The TRS Board of Directors met in a special meeting June 3, 2021, to approve new ActiveCare premium rates and plan changes.
The short version: ActiveCare rates will increase an average of 6.2%, with the Primary+ plan premiums rising by 5.5% and Primary, high-deductible (HD) and ActiveCare 2 premiums by 8%. Only the HD plan will see changes in benefits. Open enrollment for the upcoming school year will run July 12-Aug. 23.
TRS Chief Health Care Officer Katrina Daniel explained that the rate increases were about 2.5% higher than they would otherwise have been, due to the problems caused by Districts of Innovation offering competing local plans and driving employees with higher claims to ActiveCare. Read more about the issue here — note that the legislature closed the DOI loophole, so this should only be a concern for one more year while the contracts end on those competing local plans.
Please note that these are the total premium rates, and do not factor in the state and local contributions. Your costs would be at least $225 lower than the total monthly premium listed here, and even lower if your district contributes more than the required amount.
| TRS ActiveCare Primary | FY 2022 Total Monthly Premium |
Change from 2021 |
|---|---|---|
| Employee Only | $417 | +$31 |
| Employee & Spouse | $1,176 |
+$87 |
| Employee & Children | $751 |
+$56 |
| Employee & Family | $1,405 |
+$104 |
| TRS ActiveCare Primary+ | FY 2022 Total Monthly Premium |
Change from 2021 |
|---|---|---|
| Employee Only | $542 | +$28 |
| Employee & Spouse | $1,334 |
+$70 |
| Employee & Children | $879 |
+$45 |
| Employee & Family | $1,675 |
+$87 |
| TRS ActiveCare HD | FY 2022 Total Monthly Premium |
Change from 2021 |
|---|---|---|
| Employee Only | $426 | +$32 |
| Employee & Spouse | $1,209 |
+$89 |
| Employee & Children | $772 |
+$57 |
| Employee & Family | $1,445 |
+$107 |
| TRS ActiveCare 2 | FY 2022 Total Monthly Premium |
Change from 2021 |
|---|---|---|
| Employee Only | $1,013 | +$76 |
| Employee & Spouse | $2,402 | +$180 |
| Employee & Children | $1,507 |
+$114 |
| Employee & Family | $2,841 |
+$214 |
The only changes in benefits were in the high-deductible (HD) plan, in order to conform with federal and IRS guidelines for HD plans.
See below for the changes in the ActiveCare HD plan benefits
| ActiveCare HD Plan Benefit | FY 2021 | FY 2022 |
|---|---|---|
| Individual In-Network Medical Deductible Family In-Network Medical Deductible |
$2,800 $5,600 |
$3,000 $6,000 |
| In Network Coinsurance | 20% | 30% |
| Out-of-Network Coinsurance | 40% | 50% |
| Individual In-Network MOOP* Family In-Network MOOP |
$6,900 $13,800 |
$7,000 $14,000 |
*Max Out Of Pocket
There are no boundary changes for the three ActiveCare HMO plans: Baylor Scott & White (Central Texas), BCBS West TX (Panhandle and West Texas) and BCBS South TX (Rio Grande Valley).
The two BCBS plans are increasing premiums, also partly in response to the adverse selection caused by competing local plans in the area.
| Proposed Premiums | BS&W | South Texas BCBSTX |
West Texas BCBSTX |
|---|---|---|---|
| Employee Only | $542 (-$9) | $525 (+$33) | $597 (+$62) |
| Employee & Spouse | $1,363 (-$19) | $1,264 (+$82) | $1,444 (+$156) |
| Employee & Children | $872 (-$11) | $820 (+$53) | $936 (+$101) |
| Employee & Family | $1,568 (+90) | $1,346 (+$87) | $1,533 (+$163) |
| Total increase from FY 21 | 0% | +6.8% | +11.8% |
The Scott & White HMO is not proposing a premium increase, but is changing benefits.
| BS&W HMO Benefit | FY 2021 | FY 2022 |
|---|---|---|
| Individual Medical Deductible | $950 | $1,150 |
| Family Medical Deductible | $2,850 | $3,450 |
| Individual Prescription Drug Deductible* | $150 | $250 |
| Generic Prescription Drug Copay* for 30-day/90-day supply |
$5/$12.50 | $10/$25 |
| Inpatient Cost Sharing | $150 per day copay | Deductible + Coinsurance (20%) |
*Deductible for generic drugs still waived.
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