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Health Coverage for You and Your Family
Agenda
• TRS-ActiveCare Program Highlights– Enrollment Summary
– Facts and Figures
• 2013-2014 Health Plan Options– ActiveCare 1-HD, 2 and 3 PPO Plans
– HMO Plans
• How to Enroll– Who is Eligible to Enroll
– Cost of Coverage
– Enrollment Support
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What is TRS-ActiveCare?
• Established and signed into law in 2001 (Chapter 1579, Texas Insurance Code)
– Blue Cross and Blue Shield of Texas selected to administer the program in January 2002 and 2008
– Medco (now Express Scripts) selected as PBM in January 2002 and 2008
– Program effective date was September 1, 2002
– HMO options added in 2003
• A statewide health care benefits program for employees of school districts, charter schools, regional educational service centers and other educational districts
• Law authorizes funding levels to help employees pay for coverage
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1,120 districts/entities participate in TRS-ActiveCare (90% of eligible entities)
Enrollment Summary (Employees by Plan, Feb. 2013)
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FirstCare Health Plans 2.5% Scott & White Health Plan 2.7% Valley Baptist Health Plans 0.5%
280,250 Employees • 476,767 Members (Employees and Dependents)
PPO Plan OverviewActiveCare 1-HD, 2 and 3 Plans
2013-2014 Plan Year
New Deductible and Out-of-Pocket Maximum for ActiveCare 1-HD
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• ActiveCare 1-HD meets IRS definition of a high deductible health plan for all coverage tiers
• May contribute pretax dollars into a health savings account (HSA) to help pay for current health expenses and save for future qualified medical and retiree health expenses on a tax-free basis
• Individuals can establish an HSA with banks and credit unions
2012-2013 Plan Year 2013-2014 Plan Year
AC1 AC1-HD AC1-HD
Deductible(employee only/family)
$1,200/$3,000 $2,400/$2,400 $2,400/$4,800
Out-of-Pocket Maximum(employee only/family;does not include deductibles)
$2,000/$6,000 $3,000/$5,000 $3,850/$4,200
New Deductible and Out-of-Pocket Maximum for ActiveCare 2
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2012-2013 Plan Year 2013-2014 Plan Year
ActiveCare 2 ActiveCare 2
Deductible(individual/family)
$750/$2,250 $1,000/$3,000
Out-of-Pocket Maximum(individual/family;does not include deductibles)
$2,000/$6,000 $4,000/$8,000
Family Deductible IllustrationAmy covers spouse and three dependents
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$4,800
$1,000 $800 $400
Amy Sue Chris
Ted Bob Sue
ActiveCare 1-HD with $4,800 family deductible
•The family deductible may be met by one or more people
•Plan pays benefits once entire $4,800 is met ̶ there is no individual deductible to meet
ActiveCare 2 with a $1,000 individual deductible and a $3,000 family deductible
•Plan pays benefits for an individual as his/her deductible is met
•Everyone helps to meet the family deductible, but no one person pays more than the individual amount
Bob
$600
Amy
Ted
$200
Chris
Out-of-Pocket (OOP) Maximum IllustrationAmy covers spouse and three dependents
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$4,200
$4,000 $2,000 $600
Amy Sue Chris
Ted Bob Sue
ActiveCare 1-HD with $4,200 family OOP maximum
•The family out-of-pocket maximum may be met by one or more people
•Plan pays benefits once entire $4,200 is met ̶ there is no individual amount to meet
ActiveCare 2 with a $4,000 individual and $8,000 family OOP maximum
•Plan pays benefits for an individual as his/her OOP maximum is met
•Everyone helps to meet the family OOP maximum, but no one person pays more than the individual amount
Bob
$1,000
Amy
Ted
$400
Chris
PPO Network for ActiveCare 1-HD, 2 and 3
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Non-Network:
• You pay more of the cost of out-of-network benefits
– Higher deductibles, coinsurance
• You may need to file your own claim
• You could be balance billed for amounts over allowed amount
Always verify provider network statusNetwork
Statewide (all 254 counties)No need to:
– Select a Primary Care Physician– Obtain referrals for specialist care
Receive highest level of benefits: – Pay less for care
– No balance billing
No claim forms– Provider files claim for you
PPO Plan Overview (Network Level of Benefits)
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ActiveCare 1-HD ActiveCare 2 ActiveCare 3
Deductible $2,400 employee only
$4,800 family$1,000 individual
$3,000 family$300 individual
$900 family
Out-of-Pocket Maximum(does not include copays or deductibles)
$3,850 employee only
$4,200 family
$4,000 individual
$8,000 family$1,000 per individual
Coinsurance(Plan pays/participant pays)
80% / 20% 80% / 20% 80% / 20%
Office Visit Copay 20% after deductible$30 for primary
$50 for specialist$20 for primary
$30 for specialist
Primary means care provided by family practitioners, internists, OB/GYNs and pediatricians. All other physicians are specialists. Primary means care provided by family practitioners, internists, OB/GYNs and pediatricians. All other physicians are specialists.
