The Pulse, April 2018
Every year, TRS reviews the funding needed for TRS-ActiveCare for the coming year and determines if any benefit and/or premium changes are needed to have enough funds to pay for health care. Based on this recent analysis, TRS staff recommended moderate benefit and premium changes for TRS-ActiveCare and Health Maintenance Organizations (HMOs), which the TRS Board of Trustees adopted to take effect Sept. 1, 2018.
The TRS Board of Trustees also adopted modest medical and pharmacy benefit changes to reduce the average premium increase to 5.7 percent, instead of 7.2 percent. The main benefit changes were to add new freestanding emergency room (ER) copays and adjust specialist copays, deductibles and maximum out-of-pocket amounts. TRS continues to see growth in the use of freestanding ERs, which leaves the health care program and its participants with high out-of-pocket costs for services that cost much less through urgent care centers, office visits and even ERs connected to hospitals. The separate, higher copay for freestanding ERs reflects these higher costs and pattern of this trend.
Summary of "What's New" for 2019 TRS-Activecare (pdf)
TRS-ActiveCare and HMOs 2018-19 Plan Highlights (pdf)
Beginning this annual enrollment, only current TRS-ActiveCare 2 participants can stay enrolled in the TRS-ActiveCare 2 plan. Recent analysis on health claims and finances revealed a net decline in membership and a steady rise in high cost claims that make the plan unsustainable.
TRS-ActiveCare participants still have a choice between TRS-ActiveCare 1-HD and TRS-ActiveCare Select.
Freestanding ERs may seem like a convenient alternative to traditional hospital ERs and can be confused with urgent care centers, but one visit can cost you thousands of dollars more than a visit to a primary care doctor or urgent care. Know where to go for care.
Annual enrollment for TRS-ActiveCare participants will begin on July 1, 2018 and end on Aug. 24, 2018. Specific enrollment dates will vary by district, so check with your benefits administrator to find out when you can enroll. This is your annual opportunity to make changes to your health benefits without experiencing a special enrollment event. Please be sure to take the time to consider all your options.