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06 Jun 2014
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TRTA Policy Discussion: TRS Care, Day 4

Today, the Texas Retired Teachers Association (TRTA) continues its discussion about the Teacher Retirement System of Texas (TRS) sustainability study of the retiree health insurance program TRS-Care.

In our first Inside Line article about the TRS-Care study, we reviewed Option 1: Pre-funding the long-term liability. We also discussed Option 2: Funding on a pay-as-you-go basis for the biennium. Option 3 covered funding for 10-year solvency.

Today, we will review Option 4: Retirees pay full cost for optional coverage. 

By Texas state law, TRS-Care 1, which is catastrophic coverage, must be provided to TRS-Care participants at no cost to the participant (meaning the retiree pays no premiums, although they still pay deductibles and co-pays, etc.). Therefore, every TRS retiree is eligible to participate in TRS-Care 1. Many retirees opt out of TRS-Care entirely, but many prefer the benefits available in TRS-Care 2 and 3 and choose one of those as their coverage.

TRS-Care 2 and 3 are considered optional coverage. Though retirees pay premiums for these levels of coverage (as do their dependents who also utilize the coverage), TRS-Care 2 and 3 are still subsidized significantly. As you know, the state, school districts and active employees all pay into TRS-Care, and much of the funding provided by those resources helps to subsidize the costs associated with TRS-Care 2 and 3.

If Option 4 were to be put into place, all TRS-Care participants using TRS-Care 2 or 3 would have to pay for the full cost of their insurance above the actual cost for TRS-Care 1. Even with the subsidies from the state, school districts and active employees (the current contribution levels of 1.0% from the state, .55% from the school districts and .65% from the active employees), the total costs of TRS-Care 1 are not covered completely.

This means that benefits for TRS-Care 1 would be reduced in the Option 4 scenario, although the coverage for TRS-Care 1 would still be free (no premiums) to the participants. This could also mean benefit reductions for TRS-Care 2 and 3 in the future, and/or higher out-of-pocket expenses for deductibles and co-pays for all levels.

This would impact the non-Medicare population primarily, as Medicare is the primary payer for those who are Medicare-eligible and TRS-Care is secondary.

Examples of possible increases with Option 4:

For example, the current premium for TRS-Care 3 retiree-only coverage for a non-Medicare retiree with 25 years of service would increase from $295 per month to $616 per month (estimate based on best data available).

With a non-Medicare spouse, the rates would increase from $635 to $1,690 (estimate based on best data available).

Premium increases for optional coverage (again, in this case that means TRS-Care 2 and 3) would be required each year to keep pace with medical cost trends.

To summarize, Option 4 places the majority of the cost burden for TRS-Care on the participants who are utilizing more than just catastrophic coverage. This financial burden could be so significant that many participants drop out of the program entirely.

It is also possible that the higher premiums would force many participants to use TRS-Care 1 coverage only. If these participants have major medical procedures performed, they would struggle to pay the high out-of-pocket costs associated with those procedures.

As you know, TRS retirees do not receive regular cost-of-living adjustments, and an option such as this one does not take into the account the stagnant incomes of its participants.

Please bear in mind that as we review the TRS Sustainability Study on TRS-Care that no action will be taken on the program’s funding crisis until the Legislature convenes again in 2015. In the meantime, it is important to be aware of the possibilities, share your concerns with us and with each other, and let your fellow retirees and any active school employees who will retire soon know about the study.

Preserving our health care access and options is a responsibility that we all share and can achieve far more by working together! TRTA will continue to provide as much information as we can about the health care funding options being studied by TRS.

Thank You!

Thank you for being a member of TRTA. If you are not a member and would like to join, please contact our Membership Department at 1.800.880.1650.

Please continue reading the Inside Line over the next two weeks as we provide detailed updates about the remaining five options being studied by TRS to improve and sustain the TRS-Care health insurance program.

Our next update is about Option 5: Mandatory participation in the Medicare Advantage and Medicare Part D plans.

Share these articles with every retiree you know, as well as with active school personnel! Your input is important. Your membership and support are crucial. Thank you for all your help and support.

Contact us at info@trta.org with your questions, thoughts, or concerns.

