the importance of voting in the primary and making informed choices at the polls. Keep in mind that it is illegal to use school district resources to communicate information that supports or opposes specific candidates or ballot measures, but there is no prohibition on sharing nonpartisan resources and general “get out of the vote” reminders about the election.

Early voting in the 2018 primaries runs Tuesday, Feb. 20, through Friday, March 2. Election day is March 6, but there’s no reason to wait. Get out there and use your educator voice by casting your vote TODAY!

TRS board discusses future shortfalls as critical primary election looms

I was listening to a retired educator testify before the TRS board at their annual board retreat this morning. She expressed that retirees are scared about increasing healthcare premiums and upcoming changes that will greatly impact the actuarial picture of the pension fund. She also asked for TRS to advocate on behalf of retirees in dealing with the legislature. It was moving testimony. However, I wish she and all educators, active and retired, would shift their mentality from scared to angry and look not to TRS to take care of them next session, but instead look to themselves to be their own best advocates, at the polls where these decisions are really made.

The reality is TRS is an administrative agency, and while the TRS staff does a phenomenal job, their job is to implement the legislature’s will, NOT to lobby the legislature on behalf of TRS members. In fact, all state agency staff, TRS staff included, are prohibited by state law from engaging in lobbying efforts.

TRS has hard days ahead. If the defined benefit pension system or TRS-provided retiree healthcare are going to continue to exist, active teachers and retired teachers alike will have to use their voices not only at the capitol but also at the polls.

What are the factors that underpin this bleak reality?

First, TRS is set to drop its assumed rate of return from 8 percent to 7.25 percent. This one action, at least on paper, will make the fund go from healthy to anything but. There is already extreme pressure from Wall Street money managers and the politicians willing to work on their behalf to convert TRS to a 401(k) style system off of which they could make huge profits. Without other changes offsetting the drop to 7.25, this pressure will likely increase exponentially as the pension fund will look considerably more vulnerable going forward.

Second, despite the draconian changes to TRS-Care coming out of the last legislature, the retiree health insurance system, as it stands today, still is not financial sustainable. And the issues with retiree health care don’t even take into account the significant health insurance burden on active teachers, which is forcing many of them out of the education profession.

Sometimes there are smart policy initiatives that can solve statewide challenges with little or only indirect additional costs. The challenges facing TRS are NOT those kinds of challenges. The truth is that the state has for years gotten by knowingly underfunding both the pension trust fund and the retiree healthcare trust fund. On the pension side, in fact, the state’s share of an educator’s pension (at 6.8 percent) is less than half the teacher retirement system contribution rate set by the next lowest state not paying into Social Security.

Texas has now reached a point where getting by on barebones funding can no longer happen – not  if we want to continue providing teachers with a pension or retiree health insurance. What has changed?

As stated above, in response to long term market trends and despite best-in-class fund management by TRS staff, the agency is expected to reduce the assumed rate of return on the fund to 7.25 percent, down from 8 percent. This change will increase the pension’s unfunded liability by $10 billion and raise its funding period from just over 30 years to a whopping 86 years. (Anything under a 30-year funding period is considered actuarially sound, and for TRS the 30-year period has been linked to providing cost of living increases (COLAs) for retirees.) At 8 percent there was an expectation that the fund would be in a position to offer a COLA within the next few years, at 7.25 percent the fund would not be considered healthy enough to offer retirees a COLA for at least the next 56 years.
In order to offset the adjustment to the assumed rate of return, the TRS pension fund’s contribution rate will need to be increased enough to generate an additional $1.4 to 1.6 billion per biennium.

TRS must be honest and stay above political bias or pressure in setting its estimated rate of return. In truth, a lower assumed rate of return, as long as it is coupled with a proper contribution rate, will produce a healthier pension system in the long run. However, because it is up to the legislature and not TRS to adjust the contribution rate, it is vital that the agency be diligent and expedient in communicating to its members the realities and potential consequences of a decision to adjust the fund’s assumed rate of return.

