New Pricing Approach for Districts Joining TRS-ActiveCare
Effective Sept. 1, 2026, TRS-ActiveCare will use a new pricing model for districts joining the program. The change helps ensure new districts contribute their share of expected health care costs and reserves while maintaining stable rates for all participating districts.
What's Changing
Here's how pricing for new districts will work.
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Premiums are based on expected costs.
New districts will pay premiums that reflect their individual expected costs and reserves needs. Factors may include historical claims experience, age, gender and regional health care costs. The risk percentage added will never exceed 15%.
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The pool remains financially balanced.
This risk-based rating will help protect current participants while supporting long-term rate stability for new districts joining the program.
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Changes happen gradually.
New premium pricing and reserve requirements will phase in over two years to support a smooth transition, no surprises, and stable long-term rates.
Why It Matters
For many private employers, insurance premiums are heavily shaped by claims experience — a high-claims year can drive a sharp premium increase the next. That unpredictability strains budgets and complicates long-term planning.
TRS-ActiveCare premium rates include a reserve component to manage unexpected costs. This reserve amount is based on an industry-standard formula insurers use called Risk-Based Capital methodology.
Under the new approach, districts joining the plan begin building their share of this reserve during their first two years. The reserve helps protect districts when unexpected events occur, such as a public health emergency or several high-cost claims in a single year.
By preparing ahead of time, districts gain more predictable pricing and greater financial stability over the long term.
Proven Cost Management
Risk-based pricing builds on strategies already helping TRS-ActiveCare manage costs and support participating districts.
48% Lower
TRS-ActiveCare's cost growth per participant from 2013–2025 compared with peer plans. A direct result of intentional cost management like this.
$463 Per Month
Actual Plan Year 2025 cost per participant. Expected costs were $532 per month based on member demographics and health care needs. Proactive cost management kept costs 13% below expectations.
Lowest Cost
TRS-ActiveCare costs are 13% lower than comparable plans across Texas regions.
How the Transition Works
Two years to base, regional pricing. As TRS-ActiveCare grows, this approach will help maintain the stable, competitive rates districts rely on while supporting the long-term strength of the program.
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Year One: Expected-cost pricing begins.
Premiums begin reflecting the district's projected health care costs and reserve needs.
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Year Two: Reserve funding continues to phase in.
The risk-based rate cap (or maximum amount) that was determined in year one stays steady, easing the transition rather than requiring it all at once. If the district has favorable experience, their rate could be significantly less than the cap.
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Year Three and Beyond: Full participation and regional pricing.
The district is fully integrated into the pool and benefits from the financial protections of TRS-ActiveCare’s size and bargaining power.
Questions about what this means for your district?
Contact your TRS-ActiveCare consultant. Use TRS-ActiveCare Service Teams to find your consultant and their contact information.
Hear more from Dr. Crawford about why switching to TRS-ActiveCare was the right fit for Tyler ISD.