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06 Jun 2014
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Good News and What’s Ahead

Last week, the Teacher Retirement System of Texas (TRS) held its regularly scheduled meeting of the Board of Trustees to discuss various issues, including the TRS-Care retiree health insurance program and the TRS-Active Care active employee health insurance plan.

Good News
The TRS staff shared some good, if not great, news with the trustees. The pension trust fund now has $126 billion, the most amount of money that has ever been held in trust for our public education retirees in the history of the fund’s existence.

The Texas Retired Teachers Association (TRTA) Executive Director, Tim Lee, had the opportunity to testify at the meeting, sharing his appreciation of the great work the TRS staff does to maintain and grow the pension fund as well as the concerns of TRTA members about the impending shortfall to the TRS-Care retiree health insurance program.

Tim also expressed his support for the active educator community and their health care plan, TRS-Active Care, which is also in need of additional funding.

Several members of the TRS Board of Trustees made impassioned statements about the Texas Legislature’s role in funding both health care programs and their own role in providing support for both active and retired teachers.

Although Texas statute prohibits TRS and the trustees from advocating a position or lobbying the government, the sentiment expressed by these board members was uplifting. They expressed a spirit of cooperation as TRS, the Legislature, and TRTA work together to preserve the health care plans and minimize hardship on retirees and active school personnel.

Your Concerns 

We have heard from many of our own members in regards to the sustainability study being conducted by TRS. Your concerns are being heard, not just by TRTA but by TRS as well. Please know that the study is being done to prepare the Legislature in advance of the shortfall crisis.

TRS is reviewing multiple options and sharing those options with us in an effort to educate and inform. TRTA has NOT taken an advocacy position on any of the options being studied yet and the Legislature has not received the results of the study (the study will be completed by September and presented to the Legislature in the fall).

If you are concerned about the options being discussed, the best thing you can do right now is to SHARE the information you are receiving with every retiree and pre-retiree that you know! Any changes that are made to the TRS-Care health insurance plan will impact all current and future participants.

What we do know is that without intervention from the Texas Legislature, everyone will be affected in an adverse way by either increased premiums, reduced benefits, or both. This means it is up to ALL OF US to be ready and armed with information well in advance of the legislative session. We must review the information now, formulate a plan together, and pursue it together!

Our best hope for protecting TRS-Care is a united front. Please encourage others to get involved now. As one TRTA member said, “it is time to wake up!” If we are not active next session, we could be facing the unacceptable outcome of losing one of the best benefits available to our public education retirees.

Remember too that TRS cannot lobby: it is up to TRTA and its thousands of members to represent your interests in the Texas Legislature. Join us, work with us, spread the word!

Medicare Advantage Update

TRS provided some updated information about the TRS Aetna Medicare Advantage plan. Betsey Jones, Director of Health Care Policy and Administration for TRS, provided the enrollment figures for the Medicare Advantage plan and the Medicare Part D prescription drug plan. The current participation rate in Medicare Advantage is 68%, while the Medicare Part D plan has 81% participation.

TRS recently began auto-enrolling TRS-Care participants who are aging into Medicare into the Medicare Advantage plan. This means that participants on TRS-Care who are turning 65 years old will automatically become enrolled in Medicare Advantage, with the ability to opt out. This process began in April 2014.

To improve enrollment in Medicare Advantage, TRS is considering new methods, such as mailing postcards to eligible members and offering to provide one-on-one phone calls to members to help them learn more about the program. They will also create an informational video to better explain the plan as well as the purpose of Medicare Parts A, B and D and how these insurances impact members financially.

TRS-Care Sustainability Study Update

Betsey Jones also reviewed the progress of the sustainability study for TRS-Care. The project will be completed by September 2014. She revealed that the non-Medicare population costs the TRS-Care program six times as much as the Medicare population. 32% of TRS-Care participants are non-Medicare.

As of April 2014, TRS-Care has 243,100 participants:

  • TRS-Care 1: 30,100 (12%)
  • TRS-Care 2: 55,000 (23%)
  • TRS-Care 3: 158,000 (65%)

TRS-Care will be solvent through FY 2015, but will be insolvent by FY 2016. The shortfall, which was projected to be $1 billion, has improved slightly to approximately $900 million. This is due to a recent rise in active education employee payroll, which had been flat since 2009.

