Innovation Plans for Arlington ISD and Participating Region 4 Districts
Innovation Plans are TRS-ActiveCare Primary plans available to Arlington ISD and participating employers in Region 4. These plans are built to help participants save on premiums, copays and out-of-pocket costs.
Innovation plans offer the same coverage as other TRS-ActiveCare Primary plans offered in other regions, but introduce new approaches designed to improve cost transparency and help participants make more informed health care decisions before receiving care. The TRS-ActiveCare Primary x Arlington ISD plan includes in-network physician tiering, while the TRS-ActiveCare Primary x Region 4 plan includes in-network facility tiering.
This resource center provides district leaders and benefit administrators with information, communications materials and support resources related to the innovation plans.
Understanding Tiering
Tiering groups providers based on factors such as quality, cost, and clinical best practices, and the methodology varies for physicians and facilities. Participants pay less out-of-pocket costs when they choose a Tier 1 provider and pay more when they choose Tier 2.
Participants can still see a physician or go to a facility of their choice. Tiering gives participants more information to help them make choices about where to seek care.
Additional Information
The TRS-ActiveCare Primary x Arlington ISD plan includes physician tiering. In-network physicians are grouped into Tier 1 and Tier 2 categories based on criteria established by Blue Cross Blue Shield of Texas that considers quality, cost, and clinical best practices. If a participant chooses a Tier 1 primary care provider or specialist, they have a lower copay. Participants can continue using in-network physicians of their choice, but costs vary depending on the physician selected.
Primary Care Provider Copay (currently $30)
- Tier 1: $20
- Tier 2: $40
Specialist Copay (currently $70)
- Tier 1: $55
- Tier 2: $85
Employers may get questions about physician tiers and how costs vary for certain providers. Employees seeking assistance with physician selection and more information about their innovation plan should be directed to member support resources:
Personal Health Guides: Call 1-866-355-5999 or chat through the BCBSTX App
The TRS-ActiveCare Primary x Region 4 plan includes facility tiering for inpatient and outpatient services. In-network facilities are grouped into Tier 1 and Tier 2 categories. Costs can vary significantly from one facility to another. TRS tiers quality in-network facilities based on what they charge for medical services to help participants understand how their choice of facilities affects their health care costs.
If a participant chooses a Tier 1 facility, they will have a lower coinsurance rate. If a facility is Tier 2, this does not mean it is out of network. Participants can still use the facility, just with a higher cost sharing.
Outpatient & Inpatient Facility (currently 30%)
- Tier 1: 30% coinsurance after deductible
- Tier 2: 40% coinsurance after deductible
Employers may receive questions about facility tiers and how costs vary at certain facilities. Employees seeking assistance should be directed to available participant support resources:
- Region 4 Facility Tier Directory
- Personal Health Guide: call 1-866-355-5999 or chat through the BCBSTX App.
FAQs
No. Participants may continue using in-network providers and facilities.
No. Facility tiers reflect cost differences and are not quality rankings.
Participants can use Provider Finder and Personal Health Guides.
Provider Finder
To view physician tiers, open Provider Finder, select your TRS-ActiveCare plan, and search for a primary care physician or specialist.
Region 4 Directoy
Below is a list of Tier 1 and Tier 2 facilities in the innovation plan.
Available Support for Employers
TRS-ActiveCare Service Teams are available to support district leaders and benefit administrators with questions about plan administration, employee communications, enrollment processes, and available resources.
Benefit administrator advocates, district ambassadors, and other program partners work together to provide coordinated support for participating districts. For many questions, your service team can serve as a single point of contact and help connect you with the appropriate resource or subject matter expert.
