Texas Teachers: You have better health insurance options than TRS!

 

The Trouble with TRS

TRS used to be a great deal for teachers and their families.  Unfortunately that's just not the case any more.  We've found that teachers can save significant amounts of money and get better coverage by putting their family on a non-TRS plan.

Example: Why TRS isn't always the best for teachers

Let's look at an example and run a few simple numbers.  Below are the TRS premiums offered for the 2015-2016 school year, straight from the TRS Activecare website and brochure:

TRS premiums 2015

These are the gross monthly costs before any contributions from the state or from your school district.  This year, the average contribution a teacher will receive (state + district) is $225/mo for the teacher only.  Typically, there is no additional contribution for a spouse or family.  Your district may contribute a little more or less, but we'll use the average $225 for this example.

For a single teacher looking at ActiveCare 1-HD, he or she can expect to pay $341 (premium) - $225 (contribution) = $116/mo.  Not bad!

But what if the teacher is married and wants to add his or her spouse on the same plan?  The "Employee and Spouse" premium for ActiveCare 1-HD is $914 (premium) - $225 (contribution) = $689/mo.  That's $573 more each month just to add a spouse!

Similarly for a family of 3 (teacher, spouse, child), the "Employee and Family" premium for of ActiveCare 1-HD would be $1,231 (premium) - $225 (contribution) = $1,006/mo for a family of 3.  That's nearly $900/mo more expensive just to add a spouse and a kid.  Sure, health insurance has gotten expensive, but that is insane!

What if instead of adding a spouse and/or children to TRS, you put them on a private plan?  The answer is your family could save a lot of money AND get better coverage.  Considering that private plans from Blue Cross Blue Shield, Aetna, Humana, Cigna, United, and others similar to ActiveCare 1-HD generally cost between $150-$300 a month depending on your age, it would cost a lot less to put a spouse and/or children on a private plan.

Our couple could put the teacher on TRS ($116/mo) and the spouse on a similar plan from Blue Cross (~$200/mo) for a total of ~$320/mo.  That's less than half than the $689 they would pay on TRS!  And by the way, Blue Cross has many more doctors on their plans than ActiveCare does.

Similarly, our family could find great coverage for the spouse and child for $400-500/mo total instead of an outrageous $1,006/mo on TRS.

The same math also generally holds true for families looking at ActiveCare Select and ActiveCare 2.  The costs for adding a spouse and children is significantly higher on TRS than what the spouse or child could get from an equivalent private plan.

So, why does this happen?

There are likely a couple of reasons:

    1. There is a lack of competition for big group plans like TRS.  It used to be that "getting on the group plan" was the way to go.  Now with a bigger individual plan market, private plans are having to compete whereas the old "group" plans like TRS seem to get a pass.
    2. TRS is subsidizing many retired teachers, private plans are not.
    3. TRS premiums are flat--the same for everybody--whereas private plans increase with your age.  This makes TRS a great option for single teachers near-retirement, but a terrible option for teachers in their working years with families (see math above if you don't believe us).

Are there any risks putting my family on another plan?

It isn’t all a bed of roses, so you will need to consider the trade-offs to putting your family on different plans. First, the biggest impact is that if something major happens, you could be liable for the deductible and max-out-of-pocket for both plans.  This is mitigated by the fact that TRS has "family" deductibles, meaning you'll be paying double anyway if more than one person needs significant care.  Second, you would need to carry two insurance cards (one for each plan). And third, “in network” doctors may vary between the two plans, so there’s a little more to keep track of.

When is the deadline to make changes?

Teachers can make changes to their TRS enrollment status up until 8/31.  Schools will often set deadlines before this to prevent a rush of paperwork. However, you can still work with your benefit administrator up until 8/31 deadline.  You can use this form to document your changes and make life a little easier on your benefit administrator.

It's important to note that you can drop family members from your TRS plan at any time, but you'll want to make sure they qualify  have a qualifying reason within 60 days to enroll in a non-TRS plan.  Family members currently on TRS will qualify since their TRS plan is technically ending 8/31.  Check out other qualifying events or send us an email (info@takecommandhealth.com) and we can help.

What can I do?

We'd love to help you!  We've designed a first-of-its-kind website just for teachers that allows you to compare all of your options - TRS and private plans in your area - side by side.  We'll even factor in your district's contribution amount, help you search for your doctors and prescriptions, and make it really simple to figure out which plans or combination of plans will provide the best coverage for you and your family.  We don't charge any fees for the use of our teacher site and our advice is data-driven and objective.  We think teachers deserve better!

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