Compliance Statement
For Period 5/1/2009 – 4/30/2010
AYW (American YouthWorks) is committed to providing high-quality health insurance to its employees. TRS (Teachers Retirement System) requires that school districts complete a comparability study every other year, to determine whether the medical insurance that they offer their employees is comparable to the medical insurance offered to Texas State Employees, through ERS (Employee Retirement System). TRS created a complex methodology and criteria for comparing district medical benefits with those of State employees. AYW has made its best effort to evaluate the factors identified by the Texas Education Code as necessary for determining comparability. We meet the criteria for the individual measures, as follows:
1. The deductible amount for services provided inside and outside of provider networks – the deductibles for our Plan 3 are comparable to those of the TRS Active Care Plans, but the deductibles for our Plans 1 and 2 are higher.
2. The coinsurance percentages for services provided inside and outside of the network – Plan 2 has higher coinsurance percentages, but Plans 1 and 3 exceed the required coinsurance percentages.
3. The maximum amount of coinsurance payments a covered person is required to pay – Plan 2 has higher individual out-of-pocket maximums, but Plans 1 and 3 have lower out-of-pocket maximums than the TRS Active Care Plans.
4. The amount of co-payment for an office visit – Plans 1 and 2 have higher co-payments than the TRS plans, but Plan 3 has comparable co-payments.
5. The schedule of benefits and scope of coverage – both our plans and those of TRS offer a broad schedule of benefits and scope of coverage.
6. The lifetime maximum benefit amount -- our plans offer a $5 million lifetime maximum, which we have been advised should be more than adequate. In-Network, TRS offers no maximum.
AYW is in compliance with all other requirements of Section 22.004 of the Education Code.