Dear TSABAA Conference Attendees,

 

Thank you very much for inviting me to present at your mid-winter conference in Kerrville on December 8th.

I appreciated the opportunity to talk to you about funding the state's health insurance plan.  I also appreciated your feedback - both verbal and written - and I can assure you that I will share your comments and questions with our executive director, Ann Fuelberg, and appropriate ERS staff. 

 

Following are the questions submitted to me on index cards, along with answers. If you have additional questions or comments, please don't hesitate to contact me, Terese Foran, Communications & Training Manager, ERS.

 

Question: Why not stratify the premium structure per number of family members vs. just Employee and Family? It seems someone with 1 child shouldn't pay the same as someone with 8.    

 

Answer: This is one of the funding options under consideration.  

 

Question: Some states are exploring Canadian or other foreign pharmaceutical sources. Is Texas pursuing that notion?  

 

Answer: Rep. Scott Hochberg has filed HB 173 which sets up a program to have the state of Texas license Canadian pharmacies that will sell drugs to Texas citizens at lower prices. The news release is attached. (Click here for  HochbergRxBill.pdf)

 

Question: With higher copays it may reduce the frivolous doctor appointments but it also stops people from going when they really need to because they can't afford to go, which could cause higher costs down the road because they get worse, even causing hospitalization. This needs to be considered as co-pays or out-of-pocket increases.

 

Answer:  According to our health plan utilization data, higher out-of-pocket costs (e.g., 2003's increased office visit co-payments and $50 prescription drug deductible) have not had a significant effect on members' accessing of medical care. In other words, even though they pay more to see the doctor, members are going to the doctor as often as they always have. However, the point you make will be an important one to consider as we try to work within the allocated funding for the next biennium.  

 

Question: Will TexFlex be available for retirees?  

 

Answer: At this time, the Internal Revenue Code does not allow retirees to have flexible spending accounts. However, stakeholders across the country are working to change this.  As a reminder, beginning 9/1/04, return-to-work retirees can enroll in TexFlex if they choose active employee benefits (vs. retiree benefits). These retirees should speak to their benefits coordinators within their first 31 days of employment, or they can wait until Summer Enrollment to change their benefit status and enroll in TexFlex.   

 

Question: Why is there no comparison on the sheet to the health plan of the Legislature?  

 

Answer: As an employee of a state agency (the Senate or House), a state legislator's health plan is identical to that of regular class employees.   

 

Question: An audience member also inquired about the "15%" I used in explaining the portion of the total cost that consumers pay for their medical care.    

 

Answer:  See source article attached.  (Click here for HRANCPArpt.pdf)

 

Terese Foran

Communications & Training Manager

Customer Benefits Division

Employees Retirement System of Texas.

phone: (512) 867-7247

fax: (512) 867-3247

e-mail: tforan@ers.state.tx.us