PPO Plan Overview (Network Level of Benefits)
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Preventive Care Clarification
Services ActiveCare 1-HD ActiveCare 2 ActiveCare 3
Preventive Care Plan pays 100% (deductible waived)
Plan pays 100%(no copay required)
Plan pays 100%(no copay required)
Routine eye exam (one per plan year)
Hearing exam20% after deductible
$30 for primary$50 for specialist
$20 for primary$30 for specialist
• 100% coverage for certain age- and gender-specific preventive care services when network providers are used
• Must be billed by provider as “preventive care”
PPO Plan Overview (Network Level of Benefits)
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Benefits (continued)
Services ActiveCare 1-HD ActiveCare 2 ActiveCare 3
High-tech Radiology(CT scan, MRI, nuclear medicine)
20% after deductible
$100 copay per service, plus 20%
after deductible
$100 copay per service, plus 20%
after deductible
Inpatient Hospital 20% after deductible
$150 copay per day, plus 20%
after deductible
($750 max copay per admission; $2,250
max/year)
$150 copay per day, plus 20%
after deductible
($750 max copay per admission; $2,250
max/year)
Emergency Room 20% after deductible
$150 copay, plus 20%
after deductible
(copay waived if admitted)
$150 copay, plus 20% after deductible (copay waived
if admitted)
Outpatient Surgery 20% after deductible$150 copay
per visit, plus 20% after deductible
$150 copay per visit, plus 20%
after deductible
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New!! Effective Sept. 1, 2013
Benefits Value Advisor
Real-time access to current cost and
quality transparency
Appointment scheduling
Clinical decision support tools
Understanding benefits and how to best use them
Referrals to condition management programs
Preauthorizationcoordination
Help get benefits information and find network providers for:
One-Call Solution: 1-866-355-5999 Customer ServiceOne-Call Solution: 1-866-355-5999 Customer Service
Prescription DrugsActiveCare 1-HD, 2 & 32013-2014 Plan Year
Your Prescription Drug Plan
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• Express Scripts administers your prescription drug plans on behalf of TRS
– ActiveCare 1-HD, 2, and 3 plans
• Benefit includes both a retail and mail component
• Express Scripts has its own mail-order pharmacy where specialist pharmacists focus on compliance and lower cost options for the patient, and the automated filling system ensures the prescription is filled accurately.* Express Scripts buys medication from the most reputable suppliers
*Express Scripts’ mail-order pharmacies fill about 2 million prescriptions per week through a highly automated process that is 99.9997% accurate and is 23 times more accurate than a retail pharmacy
“Dispensing Error Rate in a Highly Automated Mail-Service Pharmacy Practice”; Nov. 2007, Pharmacology, a peer-reviewedjournal of the American College of Clinical Pharmacy
Prescription Drug Benefits – Network Level
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* If you obtain a brand-name drug when a generic equivalent is available, you are responsible for the generic copayment plus the cost difference between the brand-name drug and the generic drug. Chart illustrates benefits when network pharmacies are used. Non-network benefits are also available; see Enrollment Guide for more information.
Features ActiveCare 1-HD ActiveCare 2 ActiveCare 3
Drug Deductible(per person, per plan year)
Subject to plan year deductible
$0 generic; $200 brand
$75
Retail Short-Term(up to 31-day supply)Tier 1 (Generic)
Tier 2 (Preferred Brand)Tier 3 (Non-Preferred Brand)
20% coinsuranceafter deductible
$20
$40* $65*
$15
$35* $60*
Retail Maintenance(after first fill, up to
31-day supply)Tier 1 (Generic)
Tier 2 (Preferred Brand)Tier 3 (Non-Preferred Brand)
$25 $50* $80*
$20 $45* $75*
Mail Order and Retail-Plus(up to 90-day supply)Tier 1 (Generic)
Tier 2 (Preferred Brand)Tier 3 (Non-Preferred Brand)
$45$105*$180*
$45$105*$180*
Specialty Medications (retail or mail)
20% coinsurance after deductible
$200 per fill $200 per fill
New ID Cards for ActiveCare Plans 1, 1-HD and 2 Participants
• All current ActiveCare 1 participants will receive replacement cards for the new plan option in which they are enrolled.
