TRS-ActiveCare
Teacher Retirement System of Texas
Health Care Benefits for Texas Public School Employees
TRS-ActiveCare- NEW! 2011 - 2012 Premium/Rate Schedule
- NEW! 2011 - 2012 Enrollment Guide
- NEW! 2011 - 2012 Guía de Inscripción
- NEW! 2011 - 2012 Plan Highlights
- 2010-2011 Enrollment Guide
- Guía de Inscripción 2010-2011
- 2010-2011 TRS-ActiveCare Benefit Booklet
- Folleto de Beneficios 2010-2011
- PPO Network - Find a Network Provider
- Forms
- Pooling Premiums
- Split Premiums
- Prescription Drug Coverage - Medco (pg.44)
- Preferred Presciption Drug List/Formulary
- Important Terms and Example
- Section 125
- Flexible Spending Accounts
- Health Savings Accounts
- Changing Benefits
- Request for Exceptions
- Blue Cross Blue Shield Medical Policy Guidelines
- 2011 Plan Year Premium/Rate Schedules
On September 1, 2002, TRS introduced TRS-ActiveCare, a new statewide health coverage program for public education employees established by the 77 th Texas Legislature. Today, participation in that program has grown to over 445,969 employees and dependents. Of the 1,246 districts/entities eligible to participate in TRS-ActiveCare, over 88.9 percent, or 1,108 now do so.
El Paso ISD joined TRS-ActiveCare effective January 1, 2011.
Although TRS-ActiveCare offers health maintenance organization (HMO) options throughout Texas, these options are not available in the El Paso area. Employees have the four PPO plan options administered by Blue Cross and Blue Shield of Texas and Medco.
ActiveCare Plans 1-HD, 1, 2 or 3 – find specific information about each of the four plans. View the current online Benefit Booklet, and link
directly to Blue Cross and Blue Shield website. You can also link to the Medco web site for a list of Maintenance Rx‘s and Formulary.
Frequently Asked Questions (FAQs): TRS-ActiveCare
Legislation/Rules and Regulations governing the TRS-ActiveCare Health Care Benefits
2011-2012 Open Enrollment Timeline
2011-2012 Spring Open Enrollment for coverage effective September 1, 2011
This enrollment will cycle EPISD back to a 12-month plan year (September 1, 2011 through August 31, 2012). The Plan Year will be the
same 12-months each year moving forward. All deductibles and maximum out of pocket expenses reset to zero on September 1, 2011.
Every employee must go online and reaffirm your benefit elections for the new plan year, which begins on September 1, 2011 and continues through August 31, 2012.
The reason that EPISD is requesting for every employee to reaffirm is because:
- Enrollment is for the 2011-2012 Plan Year (12 months of coverage).
- TRS-AC plan options experienced plan design changes to include increased deductibles and copays as well as premium increases.
- If you are declining coverage for any eligible dependent, you must do so online and complete the Declination Certification Form which must be mailed to TRS-AC in care of BCBS of Texas.
- A new pledge must be entered for the Flexible Spending Account Plans (Medical and/or Dependent Care).
April 6 - Presentations will begin on Wednesday, April 6 and continue through Wednesday, April 27. For more specific information on dates and times, Presentation schedule.
April 19 - On-line Enrollment Link will open on Tuesday, April 19 and close on Friday, May 20
April 20 – On-line Enrollment Assistance is scheduled through Saturday, May 7th. For more specific information on dates and times, On-line Enrollment Assistance schedule.May 20 - On-line Enrollment Link will close at midnight
August 15, 2011 - First Deduction for 2011-2012 elections will be taken.
September 1, 2011 - Frist day of coverage under new 2011 -2012 Plan Year.
PLAN INFORMATION
TRS-Active Care Highlights and List of Covered Preventative Care Services
TRS-ActiveCare Comparison of Plan Changes 2011 to 2011/2012
2011- 2012 Premium/Rate Schedules
For Plan Year 2011 -2012 (September 1, 2011 to August 31, 2012) deductions will be taken a month in advance of coverage unless deductions are pro-rated in accordance with the schedule below:
Contributing members of TRS
Employees working at least 30 or more hours per week. District Contribution = up to $300 a month
Grandfathered Employees. District Contribution = up to $300 a month
Employees working at least 10 but less than 30 hours per week. District Contribution = $225 a month
Transportation employees assigned at least 20 but less than 30 hours per week. District Contribution = $262 a month
Employees Not Contributing to TRS
Employees working at least 10 but less than 20 hours per week. District Contribution = $130 a month
Pooling Funds
Married employees who are both active contributing TRS members may “pool” their district contributions to use toward the cost of TRS-ActiveCare coverage for family coverage.
Contact Employee Benefits for Assistance
E-mail hrbenefits@episd.org
Phone (915) 881-2670
Employee Benefits
Education Center Boeing
6531 Boeing Drive
El Paso, Texas 79925-1086
Communication to Employees
Dear Employees:
Email sent: Wednesday, March 30, 2011 - Spring 2011-2012 Open Benefits Enrollment is just around the corner
Spring 2011-2012 Open Benefit Enrollment begins April 19, 2011.
To receive information from the Associate Superintendent of Human Resources, Mr. Robert Almanzan.
Please open the attachment.
