Health Coverage with my CTRB Sponsored Plan – Cost& Funding

For decades, the TRB has been dedicated to offering retired teachers and spouses the highest quality plans at an affordable cost. We are pleased that the plan options for 2022 maintain the same high-quality coverage with some enhancements. 

Why the change in benefit programs?

We were able to integrate prescription and medical coverage, provide benefit enhancements for both programs, and provide cost savings to over 85% of the retirees while maintaining both plans.

Will our benefits change?

We continue to offer both the Medicare Advantage and the Medicare Supplement programs with similar or better coverage from previous years.

Why does the Medicare Advantage plan provide additional benefits, when compared to the Medicare Senior Supplement?

Medicare Advantage plans are contracted by Medicare and must meet Medicare coverage guidelines but can offer additional services not offered through traditional Medicare. Quality must be maintained in compliance with CMS guidelines and ensure the plan is able to maintain Star Ratings. United Healthcare has a 5-star rating, which is the highest rating approval by the Center for Medicare & Medicaid. Since the Medicare Supplement Program follows original guidelines, Star Ratings and additional benefits are not part of the plan and therefore not eligible for some of the services provided to those on the Medicare Advantage Plan.

Will members be receiving contributions for both plans?

Yes, the State and TRB health fund contributes 2/3 of the cost of the base plan which is the Medicare Advantage with Prescription Drug plan. This same dollar amount contributed for the base plan ($60 for 2022) is also contributed toward the cost of the Senior Supplement plan.

Why the disparity in plan cost?

It is important to note that the State statute provides retirees with a subsidy that is 1/3 of the cost of the base plan. The TRB also contributes 1/3 of the cost of the base plan. The base plan pricing determines the member’s cost of any buy-up plan, such as the Medicare Supplement plan, which the TRB may offer. As a result, when the cost of the base plan decreases, the cost of the Supplement plan increases for members. The vast majority of current enrollments is under the Advantage plan, and since it will be decreasing significantly from $125 per month to $80 per month, the Supplement plan cost will increase significantly from $228 to $319. Total premiums provided include the $50 cost for dental.

When combining the Medicare Advantage with prescription drug it creates a savings. Due to this savings, the Medicare Supplement subsidy decreases, which is one of the factors contributing to the premium differential. There are approximately 26,500 members in Medicare Advantage and 5,500 in Medicare Supplement. Smaller population and higher utilization on the Medicare Supplement also contribute to the higher monthly premium on that plan.

Why is the cost structure not broken out as in the past?

Prior year premiums showed prescription, vision, and hearing separate from medical because they were administered as separate plans under one package. This year they are integrated into one plan.