• ActiveCare 1-HD and ActiveCare 2, participants will be mailed replacement prescription ID cards reflecting the upcoming changes to benefit design.
• The effective dates printed on the cards will be the more recent of either the participant’s effective date with the plan or 9/1/10.
• Participants should expect to receive new cards around mid- to late-August.
• Participants making changes after the replacements have been mailed will result in a second set of cards being sent.
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Specialized Care is the Key to Quality Outcomes
Specialization and participant engagement are critical components to controlling health care costs and driving quality clinical outcomes:
• Specialist pharmacist
• Online Tools
• Closing gaps in care
• My Rx Choices®
• Mobile App
• Other available resources
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Extremely Satisfied/Very Satisfied with overall counseling experience
Specialist Pharmacists are specially trained to counsel patients about their conditions and connect with physicians and healthcare coaches
• Average patient call lasts 12 minutes
• Calls are monitored and recorded for training
• Pharmacists spend their time focused on a single condition
• Advanced tools let pharmacists see the “whole patient” along with their drug regimen across prescribers and pharmacies
97% of 97% of patientspatients
Specialist Pharmacists are an integral part of the healthcare continuum
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“We strive to have our pharmacists deliver the level of patient care that any of us would want for our families.”
Glen Stettin, M.D., Express Scripts’ Chief Medical Officer
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OmissionOmissionNot Using Controller Not Using Controller
Medication for AsthmaMedication for Asthma
Express Scripts’ online tools and mobile apps help connect patients and their caregivers
Online prescription management: Refills, renewals and order status Worry-free Fills ® Transfer to mail Claims, balances and history Locate a pharmacy Preferences
Benefit education and management:
Benefit highlights
Forms and cards
Pricing and coverage details
New! Accessibility featuresGap In Care AlertsHelp participants identifyand address potential safety issues with their prescriptions
Pharmacy Care Online Alerts
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Adherence
Omission
On track
Close-up: Sample Alert Message
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Ability for patients to self-close gaps as appropriate
Information about the alert and why it’s important
Printable information to take to the doctor
Access to email Express Scripts pharmacists
Links to additional resources
Video clips relevant to each alert
My Rx Choices® Your online savings tool
• Lower your cost for prescriptions with My Rx Choices®
– Features include:• Personal assessment of cost-saving opportunities based on your prescription
plan and the medications you use• Print a kit to help your doctor better understand the economic impact of different
medication alternatives• Alternative medications are based upon greatest cost savings to you presented
in order, starting with the highest value • Brand-to-generic and retail-to-mail comparisons are shown
• Simply visit www.express-scripts.com. You’ll need to take a moment to register before using this service. You can also call 1-866-355-5999
• You have to shop your benefit. Prices can vary at different retail pharmacies
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Managing prescription with ease: Transferto mail online conversion program
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New! Accessibility Features
Innovation that can help participants make better decisions for healthier outcomes
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Save money
Enable informed decisions
Auto populate with personalized informationUpdate in real-time
Improve care
Boost compliance and adherence
Manage Refills and Renewals
Unique functionality not available anywhere in healthcare today
Information Resources
• TRS Website – www.trs.state.tx.us/trs-activecare– Pharmacy Benefit Highlights– List of maintenance medications– FAQs– Download forms
• Express Scripts Participant Website – www.express-scripts.com– Prior authorization list– Formulary information– Locate a participating pharmacy– Generics Rx Advantage– My Rx Choices® / Price a Medication– Health and wellness information– Mobile App– Check prescription status– Order mail order refills– Download forms– Express Scripts widget
• Customer Service – 1-866-355-5999
• Benefits Booklet
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Valley Baptist Health PlansHMO Plan Option
Company Overview
• We have been part of the TRS-ActiveCare program since 2003 and currently cover more than 1,300 school employees and their dependents.
