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Teachers Retirement System

 TRS Board Adopts Changes to TRS-ActiveCare

The Pulse, June 2017

The TRS Board of Trustees adopted benefit and premium changes for TRS-ActiveCare plans that take effect Sept. 1, 2017. Aetna will continue to administer your health plan benefits and provide you access to its broad network of doctors and hospitals. You can still enroll in one of three plans: TRS-ActiveCare Select, TRS-ActiveCare 2, and TRS-ActiveCare 1-HD. You may also have the choice of a regional HMO, depending on where you live.

For more information, visit Aetna's dedicated website for TRS-ActiveCare

2017-2018 TRS-ActiveCare Plan Highlights

Information About TRS-ActiveCare HMO Plans

TRS-ActiveCare Plan Summaries and Rates
2017-18 TRS-ActiveCare Plan Summaries and Rates
Effective Sept. 1, 2017
TRS-ActiveCare PlansActiveCare 1-HDActiveCare Select or ActiveCare Select Whole HealthActiveCare 2
Deductible(per plan year

In-Network

$2,500 employee only/
$5,000 family

$1,200 individual/
$3,600 family

$1,000 individual/
$3,000 family

Out-of-Network

$5,000 employee only/
$10,000 family

N/A. This plan does not cover out-of-network services, except for emergencies.

$2,000 individual/
$6,000 family

Out-of-Pocket Maximum*

In-Network

$6,550 individual/
$13,100 family

Only includes covered expenses incurred by that individual

$7,150 individual/
$14,300 family

$7,150 individual/
$14,300 family

Out-of-Network

$13,100 individual/
$26,200 family

N/A. This plan does not cover out-of-network services, except for emergencies.

$14,300 individual/
$28,600 family

Coinsurance

In-Network

20%

20%

20%

Out-of-Network

40% allowed amount

N/A. This plan does not cover out-of-network services, except for emergencies.

40% of allowed amount

Premiums

Employee Only Premium

$351

$514

$714

  +Spouse

$991

$1,264

$1,694

  +Children

$671

$834

$1,062

  +Family

$1,316

$1,589

$2,004

*Per plan year; medical and prescription drug deductibles, copays, and coinsurance count toward the out-of-pocket maximum.

Regional HMO Plan Summaries and Rates
2017-18 TRS-ActiveCare Health Maintenance Organization (HMO) Plan Summaries and Rates
Effective Sept. 1, 2017
Regional HMO Options FirstCare Scott & White Health Plan Blue Essentials Access

Deductible
(per plan year)

$750 individual/
$2,250 family

$1,000 individual/
$3,000 family

$500 individual/
$1,000 family

Out-of-Pocket Maximum*

$6,000 individual/
$12,000 family

$6,550 individual/
$13,100 family

$4,500 individual/
$9,000 family

PCP (Primary Care Physician)

$20 copayment
 

$20 copayment
First Primary Care Visit for illness - $0 copayment

$25 copayment

Premiums

Employee Only

$514.82

$561.04

$460.50

  +Spouse

$1,287.60

$1,263.08

$1,113.72

  +Children

$816.07

$888.42

$720.86

  +Family

$1,298.52

$1,400.98

$1,181.28

*Per plan year; medical and prescription drug deductibles, copays, and coinsurance count toward the out-of-pocket maximum.

 

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