Options for helping resolve the TRS-Care funding crisis are not mutually exclusive and it will possible to combine some options. As we mentioned earlier, we do not know yet which of these options may be instated, whether it is one option, a combination of several, all of them or none at all. It is important, however, that we know how each option affects the participants and the program’s financial status.

The 9 options being reviewed in the sustainability study are (TRTA has reviewed four options so far and will continue its review of the remaining five options over the next two weeks):

  1. Pre-fund the long-term liability
  2. Fund on a pay-as-you-go basis
  3. Fund for 10-year solvency
  4. Retiree pays full cost for optional coverage
  5. Mandatory participation in the Medicare Advantage and Medicare Part D plans
  6. Defined contribution-establish a health reimbursement account (HRA) for non-Medicare retirees
  7. Modify eligibility for TRS-Care 3 standard plan
  8. Steerage plan design for the non-Medicare population
  9. Combine TRS-Care and TRS-Active Care

Several board members expressed their desire to keep the plan affordable with good benefits for its participants and made suggestions for other elements that should be included in the study. The study is ongoing, and the final version will be made widely available to all members of TRS.

TRS-Care Premiums 

The Board also discussed premiums for TRS-Care. It is the intent of the Legislature not to increase premiums for TRS-Care participants for 2014-2015. The TRS staff provided the following information:

  • A 1% increase in premiums for TRS-Care equals $3.8 million
  • A 10% increase in premiums for TRS-Care equals $38 million
  • If premiums were to increase by 10% now, TRS-Care would have a negative fund balance of $754 for FY 2016-17.

Following the intent of the Legislature, the TRS Board of Trustees confirmed that will be no premium increases for TRS-Care for 2014-2015To see a complete list of premium rates, please click here.

However, there have been some benefit changes to TRS-Care 2 and TRS-Care 3, which can be viewed by clicking here.

TRS provided the following statement regarding the changes:

“Consistent with ACA requirements, the deductibles and coinsurance paid by TRS-Care 2 & 3 participants will now be counted to satisfy the out-of-pocket maximum beginning with the 2014-2015 plan year. Since this allows participants to reach their out-of-pocket maximum faster, out-of-pocket limits will be increased slightly to achieve the same approximate actuarial cost to the plan. This eliminates the need to increase our participants’ premiums for another year.

Also, when TRS-Care 2 & 3 participants have their medically necessary lab work done at a Quest Lab, they will have no out-of-pocket cost due to a special arrangement Aetna has with Quest. Even if you can’t go to a full service Quest lab, many providers can have your specimens sent to a Quest lab for processing via Quest couriers.”

Thank You!

Thank you for being a member of TRTA. If you are not a member and would like to join, please contact our Membership Department at 1.800.880.1650.

Please continue reading the Inside Line over the next two weeks as we provide detailed updates about the remaining five options being studied by TRS to improve and sustain the TRS-Care health insurance program. We will resume with TRS-Care Sustainability Study Option 5 later this week.

Share these articles with every retiree you know, as well as with active school personnel! Your input is important. Your membership and support are crucial. Thank you for all your help and support.

Contact us at info@trta.org with your questions, thoughts, or concerns.

Read More
03 Jun 2014
0

TRTA Policy Discussion: TRS Care, Day 2

Today, the Texas Retired Teachers Association (TRTA) continues its discussion about the Teacher Retirement System of Texas (TRS) sustainability study about the retiree health insurance program TRS-Care.

In our first Inside Line article about the TRS-Care study, we reviewed Option 1: Pre-fund the long-term liability. Today, we move on to Option 2: Fund on a pay-as-you-go basis for the biennium.

If Option 2 sounds familiar to you, that is because the current method for funding TRS-Care is the pay-as-you-go basis. However, because TRS-Care is facing a funding shortfall of approximately $1 billion, changes would need to be made to this methodology to pay for the shortfall itself and for the costs associated with the program for the next funding cycle.

Presently, TRS-Care is funded by several sources: retirees pay premiums and co-pays; the state makes a contribution equivalent to 1.0% of the active public education payroll (presently that amount is $285 million per year); the school districts contribute .55% of the active teacher payroll; active employees contribute .65%; and other contributions, such as federal dollars, are sometimes contributed to the program.