• We are a hospital-based health plan, founded in 1998 and are owned by Valley Baptist Health System.
• We focus exclusively the Valley and cover employees who live or work in Cameron, Hidalgo, Starr and Willacy counties.
• Valley Baptist Health Plans’ mission is to provided members with comprehensive health care coverage at an affordable price.
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New for 2013-2014
• The national average increase for health insurance premiums is 9 to 11 percent per year
• For the plan year 2013-2014, there is NO rate increase!
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Coverage Category 2013 – 2014
Employee Only $387.06
Employee and Spouse $941.04
Employee and Child(ren) $607.86
Family $960.14
Benefit Highlights
• No routine claim forms
• No preexisting limitations
• College-age dependents living outside our service area have full coverage (address must be on file)
• Secure online access to your membership and claim information at www.valleybaptisthealthplans.com
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NOTE: Care must be accessed through our affiliate provider network PHCSNOTE: Care must be accessed through our affiliate provider network PHCS
Medical Benefit Comparison for 2013-2014
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2012 - 2013 2013 - 2014
Deductible$500 per individual$1000 per family
Deductible$500 per individual$1,000 per family
Out-of-Pocket Maximum$3,500 per individual
$7,000 per family
Out-of-Pocket Maximum$4,000 per individual
$8,000 per family
Office VisitPrimary Care – $25
Specialist – $60
Office VisitPrimary Care – $25
Specialist – $60
Inpatient / Outpatient Copayment20% – after deductible
(member share)
Inpatient / Outpatient Copayment20% – after deductible
(member share)
Rx Benefit Comparison for 2013-2014
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2012 - 2013 2013 - 2014
Deductible$50 per individual
Deductible$100 per individual
Rx Yearly MaximumUnlimited
Rx Yearly MaximumUnlimited
CopaymentsTier 1 – $10Tier 2 – $30Tier 3 – $60Tier 4 – N/A
CopaymentsTier 1 (Generic) – $10
Tier 2 (Preferred Brand) – $30Tier 3 (Non-Preferred Brand) – $65
Tier 4 (Specialty) – 20% After Deductible
Formulary Open
FormularyClosed
Valley Baptist Health Plans
Service Area
• Rio Grande Valley
• Counties– Cameron
– Hidalgo
– Starr
– Willacy
• Provider Network– More than 900 providers
– 14 hospitals Valley-wide
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Valley Baptist Provider Network
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Valley Baptist Health Plans has a comprehensive network of local
physicians, hospitals, and pharmacies that offer a full range of medical services.
A complete list of network providers is available at
www.valleybaptisthealthplans.com.
Our Harlingen office is located at:
2005 Ed Carey DriveHarlingen, TX 78550
(956) 389-2273
Come visit us and meet the staff.
Harlingen Hospitals:Valley Baptist Medical CenterHarlingen Medical Center
Other Regional Hospitals:Valley Baptist Medical Center-BrownsvilleKnapp Medical CenterMcAllen Medical CenterMcAllen Heart HospitalDoctor’s Hospital RenaissanceEdinburg Regional HospitalEdinburg Children’s HospitalCornerstone Regional HospitalSouth Texas Rehab HospitalSolaraMission Hospital
Why Choose Valley Baptist Health Plans?
• We have experience with TRS-ActiveCare benefits. In fact, we cover more than 1,300 school employees and their dependents.
• We are a hospital-based health plan that supports our local communities.
• Medical decisions are made locally by physicians who understand how health care is delivered in your area.
• A dedicated Valley Baptist Health Plans representative is available to answer your questions.
• Unique e-mail address for TRS members and Benefit Administrators.
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Contact Us
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You may submit your questions or comments via e-mail to [email protected]
You can also write or call customer service at:
Valley Baptist Health Plans7878 N. 16th Street
Suite 105Phoenix, AZ 85020-4443
800-829-6440
http://www.trs.state.tx.us/trs-activecare
How to Enroll2013-2014 Plan Year
How to Enroll
Who is Eligible to Enroll?
To be eligible for TRS-ActiveCare coverage, you must:
• Be employed by a participating district/entity and– Be an active, contributing TRS member or
– Be employed 10 or more regularly scheduled hours each week
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Health care coverage for public school employees and their familiesHealth care coverage for public school employees and their families
Employees NOT Eligible to Enroll
• State of Texas employees or retirees
• Higher education employees or retirees
• TRS retirees, receiving or who declined coverage under TRS-Care
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These individuals are not eligible to enroll for TRS-ActiveCare coverage as employees, but they can be covered as a dependent of an eligible employee.
