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Medical Benefits

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Health Insurance Plan Options

The State of Texas provides benefits-eligible employees with health coverage that includes medical care and prescription drug benefits. For full-time employees, coverage begins on the first day of the month after your 60th day on the job.

During your first 60 days of employment, you can sign up your dependents for health insurance with no questions asked and without evidence of insurability. Even if you or a family member has a chronic medical condition, coverage is guaranteed. If you enroll dependents in health coverage, Alight Solutions will send you a letter describing the steps you must take to prove your dependents’ eligibility. Please call Alight Solutions toll-free at 800-987-6605 (TTY: 711) Monday - Friday, 7 a.m. - 10 p.m. CT. More information is available on the ERS dependent eligibility verification website.

Employees are considered full-time for health insurance purposes if they are scheduled to work 30 or more hours a week.

If you and your dependents are enrolled in the health insurance plans, you are required to certify whether you and your dependents use tobacco. The monthly premium is $30 per person, up to $90 per household. If you do not certify, you will be subject to the monthly Tobacco User Premium. For more information, view the ERS tobacco policy.

The prescription drug deductible starts over every January 1—you and each of your covered dependents must pay separate $50 deductibles before the plan begins to cover drug costs.

For the latest information about health insurance plans and rates, visit the ERS website.


HealthSelect

Following this plan, you choose a HealthSelect PCP and that doctor refers you to specialists and other providers within the network. When you stay in the network, you reduce your costs.

These are the monthly rates established for Sept. 1, 2023 – Aug. 31, 2024:

HealthSelect Health Plan Coverage
Plan Members Pay
Member only
$0.00
Member and spouse
$380.00
Member and children
$239.70
Family
$597.70

For more details about this plan, visit the ERS HealthSelect website.

HealthSelect Prescription Drug Plan

Express Scripts will be the administrator for the HealthSelect Prescription Drug Program beginning Jan. 1, 2024. You may visit www.HealthSelectRx.com for program information. Employees may contact customer care representatives toll-free at 800-935-7189.

Consumer Directed Health Select

Consumer Directed HealthSelect is a high-deductible health plan, which means you could pay much more in out-of-pocket costs for health services and prescriptions. The member is responsible for paying an annual in-network deductible of $2,100 for an individual or $4,200 for a family (member plus at least one family member) for covered health services and/or prescriptions before the plan begins to pay for anything except for preventive services. Preventive services, like annual check-ups or vaccinations, are covered at 100%. The member would have to pay the full cost of other services and prescriptions until the deductible is met, and it’s important to understand what the full costs are, especially for prescriptions. After the deductible is met, the health plan pays 80% of covered, in-network services and prescriptions.

One of the advantages of joining Consumer Directed HealthSelect is that you can contribute to an HSA. An HSA is a personal bank account to help you save and pay for health care while giving you real tax savings.

These are the monthly rates established for Sept. 1, 2023 – Aug. 31, 2024:

Consumer Directed HealthSelect Health Plan Coverage
Plan Members Pay
Member only
$0.00
Member and spouse $322.20
Member and children
$215.72
Family
$537.92

For more details about this plan, visit the ERS Consumer Directed HealthSelect website.

Consumer Directed HealthSelect Prescription Drug Plan

The Consumer Directed HealthSelect Prescription Drug Program is Express Scripts. You may visit www.HealthSelectRx.com for program information. Employees may contact customer care representatives toll-free at 800-935-7189.

Virtual Visits

With your medical plan, you may access medical health care through Doctor On Demand® and MDLIVE®. Virtual Visits give you 24/7 non-emergency care from a board-certified doctor by phone, online video or mobile app from almost anywhere. If you need assistance signing up for virtual visits or making an appointment, go to the virtual visits page on the HealthSelect website or call a Blue Cross and Blue Shield of Texas (BCBSTX) Personal Health Assistant toll-free at 800-252-8039, Monday–Friday, 7 a.m. - 7 p.m. and Saturday 7 a.m. - 3 p.m. CT.

Mental Health

You can see a licensed mental health professional by scheduling an in-office visit. If an office visit is not convenient, you also can meet with a provider from the comfort of your home or office by scheduling a mental health virtual visit. Mental health virtual visits are offered through Doctor On Demand® and MDLIVE® and are covered at the same benefit level as an in-office mental health visit. You must make appointments in advance.