Letter from Mr. Almanzan
Email sent: Tuesday, April 5, 2011 - 2011-2012 TRS-AC Highlights & Preventive Care List
As we gear up for the 2011-2012 Spring Open Enrollment, you are encouraged to visit the Employee Benefit Website at www.episdbenefits.org
When you click on the TRS-ActiveCare tab, you will find all the information you need to prepare for the upcoming Open Enrollment. The elections you make will cover you for twelve months beginning September 1, 2011 and ending August 31, 2012.
To view the changes from the current plan options to the new 2011-2012 options, click on the TRS-ActiveCare Comparison of Plan Changes 2011 to 2011/2012.
The Online Enrollment opens on Tuesday, April 19, 2011 and closes May 9, 2011.
In addition to the updated TRS-AC tab, the Employee Benefit Website has an up-dated Benefits Overview page, updated information on
the Flexible Spending Account and the Health Savings Account and more.
Please open the attachment.2011-2012 TRS-AC Highlights & Preventive Care List
If you are having difficulties opening the attachment, PDFs require the Acrobat Reader for viewing. If you do not have Acrobat Reader,
you can download Acrobat Reader by clicking on the link below or copying and pasting to into your browser:
www.adobe.com/products/acrobat/readstep2.html
Email sent: Monday, April 18, 2011 - NEW Declination Process for 2011-2012 Open Benefit Enrollment
Very Important Message to any employee eligible to enroll for the health plan as offered by TRS-ActiveCare (TRS-AC) and
chooses to waive/decline coverage for self or any eligible dependents for the 2011-2012 plan year.
Every year, any eligible employee who waives/declines coverage for self and or any eligible dependents (to include spouse
or dependent children eligible for coverage under TRS-AC), must go through the EPISD Online Enrollment process to decline
coverage. The declination process must be completed each year.
Additionally, TRS-AC requires that the TRS-ActiveCare DECLINATION CERTIFICATION Form be completed and that the employee
mail the completed form directly to TRS-ActiveCare if they are declining coverage for either themselves and/or any eligible
dependents.
If you and your spouse works for EPISD and you are waiving/declining coverage for your spouse because they are electing coverage for self and family, you must complete the form to indicate that you are waiving/declining coverage for spouse
and children and your spouse must complete the form indicating that they are waiving/declining coverage for you.
Every eligible dependent that you will be waiving/declining coverage for must be listed, as well as a reason for the declination. Eligibility for future coverage is dependent on TRS-AC receiving the form. Please keep a copy for your records. If a future change of status requires enrollment under TRS-AC and no Declination Form is on file,TRS-AC may delay the effective date of coverage.
For your convenience, the TRS-ActiveCare DECLINATION CERTIFICATION Form is attached. The Form can also be found on the
Employee Benefits Website under the Forms tab. Please open the attachment. NEW Declination Process for 2011-2012 Open Benefit Enrollment
Email sent: Tuesday, April 19, 2011 - Important Message about the Spring Open Benefit Enrollment
I know that it is tempting to ignore the Spring Open Enrollment but before you do nothing, please keep these points in mind:
- EPISD is cycling back to a 12-month plan year effective September 1, 2011 and ending August 31, 2012.
- TRS-ActiveCare Health Plan coverage options have changed as well as the premium/rates that may affect you. Please review this carefully.
- If you participate in a Flexible Spending Account and would like to have it during the next plan year (September 1 through August 31), you MUST go on-line and pledge your new contribution amount. THIS IS REQUIRED EVERY YEAR. If you do not make a new pledge, no FSA will be available.
- If you are declining TRS-ActiveCare coverage for self or any eligible dependent (to include spouse or children) whether covered before or never covered under your coverage, you ARE REQUIRED to go on-line and decline coverage. THIS IS MANDATORY EVERY YEAR. If you fail to decline and do not complete the Declination Form as required by TRS-AC, coverage may be delayed in the future.
- Even if you are not making any changes, by enrolling on-line, you are reaffirming your benefit selections.
It is your responsibility to make an informed decision and to complete the on-line enrollment process based on your circumstances.
The Online Enrollment System is now open! It will remain open until midnight May 9, 2011.
On Wednesday, April 20, from 4:00 to 6:00 p.m., we will be at the Professional Development Center to provide assistance with the Online Enrollment Process.
The next Open Enrollment Benefit Presentation is scheduled for Wednesday, April 27, at the Bowie Fine Arts Building.
Email sent: Thursday, April 21, 2011 - As your employer, EPISD offers various tax reduction benefits through payroll deduction
As you enroll for your benefits, be informed about the tax reduction programs that can help you with your tax liability, provide extra
cash flow each paycheck, and provide a savings account for out of pocket expenses.
These programs can only be offered by your employer through payroll deductions.
If you are interested in learning more, open the attachment EPISD offers various tax reduction benefits through payroll deduction.
If you are currently (2011) enrolled in a Flexible Spending Account, the FSA Plan Year began January 1, 2011 and will continue through
August 31, 2011. EPISD has adopted the "Grace Period" that allows an additional 75 days to incur eligible expenses, the deadline is November 14, 2011. The date of service NOT THE DATE OF PAYMENT controls the reimbursement.
The "Grace Period" allows for claims incurred during a Flexible Benefit Plan Year to be filed or substantiated with TaxSaver Plan up to 90 days after the end of the plan year. For 2011, the deadline for filing or substantiating the claim is November 30, 2011.
If you want to pledge a new amount for the new plan year (September 1, 2011 through August 31, 2012), you will need to enroll during this open enrollment period and pledge a new amount.
FSA deductions for the 2011-2012 Plan Year will begin on September 1, 2011 and continue through August 31, 2012.