TRS explains TRIP and TRAIL retiree health plans, enrollment rules and contact points
Loading...
Summary
Teachers' Retirement System outreach coordinator Sandy Benhart outlined TRIP (pre‑Medicare) and TRAIL (Medicare Advantage), eligibility (minimum eight years of TRS service credit for TRIP), premiums, enrollment windows, and how members can enroll or get help.
Sandy Benhart, outreach coordinator at the Teachers' Retirement System, gave a step‑by‑step guide to TRS retiree health coverage, focusing on TRIP (the Teacher Retirement Insurance Program) for members before Medicare eligibility and TRAIL, the TRS Medicare Advantage option for those on Medicare.
Benhart said TRIP provides primary medical and prescription coverage for retirees who meet TRS eligibility and are receiving a pension. "You need to have at least 8 years of service credit specifically with TRS," she said, noting that years earned in other systems do not always count toward TRIP eligibility.
Why it matters: The choice between TRIP and TRAIL affects members' monthly premiums, which depend on plan type, county of residence and whether dependents are covered. Benhart emphasized the timing rules that determine when members may enroll: employer coverage termination (up to four months after retirement) and annual open enrollment periods.
Key enrollment windows and administration: TRIP open enrollment is in May with coverage effective July 1; TRAIL open enrollment runs mid‑October to mid‑November with coverage effective Jan. 1. Benhart clarified roles: TRS determines eligibility and withholds premiums from pensions, Central Management Services administers contracts and rates, and "MyBenefits Service Center" handles enrollments and midyear changes.
Costs and dependents: For members in the not‑Medicare primary (ages 26–64) TRIP category, managed care (HMO/open access) is $3.30 per month and the PPO is $7.71 per month for the member. Adding a spouse or children raises the premium: Benhart gave examples (managed care spouse $13.22, child $4.25; PPO spouse $15.43, child $5.52). She also noted if no managed care is available in a member's county, the member PPO may be available at half price (example given: $3.85/month), but that reduced rate does not apply to dependents.
Transition to Medicare and TRAIL: Members should sign up for Medicare Parts A and B at ssa.gov within 90 days before turning 65 and send a copy of the Medicare card to TRS. "Once you get your Medicare card, you will send a copy of that to TRS," Benhart said. After that members contact MyBenefits to opt into TRAIL, the Medicare Advantage plan administered through Aetna. Benhart described TRAIL as an Aetna PPO that coordinates with Medicare: Medicare remains the underlying coverage while the Medicare Advantage plan handles claims processing and provider payments.
Household timing and exceptions: When one spouse becomes Medicare-eligible before the other, the Medicare-eligible person moves to Medicare‑primary premiums while the other stays on TRIP until both are eligible. If everyone on a TRIP enrollment becomes Medicare-eligible, the plan must move to TRAIL. Benhart explained a less common case where a retiree never paid into Medicare: they may remain on TRIP in a "not Medicare primary 65 or older" category with different premium amounts.
Coverage limits and alternatives: Benhart repeatedly noted that both TRIP and TRAIL include medical and prescription drug coverage but do not include dental or vision. She suggested members consider COBRA, retired teacher organizations, or retail plans for dental and vision and said TRS can withhold premiums for external plans from pension payments.
Provider acceptance and prescriptions: If a provider accepts Medicare, TRS members can receive care even if the provider is not in Aetna's network; providers often bill Medicare directly. Benhart clarified that members do not separately sign up for Medicare Part D because both TRIP and TRAIL include prescription drug coverage. She advised members to consult insurer formularies and the TRS brochure or plan links to check drug coverage and provider network status.
How to get help: Benhart gave contact points: TRS member services at (877) 927-5877, email members@trsil.org (handled by TRS benefits counselors), and MyBenefits Service Center at (844) 251-1777 for plan selection, adding or removing dependents, or cancellations. She also directed members to the TRS website and TRS social channels and YouTube for webinars.
Next steps: Members who expect to lose employer coverage, are approaching Medicare eligibility, or who want to compare plans should gather their termination letter or Medicare card and contact TRS or MyBenefits for enrollment instructions and to confirm plan availability in their county.