Dependent Eligibility
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Spouse, including common law spouse
A child under age 26: a natural child, an adopted child (or a child who is lawfully placed for legal adoption), foster child, or child under legal guardianship of the employee
“Any other child” under the age of 26 (unmarried) in a regular parent-child relationship with the employee – Must meet residency and support criteria
A grandchild under age 26
Unmarried disabled dependent (age 26+) – Must live with employee
• A dependent does not include a brother or sister of an employee unless the sibling is an unmarried individual under 26 years of age who is either: (1) under the legal guardianship of the employee, or (2) in a regular parent-child relationship with the employee and meets the “any other child” criteria
• Parents and grandparents of the covered employee do not meet the definition of an eligible dependent
Special Eligibility Situations
• If employee and spouse both work for a participating district/entity:
– A spouse may be covered as an employee or as a dependent of an employee
– Only one parent can cover dependent children
• A child (under age 26) employed by a district/entity and a contributing TRS member cannot be covered as a dependent
– The child must be covered as an employee
– If the child is not a contributing TRS member, the child may be covered as a dependent
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Three Steps to Enroll
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2 Complete an Enrollment Application and Change Form
Available online or from your Benefits Administrator1 Choose your
health plan
3 Sign, date and submit form to your Benefits Administrator
Enrollment
• Enrollment Periods for 2013-2014 Plan Year:– April 22 – May 24 (Spring Enrollment)
– August 1 – August 31 (Summer Enrollment)
• No pre-existing condition exclusion applies except for those who previously declined coverage (may be reduced by prior creditable coverage)
• Passive enrollment – If no plan or coverage changes, then no form required
• Premium adjusted to reflect any rate change, effective September 1
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Exception: If an employee is enrolled in ActiveCare 1, he or she will be automatically enrolled in ActiveCare 1-HD effective September 1, 2013, unless he or she submits an Enrollment Application and Change Form to select a different TRS-ActiveCare plan option or terminate coverage
Enrollment Application and Change Form
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Who needs to submit a form?
• New hires– Enrolling or declining TRS-ActiveCare coverage– Enrolling for TRS-ActiveCare coverage with a different participating
district/entity
• Employees already enrolled, but making changes such as:– Selecting a different TRS-ActiveCare plan option– Adding or dropping dependents– Choosing to cancel and/or decline coverage (cancellations and declinations
must be completed on two separate forms)– Changing name or address or correcting date of birth or Social Security
number
• Current enrollees in ActiveCare 1 will automatically be enrolled in ActiveCare 1-HD, effective September 1, 2013; must submit a form to select a different plan option
Enrollment Application and Change Form (Cont’d)
Enrolling for the first time:
• Forms due to the Benefits Administrator before:– The end of the plan enrollment period, or
– 31 calendar days after the employee’s actively-at-work date, or
– 31 calendar days after a special enrollment event
• New hires may choose their effective date of coverage – Actively-at-work date, or
– First of the month following their actively-at-work date
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Full premium for the month will be due if choosing actively-at-work date; premiums are not pro-rated
Full premium for the month will be due if choosing actively-at-work date; premiums are not pro-rated
Pre-existing Condition Exclusions
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• Pre-existing condition exclusions will not apply:– To any individual under the age of 19
– To employees that initially enroll when the district/entity begins participating in TRS-ActiveCare
– To new hires who enroll within 31 days after their actively-at-work date
– To HMO enrollees
• A 12-month pre-x waiting period may apply to employees or dependents enrolling in the ActiveCare PPO plans due to:
– A special enrollment event
– A transfer to another participating district/entity (or rehire by the same participating district/entity), if the employee or any covered dependent has any remaining pre-existing waiting period or a gap in coverage of 63 or more consecutive days.