In addition to needing $1.5 billion or more in new pension contributions, TRS will also need substantial additional dollars just to sustain TRS-Care at the new 2018 levels. In all, TRS estimates that it will be asking the legislature to appropriate between 2 and 2.5 billion additional dollars next biennium. Lobbyists for each of the four statewide educators groups (including ATPE), the retired educators group, and a group representing school districts, when given the opportunity to comment, expressed their belief that such an ask would be a complete non-starter with the current group of legislators, particularly the Governor, Lt Governor, and the majority of Texas Senate.

Without substantial additional funds; TRS-Care will quickly go bankrupt and cease to exist. Active teachers’ health insurance costs will continue to rise unchecked pushing more and more good teachers out of the profession, and the TRS pension fund will be on a certain path toward being abolished. That is the very likely future, unless retired and active educators alike decide to make their voices heard at the polls this election year. Early voting starts Tuesday, Feb 20, and runs through Friday, March 2. Election day is Tuesday, March 6. With over one million active and retired education professionals in the state of Texas, the question is not whether you can save your retirement, fix your health insurance, and improve public education policy for 5.4 million students in this state. No, the only question is – will you?

Important update on TRS retiree healthcare

ATPE has just received the following announcement from the Teacher Retirement System of Texas (TRS) regarding participants, members, or their dependents who originally terminated coverage with TRS-Care between July 1, 2017- January 1, 2018, but want to return.

For more information please visit the TRS Website of contact TRS at 1-888-237-6762.

From TRS:
2018 TRS-Care Plan Changes Grace Period

The Teacher Retirement System of Texas (TRS) has received a number of requests from TRS-Care participants who terminated health plan coverage but want to return to TRS-Care.

Under TRS plan rules, retirees and dependents who terminate coverage cannot return to TRS-Care unless they experience a rare special enrollment event. However, TRS understands that there may be some individuals who did not wish to leave TRS-Care, or who now wish to reverse their decision and re-enroll.

Therefore, TRS is offering a one-time grace period until February 28, 2018 to allow former TRS-Care participants to re-enroll in TRS-Care if they terminated coverage or dropped a dependent due to the 2018 plan changes.

Who can re-enroll in TRS-Care during the grace period:

To be eligible for this grace period, participants must have a TRS-Care termination date of July 1, 2017 through January 1, 2018.

This is not an opportunity to add new dependents. You can only reinstate dependents that were previously covered under TRS-Care and were terminated from TRS-Care coverage between July 1, 2017 and January 1, 2018.

Steps to take to re-enroll:

To re-enroll with TRS-Care, please submit a signed application for TRS-Care. Your application must be post-marked no later than February 28, 2018. Your coverage will be effective the first day of the month following the time we receive your application.

Please note that if you submit your application near the end of the month, there may be a delay until TRS can make your coverage retroactively effective. Please submit your application as soon as possible.

If you wish to re-enroll in TRS-Care, please complete the application that applies to you based on your Medicare status, and sign and return the application to TRS postmarked no later than February 28, 2018.

There are two versions of the application—one for participants with Medicare and one for retirees without Medicare.

Please refer to the following link on the TRS website for more information.

TRS Annual Review

Each year the Teacher Retirement System of Texas (TRS) puts out an annual review of both the TRS Pension Fund and the TRS health care systems / trust funds which they present to the TRS Board members.

The TRS health care update this year is focused on an in-depth analysis of the changes from the 2017 Care and ActiveCare plans to those going into effect during the 2018 plan year, as a result of legislative action during 85th regular and special sessions. ATPE has reported a number of times on the TRS-Care and ActiveCare changes as they have unfolded. The changes to TRS are set to take effect Jan 1, 2018.

TRS has produced two helpful videos to help explain the new insurance program, one for participants who are Medicare eligible and another for participants who are non-Medicare.

You can click the link here to view the full TRS health care document produced by TRS.

The Board also received its annual review on the health of the TRS pension trust fund, including a preview of some major actions the staff intends to undertake in the coming year. The review of the pension fund was a much rosier conversation in the recent past than the health care discussion, but the board is planning to undergo an experience study in early 2018 that could present some new long term challenges if it results in lowering the assumed return of the fund.

