The Texas Employees Group Benefits Program (GBP), formerly the Texas Employees Uniform Group Insurance Program, began September 1, 1976. The GBP was implemented to meet the stated purposes of Texas Employees Group Benefits Act, Chapter 1551. The Act requires uniformity in health, life, and accident insurance benefits for all employees and retirees of state agencies and institutions of higher education.
In 1991, the 72nd Texas Legislature passed House Bill 2, which mandated the consolidation of higher education insurance programs into the GBP beginning September 1, 1992. Two university systems were exempt from consolidation; the University of Texas System and the Texas A & M University System. Eleven (11) four-year public university systems representing twenty-five (25) separate universities and health science centers and forty-eight (48) public community/junior colleges located throughout Texas began participating in the GBP on September 1, 1992.
On September 1, 1992, ERS implemented a fully self-funded managed care point-of-service plan, HealthSelectSM of Texas (HealthSelect). BlueCross BlueShield of Texas, a division of Health Care Services Corporation, a Mutual Legal Reserve Company (BCBSTX) was the administrator until August 31, 2012. United Healthcare, a division of UnitedHealth Group, is the current administrator effective September 1, 2012. All counties in Texas have had provider networks available since September 1, 1999. As of August 2013, the number of participants in HealthSelect is approximately 437,964 employees, retirees and their dependents.
HMOs were first offered in the GBP on September 1, 1977. Participating HMOs were first required to offer standardized benefits on September 1, 1989. Since Fiscal Year 1991, ERS has required HMOs to provide adjusted community rates established at levels required to generate the revenue necessary to provide coverage to GBP participants. ERS has approved adjusted community rates only when supported by documentation satisfactory to ERS' consulting actuary on insurance matters. Such documentation includes actual utilization and cost data for GBP participants. Standardization of HMO copayments and regionalized competitive bidding were implemented on September 1, 1998.
Effective September 1, 2010 ERS contracts with two commercial HMOs on a fully insured basis; Scott & White in Temple/Waco and Community First in San Antonio. As of August 2013, there are approximately 26,454 participants in both HMOs, including dependents.
Pharmacy Benefit Manager
The Prescription Drug Program (PDP) for HealthSelectSM Pharmacy Benefit Management (PBM) services has been administered by Caremark Rx., LLC since September 1, 2008.
Life and Disability Coverages
In addition to the health plans, ERS provides group term life, voluntary accidental death and dismemberment (Voluntary AD&D), and disability income coverages to employees and retirees enrolled in the GBP. The group term life coverages are provided on a fully insured, minimum premium basis and the Voluntary AD&D coverage is fully insured and is currently administered by Minnesota Life Insurance Company effective January 1, 2012. The disability income coverages became self-funded on September 1, 1995 and are currently administered by Aon Hewitt Absence Management LLC effective September 1, 2013.
The State offers two voluntary dental plans, a Dental Health Maintenance Organization (DHMO) plan and a Preferred Provider Organization (PPO) plan. Both were implemented on May 1, 1992. As of September 1, 2014, the State will begin offering a Dental Discount Program.
The PPO plan was administered by the Government Employees Health Association, Inc. (GEHA) from September 1, 2006 through August 31, 2009. On September 1, 2009, HumanaDental Insurance Company was selected by the ERS Board of Trustees to administer the PPO plan.
The DHMO plan was administered by Aetna Dental, Inc., a member of Aetna US Healthcare from September 1, 2008 through August 31, 2009. On September 1, 2009, HumanaDental Insurance Company was selected by the ERS Board of Trustees to also administer the DHMO plan.
On December 6, 2013, Careington International Corporation was selected by the ERS Board of Trustees to administer the Dental Discount Program from September 1, 2014 through August 31, 2018.
As of August 2013, the number of participants in the DHMO plan is approximately 147,361, which includes employees, retirees and their dependents. There are approximately 259,787 participants in the PPO plan. Since electing dental benefits is voluntary, no state contribution is provided.
Employee Discount Program
The Employee Discount Program has been administered by Beneplace, Inc. since September 1, 2010.
Flexible Benefits Administration
As of August 2013, approximately 56,000 state agency and higher education employees are enrolled in the TexFlex benefits plan, with a total eligible population of approximately 302,703. All employees eligible to participate in the GBP are eligible to enroll in the TexFlex Program. On September 1, 2008, Payflex Systems USA, Inc. replaced Fringe Benefits Management Company as the administrator of the flexible benefits plan.
Effective September 1, 2007, ERS implemented annual automatic re-enrollment for all participants currently in the TexFlex Program. New participants complete an initial enrollment form to participate. Since September 1, 2012, there is an administrative fee of $12 per TexFlex Program Account.
The State offers two Medicare Advantage plans, a Health Maintenance Organization (HMO) plan and a Preferred Provider Organization (PPO) plan. As of August 2013, there are approximately 53,170 total participants in the Medicare Advantage plans.
On September 1, 2011, KelseyCare Advantage was named the administrator for the HMO plan. This plan provides health coverage to Medicare-enrolled retirees, surviving spouses, and their dependents who are enrolled in Medicare Parts A & B that live in certain counties in Texas.
On January 1, 2012, Humana Insurance Company was named the administrator for the PPO plan. This plan is provides health coverage to Medicare-enrolled retirees, surviving spouses, and their dependents who are enrolled in Medicare Parts A & B that live in the United States.
Effective September 1, 1999, all eligible GBP participants are enrolled in a premium conversion program