When do the changes become effective?
To ensure that adequate funds are available for timely payment of TRS-ActiveCare claims, the billing cycle and due dates for premiums will change effective September 2013.
Why is the TRS-ActiveCare billing cycle changing?
TRS-ActiveCare is a self-funded plan. The premiums paid by participating entities are the sole source of funding for the plan and must be sufficient to cover claims and administrative expenses. TRS-ActiveCare claims have exceeded projections for the current plan year, and the most significant claims months are ahead. Historically, claims activity in the summer months is by far the highest in volume, cost, and volatility. In addition, during the 83rd Legislative session, Senate Bill 1484, relating to coverage for enrollees diagnosed with autism spectrum disorder, was passed and will go into effect September 1, 2013. It is estimated that this legislation will have a significant fiscal impact on the program. The changes are necessary to help maintain solvency.
When will districts be billed and when will premiums be due?
Effective September 2013, Blue Cross and Blue Shield of Texas will generate each participating district/entity's billing summary on the 1st of each month. If the 1st is not a business day, the bill will be produced on the first business day after the 1st. Payment will be due by the 15th of the month. If the 15th of the month is not a business day, payment is due by the last business day prior to the 15th.
The chart below shows the billing generation and due dates through the end of the 2013-2014 plan year. The shaded cells represent the new billing cycle and payment due dates beginning in September.
|For transactions effective this month...
||Billing will generate on...
||And payment will be due by...
Why is the September invoice not available until September 3rd and payment is due on September 13th?
Because Sunday, September 1st is a non-business day and Monday, September 2nd is a federal holiday, the bill for September will not generate until Tuesday, September 3rd. September 15th is on a Sunday, so per the new guidelines, payment will be due on Friday, September 13th, the last business day prior to the 15th of the month.
Will this change impact all school districts?
All participating districts/entities under the TRS-ActiveCare program will be impacted.
Will districts continue to submit their premium payments through TEXNET?
Yes, payments will continue to be submitted via TEXNET.
Can districts still call BCBSTX to request copies of a bill?
Districts can continue to call BCBSTX Customer Service (1-866-355-5999) to request copies of their monthly bills.
Will a new Administrative Guide be available that will include the updated billing cycles and due dates?
No, the Administrative Guide will not be reprinted or redistributed at this time. A revised billing summary chart with the new billing cycle and due dates appears above in this document. Later this summer, BCBSTX will revise the Quick Reference Guide and send an electronic copy to Benefits Administrators.
What is Senate Bill 1484?
During the 83rd Legislative session, Senate Bill 1484, relating to coverage for enrollees diagnosed with autism spectrum disorder, was passed and will go into effect September 1, 2013. It is estimated that this legislation, which removes age restrictions for coverage, will have a significant fiscal impact on the program.
How will districts make adjustments to their payroll system due to this change?
TRS cannot provide guidance to districts/entities on how to handle payroll arrangements.
It appears districts/entities will have to pay premiums twice in September (for August and September premiums).
This is correct.
Who may I contact if I have questions about this change?
If you have questions, please contact Rosa Franco at (512) 542-6396.
Who approved or decided to make this change to the TRS-ActiveCare billing cycle?
TRS-ActiveCare management and the health care consultant determined that changing the premium billing cycle and due dates would help ensure the program meets its claims liability and solvency requirements. The TRS Board of Trustees approved this change at the June 14, 2013 Board meeting.
To what extent is BCBSTX involved in this change?
TRS-ActiveCare is working closely with BCBSTX, the plan administrator for the program, to modify systems and schedules for successful transition to the new billing cycles and due dates. BCBSTX will continue to assist TRS with communications and training as well as provide Customer Service to generate and distribute bill copies, assist Benefits Administrators in retrieving and reviewing bills through Blue Access for Employers, and address inquiries–on billing, membership processing, and claims.
|Contact our toll-free Customer Service Lines.
|TRS-ActiveCare Customer Service Number:
Option 1, Aetna (medical)
Option 2, Caremark (prescription drug)
|Blue Cross and Blue Shield of Texas and Express Scripts:
|Scott & White Health Plan:
|Allegian Health Plans: