Plan Options:
The district’s medical plans are offered through TRS. There are four medical plans to choose from. From in- and out-of-network options to comprehensive prescription drug coverage and special health and wellness programs, TRS-ActiveCare has been designed to flexibly meet the needs of nearly half a million public education employees.
Expand plans for details.
Administered by Aetna (medical) & CVS/Caremark (pharmacy)
ActiveCare 1-HD
- High deductible plan – must meet deductible before plan begins cost share
- In-network and out-of-network benefits – separate out-of-network deductible/out-of-pocket maximum
- Provider network is Aetna Choice POS II
- Deductible applies to medical and pharmacy
- There is no individual deductible. Should only one member of a family incur major expenses, that family member would have to meet the full family deductible.
- Employee is eligible to set up/contribute to a Health Savings Account
Plan Highlights – two page comparison of Aetna plans, including covered preventive care services
Benefits Booklet – 100+ pages of Aetna plan details including a detailed comparison of Aetna plans, list of covered services, limitations and exclusions, important terms and plan provisions
ALEX Benefits Counselor – interactive tool for choosing an Aetna plan that talks you through choices
Find a Doctor or Facility – search for network providers
Aetna Navigator – access medical ID cards, medical claims payments and Explanations of Benefits
Mobile Apps – get ID cards and plan information on the go
Resource Guides – one for each plan explaining what is offered with website links for more info:
- How the plan works – deductibles, co-pays, co-insurance, out-of-pocket maximums
- Choosing network providers and what happens if you go out-of-network
- Routine and emergency care options and costs
- Teladoc – doctors available 24/7 to diagnose, treat and prescribe medications
- 24-Hour Nurse Information Line – registered nurses answer questions and advise on care
- Aetna member discounts – save on health related products and services
- Wellness programs and services
- Care Advocate Team – trained nurses who can help you understand confusing medical conditions and treatments, and coordinate complex medical care
- Beginning Right Maternity Program – obtain support during your pregnancy and receive a $100 gift card for participation
- Finding participating retail pharmacy providers
- Maintenance medications and Specialty medications – options for obtaining them
- How to receive savings on glucose meter and supplies
- Drug Cost Tool – see what medications cost under your plan
Summary of Benefits & Coverage – for each plan, a summary of what you pay/what the plan pays for medical/pharmacy
ActiveCare Select
- Co-pay plan – pay flat fees for office visits and prescriptions
- Network-only – no out-of-network benefits
- Provider network is determined by the county in which the employee lives
- Note: If you obtain mail through a P.O. Box you must also list the street address at which you live.
- Dependents who temporarily or permanently live outside the network area would only have benefits in the event of a “true medical emergency” as defined by the plan and determined by Aetna.
Plan Highlights – two page comparison of Aetna plans, including covered preventive care services
Benefits Booklet – 100+ pages of Aetna plan details including a detailed comparison of Aetna plans, list of covered services, limitations and exclusions, important terms and plan provisions
ALEX Benefits Counselor – interactive tool for choosing an Aetna plan that talks you through choices
Find a Doctor or Facility – search for network providers
Aetna Navigator – access medical ID cards, medical claims payments and Explanations of Benefits
Mobile Apps – get ID cards and plan information on the go
Resource Guides – one for each plan explaining what is offered with website links for more info:
- How the plan works – deductibles, co-pays, co-insurance, out-of-pocket maximums
- Choosing network providers and what happens if you go out-of-network
- Routine and emergency care options and costs
- Teladoc – doctors available 24/7 to diagnose, treat and prescribe medications
- 24-Hour Nurse Information Line – registered nurses answer questions and advise on care
- Aetna member discounts – save on health related products and services
- Wellness programs and services
