Blog

10 Jan 2014

Aetna Settlement in Lawsuit Impacts Some TRS Members

by rvarney in TRS, Update

Message from Tim Lee, TRTA Executive Director

Correcting Information Originally Provided Regarding Aetna Settlement

TRTA strives to provide the best, clearest, and most accurate information available on all issues pertaining to the Teacher Retirement System of Texas (TRS) and our members’ interests.

Last week, we learned about a class action lawsuit settlement between Aetna and those who have received payment or compensation for out-of-network coverage as part of their benefits through Aetna (the determined class of people represented by this legal settlement).

Based on the information we received, we developed an update that stated that a member receiving information from Aetna about the lawsuit did NOT have to do anything to be a participant in the class action settlement.

This information is inaccurate. A claimant wanting to participate in the class action settlement MUST complete the forms that are being provided by Aetna as part of this settlement.

A complete description of the action needed on those forms is provided in TRTA’s revised update below. If you have filed away your Aetna form, lost it, or just discarded it, you can download the forms by clicking here (http://nebula.wsimg.com/a7360ba6f4cbbba96355bb1e74f67fac?AccessKeyId=01F1A4624253D6F9587B&disposition=0). You may also choose to contact Aetna UCR Litigation to request an additional copy of the forms (1.800.600.3079).

I deeply regret and apologize for providing inaccurate information about this settlement. As I said, we take our role of providing accurate and timely information very seriously, and we are all disappointed in our service to you when we make mistakes.

We will work diligently to assure our members that mistakes like this are not made in the future.

Sincerely,

Tim Lee
TRTA Executive Director

(Begin TRTA Updated Article on Aetna Settlement)

Aetna Settlement in Lawsuit Impacts Some TRS Members: CORRECTED AND NEW INFORMATION

Last week, the Texas Retired Teachers Association (TRTA) sent out an Inside Line article regarding a lawsuit being settled by Aetna. As a member of the Teacher Retirement System of Texas (TRS) who participates in the TRS-Care medical insurance program, you may have received or may soon receive a notice from Aetna in the mail regarding this lawsuit.

A settlement under which Aetna agreed to pay up to $120 million has been given preliminary approval by the New Jersey District Court. The settlement relates to class action litigation over payments for out-of-network benefits. The litigation for this case began in 2007 over payments for out-of-network benefits. This litigation is known as MDL 2020 (originally filed under the plaintiff name Cooper).

Although our article was reviewed by parties with first-hand knowledge of the Aetna settlement prior to being published, additional information has established that some of the instructions provided by TRTA regarding how to receive payment from this settlement are INCORRECT.

If you received the lawsuit notice from Aetna, PLEASE READ THE CORRECTED INFORMATION PROVIDED BELOW. We have also included some NEW INFORMATION not previously provided.

Who is receiving this notice?

All Aetna policy holders whose benefit structure includes in-network and out-of-network benefits may receive this notice. The settlement is not limited to TRS-Care or Texas Aetna coverage. These notices are going out to Aetna policy holders nationally.

You may receive this notice if you used out-of-network providers and/or benefit options through TRS-Care at any time since 2001 and through 2013.

Anyone who receives the notice can partake in the Class Action Suit and can be reimbursed up to$40 per year (this amount may be less depending upon the number of people who accept the settlement proposal).

If I receive the notice, what should I do? (CORRECTED INFORMATION INCLUDED IN THIS SECTION)

In order to receive these reimbursements, you should NOT opt out. If you are affected by this settlement, you are automatically eligible to receive up to $40 per year in which you had eligible claims. In order to receive your settlement, you must select Option 1 on the Subscriber Claim Form. This should be on page 7 of the document you received. You should also complete pages 8 and 10 of the document. Return these forms to: Aetna UCR Litigation – Subscriber, c/o Berdon Claims Administration LLC, P.O. Box 15000, Jericho, NY 11853-0001.

The information you return to Berdon Claims must be postmarked no later than March 28, 2014.

Previously, TRTA instructions said you had to do nothing to receive this settlement. The CORRECT information is that you must select Option 1 and return that page (7) along with pages 8 and 10 to Aetna UCR Litigation with a postmark no later than March 28, 2014.

