| 1. Does an employer that participates in TRS-ActiveCare need to notify TRS if they plan to remain in the plan? No. Employers that currently participate in TRS-ActiveCare do not need to notify TRS if they plan to remain in TRS-ActiveCare. 2. When does an employer need to provide notice to TRS? Only employers planning to leave TRS-ActiveCare or employers planning to join TRS-ActiveCare need to notify TRS by Dec. 31 of the year before the plan year they intend to leave or join. Employers wanting to leave or employers wanting to join effective Sept. 1, 2023, will need to notify TRS by Dec. 31, 2022. 3. Is plan year 2022-23 the only year an employer can choose to leave? No. Employers in TRS-ActiveCare that decide to remain in the plan next year can still decide to leave in future years as long as they notify TRS by Dec. 31 of the year before the plan year they intend to leave; and comply with any applicable five-year commitment or exclusion provisions. 4. Can an employer access claims data to compare TRS-ActiveCare to other options for employee health benefits? Yes. TRS is providing this data at no cost to the districts. For information about how to request your claims data, please visit our claims data webpage. 5. If an employer is currently offering alternative group health coverage in addition to TRS-ActiveCare, can they continue, or do they only have one more year to offer the alternative coverage? An employer that participates in TRS-ActiveCare that continues to offer alternative coverage after Sept. 1, 2022, may not continue to participate in TRS-ActiveCare. The law does not grandfather existing alternative coverage. 6. If a participating employer is currently a District of Innovation (DOI) but not offering alternative coverage in addition to TRS-ActiveCare, can they add alternative coverage for the upcoming plan year? Employers that participate in TRS-ActiveCare are already prohibited from providing alternative group health coverage in addition to TRS-ActiveCare. SB 1444 further clarifies that employers are not permitted to offer alternative coverage in addition to TRS-ActiveCare, and the new law provides flexibility for employers by allowing them the option to leave the plan. The prohibition on offering alternative coverage takes effect on Sept. 1, 2022, in recognition that some participating employers may already be offering alternative coverage and may need some time to transition away from those alternative plans in order to remain in TRS-ActiveCare. An employer that participates in TRS-ActiveCare that offers alternative coverage after Sept. 1, 2022, may not continue to participate in TRS-ActiveCare. 7. When will TRS provide more information about how to leave or join TRS-ActiveCare? TRS will continue to post guidance and updates on the Your Future, Your Way landing page and send emails about key developments related to implementation.
8. Why are there five-year commitment and exclusion periods?
The five-year commitment and exclusion periods work to protect TRS-ActiveCare from the impact of employers leaving TRS-ActiveCare to seek low cost coverage and then returning to TRS-ActiveCare only when they experience high claims. That dynamic, called adverse selection, creates volatility in the fund and raises costs for all employers in TRS-ActiveCare.
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| 9. How does this legislation affect TRS-ActiveCare costs? Without this bill, costs would rise more sharply in future years. TRS provides comprehensive coverage employers rely on and will continue to do so with the best premiums possible.
10. If an employer eliminates its alternative coverage entirely to remain in TRS-ActiveCare, can qualified beneficiaries receiving continued coverage under the Consolidated Omnibus Budget Reconciliation Act (COBRA) on the other plan continue their COBRA enrollment in a TRS-ActiveCare plan? No. TRS will not offer continuation coverage to the COBRA beneficiaries of the alternative coverage if the alternative coverage is terminated. The plan’s sponsor is responsible to provide continuation coverage under COBRA. TRS sponsors TRS-ActiveCare. The employer that provides alternative group coverage in addition to TRS-ActiveCare is the sponsor of the alternative coverage. It will be the participating employer’s responsibility to ensure compliance with COBRA for those qualified beneficiaries because TRS will not offer continuation coverage to the COBRA beneficiaries of the alternative coverage if it is terminated. The employer should consult its own legal counsel regarding its COBRA obligations for the alternative group coverage. 11. If an employer decides to leave TRS-ActiveCare and they have COBRA enrollees on TRS-ActiveCare, can those enrollees remain on continuation coverage under TRS-ActiveCare? Yes. TRS-ActiveCare may continue the COBRA coverage if the employer decides to leave TRS-ActiveCare. However, TRS might terminate coverage earlier than the end of the maximum period under certain circumstances, including the following: - Premiums are not paid in full on a timely basis;
- TRS ceases to maintain TRS-ActiveCare;
- The enrollee begins coverage under another group health plan after electing COBRA continuation coverage;
- The enrollee becomes entitled to Medicare benefits after electing COBRA continuation coverage; or
- The enrollee engages in conduct that would justify the plan in terminating coverage (such as fraud).
12. Will TRS offer TRS-ActiveCare COBRA coverage to employees who enrolled in an alternative health plan? TRS is not responsible for covering COBRA continuation coverage for employees of participating employers that offered alternative plans alongside of TRS-ActiveCare in Plan Year 2022-23 and will be terminating these plans as of August 31, 2022. See more information here.
13. If a participating employer submits a Notice of Election to Discontinue form and documentation to TRS, can they change their decision if it’s before Dec. 31?
Once the Notice of Election to Discontinue is complete, and TRS issues a notice of acceptance,, the decision cannot be changed. Once the submitted Notice is accepted by TRS, the Notice is binding and cannot be reversed.
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