The headline from the pension report is the TRS Trust Fund earned a return of 12.9% and ended the 2017 fiscal year at a market value of $147 billion compared to a market value of $134 billion for the fiscal year ending 8/31/16.

Results of the 8/31/17 valuation and comparisons to the 8/31/16 valuation are summarized below:

The strength of the previous year raises the fund’s 10-year return to over 8%, and the fund’s returns since inception (approximately thirty years) continue to exceed 8% as well.

Despite TRS’s exceeding the assumed rate of return during both of these time frames, there is a strong expectation that external consultants who will perform the experience study in early 2018 will come back with a strong recommendation to lower the assumed rate of return for the fund from 8% to somewhere in the neighborhood of 7.5%. The result of such a move, in isolation, is to dramatically increase the unfunded liability of the fund on paper, which also increases the number of years required to fully fund the pension. Under the state’s definition of actuarial soundness, the funding window must be less than 30 years to consider the fund actuarially sound for purposes of increasing retiree benefits, such as by providing retirees with a cost of living adjustment (COLA).

Should TRS ultimately lower the assumed rate of return, it will be incumbent upon the agency, active and retired teachers, and those groups that represent them to impress upon the legislature the absolute necessity of increasing TRS funding to make up for the assumed loss of investment income. The amount of new funding needed to offset a decrease in the assumed rate from 8% to 7.5% will be approximately $800 million per biennium.

You can click the link here to view the full TRS Pensions document produced by TRS.

TRS-Care info tour coming to a city near you

ThinkstockPhotos-162674067-pillsWith TRS-Care set to undergo significant changes in 2018, TRS staff have designed a comprehensive communications plan to ensure that all  plan participants have access to the information they will need to make decisions about their healthcare coverage. TRS has designed the communications plan to “touch” the 270,000 TRS-Care participants nearly two million times between now and January.

In addition to reaching out to participants through print and electronic communications, TRS staff will be going on the road to conduct in-person seminars. The seminar schedule includes 31 locations all across the state between October 9 and November 2, 2017.

The seminars will be presented in four parts and are divide into two segments of approximately 90 minutes each. The first hour and a half focuses on participants covered by Medicare; the second hour and a half covers plan changes for the pre-Medicare population. In many of the stops, the three hour seminar will be offered once in the morning from 9 am to noon, and once in the afternoon from 1:30 to 4:30 pm. Here is a list of the scheduled meetings released by TRS. To attend an in person event will require an RSVP by phone. Seating is limited. ​Please call 1-800-850-1992 Monday-Friday, 8:00 a.m. – 5:00 p.m., Central time to reserve your seat.

For those who wish to participate in the TRS-Care seminar but are not able to attend one in person, TRS will also hold a minimum of eight webinars. TRS is adding additional webinars during the week of Nov. 6 to help offset its inability to hold more onsite seminars in the Houston area due to Hurricane Harvey.

For additional questions, please visit the TRS website or call TRS at 1-888-237-6762.

Those interested in the recent changes adopted for TRS-Care may also view video of the last TRS board meeting. The board’s discussion on TRS-Care begins around the 3 hour and 46 minute mark on the video and lasts approximately 45 minutes.

TRS adopts retiree healthcare changes, considers 403(b) provider rules

TRS logoATPE lobbyist Monty Exter attended a TRS Board meeting in Austin today. Today’s meeting was rescheduled from last week when it had to be delayed due to Hurricane Harvey. The agenda and board materials for the meeting can be found on the TRS website.

After preliminary housekeeping issues, the board took public comments. TRTA Executive Director Tim Lee engaged the board on the implementation and issus needing to be addressed due to recent legislation which made significant changes to TRS-Care.

After Mr. Lee, multiple industry professionals came to give their comments on TRS’s proposed rule change regarding 403(b) programs. All but one of those offering comments had strong concerns about the effect of the rules on the future availability of a robust cohort of providers for educators to choose. One witness thought the number of companies and products currently in the space was excessive and presented Texas educators with an overly complex and excessively expensive set of options. The board will further consider these rules during an agenda item later today on which we will report afterward for Teach the Vote.

After public comments, the board recognized Howard Goldman for his 24 years of service as TRS Communications Director.