What if I need to submit a claim for extensive out-of-pocket expenses? (NEW INFORMATION INCLUDED IN THIS SECTION)

If you feel that your claims warrant more attention due to extensive out-of-pocket expenses, you would need to submit a claim and show proof of your balance billing activity. This would mean you would be opting out of the settlement and pursuing a personal claim. To do this, you must select Option 2 on the Subscriber Claim Form. Please note that you cannot select both options 1 and 2. Those completing Option 2 also need to complete and return pages 8, 9, and 10.

Those who qualify will receive between 3-5% of the allowed amount. As an example, if a plan paid out of network at 80% of regular and customary, and allowed $100 of a $150 charge, the member could get 3-5% of the $100 that was allowed. If it was a TRS member that was held to the proprietary fee schedule and may have been allowed $75, they would get 3-5% of the $75.

If you feel that you should submit a claim because of extensive out-of-pocket expenses, you should contact the Aetna class counsel. You can reach them by calling 1.800.600.3079 or Aetna UCR Litigation, c/o Berdon Claims Administration LLC, P.O. Box 15000, Jericho, NY 11853-0001.

The number provided above is not for the insurance company, but for the class counsel settlement team. The insurance company itself legally cannot assist in completing claims, but can provide assistance by printing Explanation of Benefits (EOBs) and claim information.

Members who submit claims must elect to recover from either the general fund ($40/year) or the fund requiring documentation. Members CANNOT recover from both funds.

I’m not sure if I had extensive out-of-pocket expenses. How do I learn more? (NEW INFORMATION)

Included in the document sent out by Aetna UCR Litigation on page 15 is a Claims Information Request Authorization Form. You may complete this form and return it to Aetna UCR Litigation to receive a copy of the claims information made available to the Settlement Administrator by Aetna in connection with this lawsuit.

You may also contact Aetna to receive EOBs and other claim information by calling 1-800-US-AETNA (1-800-872-3862).

Does this settlement have anything to do with the American Affordable Care Act?

This settlement is not related in any way to the Affordable Care Act (ACA or sometimes referred to as Obamacare). This settlement is part of a Class Action Lawsuit brought by various medical providers from the state of New Jersey, but does have national implications for all Aetna policy holders that have in-network and out-of-network benefits as part of their plans.

When can I expect to receive my payment if I qualify for this settlement?

Aetna has not yet provided a timeframe for when payments will be distributed. Because this is a proportional or pro-rata distribution, all claims will be paid at the same time. Since Aetna insures millions of people, they expect to receive a very large number of claims. This process may take a substantial amount of time. All claims are first reviewed and evaluated and then claimants with deficient claims are given a chance to cure them. After the Court approves the distribution, payments will be made to eligible claimants based on the Settlement administrator’s findings. Aetna asks for your patience at this time.

Will TRS-Care experience any changes in benefits or costs this plan year due to this settlement?

No.

Our Sincerest Apologies

TRTA knows that receiving information about class action lawsuit settlements can be both unsettling and confusing, and the article sent out last week contributed to this confusion. We apologize for providing you with the incorrect information and hope that the corrected information provided today is helpful to you.

IMPORTANT: If you read last week’s update and discarded the documents you received from Aetna UCR Litigation, please contact them as soon as possible to request an additional copy. You may reach them at 1.800.600.3079.

Finally, if you have any additional general questions about this settlement, please email us at info@trta.org and we will do our best to answer. Thank you for being a TRTA member. We appreciate your support! If you are not a member, please contact our office at 1.800.880.1650 and we will be happy to assist you with any membership questions you may have.

23 Dec 2013

TRTA: Looking Forward to 2014!

by rvarney in TRS-Care, Update

The Fight to Preserve our TRS-Care, Pension Protection, TRTA Members Focus on Upcoming Primary!

We have come to the end of 2013. What a great year this has been for TRTA members and all TRS retirees! The TRTA Board of Directors, state and local leaders and staff are grateful for your support.

Many of you have paid your annual dues for the current membership year. Thank you for your tireless support. We appreciate your dedication to making TRTA the most knowledgeable, active, and effective organization protecting and improving retirement benefits for all current and future TRS retirees.

