TRS-ActiveCare Moves to Regional Pricing

TRS-ActiveCare will move to a regional pricing system beginning September 1, 2022, in response to Senate Bill (SB) 1444 which enables employers to compare TRS-ActiveCare’s statewide premiums to other plans’ regional premiums based on regional costs of care.

The new regional ratings will ensure that TRS-ActiveCare rates align with the costs of healthcare in the area. Lower cost regions will see lower cost rates when compared to the state average. Districts in higher cost regions will likely see increases to their healthcare rates.

The Regional Rating Process

TRS will begin with the average statewide rate. From there, adjustments to each regional rate will be made based on all the following:

• Costs of care in each ESC region
• Regional overall accessibility of care
• Ages, genders, and health issues of each enrolled population
• Historical health care costs in each region
• Health plans offered and the local network of doctors and hospitals
• Whether or not the majority of participants in each region cover just themselves or their family members

Risk Pool

Although regionally rated, TRS-ActiveCare plans will still share the risk pool of all participants in the state. In other words, districts with a high-cost claimant will still share those costs across all participants. Risk won’t be limited to just participants in the local district or region, as is often the case in alternative plans.

Resources

More information on the changes can be reviewed on TRS’s website.