Next the board received an update on the TEAM program. TEAM is the name given to TRS’s work toward updating the agency’s considerable computer infrastructures and data systems. Go live on phase one of the TEAM upgrades is set for October 2, 2017. There are some contingencies based on delays caused by Hurricane Harvey, as the storm may affect as many as 321,705 TRS members.

After the TEAM discussion, Brian Guthrie, TRS Executive Director, gave the board a special session update, including reporting on the passage of House Bill (HB) 21, which included an appropriation of $212 million for TRS-Care. The money appropriated will be used to soften the blow of the increased premiums and deductibles. The board returned to the issue of TRS-Care when it reviewed and adopted the premiums and plan design for TRS-Care, the retiree health benefits program, including the standard plan, the fully insured Medicare Advantage Plans, and the Medicare Part D Plans.

The attached document from TRS staff provides details of the now adopted TRS-Care plan design, how the new plan compares to the current TRS-Care plans, and what the plan would have looked like had HB 21 not passed during the special session. Changes to TRS-Care will not go into effect until Jan 1, 2018.

Following Guthrie’s comments, the board took up the certification of the contributions TRS will receive to fund TRS-ActiveCare. The board voted to certify to the State Comptroller the estimated amount of state contributions to be received by TRS-Active Care for fiscal year 2018. The certification amount totals $795,729,797 which includes $401,129,797 to meet the state contribution rate; $182,600,000 in supplemental funding passed during the regular session; and $212 million passed during the special session via HB 21. The state contribution rate has increased from 1.0% to 1.25% due to the passage of HB 3976 relating to changes for TRS-Care during the regular legislative session earlier this year.

TRS had initially scheduled a Policy Committee meeting to happen concurrently with today’s full board meeting, but that meeting had to be canceled as a result of a lack of quorum of those committee members due to Hurricane Harvey.

Proposed TRS meeting dates for 2018 are Feb. 14-16, April 19-20, June 14-15, July 27, Sept. 20-21, Oct 19, and Dec 13-14

The Board’s next regularly scheduled meeting will be September 21-22.

Important update for retirees: TRS-Care list of no cost medications

Drugs and MoneyThe Teacher Retirement System of Texas (TRS) has released a list of medications which will be available at no cost to members on the TRS-Care Standard Plan, which will be the plan available to any pre-65 TRS retirees who are not yet Medicare eligible. The list does not apply to TRS retirees who are eligible for the TRS-Care Medicare Advantage plan (primarily retirees over the age of 65). Medicare Advantage participants will continue to have a co-pay plan that applies to their prescription purchases generally.

Note that none of the changes taking place to TRS-Care, including the introduction of this no cost prescription list, will take effect until January 1, 2018.

If you have additional questions about changes anticipated for TRS-Care, check out this blog post or contact ATPE Governmental Relations.

Teach the Vote’s Week in Review: Aug. 25, 2017

Welcome back to school, educators! Here’s this week’s ATPE wrap-up of education news:


TRS logoTRS has posted info on its website and social media telling plan participants in areas affected by Hurricane Harvey that they can fill prescriptions in advance of the storm.

Both CVS Caremark and Express Scripts are allowing one-time emergency refills of medications for those in areas affected by the hurricane.

The article on TRS’ website informing participants they can pick up medications in advance of the storm and which provides the PBMs’ phone numbers can be found here.

Participants with questions about how to access prescriptions, can contact TRS pharmacy benefit managers at the following numbers:

• Active employees: CVS Caremark 1-800-222-9205 (option 2)
• Retirees: Express Scripts 1-877-680-4881

TRS participants can get to the article from the “What’s New” section of the TRS homepage and from the health care news main page.


Retirement planning written on a notepad.The board of trustees of the Teacher Retirement System (TRS) was scheduled to meet today for the first time following the conclusion of the 85th legislature’s special session. However, the meeting has been postponed until Sept. 1 on account of Hurricane Harvey and the inability to secure a quorum.

To learn more about changes the board is expected to consider for TRS-Care when it meets next week, check out this recent post from ATPE Lobbyist Monty Exter.


