TRS outlines TRIP and TRAIL retiree health plans and new Medicare family split

Carly Leffel, a benefits counselor with the Teachers' Retirement System, outlined eligibility, enrollment windows, premiums and recent rule changes for TRIP and TRAIL retiree health insurance during a TRS webinar.

The guidance matters because the changes affect when retirees and their dependents must move to TRS's Medicare plan, what they pay for monthly premiums and what steps members must take to enroll in TRAIL when they become Medicare eligible.

TRIP and TRAIL: what they are and who administers them TRIP (Teachers Retirement Insurance Program) is the TRS group health plan for members who are not yet Medicare eligible; it serves as primary coverage before age 65 and includes medical, prescription, and, beginning 07/01/2025, dental and vision. TRIP carriers and plan types (HMO, OAP, PPO) vary by state and county.

TRAIL (Total Retiree Advantage Illinois) is a nationwide Medicare Advantage prescription drug plan (MAPD) administered by Aetna; it is a single PPO plan that bundles Medicare Part C (advantage) and Part D (prescription drug) coverage. TRAIL added dental and vision on 01/01/2025.

TRS, Central Management Services (CMS) and the MyBenefits Service Center (MBSC) have distinct roles: TRS determines member eligibility and withholds monthly premiums from pension payments; CMS (Illinois Central Management Services) negotiates contracts, selects carriers and designs plans; MBSC handles enrollment and plan selection.

Who is eligible and when they can enroll To enroll in TRIP or TRAIL a retiree must be retired and have at least eight years of TRS service credit. TRS staff clarified that TRS service credit can include sick days and certain optional service but does not include reciprocal service from other retirement systems. Participation is optional and there are several enrollment opportunities: - At retirement: the participation election form is included in the retirement packet; TRS first confirms eligibility and then members contact MBSC to complete enrollment. - Involuntary loss of other coverage (for example, when a working spouse retires): members must supply a termination letter from prior coverage to enroll outside open enrollment. - Medicare eligibility: members who enroll in Medicare Parts A and B and provide proof (Medicare card or letter) may enroll in TRAIL. - Annual open enrollment: TRIP open enrollment occurs in May with coverage effective July 1; TRAIL open enrollment runs mid‑October through mid‑November with a January 1 effective date.

Premiums and subsidy rules TRS said TRIP premiums are set for an academic year (July 1–June 30). Example premium figures presented during the webinar (for the 07/01/2025–06/30/2026 plan year) included: - TRIP managed‑care (HMO/OAP) member premium (age 26–64): $370.76 per month. - TRIP PPO (Teacher's Choice Health Plan, administered by Aetna) typical member premium: $857.02 per month. - TRIP subsidized PPO rate (when managed‑care is unavailable in a county): $431.60 per month (TRS said this applies in only a few counties). - TRIP dependent premiums are not subsidized; example dependent amounts shown included $1,483.01 (spouse on HMO example) and $1,726.40 (spouse on PPO example). A non‑Medicare dependent under 26 was shown as $624.46 in the example chart.

For TRAIL, TRS presented simpler rates because TRAIL is a single plan: member contribution $7.35 per month and dependent $27.14 per month.

Teachers Health Insurance Security Fund (THIS) helps subsidize member premiums in retirement; TRS noted the fund does not subsidize dependents' premiums.

Medicare family split and transitions between TRIP and TRAIL TRS announced a new Medicare family split effective 07/01/2025: if any individual on a member's plan is Medicare eligible, that person must enroll in TRAIL while non‑Medicare individuals may remain on TRIP until they are Medicare eligible. TRS clarified that it is now permissible for one household member to be on TRAIL and another on TRIP simultaneously.

TRS also said that non‑Medicare family members who remain on TRIP must be enrolled in the same TRIP plan type (for example, the same OAP) when they are all non‑Medicare.

Steps TRS advised for transitioning to TRAIL TRS described a three‑step process for members approaching age 65: 1) About three months before turning 65 TRS sends an "age‑65" letter with a Medicare checklist. 2) The member should apply to Social Security/Medicare for Parts A and B (typically available about 90 days before the month of the 65th birthday) and provide TRS with a copy of the Medicare card or enrollment letter as proof. 3) The member should call MBSC the month before the desired Medicare effective date to complete TRAIL enrollment; TRS recommended calling early in the month prior to the effective date so coverage starts on the first of that month.

Other enrollment and coverage notes raised in Q&A - Members do not need to have been on TRIP previously to enroll in TRAIL; TRS uses the same participation election form for both programs. - Insurance ID cards come from the carrier chosen (not from TRS). Delta Dental provides dental cards and EyeMed provides vision cards. TRS suggested creating an online account with the carrier for digital ID information if a physical card has not yet arrived. - Surviving spouses can continue coverage after a member's death; a surviving spouse who continues becomes the benefit recipient and pays the member (benefit recipient) rate. - Children may remain as dependents up to age 26. Adult disabled dependents can remain covered if they meet state/CMS requirements; TRS said the dependent generally must be claimed on the member's taxes and that CMS sets some documentation rules. TRS advised members with disabled adult children to contact TRS to review survivor‑benefit and insurance implications. - To check whether a provider is in‑network, TRS directed members to carriers' "find a doctor" tools or to the carrier's phone number listed on TRS's trip summary documents on trsil.org. TRS also pointed attendees to an online chart listing plan availability by state and county for members living outside Illinois.

Contacts and resources TRS told attendees to start at the TRS website (trsil.org) under Retiree → Health Insurance for plan summaries, carrier contacts and a searchable spreadsheet of out‑of‑state plan availability. MBSC handles enrollments and can be reached at (877) 927‑5877, Monday–Friday, 7:30 a.m.–4:30 p.m. TRS emphasized that for carrier‑specific deductible and provider network questions, members should contact the carrier directly.

The webinar closed with TRS staff offering to remain online to answer additional attendee questions and to provide the published summaries and contact information on the TRS website.