Exception: If a participant has been covered at any time since 2002, pre-x may apply if employee is hired by another participating district/entity (or rehired by same district/entity)
Making Changes/Special Enrollment Events
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Enrollees may be able to enroll for coverage, change plan options, or change the dependents he or she covers during the plan year within 31 days after a special enrollment event occurs
•New dependent– Marriage, birth, adoption or placement for adoption– Special rules apply to newborns
•Loss of other coverage
Changing districts/entities is not considered a special enrollment event
Newborns
• Covered first 31 days if employee has coverage– Does not apply to newborn grandchildren
• Must add newborn within 60 days after the date of birth or up to one year after the date of birth if:
– Employee has “employee and family” or “employee and child(ren)” coverage at the time of birth and at the time of enrollment
• Plan changes must be made within 31 days after the newborn’s date of birth
• Not necessary to wait for newborn’s Social Security number
– Submit application without SSN to enroll
– Re-submit another form after SSN is issued
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Cost for Health Coverage2013-2014 Plan Year
Cost of Coverage
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Funding to Help Offset the Cost of TRS-ActiveCare Coverage
District/Entity (minimum $150) $165
State of Texas $75
Total Per Month $240
Funding applies to active, contributing TRS members
Cost charts illustrate the monthly gross premiums
Monthly Cost for Coverage
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• See page 17 of Enrollment Guide
• $225 in district/entityand state funds to help pay for coverage
Application to Split Premium
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• Married couples working for different participating entities may “pool” funds
• Optional
• Requires an Application to Split Premium form to be completed by both employees and employers
• Form available online
ID Cards (mailed to your home)
• PPO plans (ActiveCare 1-HD, 2 and 3)– Separate cards for medical and prescription drugs
• Blue Cross and Blue Shield of Texas• Express Scripts
– BCBSTX will reissue ID cards to existing plan participants transitioning from AC1-HD to ActiveCare 1 (medical plan ID cards do not expire)
– Prescription drug ID cards will be reissued by Express Scripts for ActiveCare 1-HD and ActiveCare 2 plan participants
• HMO plans – All HMO participants will receive new cards
– Each individual covered under the plan will receive a card
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Online Enrollment Support
Available online – www.trs.state.tx.us/trs-activecare and www.bcbstx.com/trs
• Enrollment guide
• Summary of Benefits and Coverage (SBC)
• Downloadable forms (application and change form, application to split premium, claim form, etc.)
• Provider locator
• Enrollment presentation
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57
www.bcbstx.com/trswww.bcbstx.com/trs
Enrollment Info
Blue Access for Members
Blue Access for MembersSM
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Online member management tool• Research health conditions
• View claims history and print Explanation of Benefits (EOB) statements
• Locate a network doctor or hospital
• Order additional ID cards, or print a temporary ID
• Take a confidential health assessment
Send secure email messages to BCBSTXCustomer Advocates Monday thru Friday 7 a.m. to 10 p.m. (CT)
EOBs are available online; you must log in and elect to receive paper copiesEOBs are available online; you must log in and elect to receive paper copies
Blue Access MobileSM
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Public Site – No log-in required
• Health Care 101• Find a Doctor or Hospital• Blue Access for Members Log-in• Contact Information
Provider Finder AppFor iPhone® and Android® phones
A claim has been paid. Please log in to Blue Access for Members for details.
A claim has been paid. Please log in to Blue Access for Members for details.
A claim has been paid. Please log in to Blue Access for Members for details.
Blue Access for MembersSM Secure Site – Log-in Required
• ID Card
• My Coverage – Benefits / Eligibility
• Visits and Claims
• Health and Wellness – Diabetes, Obesity, Nutrition, Fitness, Metabolic Syndrome, Maternity Care, Member Care Profile
• User Profile
• Register for Blue Access for Members
Text MessagingStatic – One-Way SMS Messaging Diabetes Management, Claim Status Notification Alerts
Dynamic – Two-Way Messaging member initiates text with keyword (ID Card Management)
What if I Have Questions?
• Call TRS-ActiveCare customer service for:– Claim questions/status
– Network provider information
– Membership and eligibility
– Medical and Rx coverage questions
– Inquiries (telephone and email)
– ID card requests
– Transition of care information
– Help with online tools!
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Customer Service
1-866-355-5999
Personalized Service
QuestionsThank you for attending
TRS-ActiveCare is administered by Blue Cross and Blue Shield of Texas, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association. Blue Cross and Blue Shield of Texas provides claims payment services only and does not assume any financial risk or obligation with respect to claims. Prescription drug benefits for ActiveCare 1-HD, 2 and 3 plans are administered by Express Scripts, Inc. HMO plans provided by: SHA, L.L.C. dba FirstCare Health Plans, Scott and White Health Plan, and Valley Baptist Insurance Company dba Valley Baptist Health Plans.