ATPE Input on the Texas ESSA Plan_FINAL_Page_1As we reported yesterday, ATPE has submitted formal input this week on the draft Texas state plan for ESSA compliance recently shared by the Texas Education Agency (TEA). Click here to read ATPE’s feedback, prepared by ATPE Lobbyist Kate Kuhlmann, which focuses on aspects of the federal such as student assessment, setting long-term performance goals for students, and analyzing school climate as a quality indicator.


tea-logo-header-2This week, TEA also announced the availability of a new Equity Toolkit to help school districts comply with ESSA requirements to submit equity plans reporting on whether low-income students and students of color are served at disproportionate rates by “ineffective, inexperienced, or out-of-field teachers” in the district. Learn more about the toolkit in this blog post from ATPE Lobbyist Mark Wiggins.


ATPE state officers and staff have been talking to the media about the 85th legislature recent special session and how educators feel about issues heading into the 2018 election season.

Jennifer Canaday

Jennifer Canaday

A guest editorial by ATPE Governmental Relations Director Jennifer Canaday was published this week by both the Houston Chronicle and the Austin American-Statesman. In her piece entitled “Maybe it’s time for a legislative gap year,” Canaday writes about the legislature’s decision not to make any major changes to the state’s school finance system in a way that would also provide local property tax relief. “The Legislature, unfortunately, punted on an opportunity to make structural changes to our beleaguered school finance system, opting to study the issue for two more years,” writes Canaday. “Like a seventh- or eighth-year college student still living at home, at some point the Texas Legislature must complete its studies and start working on the real job of fixing what is broken.”

Tonja Gray

Tonja Gray

The legislature will instead appoint a new commission to study and recommend improvements to the school finance system. ATPE State Secretary Tonja Gray spoke to reporters with KTXS in Abilene  about the commission and about her experiences testifying at committee hearings during the regular and special sessions. Gray said she was happy to see the legislature’s passage of a measure to provide additional funding for retired teachers’ healthcare needs.

Gary Godsey

Gary Godsey

Byron Hildebrand

Byron Hildebrand

ATPE State Vice President Byron Hildebrand and ATPE Executive Director also taped an appearance for the debut episode of “In Focus,” a new public affairs program produced by Spectrum News Austin and Spectrum News San Antonio. Local viewers can catch the program at 9:30 am on Sunday mornings beginning Sept. 3, 2017. For a sneak preview, check out this clip featuring Hildebrand discussing retired teachers.



TRS to vote on changes to retiree healthcare plan next week

Drugs and MoneyIf you are a retired educator or someone planning to retire soon from the profession, you’ll be interested in next week’s meeting of the Teacher Retirement System (TRS) Board of Trustees. The board will meet Friday, Aug. 25, to discuss and adopt modifications to the TRS-Care healthcare program for retirees.

As we reported on Teach the Vote back in June, TRS recently announced several changes to the design of its healthcare plans after the legislature failed to completely fill a funding shortfall during the regular session. But in response to outcries from educators, legislators convinced Gov. Greg Abbott to add retiree healthcare costs to his call for the special session that ended Tuesday. The legislature passed House Bill 21 by Rep. Dan Huberty during special session that will funnel $212 million in additional money to TRS for healthcare.

TRS logoThe attached document from TRS staff provides details on plan changes that TRS board members are expected to adopt next week. Changes to TRS-Care will go into effect on Jan 1, 2018.

TRS board approves major healthcare changes

TRS logoThe board of trustees for the Teacher Retirement System (TRS) of Texas met Friday to make changes to healthcare and retirement following the actions of the 85th Texas Legislature, which adjourned sine die on Monday.

Before delving into plan information, the board approved new contracts with CVS Caremark as the pharmacy benefit management (PBM) administrator for TRS-Care Standard, TRS-Care Part D, and TRS-ActiveCare. Staff then reviewed the two major pieces of legislation that will define healthcare and retirement benefits under TRS moving forward:

Senate Bill (SB) 1

The state budget covered roughly $480 million of the estimated $1 billion shortfall facing TRS-Care by increasing contributions by both the state and school districts, including one-time state supplemental funding of $182.6 million. While this prevented a worst-case scenario for retirees, the balance will unfortunately have to come from higher premiums and benefit reductions.

