Texas Register, Volume 37, Number 40, Pages 7815-8094, October 5, 2012 Page: 7,982
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tiree's annuity payments are forfeited. A disability retiree shall pay
the total monthly cost of coverage starting with the calendar month
for which the first annuity payment is forfeited. The disability retiree
shall continue to pay the total monthly cost of coverage for each month
of coverage in which the annuity payment for that month is forfeited
in accordance with 31.36 of this title. Nothing in this section shall
be construed to prevent TRS from collecting the total monthly cost of
coverage for months in which annuities should have been but were not
forfeited if TRS determines that a disability retiree knowingly failed to
report compensation as required and the failure resulted in payment of
annuities by TRS that the disability retiree was not eligible to receive.
(g) Notwithstanding subsections (d) and (e) of this section, a
disability retiree whose annuity payments are forfeited under 31.36
of this title who fails to timely pay the full amount of a required con-
tribution for coverage attributable to his participation or that of his de-
pendents, including but not limited to amounts found due and owing
pursuant to a TRS determination that a disability retiree knowingly
failed to report compensation as required and the failure resulted in
payment of annuities by TRS that the disability retiree was not eligi-
ble to receive, shall have coverage under TRS-Care for himself and his
dependents suspended unless TRS-Care receives full payment of all
costs of coverage currently due and owing within thirty-one (31) days
after TRS-Care mails written notice to the disability retiree of the cur-
rent amount due and owing. Under such circumstances, the suspension
of coverage will be effective at midnight of the last day of the month
in which TRS-Care mailed the above written notice to the disability
retiree of the current amount due and owing. During such a suspen-
sion, coverage under TRS-Care will cease and the costs of coverage
for TRS-Care will no longer accrue.
(h) If TRS resumes payment of an annuity to a disability retiree
whose coverage has been suspended as described in subsection (g) of
this section, the following shall apply:
(1) Such disability retiree shall pay, no later than the last
day of the month in which TRS resumes annuity payments to the dis-
ability retiree, all costs of coverage due and owing attributable to the
participation of that disability retiree and the dependents of that dis-
ability retiree, including past due amounts for coverage prior to the
suspension and the costs of coverage for all months during which the
disability retiree's annuity payments are resumed, if any.
(2) Upon payment, reinstatement of TRS-Care coverage
shall be effective the first day of the earliest month for which the dis-
ability retiree's annuity payments are resumed.
(3) If payment in full of all required contributions then due
and owing is not timely received by TRS-Care, then notwithstanding
subsections (d) and (e) of this section:
(A) TRS-Care coverage for the dependents of that dis-
ability retiree shall be terminated effective the last day of the month in
which coverage was suspended under subsection (g) of this section;
(B) TRS-Care coverage for the disability retiree
enrolled in a TRS-Care 2 plan or a TRS-Care 3 plan prior to the sus-
pension, as applicable, will terminate effective the last day of the last
month during which the disability retiree's coverage was suspended
and the disability retiree will be enrolled in TRS-Care 1, effective
the first day of the earliest month for which the disability retiree's
annuity payments are resumed following the suspension, resulting in
a decrease in coverage; and
(C) TRS-Care coverage for the disability retiree en-
rolled prior to the suspension in TRS-Care I will resume effective the
first day of the earliest month for which the disability retiree's annuity
payments are resumed following the suspension. The disabilityretiree will not be able to change his TRS-Care coverage tier (level
of coverage) or add dependents unless and until the disability retiree
has an additional enrollment opportunity as set out in 41.2 of this
title [(relating o Additional Enrollment Opportunities) or some other
opportunity under Insurance Code, 1575.161.
41.7. Effective Date of Coverage.
(a) Except as allowed by subsection (c) of this section, for TRS
members who take a service or disability retirement and enroll in cov-
erage during their initial enrollment period as described in 41.1 of this
title (relating to Initial Enrollment Periods for the Health Benefits Pro-
gram Under the Texas Public School Retired Employees Group Bene-
fits Act (TRS-Care)), the effective date of coverage is:
(1) the first day of the month following the effective date
of retirement if the application for coverage is received by TRS-Care
on or before the effective retirement date; or
(2) the first day of the month following the receipt of the
application for coverage by TRS-Care if the application is received af-
ter the effective retirement date but within the initial enrollment period.
(b) A TRS member who takes a service or disability retirement
and enrolls in coverage during his or her initial enrollment period may,
at any time during his or her initial enrollment period, make changes
to his or her coverage elections. The effective date of coverage for
the new elections is the first day of the month following receipt by
TRS-Care of the application requesting the change in coverage.
(c) Regardless of the date a TRS member submits his applica-
tion for retirement, if a TRS member enrolls in coverage during his ini-
tial enrollment period as described in 41.1 of this title, the TRS mem-
ber may defer the effective date of coverage described in subsection (a)
of this section for himself and his eligible dependents to the first day
of any of the three (3) months immediately following the month after
the effective date of retirement. This deferment period runs concurrent
with, and does not extend, the enrollment period as described in 41.1
of this title. In no event may a TRS member defer the effective date of
TRS-Care coverage to a date prior to the date upon which TRS-Care
receives the application for coverage from the TRS member.
(d) The effective date of coverage for a surviving spouse or
for a surviving dependent child is the first day of his or her eligibility if
TRS-Care receives an application within the initial enrollment period
as described in 41.1 of this title and the deceased participant had the
surviving spouse or the surviving dependent child enrolled in TRS-
Care before the participant died.
(e) If the surviving spouse or the surviving dependent child
was not enrolled in TRS-Care immediately preceding his or her be-
coming eligible for coverage, the effective date of coverage will be, at
the election of the surviving spouse or the surviving dependent child,
either the first day of the month following:
(1) TRS-Care's receipt of an application during the initial
enrollment period as described in 41.1 of this title; or
(2) the month of the death of the deceased TRS service or
disability retiree or deceased active TRS member, provided TRS-Care
receives an application during the initial enrollment period as described
in 41.1 of this title.
(f) The effective date of coverage for an eligible dependent
who is enrolled under a retiree's or surviving spouse's TRS-Care cov-
erage during the initial enrollment period is the same date as the retiree
or surviving spouse's effective date of coverage unless the dependent is
enrolled after the retiree's effective retirement date and after the retiree
has enrolled but within the initial enrollment period, in which case the37 TexReg 7982 October 5, 2012 Texas Register
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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/m1/168/: accessed July 17, 2024), University of North Texas Libraries, The Portal to Texas History, https://texashistory.unt.edu.; crediting UNT Libraries Government Documents Department.