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2017-2018 Medical Plan Recommendations

Get an overview of the 2017-2018 Medical Plan Recommendations, including zero premium increases for Basic and High Deductible Plans, increased deductibles, implementation of a spousal surcharge, and more. Stay competitive and aligned with TRS-Care.

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2017-2018 Medical Plan Recommendations

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  1. 2017-2018Medical Plan Recommendations

  2. 2016-2017Medical Plan Review • Continue to align benefits and premiums to meet or exceed those of TRS-Care and remain competitive • Zero premium increase for the Basic and High Deductible Plans • Premium increase of $30-$50/month and deductible increase from $300 to $750 for the Core Plan only.

  3. 2016-2017 Statistics • Core Plan expenditures were 89% greater than revenue generated by premiums • Basic and High Deductible Plan performed below the revenue generated by premiums • Spouse claims increased 50.9% and dependent claims increased 58.2% in 2015-2016. Both continue to increase in current year. • For the 2016-2017 plan year, there are 3 participants with claims over $150,000

  4. 2017-2018 Recommendations • Zero premium increases for Basic and High Deductible Plans • Increase the Core premiums by 15% • Increase the HDP Plan deductibles: • Individual deductible from $2,200 to $2,500 • Family deductible to $4,400 to $5,000 • Increase out-of-pocket maximums for all plans: • Network providers from $6,250 to $7,000 • Out-of-network providers from $12,500 to $14,000

  5. 2017-2018 Recommendations • Implement a $100/month spousal surcharge for spouses who have coverage through their employer but elect to enroll in the district’s insurance • Add a telemedicine option for medical plan participants • Continue to provide the PHA participation incentive, reducing the premium cost $25 per month for an employee and $50 per month for employee/spouse or employee/family

  6. 2017-2018 Recommendations • Increase the Dental High Plan premiums by 9% • Decrease the Dental Low Plan premiums by 10% • Basic Life Insurance paid by the District will increase by $24,500 annually

  7. 2017-2018 Proposed Premiums • Zero increase to premiums for the BasicPlan and High Deductible Plan

  8. 2017-2018 Proposed Premiums

  9. Surrounding District Contributions

  10. What’s on the horizon with TRS-Active Care? • Legislature considering all school districts with 1,000 or more employees will be required to exit TRS-Active Care • Joint committee recommendation to only offer the High Deductible Plan • Surrounding districts on Active Care waiting to determine district contributions and if they will need to seek out medical providers

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