If you have not had a chance to renew your dues, or if you are new to TRTA and want to join in our efforts as we work to protect your pension and health care benefits, you still have time! Though our TRTA office is closed for the holidays December 23 through January 2, you can send an email to our TRTA membership team directly at membership@trta.org.

Recent News Further Indication TRS Fund is in Good Shape

Both the Teacher Retirement System of Texas (TRS) and the Employees Retirement System of Texas (ERS) recently reported on their actuarial condition. TRTA members worked to pass vital legislation this past session to protect the long-term solvency of the TRS pension trust fund. The Actuarial Soundness Bill (SB 1458) made our pension fund actuarially sound, provided a benefit increase to 2/3 of all current retirees, and put us on a path to provide benefit increases for retirees in the future. In fact, TRTA believes these enhancements have made TRS Texas one of the best funded public retirement plans in the country (especially amongst other funds that are not coordinated with the Social Security program).

TRS also has more money in the trust fund than any other time in its history: over $119 billion protecting the retirement security of 1.3 million Texans who have or are working in our great public schools!

Shortly after TRS reported on its actuarial condition, we learned that ERS is not as fortunate. While ERS also had landmark legislation passed to improve its actuarial condition, the ERS fund does not have a “funding” period and does not meet the statutory definition of actuarial soundness.

We raise this point simply to point out that TRS Texas ended the legislative session and the state fiscal year in better shape than many pension detractors said was even possible, and is one of the best public pension plans in Texas. We know that there are still many challenges ahead of us and that changing market conditions could create a circumstance that makes the fund not “actuarially sound.” Today, though, if you are an education employee or retiree in the TRS Texas pension fund, you are in one of the best funded, most secure retirement systems in the state!

This is all thanks to the work of each and every member of TRTA!

Looking Ahead to 2014

We end 2013 with this as just one of TRTA’s many accomplishments; but as we look ahead to 2014, the challenges for our TRS retirees continue to grow.

One of our members wrote to us asking a great question about media coverage and public perception of state retirement funds. We have reprinted this question and our official TRTA response at the end of this update. It is a great question and provides vital information for every TRTA member.

The truth is that our TRS fund and its defined benefit traditional retirement plan will remain under attack by the ideologues and political powers that simply hate public pension funds. News about pension funds that are struggling due to bad decisions made by political leaders in other states or cities will influence opinions about pension plans here in Texas. Most of the time, these “comparisons” do not hold up to scrutiny; but those who are anti-public pensions will not care about the facts—they simply want to incite distrust of the plans and dismantle them altogether.

These struggles may grow even more challenging as other state or municipal funds make more drastic changes to their plans and influence decision makers here. We must remain vigilant and prevent those attacks from impacting our TRS Texas pension benefit plan.

TRTA is also preparing for serious challenges with TRS-Care. If you are a TRS retiree or you will be, and you participate or plan to participate in this retiree health insurance program,we need your help.

The health care plan will have a serious funding shortfall in the coming legislative session.TRTA will spend an entire year meeting with legislators, retired TRS members, active school employees, media representatives, and anyone else who may have an interest in addressing this upcoming crisis. We know the crisis is coming. We have 2014 to rally every TRS retiree and future retiree together to help maintain this vital health care coverage.

While we will be extremely focused on TRS-Care, we will also be watching the progress of ideas through Congress that could impact TRS benefits. This includes mandatory Social Security for states like Texas (where not all employees are coordinated with the federal program), as well as progress on repealing or modifying the Government Pension Offset (GPO) and the Windfall Elimination Provision (WEP). These federal issues and others may keep TRTA very active with our federal legislative agenda in 2014.

TRTA members have been very effective this year during and after the legislative session by reaching out to legislators. As the new year approaches, we should be ready to educate, advocate for our important benefits, and VOTE.

While you may think your vote in a primary is not important or may believe your friendly legislator does not need your support in a primary election, please know that EVERY TRTA MEMBER SHOULD VOTE IN THE UPCOMING PRIMARIES. Your power is in your vote! We MUST know where the candidates stand and send people who are dedicated to preserving our benefits to Austin.

