The Teacher Retirement System of Texas (TRS) Board of Trustees met Friday, September 1, 2017 to approve the new TRS-Care retiree health insurance plans as laid out during the first called Special Session of the 85th Texas Legislature. As members of the Texas Retired Teachers Association (TRTA) may recall, Governor Greg Abbott added TRS-Care to the special session call this summer after retirees across the state expressed serious concerns about high deductibles and premiums.
TRTA Executive Director Tim Lee provided public comment.
“At every level,” Lee said, “the leaders of the legislative branch (and executive branch) were involved in addressing retirees concerns.” Lee included thanking Governor Abbott, Lieutenant Governor Dan Patrick, and Speaker of the House Joe Straus. “The leaders in the state have not forgotten about the service educators have given to Texas.”
More importantly, Lee expressed thanks for the commitment hundreds of thousands of retired and active teachers put into contacting legislators about improving the plans. Lee thanked the trustees and TRS staff for sharing information in a timely fashion.
Lee lauded TRS for working to the Legislature to “provide the information we needed to help improve this situation.”
Lee also addressed the issue of return-to-work provisions. These provisions have been impacting more and more retirees, and they have very little tolerance for minor infractions. Nonetheless, these provisions sometimes penalize retirees who never intended to infringe upon the rules.
The TRS Board expressed its gratitude for the information, and reaffirmed its commitment to working with TRTA and stakeholders to find areas of improvement.
TRS Chief Health Care Officer Katrina Daniel made a presentation to the board members with the plan changes as reflected by the additional $212 million provided by the Legislature.
Daniel addressed the concerns retirees have had about medical providers accepting Medicare Advantage. Daniel stated that 96 percent of providers were willing to bill Humana for the Medicare Advantage plan.
“I’ve yet to see a provider that’s not willing to bill Humana,” Daniel said.
TRTA members have reported from all over the state that various doctors or providers have said they will not take the Humana Medicare Advantage program. Today’s discussion pointed out that many times the providers mistake TRS-Care plan as an “individual Medicare Advantage” plan. These providers are experiencing confusion about the far richer benefits provided through the TRS-Care “group” plan.
If your doctor says they do not accept Medicare Advantage, print this form and bring it to them. They can direct any questions they have to TRS.
Since TRS-Care is its own group, it can set different rules and provide richer benefits for retirees as well as special program components that help ensure provider acceptance. TRS is working on communications strategies to clarify these differences with providers. TRS is urging retirees to speak to providers who are claiming not to accept the TRS-Care coverage.
Daniel also detailed the communication plan TRS has crafted to reach out to retirees about the health care changes. She described the plan as “very robust.” As a part of this communication effort, TRS is providing retirees with an enrollment kit. These enrollment kits include a document that can be taken to health care providers explaining the payment situation.
“We’ve never undertaken a communications effort on this scale,” said Daniel.
TRTA shared the communications timeline provided by TRS in an Inside Line recently. This timeline establishes the plan TRS has made for informing plan participants about changes to TRS-Care and includes the start and end dates for the much-anticipated in-person retiree seminars that will begin in October.
The original plan was for TRS to have 88 meetings over 40 days, but those plans have since been derailed due to Hurricane Harvey. TRS has released the schedule for these seminars, and retirees will have the opportunity to RSVP online starting Sept. 11, 2017.
During his presentation, Tim Lee stressed the importance of releasing the retiree information seminar schedule as soon as possible, as many retirees who may have concerns about whether or not to stay with the plan may make an irrevocable decision without having enough information to make an educated choice. He also asked TRS to consider administrative and procedural accommodations for retirees as the changes to TRS-Care are drastic.
The TRS website is also a great source of information about all current and future TRS-Care plans:
High Deductible Health Plan for Retirees under Age 65
HD Monthly Premium Rates
HD Plan Prescription Information for 2018
TRS has also provided TRTA with the list of approved generic drugs that will be covered under the TRS-Care high deductible health care plan for retirees under the age of 65. You can view that list by clicking here.
NOTICE: Current Plan Year (2017) Prescription Changes
Retirees under age 65 using the current TRS-Care plans have also been transitioned to a new prescription plan for the remainder of the current plan year (September 1, 2017 through December 31, 2017). CVS Caremark will now be the prescription drug provider. Learn more by clicking here. You can also click the links below to check on prescription costs for the remainder of 2017.
New Medicare Advantage Plan for Retirees Age 65 and Older
New Medicare Prescription Drug Plan
- Prescription drug benefits for non-Medicare participants will be integrated with medical benefits and subject to the plan’s deductible and out-of-pocket maximums.
- Prescription drug benefits for Medicare participants will be provided through a Medicare Part D plan.
- Please note, the above chart does not mention that the mail order cost refers to a 3-month supply. (Click this link to learn more).
- Unlike the under age 65 prescription plan, the new provider, CVS Caremark SilverScripts, will not take over until January 1, 2018.
What If I Can Not Afford Dependent Premiums?
Medicare eligible retirees and dependents thinking about leaving TRS-Care need to be cautious. If you leave TRS-Care, TRS may not let you re-enroll.
Please remember, your benefits do not change until Jan. 1, 2018. This extra time will allow you to consider all of your options. TRS is just starting the education process.
The TRS Medicare Advantage plan is a group plan, which contains rich benefits. The plan cannot be replicated in the individual market.
However, many TRTA members have expressed that the TRS-Care plan is unaffordable. If you are looking to the individual market as an alternative to TRS-Care, know that TRTA has heard your concerns.
We are studying the individual Medicare market, and we are working with potential vendors to find alternative plans. We will make an announcement about these options with our members this fall.
What Do These Plan Changes Mean for the Future of TRS-Care?
While the full results of these changes remain to be seen, it is expected that TRS-Care will still experience a revenue shortfall by the next biennium. Benefit and premium changes resulting from the special session of the Legislature are projected to increase the FY2021 shortfall by $212 million with no further rate and benefit adjustments by the TRS board for the 2019 plan year.
Thank you for your membership to TRTA. Our hearts go out to those affected by Hurricane Harvey.
If you know a retiree who is not yet a member of TRTA, please encourage them to join.