| (a) Applicability. This section is applicable to the
election to participate in TRS-ActiveCare by eligible entities such
as school districts, other educational districts, charter schools,
and regional education service centers, as these terms are defined
in Chapter 1579, Insurance Code.
(b) Manner, form and effect of election.
(1) Form of the notice of election. All elections to
participate or discontinue participation in the health benefits program,
referred to as "TRS-ActiveCare," under the Texas School Employees
Uniform Group Health Coverage Act (the "Act"), Chapter 1579, Insurance
Code, shall be in writing, in a form prescribed by the Teacher Retirement
System of Texas (TRS), as trustee of TRS-ActiveCare.
(2) Incomplete notice of election. An incomplete or
unsigned notice of election will not be deemed received by TRS for
purposes of determining whether a valid election has been exercised.
Written notice of election to participate in TRS-ActiveCare under
this section submitted without the information required under §41.45
of this title (relating to Required Information from School Districts,
Other Educational Districts, Charter Schools, and Regional Education
Service Centers Electing to Participate in TRS-ActiveCare) will be
considered incomplete and will be denied by TRS. In order to reduce
the possibility of submitting an incomplete form, entities should
reach out to TRS before the election deadline referenced in this section
to ask questions and address issues.
(3) Timing of the receipt of the notice of election.
A notice of election to participate or discontinue participation that
is otherwise valid must be received by TRS no later than December
31 of the year preceding the first day of the plan year in which the
election will be effective.
(4) Mandatory Participation and Exclusion Timeframes.
Each time an entity submits a notice of election to participate in
TRS-ActiveCare in accordance with subsection (b)(1) - (3) of this
section, the entity is committing to participate for a minimum of
five plan years, after which the entity may choose to submit a notice
to discontinue participation. In the same manner, each time an entity
submits a notice to discontinue participation in TRS-ActiveCare in
accordance with subsection (b)(1) - (3) of this section, the entity
is committing to leave the program for a minimum of five plan years,
after which the entity may choose to submit a notice of election to
participate. Mandatory participation and mandatory exclusion periods
will be strictly enforced.
(c) Charter schools. Pursuant to §1579.154(a),
Insurance Code, to be eligible, a charter school must agree to inspection
of all records of the school relating to its participation in TRS-ActiveCare
by TRS, by the administering firm as defined in §1579.002(1),
Insurance Code, by the commissioner of education, or by a designee
of any of those entities, and further must agree to have its accounts
relating to participation in TRS-ActiveCare annually audited by a
certified public accountant at the school's expense. The agreement
of the charter school shall be evidenced in writing and shall constitute
a part of a notice of election in a form prescribed by TRS pursuant
to subsection (b) of this section.
(d) Effective Date of Participation or Discontinuation
of Participation. An entity will become a participating entity or
discontinue to be a participating entity in TRS-ActiveCare on the
first day of the plan year following the December 31st date on which
TRS receives the entity's notice of election to become a participating
entity or discontinue being a participating entity referenced in subsection
(b) of this section.
(e) Alternative group health coverage prohibition.
In accordance with Section 1579.1045, Insurance Code, a participating
entity is prohibited from offering or making available group health
coverage other than that provided under the TRS-ActiveCare program
to the entity's employees or their employees' dependents.
(f) Remedies for failure to comply. If, contrary to
subsection (e) of this section and Section 1579.1045 of the Insurance
Code, a participating entity offers alternative group health coverage,
TRS may pursue remedies for noncompliance, including but not limited
to removal from or denial of entry into TRS-ActiveCare. TRS may impose
or pursue one or more remedies. The pursuit of one remedy does not
constitute a waiver of any other remedy that TRS may have at law or
equity. If TRS discovers that a participating entity is in violation
of subsection (e) after the beginning of a plan year, in addition
to any other available remedy, TRS will remove the entity from the
program effective at the end of the month in which TRS discovers the
situation; and it will be the entity's liability to procure alternative
coverage or provide other remedies for the employees and their dependents
that lose coverage under these circumstances.
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| Source Note: The provisions of this §41.30 adopted to be effective January 1, 2002, 26 TexReg 11035; amended to be effective March 12, 2003, 28 TexReg 2114; amended to be effective June 18, 2003, 28 TexReg 4560; amended to be effective March 8, 2007, 32 TexReg 1092; amended to be effective April 1, 2011, 36 TexReg 2001; amended to be effective December 22, 2014, 39 TexReg 10029; amended to be effective October 17, 2021, 46 TexReg 6944 |
