Simplicity - Care Coordinators
Under the Care Connect program, a Care Coordinator becomes a personal concierge for the members in the TSHBP. Today most health plans require members to navigate a complicated maze of in-network confirmation requirements, the TSHBP is designed so the Care Coordinator steps in on behalf of the member and fully supports the member through the process. The Care Coordinator will explain benefits, verify eligibility, answer questions, research quality on every encounter, schedule procedures, and negotiate with facilities for best rates. Our goal is to simply and easily schedule the member with high quality, fair priced facilities in the easiest possible manner while supporting the member through all aspects of their health care journey.
2023-24 Plan Year Options
The TSHBP is proud to offer a blended health model for the 2023-24 Plan Year to meet your school district needs. Plans include the TSHBP Directed Care High Deductible Health Plan (HD) and CoPay Plan, as well as the Aetna Signature PPO Plan.
TSHBP DIRECTED CARE PLANS
- TSHBP Directed Care High Deductible (HD)
- TSHBP Directed Care CoPay Plan
- Embedded Deductible
- In and Out of Network Benefits
- HealthSmart national network for Physician, Specialist and Ancillary services.
- Care Coordinator is mandatory for hospital and
planned procedures - Specialty Drugs - Full Coverage, participation in the Patient Assistance Program (PAP) is required
AETNA SIGNATURE PPO PLAN
- Aetna Signature Plan
- In Network Benefits
- Aetna Signature PPO network for both Physician and Hospitals
- Comparable to TRS-ActiveCare
- Specialty Drugs - Full Coverage, participation in the Patient Assistance Program (PAP) is required
- Care Coordinator is an optional benefit
Health & Wellness Services
About the TSHBP
The Texas Schools Health Benefits Program is a regionally rated program developed for Texas school districts. Our purpose is to support the school children of Texas. We do this by providing health benefit solutions to our dedicated teachers, administrators, and support staff so they can concentrate on what they do best – teaching and supporting our kids. It is our desire to increase member health and well-being and provide tools necessary to identify and manage the health of each and every member.
The Program’s reimbursement model is combined with the rapidly emerging concierge care model being utilized with large employers across the country as a way to enhance member experience by supporting them as they use the complicated healthcare delivery system. The TSHBP plan reflects the current industry trend towards updated plan designs focused on helping members find high-quality fairly priced healthcare. The results of this concierge consumerism are overall lowered healthcare costs which are then passed on to the membership in the form of lower contributions, lower co-pays, and increased benefits.
The TSHBP is proud to offer a variety of plans and benefits to meet school district needs. Plans for 2023-24 include our Directed Care Plans and our Aetna Signature PPO Plan. Both plans are designed so members can easily navigate through their health medical needs.
TSHBP plans are available for school district employees who are employed by participating districts and are active, contributing TRS members.