- Care Advocate Team – trained nurses who can help you understand confusing medical conditions and treatments, and coordinate complex medical care
- Beginning Right Maternity Program – obtain support during your pregnancy and receive a $100 gift card for participation
- Finding participating retail pharmacy providers
- Maintenance medications and Specialty medications – options for obtaining them
- How to receive savings on glucose meter and supplies
- Drug Cost Tool – see what medications cost under your plan
Summary of Benefits & Coverage – for each plan, a summary of what you pay/what the plan pays for medical/pharmacy
ActiveCare 2 - CLOSED TO NEW ENROLLEES
- THIS PLAN IS CLOSED TO NEW ENROLLEES
- Co-pay plan – pay flat fees for office visits and prescriptions
- In-network and out-of-network benefits – separate out-of-network deductible/out-of-pocket maximum
- Provider network is Aetna Choice POS II
- Highest cost plan
Plan Highlights – two page comparison of Aetna plans, including covered preventive care services
Benefits Booklet – 100+ pages of Aetna plan details including a detailed comparison of Aetna plans, list of covered services, limitations and exclusions, important terms and plan provisions
ALEX Benefits Counselor – interactive tool for choosing an Aetna plan that talks you through choices
Find a Doctor or Facility – search for network providers
Aetna Navigator – access medical ID cards, medical claims payments and Explanations of Benefits
Mobile Apps – get ID cards and plan information on the go
Resource Guides – one for each plan explaining what is offered with website links for more info:
- How the plan works – deductibles, co-pays, co-insurance, out-of-pocket maximums
- Choosing network providers and what happens if you go out-of-network
- Routine and emergency care options and costs
- Teladoc – doctors available 24/7 to diagnose, treat and prescribe medications
- 24-Hour Nurse Information Line – registered nurses answer questions and advise on care
- Aetna member discounts – save on health related products and services
- Wellness programs and services
- Care Advocate Team – trained nurses who can help you understand confusing medical conditions and treatments, and coordinate complex medical care
- Beginning Right Maternity Program – obtain support during your pregnancy and receive a $100 gift card for participation
- Finding participating retail pharmacy providers
- Maintenance medications and Specialty medications – options for obtaining them
- How to receive savings on glucose meter and supplies
- Drug Cost Tool – see what medications cost under your plan
Summary of Benefits & Coverage – for each plan, a summary of what you pay/what the plan pays for medical/pharmacy
Administered by Scott & White
SWHP HMO For TRS
- Co-pay plan – pay flat fees for office visits and prescriptions
- Network-only – no out-of-network benefits
- Provider network: Scott & White Health Plan
- Dependents who temporarily or permanently live outside the network area would only have benefits in the event of a “true medical emergency” as defined by the plan and determined by Scott & White.
- Specialty benefits can be obtained without a referral
Benefits Brochure – one page summary of HMO benefits
Service Area Map – counties where network providers can be found
Summary of Benefits & Coverage (SBC) – a summary of what you pay/what the plan pays for medical/pharmacy
Wellness Brochure
- Nurse Advice Line – talk to a nurse
- Wellness Assessment – digital health survey with action steps
- Lifestyle Management Programs – help for common health & wellness concerns
- Disease Management – assistance dealing with chronic conditions
- Case Management – assistance with complex care needs
- MOMS program – resources and support for new parents
Other Options
- Search for a network provider or facility
- Find urgent care centers
- Order an ID card
- View covered medications
- Search for a preferred pharmacy
- Frequently asked questions
- Tools and resources
- MyBSWHealth app
- Covered Preventive Services
ID Cards
AETNA (medical)
- Aetna Mobile App
- Aetna Navigator
- Call Aetna:
1-800-222-9205 – Option 1
M-F, 8 a.m. to 6 p.m. CST
CAREMARK (pharmacy)
- Caremark Mobile App
- Caremark Temporary Card
- Caremark Website for ActiveCare
- Call Caremark:
1-800-222-9205 – Option 2
7 days/week, 24 hours/day
SWHP HMO (medical/pharmacy)
- MyBSWHealth App
- SWHP Member Portal
- Call Scott & White HMO:
1-800-321-7947
7 days/week, 7 a.m. to 8 p.m.