House Bill (HB) 3976

This bill represents a major structural overhaul of TRS-Care. It establishes two separate plans: A single High Deductible Plan for non-Medicare participants and a Medicare Advantage and Medicare Part D Plan for Medicare participants.

Under HB 3976, TRS cannot charge a premium during the 2018-2021 plan years to disability retirees who retired as a disability retiree effective on or before January 1, 2017, who are currently receiving disability retirement benefits, and who are not eligible to enroll in Medicare. The bill eliminates the statutory requirement to provide a free healthcare plan for retiree-only coverage, but will provide free generic preventative maintenance medications for enrollees in the high deductible plan. The new program provides an opt-in window for retirees under the age of 65 who choose coverage elsewhere to opt-in to the Medicare Advantage Plan at age 65.

What’s next

On Friday, the board approved the new TRS-Care plans created under HB 3976. From September 1, 2017, to December 31, 2017, the agency will maintain the current TRS-Care 1, TRS-Care 2, and TRS-Care 3 Plans, such that FY 2017 will be an extended 16-month plan year. Deductibles and out-of-pocket accumulators will not restart on September 1, 2017. The agency plans to maintain current retiree premium contributions by plan, Medicare status, family size, and years of service.

New TRS-Care plans

Non-Medicare participants on the TRS-Care 1, TRS-Care 2, and TRS-Care 3 plans will be absorbed into the new TRS-Care Standard Plan. In-network coverage will include a $3,000/$6,000 deductible, $7,150/$14,300 maximum out-of-pocket limits, and 80/20% coinsurance. Out of network coverage will include a $6,000/$12,000 deductible, $14,300/$28,600 maximum out-of-pocket limits, and 60/40% coinsurance.

Medicare participants will be absorbed into the TRS-Care Medicare Advantage/Medicare Part D Plan, which includes a $500 deductible, $3,500 maximum out-of-pocket limit, 95/5% coinsurance, $500 IP hospital copay per stay, $250 OP hospital copay per visit, $65 ER copay, $35 urgent care copay, $5 PCP office visit copay, $10 specialist office visit copay, $0 preventive services copay, $5/$25/$50 retail pharmacy copay, and $15/$70/$125 mail order pharmacy copay.

TRS will make an alternative plan available for certain participants who are Medicare eligible but not enrolled in either Medicare Part A or Medicare Part B, or cannot access a provider through the TRS-Care Medicare Advantage Plan.

New premiums are scheduled to take effect January 1, 2018. A non-Medicare retiree only will see a monthly premium of $200, and a Medicare retiree only will see a monthly premium of $146. Premiums for retiree and spouse are $739/$590, retiree and children $433/$504, and retiree and family $1,074/$1,106.

The TRS-Care Medicare Advantage network is a PPO plan network with an out-of-network benefit equivalent to the in-network benefit. Providers do not need to be in network as long as a provider accepts Medicare and agrees to bill Humana, the TRS-Care vendor.

The agency has already begun the first phase of implementation, which involves communicating to participants the changes that will take effect January 1, 2018. These communications will include a monthly e-newsletter, direct mail correspondence, and online information. While these changes will increase the burdens on plan participants, they are estimated to keep TRS-Care positively funded until 2021.

TRS-ActiveCare Changes

The legislature did not pass any legislation affecting TRS-ActiveCare, which is a self-funded program, but the board did make significant plan changes on Friday.

The sole source of funding for TRS-ActiveCare is premiums. The state contributes $75 per month per employee through the school finance formulas, and districts contribute a minimum of $150 per month per employee, with some districts contributing more. Employees contribute the remainder of the projected gross premiums. Funding requirements for the state and districts have not changed since the program’s inception in 2002.

While in much better shape than TRS-Care, TRS-ActiveCare is facing a shortfall of just under $100 million in 2018, which has placed pressure on premiums. The agency’s goal is to balance premium increases against the need to build the fund balance to protect the plan. The target fund balance at the end of FY 2018 is one month of claims, or $158 million. Without plan design changes, staff suggested an average rate increase of 9.9 percent would be required to achieve the target ending fund balance.

