TRS-Care, ActiveCare changing plan administrators

This article appeared in the Spring 2020 issue of The Classroom Teacher.

Trustees’ decision to change administrators is separate from upcoming decisions on what the ActiveCare plans will cover and how much they will cost members.

During the February meeting of the TRS Board of Trustees, the board took action to approve new health insurance plan administrators for TRS-ActiveCare and both TRS-Care plans (Medicare-eligible and non-Medicare-eligible). TRS negotiates the health plan administrator contracts frequently in an effort to achieve new savings for the plans. Staff members estimate that the changes will save the insurance plans hundreds of millions of dollars in the upcoming year, hopefully mitigating any reductions in benefits or increases in premiums.

What is changing and when?
Administration of TRS-ActiveCare and the plan for retirees not eligible for Medicare (TRS-Care Standard) will switch from Aetna to Blue Cross Blue Shield (BCBSTX). For active employees, the change will go into effect Sept. 1, 2020; the retiree change will begin Jan. 1, 2021. TRS-Care Medicare Advantage will move to UnitedHealthcare (UHC), from Humana, beginning Jan. 1, 2021. Participants will continue under their current benefits and providers until these dates.

What about my prescriptions?
The pharmacy benefit administrators (CVS Caremark for ActiveCare and TRS-Care Standard, and SilverScript for TRS-Care Medicare Advantage) will not change.

Can I keep my doctor?
TRS maintains that BCBSTX has a broader provider network, and most ActiveCare and TRS-Care Standard enrollees’ current providers are in the new network. It is too early now to check on your specific doctor(s) but BCBSTX will roll out its provider search tool this summer.

With regard to the Medicare Advantage plan, TRS says “99% of the providers that TRS-Care participants use the most” will be in the UHC network. Some retirees in the Medicare Advantage plan have been concerned about their ability to stay with Houston Methodist Hospital, since the hospital recently terminated its relationship with UHC. However, the hospital’s website includes a note that Medicare Advantage plans are not affected by the termination. TRS also points out that its MA plan has the same benefits whether participants are in or out-of-network. “Medicare Advantage participants can go to any doctor they choose as long as they accept Medicare and agree to bill UnitedHealthcare.”

Will the benefits or premiums change?
ActiveCare plan benefits and premium rates are adopted annually and will be considered at the board’s April meeting. TCTA will notify our members when these decisions are made.

TRS does not intend to increase premiums or decrease benefits for the retiree plans through 2021.

Special programs such as “Go365” — a feature of the Medicare Advantage plan — are unique to the current plan administrators, but may be replaced by similar programs offered by BCBSTX and UHC.

To learn more about the upcoming changes, click here.