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On February 21, 2012, the ERS Board of Trustees agreed to enter into contract negotiations with San Antonio-based United HealthCare Services, Inc. to serve as the third party administrator (TPA) for the self-funded HealthSelect of Texas health plan starting September 1, 2012.
ERS rebids Texas Employees Group Benefits Program contracts regularly to ensure members get quality benefits at a reasonable cost. After careful review during an eight-month selection process, United HealthCare was selected based on the quality of their programs and services, combined with a low administrative fee. The TPA is contracted to pay claims, provide customer service, offer health-and-wellness programs and manage the HealthSelect provider network.
HealthSelect is a self-funded managed care point-of-service plan, which allows ERS Trustees some control of healthcare benefits. Because ERS controls the plan design, a change in third party administrators does not mean that the benefits will change. The new contract is expected to save $41 million, which would benefit HealthSelect members by helping to offset the rising cost of medical care.
Network disruption is expected to be limited, as ERS projects that only about 2 percent of HealthSelect members will be required to choose a new primary care physician (PCP) because their current PCP does not participate. HealthSelect members should go to United HealthCare Choice Plus network and select United HealthCare Choice Plus, the ninth entry on the list, to find out if their doctor is in the network.
HealthSelect members do not need to take any immediate action and most will not be required to take any action at all. Members should automatically receive a new HealthSelect ID card before the next plan year starts on September 1, 2012, when United HealthCare will take over as TPA. ERS will post updates on their website during the transition and full details will be provided during Annual Enrollment.
To learn more about this healthcare contract, click on this link to the ERS website for answers to frequently asked questions.