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The Teacher Retirement System Board of Directors met in late February 2010 for three days in Katy, Texas, with a lengthy agenda that included extensive overviews of the different divisions within the TRS agency. The Board also took action on a handful of items, most notably approving changes in premium costs and in plan design of the health insurance plans under its jurisdiction.

TRS-Care

The funding structure for TRS-Care insurance for retirees is sufficient to allow the TRS Board to maintain current premium rates for next year. The portion of Medicare-eligible retirees in the plan is growing more quickly than the non-Medicare-eligible group, which is beneficial to the health insurance fund. Coverage was added for an annual physical or a well-woman gynecological exam; we will link to details on the TRS website when they become available.

TRS-ActiveCare

Premium rates for TRS-ActiveCare will be increased by 7% across the board next fall. The increase reflects the continuing upwards trend in the costs of medical care and prescription drugs. TRS is using part of its reserve fund to subsidize a portion of the increase – without the use of the reserve fund, the increase would be closer to 12%.

NOTE: This chart does not reflect amounts paid by the employer toward health insurance premiums; employers must pay at least $225/month for each employee.

 

2009-10

 2010-11 Dollar change

ActiveCare 1

      

  Employee Only

$278

 $297 $19

  Employee + Spouse

$633

 $677 $44

  Employee + Children

$443

 $474 $31

  Employee + Family

$697

 $746 $49

ActiveCare 1-HD

      

  Employee Only

$245

 $262 $17

  Employee + Spouse

$600

 $642 $42

  Employee + Children

$382

 $409 $27

  Employee + Family

$785

 $840 $55

ActiveCare 2

      

  Employee Only

$370

 $396 $26

  Employee + Spouse

$842

 $901 $59

  Employee + Children

$589

 $630 $41

  Employee + Family

$926

 $991 $65

ActiveCare 3

      

  Employee Only

$498

 $533 $35

  Employee + Spouse

$1,134

 $1,213 $79

  Employee + Children

$794

 $850 $56

  Employee + Family

$1,247

 $1,334 $87

In addition, a few plan changes were recommended and approved for the 2010-11 plan year:

  • For all levels of ActiveCare, the out-of-network allowance will be set at 50% of billed charges, after which plan design provisions will be applied. This is intended to clarify an area of confusion regarding rates charged for enrollees who utilize non-network providers.
  • For ActiveCare 2 – the office visit copay for primary care physicians will increase from $25 to $30, and for specialists will increase from $35 to $50.
  • For ActiveCare 1 and 1-HD – to comply with federal guidelines, the employee-only deductible for ActiveCare 1 will increase from $1,150 to $1,200, and the ActiveCare 1-HD employee-only and family deductibles will both increase from $2,300 to $2,400.

TRS staff referred to an Austin American Statesman article which reports that the state employee health insurance plan is also facing rising costs, and state employees could experience higher premiums and lower benefits in the coming plan year.

HMO changes

TRS also contracts with three HMOs to provide services in certain regions of the state. TRS does not have authority over the premium rates for the HMOs. Several changes are being made to plan design and premium costs for the FIRSTCARE, Valley Baptist Health Plan, and Scott & White HMOs, and more information can be found on the TRS website.

Posted: 02/26/10