With Option 2, TRS has presented several possibilities for increasing the contribution amounts:

  • Increasing the state contribution only;
  • Increasing the state, school district and employee contributions proportionally;
  • Increasing the state, school district, employee and retiree contributions proportionally; and
  • Making the state contribution based on the number of covered retirees instead of the active teacher payroll.

As we mentioned in yesterday’s article, we are starting with a deficit: the $1 billion shortfall. If, for example, the contribution amounts did not change AT ALL from all sources, that deficit would continue to grow each biennium. With this information we can see that the shortfall would be $1 billion in the 2016-17 biennium, then would be $1.5 billion in the 2018-19 biennium. This deficit would only continue to grow at the current contribution rates.

This means that every legislative session, the Legislature would have to revisit the issue, as this option does not establish a long-term funding solution for the program. In this coming biennium (2016-17), they would have to pay for the deficit PLUS any expected costs for 2016 and 2017. Then the following session, they would have to pay for the next deficit (expected to be even higher) PLUS any expected costs for 2018 and 2019.

TRTA would be returning to the Legislature every session asking for more and more funding simply to keep the program functioning for another two years. This occurs because TRS-Care does not EARN any money (like the pension fund does), but only accrues expenses. Because there is no guarantee that the state would bear sole responsibility for increasing this funding every session (remember, there are school district, active employee and retiree contributions), it is possible that retiree premiums could continue to rise every session as well as taxpayer contributions.

Here are a few examples of how Option 2 could work:

Increasing the state contribution only:

  • State increase from its current 1.0% (of payroll) to approximately 2.5%

Increasing the state, school district and employee contributions proportionally:

  • State increase from 1.0% to 1.7% (an increase of .7%)
  • School district increase from .55% to .9% (an increase of .35%)
  • Active employee increase from .65% to 1.1% (an increase of .45%)

Increasing the state, school district, employee and retiree contributions proportionally:

  • State increase to 1.43%
  • School district increase to .89%
  • Active employee increase to .93%
  • Retiree premiums increase 85% (estimated) as of September 1, 2016

The above-mentioned figures would be for the 2016-17 biennium only, and would be recalculated for the following biennium to make up for the new shortfall and pay for the program’s costs for 2018-19.

Making the state contribution based on the number of covered retirees instead of the active teacher payroll:

This method of determining contributions merely changes calculated, but does not eliminate the need for those contributions. In other words, the shortfall still exists as do the projected costs. Instead of looking towards payroll to pay for the cost of the program, the state would look to the number of participants in the program.

For example, the state’s current 1.0% contribution is roughly equivalent to paying $106 per TRS-Care participant per month (the school district’s .55% is equivalent to $71 per month, the active employees .65% is equivalent to $80 per month). If we assume that all three will bear a proportional increase in their contributions, this is like saying the state will have to pay $177 per participant per month, the school districts will have to pay $100, and the active employees $115 (for the 2016-17 biennium).

Basically, this method of calculating contributions uses a dollar amount as opposed to a percentage. As we mentioned earlier, this does not change the fact that in this Option 2 scenario, there is still a $1 billion shortfall to pay for as well as the actual cost of the program for 2016-17.

No Easy Solution

As you can tell from TRTA’s review of these two TRS-Care options, the challenge ahead of us next legislative session is significant. Even as we continue to study these difficult recommendations about TRS-Care sustainability, we must not lose our commitment to the cause. Thousands of public school employees and retirees are counting on TRTA to lead an unyielding, unwavering, unrelenting effort to protect these vital health care benefits.

We have faced significant challenges before, but our success is rooted in our members’ and friends’ willingness to be engaged and vocal.

As we continue to educate our members and all interested parties on this important topic, please know that we will offer educational and advocacy resources to use when discussing this health care crisis with our elected leaders. They need to hear from you as we prepare for the coming legislative session.

Keep in mind, our TRTA members will receive a special advocacy guide in the upcoming issue of our association publication, The Voice. Look for it this summer.

Thank You!

Thank you for being a member of TRTA. If you are not a member and would like to join, please contact our Membership Department at 1.800.880.1650.

Please continue reading the Inside Line over the next several days as we provide detailed updates about the remaining seven options being studied by TRS to improve and sustain the TRS-Care health insurance program. Our next update is about Option 3: Funding for 10-year solvency.

Share these articles with every retiree you know, as well as with active school personnel! Your input is important. Contact us at info@trta.org with your concerns.

Read More