Conclusion

Again, thank you for a great year. This was one of the most successful years in TRTA history! 2014 will bring new challenges and opportunities for success. Please be ready to stand with us and fight for the benefits you have earned serving Texas public schools.

TRTA Response to Member on Media Attacks Against Public Pension Plans

TRTA Member Question:

“Bill King of the Houston Chronicle keeps writing articles saying that public pensions should be stopped. Some might be bad but not TRS. From a quick reading of one of King’s articles I saw no reason to stop TRS and it appeared to me that maybe he is hoping that the mutual fund companies can get their hands into the money of TRS.

I mentioned this to a friend in Houston who is a retired realtor and he is for King and said that the State of Texas has to help with funding TRS when they run out of money. I emailed TRS and they said that had never happened. The State does put some matching funds in at the beginning but I consider that their part in helping to support education for the Texas citizens.

Do you have any thoughts or information you can send me on this?”

TRTA Response:

This is a great question and one that many of our members have probably heard before or thought of themselves. The information our member received from TRS is correct: the state of Texas makes a yearly contribution to the TRS pension fund. Active employees that will benefit from TRS when they retire also make contributions to TRS. These contributions are used by TRS to make investments and generate more money, which goes directly into the pension fund.

The state contribution is presently 6.4% (of active employee payroll), and will increase to 6.8% in 2014. The active employee contribution is presently 6.4%. This means that 6.4% of an active teacher’s paycheck goes directly into their retirement fund. This will increase gradually over time to 7.7%, starting with a small increase in 2015 to 6.7%.

In all, the contributions from both the state and the active members equate to approximately 40% of the value of the TRS pension fund. The other 60% is generated by investment earnings. TRS is the fiduciary of these funds, meaning its employees are responsible for making both long and short-term investment decisions that will protect and grow the fund’s value.

Just yesterday, TRS reported a total fund value of $119.7 billion! This means that 60% of that value, or $71.82 billion, was generated by investment earnings alone!

The Texas Legislature has a constitutional responsibility to provide for a retirement plan for our public education employees. Unlike some other states, Texas has never skipped a “payment” to TRS, meaning they have always made a contribution to the pension fund that is between 6% and 10% of active employee payroll. 6% is the statutory minimum, while 10% is the statutory maximum that the state may contribute.

Without a doubt, contributions from the state provide a stable source of revenue for TRS, as do active employee contributions. After the passage of Senate Bill 1458 in 2013, another revenue stream for TRS will go into effect. In 2015, school districts that do not contribute to Social Security will provide a 1.5% (of payroll) contribution to the pension fund. These sources of revenue, combined with the expert ability of the TRS investment team, ensure that your pension fund will be healthy for many years to come.

Today, TRS is considered “actuarially sound.” The state of Texas’ definition of “actuarially sound” is that a fund should be able to pay for all of its liabilities within a 31 year period. If you think of this like a mortgage, this would translate into TRS being able to pay the entire pension for every current and future retiree already vested in the system within a 31 year period. TRS could accomplish this goal within a 28 year period based on its present value and revenue sources.

TRS is not in danger of running out of money and has a strong financial plan for the future. Even when TRS lost billions of dollars during the market crashes in 2008 and 2009, the state did not have to rescue the fund. Market fluctuations do occur and will again in the future, but it is the smart investment decisions made by TRS that enable the fund to ride the waves and recover. TRS reached a funding level of $68 billion in February 2009, and has since gained back more than $51 billion.

Our members also know that TRS is the only form of retirement security guaranteed to our public education retirees in Texas. This is because 95% of school employees in Texas do not pay into Social Security. The TRS fund is more stable than the federal Social Security (SS) program, and provides nearly three times as much in benefits to TRS retirees as SS does to SS participants. The cost to pay into TRS or Social Security is the same for public education employees and Texas taxpayers, but the benefits and retirement security provided by TRS are far greater.

It is to the benefit not only of our retirees but also the state of Texas that TRS remains strong. TRS retirees stimulate the economy by spending their benefits in Texas. Retirement benefits generated $694 million in state revenues and $272 million in local government revenues in 2012. TRS benefits also provided for almost 92,000 jobs across Texas in 2012.

