HMOs no longer offered starting Sept. 1

June 07, 2021

Learn about options for plan participants

Starting September 1, ERS will no longer offer Scott and White Care Plans (SWCP) and Community First Health Plans (CFHP) through the Texas Employees Group Benefits Program (GBP). In June, ERS is mailing current HMO participants information about changing to another health plan.

Participants not enrolled in Medicare

Scott and White logo and Community First Health Plans logo

If you and your covered dependents are not eligible for Medicare, ERS will automatically enroll you in HealthSelect of Texas® effective September 1, unless during Summer Enrollment you choose to enroll in Consumer Directed HealthSelectSM. These two HealthSelect medical plans are administered by Blue Cross and Blue Shield of Texas (BCBSTX) and have prescription drug coverage administered by OptumRx. See details about the two plans in your Summer Enrollment packet or on the ERS website.

You can also waive GBP health coverage or choose Health Insurance Opt-Out Credit if you have other group health insurance that is comparable to GBP health coverage. If you waive GBP health coverage or elect the Opt-Out Credit, you will no longer have prescription drug coverage or Basic Life insurance through the GBP.

Medicare-enrolled HMO participants

If you or a dependent is enrolled in SWCP or CFHP and Medicare, you must submit your Medicare Beneficiary Identifier (MBI) to ERS by July 30 to enroll in HealthSelectSM Medicare Advantage Plan, a preferred provider organization (MA PPO), effective September 1. You can submit this information through your ERS OnLine account or by calling ERS toll-free at (877) 275-4377. HealthSelect MA PPO is insured by UnitedHealthcare.

If you don’t provide ERS with your Medicare information, ERS will enroll you in HealthSelectSM Secondary (administered by BCBSTX) effective September 1. This plan is not a Medicare Advantage plan. It has higher premiums for retirees whose premiums aren’t paid 100% by the state and higher out-of-pocket costs than the Medicare Advantage plan.

HealthSelect MA PPO and HealthSelect Secondary include prescription drug coverage through HealthSelectSM Medicare Rx, administered by UnitedHealthcare. You can provide your MBI to ERS at any time, but ERS must have it by July 30 for your Medicare Advantage coverage to be effective September 1. You can switch from the Medicare Advantage plan (HealthSelect MA PPO) to the non-Medicare Advantage plan (HealthSelect Secondary) at any time. All previous HMO participants will get plan guides and ID cards from their new GBP medical and prescription drug plans before September 1.

View HMOs will not be available in Plan Year 2022 for more information or call ERS toll-free at (877) 275-4377 (TTY: 711). To talk to an insurance specialist, say “insurance” then select option 2 when prompted. Representatives are available Monday through Friday, 8 a.m. – 5 p.m.