With that in mind, the board approved a number of changes based on agency recommendations. Those on the TRS-ActiveCare-Select and TRS-ActiveCare-2 plans will see increased costs associated with out-of-network providers, and will see ER copays increase to $200 from $150. There are no changes planned regarding prescription drug benefits.

These changes will allow for a slightly smaller 8.1 percent average rate increase. TRS-ActiveCare-1HD rates will increase 2.9 percent for employee only, 8.4 percent for employee and spouse, 9.1 percent for employee and children, and 6.9 percent for employee and family. TRS-ActiveCare Select rates will increase 6.2 percent for employee only, 10.2 percent for employee and spouse, 7.1 percent for employee and children, and 16.8 percent for employee and family. TRS-ActiveCare-2 rates will increase 10.7 percent for employee only, 9.1 percent for employee and spouse, 1.9 percent for employee and children, and 25.5 percent for employee and family.

Other legislative changes

At Thursday’s meeting, executive director Brian Guthrie told board members “we are very pleased” with how the legislative session turned out for TRS. Three key bills related to the system passed within minutes of a crucial deadline late in the session. Debriefing the board, TRS governmental relations director Merita Zoga identified several additional items passed by the legislature related to TRS:

  • HB 89 prohibits governmental entities from contracting with or investing in a company that boycotts Israel.
  • SB 253 adds to the existing divestment statute, prohibiting TRS from investing in companies designated as terrorist organizations.
  • SB 252 prohibits government entities from contracting with companies doing business with Iran, Sudan, or a foreign terrorist organization.
  • SB 7, the teacher misconduct bill, includes language related to TRS. The bill strips the service retirement annuity from a TRS member who is convicted of felony sexual abuse, sexual assault, or improper relationship between educator and student. All or part of the annuity may be awarded instead to an innocent spouse.
  • SB 500 would strip the service retirement annuity of a member of a public retirement system, such as TRS or ERS, if the member is an elected official and is convicted of certain qualifying felonies, including bribery, corruption, perjury, and other offenses related to their official capacity.
  • HB 1428 would allow TRS to act as a mediator in balance billing disputes.

Staff pointed out that the legislature did not pass any bills related to a cost of living adjustment (COLA), TRS-ActiveCare, or pension studies. Other major bills affecting TRS include the following:

SB 1954

This bill allows Optional Retirement Program (ORP)-eligible employees who are not notified properly additional time to elect ORP participation. The proposed bill creates an error correction process for reporting an ORP employee to TRS when the employee is not eligible for TRS. The person would be restored to ORP participation and member, state, and employer contributions related to the incorrect reporting, plus interest, would be paid to the employee’s ORP account. Amounts contributed to TRS that are in excess of participant contributions due to ORP would be refunded to the individual.

SB 1663

SB 1663 provides a number of member friendly benefit and administrative changes. It allows the TRS board to go into executive session to discuss particular investment transactions, strategies, portfolios, and other potential transactions related to private investments if the board determines that deliberating or conferring in an open meeting would have detrimental effect on TRS’s negotiations with third parties or place TRS at a competitive disadvantage in the market. The bill provides TRS with the authority to charge late fees on late reports by reporting entities.

It further allows TRS to add an additional five years of service credit when determining whether an early age reduction is applicable and the amount of the reduction, for a 100 percent joint and survivor annuity payable at the death of an active member. The bill amends current law to provide that disability retirees with less than 10 years of service credit who choose a $150 per month annuity for the number of months of membership to allow their beneficiaries to receive any remaining member contributions as an additional death benefit if the disability retiree dies before the period ends. The bill also moves the TRS sunset review to 2025.

SB 1664

SB 1664 bill provides IRS code compliance, statutory corrections, and member friendly benefit changes. It provides additional time for TRS members to purchase sick and personal leave service credit at retirement and corrects an error referencing the TRS board rather than the Texas Higher Education Coordinating Board to certify state contributions to the ORP.

SB 1665

This bill continues the use of derivatives and external managers capped at 30 percent of total assets and repeals the sunset dates on the authorities.