While naysayers such as King will continue to be critical of pension funds, not all pension funds are alike. TRS Texas is the sixth largest pension fund in the nation and one of the strongest in the world. The success of a pension fund depends on a variety of factors, and TRS Texas uses a balanced and educated approach to managing the retirement security of hundreds of thousands of retirees.

26 Nov 2013

Thoughts of Thanksgiving

by rvarney in TRTA, TRTF, Update

Thanksgiving is just a couple days away and, like you, I too am reflecting on all that I am thankful for. Of course, at the top of the list I am thankful for my wonderful family, their health, for safe travels as I visit local TRTA meetings and attend conferences around the country.

I am also thankful for TRTA, for you, and for our TRTA members and all those who have or are serving in our public schools.

We have much to be thankful for this year. TRTA members worked tirelessly during the past legislative session and we passed legislation that made our TRS pension trust fund actuarially sound! What a great accomplishment to know that our TRS pension trust fund is on sound financial ground and that we are on track to have one of the best funded public pension funds in the country.

We are also grateful for the much needed pension increase for almost 195,000 TRS retirees. We know this has been a long time in the making, and we are grateful to the TRTA members that helped make this legislation a top priority in the Legislature.

We are also grateful for a membership that is ready to get back to work and fight for an increase for those retirees who did not get the raise. We know that all our TRS retirees are hoping to get an increase in their annuity and TRTA is not done working for you! We will continue to fight and represent your needs before the Legislature next session.

We are thankful for all the Texas legislators who unanimously supported our TRTA legislative agenda. We are especially grateful for Senator Robert Duncan and Representative Bill Callegari for authoring SB 1458 and who worked so closely with TRTA to ensure the passage of this vital legislation.

Beyond all else, the TRTA Board of Directors, our TRTA volunteer leaders, your TRTA staff and I are thankful for our TRTA members! It is your support, dedication, organization, leadership, tenacity, and heartfelt commitment to this organization that has made our efforts so successful this year.

Thank you for reading these emails, taking action when asked, working with your legislators, communicating with your fellow TRS retirees and for helping protect TRS benefits for all current and future TRS retirees.

As a final note, I am passing along a special greeting from Beth Unite who is our Texas Retired Teachers Foundation Coordinator. The TRTF Board of Trustees has been very active helping retirees in need, working with the West, Texas relief efforts, promoting our defined benefit retirement plan as a true legacy in this state, and helping Texas active school employees. Please read the message below and know that your generosity is making a difference in hundreds and thousands of lives around Texas.

Yours,
Tim Lee

With Thanksgiving just days away, it is the perfect time to reflect on the many things for which I am most thankful. Of course, my family, friends, and health are some of the more obvious reasons to be grateful, but I am also extremely thankful for YOU, our devoted TRTA members and advocates. In trying to live a life filled with more gratitude, I feel especially indebted to you for the support you have shown our sister charitable organization, the Texas Retired Teachers Foundation. It is humbling to be a part of an organization that cares so much for their fellow educators.

Since the beginning of November, you have helped us to raise over $72,000, allowing us to be only 28% from reaching our goal! These generous donations in response to our annual appeal are overwhelming and are going to a great cause. Just last week, TRTF received three “A Helping Hand” applications from retirees who are unable to make ends meet due to unexpected illnesses, car and home repairs. Your thoughtfulness will make a difference, not only in the lives of retirees, but in future educators as student scholarships are awarded. Also, active teachers will receive grants to fund innovative projects that further enhance the educational experience of our students.

Many of you have written notes that express your wish to give but the inability to do so due to financial constraints. Your support is equally important to our cause and your desire to help is much appreciated. Contributions come in all different shapes and sizes and your willingness to spread the word of our Legacy Campaign is priceless. Promoting a positive image of public education and educators by providing factual information to our retirees, active teachers, community and legislators on the many issues, including healthcare is invaluable.

May you all have a safe and enjoyable Thanksgiving as we celebrate not only our freedom but the joy of being included in a family of individuals with a common interest and aspiration to take care of our own.

–Beth Unite, TRTF Coordinator

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