Click above for Benefit Choice information and options
The Benefit Choice Period will begin May 1, 2012, for all benefit recipients. Even though the Benefit Choice Period will begin May 1st, an end date has not been set since the health carrier options for plan year 2013 have not yet been finalized. Once the health carrier contracts are finalized, the Benefit Choice Period end date will be announced. Benefit recipients will be given sufficient time to make an informed decision regarding their health plan election.
During the annual Benefit Choice Period, benefit recipients are allowed to add dependent coverage. This year, members should delay making health plan changes until the health carrier contracts have been finalized. Once the Benefit Choice Period end date has been announced, the Benefit Choice Election form will need to be submitted to TRS by the announced due date. Any elected changes in coverage will be effective July 1, 2012.
Benefit recipients who enroll in the Teachers' Retirement Insurance Program (TRIP) receive health, prescription and behavioral health benefits. Dependent beneficiaries can be enrolled in the program at an additional cost and will have the same health plan and other benefits as the benefit recipient.
The health and prescription benefits offered to TRIP participants are administered by various plan administrators. Benefit recipients interested in changing their coverage elections may do so upon experiencing an eligible qualifying change in status and should contact TRS for more information.
All available benefit plans and programs are explained in detail in the Member Handbook and Benefit Choice Options Booklet. Also included are amendments that update the handbook and a summary document indicating the benefit levels of the Teachers' Choice Health Plan (TCHP).
Health
The health insurance plans available to TRIP members differ in the benefit levels they provide, the doctors and hospitals you can access and the out-of-pocket cost to you. In general, managed care plans, such as Health Maintenance Organizations (HMOs) and the Open Access Plan (OAP), deliver healthcare through a system of network providers and have a lower monthly premium than the Teachers' Choice Health Plan (TCHP). Members will find a listing of providers who participate in the health plan's network when they go to the provider directory page on the plan's website.
There are several managed care health plans located throughout the State available to TRIP members. Benefit Recipients may view the map of the managed care plans’ coverage areas.
The TCHP is administered by Cigna and allows plan participants to access any provider nationwide; however, enhanced benefits are available when services are received from a TCHP network provider.
Medicare
Information regarding Medicare and how it affects your Teachers’ Retirement Insurance Program coverage.
Prescription
Plan participants enrolled in any TRIP health plan have prescription drug benefits included in the coverage. All prescription medications are compiled on a preferred drug list ("formulary list") maintained by each health plan's Prescription Benefit Manager (PBM). Formulary lists categorize drugs in three levels: generic, preferred brand and nonpreferred brand. Each level has a different copayment and/or coinsurance amount.
Participants enrolled in the Teachers' Choice Health Plan (TCHP) pay 20% of the retail cost of prescriptions, not to exceed a set maximum or be less than the set minimum copayment amount. Additionally, TCHP plan participants have a $1500 annual prescription out-of-pocket maximum. Once this out-of-pocket maximum has been met, prescriptions obtained for the remainder of the plan year will be covered at 100%.
Coverage for specific drugs may vary depending upon the health plan. It is important to note that formulary lists are subject to change any time during the plan year. To compare formulary lists, cost-savings programs and to obtain a list of pharmacies that participate in the various health plan networks, plan participants should visit the website of each health plan they are considering. Plan participants who have additional prescription drug coverage, including Medicare, should contact their plan’s PBM for Coordination of Benefits (COB) information.
Medco the prescription drug plan administrator for Health Alliance Illinois, HealthLink OAP, Coventry Health Care OAP (formerly PersonalCare OAP) and the Teachers' Choice Health Plan (TCHP), maintains a list of retail pharmacies within Illinois [PDF, 276KB] and retail pharmacies outside of Illinois [PDF, 5MB] that contract with Medco to accept the copayment amount for prescriptions. A Medco claim form [PDF, 26KB] is available for members who request reimbursement due to using an out-of-network pharmacy.
Contact Information
Please visit the Teachers' Retirement System website for more information regarding the Teachers' Retirement Insurance Program.
FAQs
A list of Frequently Asked Questions regarding TRIP can be accessed by clicking on this link.
Notices