Texas Register, Volume 37, Number 40, Pages 7815-8094, October 5, 2012 Page: 7,981
7533-7814 p. ; 28 cm.View a full description of this periodical.
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(5) An eligible participant who is not enrolled in Medicare
Part A at the time of his or her Age 65 Additional Enrollment Oppor-
tunity can enroll:
(A) in any plan, for which he or she is eligible under
law, located in the next-higher TRS-Care coverage tier (level of cover-
age), as determined by TRS-Care;,[] and
(B) add dependent coverage in any plan, for which the
dependent is eligible under law, located in that same coverage tier level
of coverage).
(6) An eligible participant who is enrolled in Medicare Part
A at the time of his or her Age 65 Additional Enrollment Opportunity
can enroll:
(A) in any plan, for which he or she is eligible under
law, located in any TRS-Care coverage tier (level of coverage); and
(B) add dependent coverage in any plan, for which the
dependent is eligible under law, located in that same coverage tier (level
of coverage).
(7) An eligible participant, at the time of his or her Age 65
Additional Enrollment Opportunity, can:
(A) choose to remain in the same TRS-Care coverage
tier (level of coverage);
(B) enroll in any plan, for which he or she is eligible
under law, located in that same TRS-Care coverage tier (level of cov-
erage); and
(C) add dependent coverage in any plan, for which the
dependent is eligible under law, in that same coverage tier (level of
coverage).
(8) The period to enroll in TRS-Care pursuant to the Age 65
Additional Enrollment Opportunity for eligible participants described
in paragraph (2) or (3) of this subsection expires at the end of the later
of:
(A) the 31st day following the last day of the month in
which the eligible participant becomes 65 years old; or
(B) the 31st day after the date printed on the notice of
the additional enrollment opportunity sent to the eligible participant at
the eligible participant's last-known address, as shown in the TRS-Care
records.
(b) Special Enrollment Opportunity.
(1) An [For a special enrollment event that oeeurs on or
after Septemb2er - 211 an] individual who becomes eligible for cov-
erage under the special enrollment provisions of the Health Insurance
Portability and Accountability Act of 1996 (Pub. L. No. 104-191, 110
Stat. 1936 (1996)), including a dependent whose coverage under TRS-
Care was waived due to the existence of other coverage for the depen-
dent during the Age 65 Additional Enrollment Opportunity described
in subsection (a) of this section, may elect to enroll in TRS-Care.
(2) The enrollment period for an individual who becomes
eligible for coverage due to a special enrollment event shall be the
31 calendar days immediately after the date of the special enrollment
event. To make an effective election, a completed TRS-Care applica-
tion must be received by TRS within this 31-day period.
1(2) For a special enrollment e-ent that oeeus on or be-
fore August 3 204 except as provided in the exceptions found in
suragr.... (Ap - (C) of this paragraph an indiidial who be emes
eligible for coverage under the special enrollment provisions of the
Health Insurance Poi4ability and Aecountability Act of 996 (P-ub7 lNo 404-194- 4-10 Stat 4936 ( 996), including a dependent whose
coverage under TRS-Care was waived due to the existence of other
eoerage for the dependent during the Age 65 Additional Enrollment
Opportunity described in subsection (a) of this setion, may elect to
enroll in TRS-Care.]
(A) In no event may an individual who is already en-
rolled in TRS-Care eleet a different plan for himself or any eligible
depend.ents t may nly add eligible dependent for ceerage .nder
the indic rira'se- gp1 n eleti nup the e ce f a pe ial
enrollment ICen
(B) In no event may a TRS retiree enroll in TRS-Care
as a resofa special enrollment eent applicable to his dependent.]
(C) Inno event asa resuft of a special enrollment event
applicable to the dependent may the dependent of a TRS retiree enroll
in TRS-Care if the TRS retiree is not enrolled in TRS-Care.]
(c) Enrollment Opportunity Established by TRS. If an eligible
TRS retiree or his eligible dependent does not have either an Age 65
Additional Enrollment Opportunity or a special enrollment event, then
he may enroll in TRS-Care only during a subsequent enrollment period
established by TRS.
(d) This section does not affect the right of a TRS service re-
tiree or surviving spouse enrolled in a TRS-Care coverage tier (level
of coverage) to drop coverage, select a lower coverage tier (level of
coverage), or drop dependents at any time.
41.5. Payment of Contributions.
(a) Retirees, surviving spouses, and surviving dependent
children or their representative (collectively, "participants") shall
pay monthly contributions as set by the trustee for their and their
dependents' participation in TRS-Care.
(b) To be eligible for TRS-Care coverage, a participant must
authorize the trustee in writing to deduct the contribution amount from
the annuity payment. After such authorization, the trustee may deduct
the amount of the contribution from the annuity payment.
(c) If the amount of the contribution is more than the amount
of the annuity payment, the participant will be billed directly by TRS
or the TRS-Care administrator for the entire contribution amount.
(d) Failure to timely pay the full amount of a required contri-
bution for coverage of a dependent or a surviving dependent child will
result in termination of coverage for the dependent or surviving depen-
dent child at the end of the month for which the last contribution was
made.
(e) Failure to timely pay the full amount of a required con-
tribution for coverage of a retiree or a surviving spouse enrolled in a
TRS-Care 2 plan or a TRS-Care 3 plan will result in termination of
coverage in the TRS-Care 2 plan or the TRS-Care 3 plan, as applica-
ble, and enrollment in TRS-Care 1 for the retiree or surviving spouse,
resulting in a decrease in coverage at the end of the month for which
the last contribution was made. The retiree or surviving spouse will not
be able to change his or her TRS-Care coverage tier (level of coverage)
unless and until the retiree or surviving spouse has an additional enroll-
ment opportunity as set out in 41.2 of this title (relating to Additional
Enrollment Opportunities) or some other opportunity under Insurance
Code, 1575.161.
(f) A disability retiree whose annuity payments are forfeited
under 31.36 of this title (Relating to Forfeiture of Disability Retire-
ment Annuity Payments Due to Excess Compensation) shall pay the
total monthly cost of coverage, as determined by the trustee, attribut-
able to the participation of that disability retiree and the dependents
of that disability retiree during the months for which the disability re-PROPOSED RULES October 5, 2012 37 TexReg 7981
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Texas. Secretary of State. Texas Register, Volume 37, Number 40, Pages 7815-8094, October 5, 2012, periodical, October 5, 2012; Austin, Texas. (https://texashistory.unt.edu/ark:/67531/metapth288982/m1/167/: accessed July 17, 2024), University of North Texas Libraries, The Portal to Texas History, https://texashistory.unt.edu.; crediting UNT Libraries Government Documents Department.