TRS board adopts health insurance plan changes

TRS logoThe Teacher Retirement System (TRS) Board of Trustees met Thursday to discuss premium and plan design changes for both TRS-Care and ActiveCare, the health insurance programs offered to retired and active public education employees. Both programs have faced significant structural funding issues that have caused the retiree plan to be financially unstable and the active employee plan to have employee premiums and out-of-pocket expenses that are greater than comparable private sector plans.

ActiveCare

The Board adopted premium changes for TRS ActiveCare for the upcoming plan year. The good news is that those premium increases are going to be relatively small compared to historical increases. The bad news is that the increases will likely be borne entirely by employees, unless individual school districts choose to increase their contributions to employee health insurance. The state contribution remains $75 per employee per month and has not changed since the health insurance program was created in 2001.

ActiveCare premium increases and plan design changes for the upcoming year:

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  • ActiveCare 1 HD: 0%
  • ActiveCare Select: 2.2 to 2.3%
  • ActiveCare 2: 5%
  • Maximum out-of-pocket limits are increased for all plans.
  • Retail pharmacy co-pays for maintenance drugs are increased to $35 for generic drugs, $60 for preferred brand, and $90 for non-preferred brand.
  • HMO increases range from 5% to 13% depending on the HMO and tier of coverage.

TRS-Care

TRS-Care has faced serious structural funding problems for several years now, with claims expenditures outpacing the funding stream allocated by the Texas legislature. This problem was further exacerbated in 2011 when the legislature cut state funding for Care in half for one year as a result of a projected state revenue deficit. In 2015, the legislature was forced to allocate $768 million simply to keep TRS-Care solvent through 2017 when the legislature will meet again. At the end of 2017, Care is projected to run out of funds and will require over $1.3 billion in additional funding to operate for another two years, or more preferably a more long-term solution including potential funding changes will have to be enacted. As reported here after the last TRS Board meeting, because of a cash flow issue where some revenue dedicated for the current plan year may not be available until after the end of 2017, there is a possibility that the cash balance for Care will be negative. As a result, some plan design changes for the upcoming plan year are necessary to account for this looming negative fund balance. It is important to remember that it has been 12 years since there have been plan design changes to TRS-Care, and premiums have remained unchanged since 2005.

TRS-Care changes recommended by staff and adopted by the board:

  • There will be no increase in premiums for the upcoming plan year.
  • Medical deductibles and out-of-pocket expenses will be increased for all plans.
  • Existing pharmacy co-pays are increased by $3 to $25 by tier for the traditional plans.
  • A retail maintenance co-pay structure for the traditional prescription drug plan will be implemented.ThinkstockPhotos-162674067-pills
  • Effective January 1, 2017, the prescription drug plan for Medicare eligible members will be the Medicare Part D plan, with members who do not have either Part A or Part B remaining in the traditional prescription drug plan. Pharmacy co-pays for Medicare Part D will remain at current levels.

Both TRS-Care and ActiveCare are currently being studied by the legislature as the result of interim charges in the Senate and House of Representatives. Both plans will be hot topics when the legislature meets again beginning in January. Stay tuned to TeachtheVote.org for updates.

 

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9 thoughts on “TRS board adopts health insurance plan changes

  1. Pingback: Teach the Vote’s Week in Review: June 17, 2016 | Teach the Vote

  2. Barbara Lien

    Teaching as a career is both mentally and physically demanding. Between the T-TESS and the lack of financial support needed by educators, I feel that we are no longer being treated as public servants but public slaves. The state will not attract new teachers or keep many qualified current ones with this type of treatment (yes, that was a pun). In the end, it will be students who will suffer.

    Reply
    1. Bernice Gould

      I agree with Barbara Lien. In one district where I worked, our planning times were regularly used by administrators until an attorney, who sat with me at a meeting with my principal who stated that I didn’t attend planning time meetings. The principal was informed about the laws specific to planning time and my choice in attending any meetings scheduled during educator planning times.

      Additionally, during a planning time meeting scheduled by district personnel, it was stated that, “While you are home watching Dancing with the Stars or any other tv program, you can go into the new RTI software and play around with it to learn the system.” Many of us who were career teachers were doing schoolwork already at night and on weekends. We didn’t have time to watch any tv.

      This is a real life example, not opinion, of how teachers were becoming working slaves to adminisrtators and districts. Those of us who retired from the profession need the support of ATPE to protect the few benefits to which we were entitled. Speaking for myself, I had so little free time, that I neglected my health and did not use my health benefits when I was teaching due to all of the after school and weekend hours required to meet expecations of the principal and school district.

      Reply
  3. Dabney S Johnson

    Josh, I appreciate all you do and information about the fight to fund TRS Care. All teachers need to stay active and write this legislature. Vote and urge others to vote and call. If you expect everything to just work out, good luck. Support ATPE, they support us in our fight for health dollars. Retired teachers need all the help they can get.

    Reply
  4. Amy

    I don’t understand why healthcare is offered to the whole instead of the individual districts. Police, fire departments, and other public servents do not pay anywhere close to what we pay. In the corporate world, the more people you have working for your company, the better the insurance at the lowest cost. There are thousands of teachers across Texas, why can’t we all join together?

    Reply
    1. Emily

      I totally agree with Amy, why do we pay so much? If we as a state pull together and have one low flat rate, wouldn’t that be better. Yes our district received a raise but we all know any raise we get goes directly to insurance and even that doesn’t even come close.

      Reply

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