| (a) A full-time or part-time employee enrolled in TRS-ActiveCare
who, on or after September 1, 2011, changes employment from one participating
entity to another participating entity within the same plan year may
not change coverage plans or add dependents unless:
(1) changes to add dependents are authorized due to
a special enrollment event under provisions of the Health Insurance
Portability and Accountability Act of 1996 (Pub. L. No. 104-191, 110
Stat. 1936 (1996));
(2) an open-enrollment period exists on the first day
of the new employment and the full-time or part-time employee makes
such changes in compliance with open-enrollment conditions prescribed
by the trustee; or
(3) the new employment is with a participating entity
that does not make available the option under which the individual
was covered on the last date of previous employment, provided that
options are offered under TRS-ActiveCare that are not applicable to
all participating entities.
(b) A full-time or part-time employee enrolled in TRS-ActiveCare
who, on or before August 31, 2011, changes employment from one participating
entity to another participating entity within the same plan year may
not change coverage plans or add dependents unless:
(1) changes to add dependents are authorized due to
a special enrollment event under special enrollment provisions of
TRS-ActiveCare;
(2) an open-enrollment period exists on the first day
of the new employment and the full-time or part-time employee makes
such changes in compliance with open-enrollment conditions prescribed
by the trustee; or
(3) the new employment is with a participating entity
that does not make available the option under which the individual
was covered on the last date of previous employment, provided that
options are offered under TRS-ActiveCare that are not applicable to
all participating entities.
(c) No break in coverage will occur for a full-time
or part-time employee enrolled in TRS-ActiveCare who changes employment
from one participating entity to another participating entity within
the same plan year if all the criteria set forth in paragraphs (1)
- (3) of this subsection are met. The former employer participating
entity shall determine the last date of employment for purposes of
this subsection.
(1) The new employer makes available the same coverage
option under which the full-time or part-time employee was enrolled
on the last day of employment with the former employer;
(2) The individual is employed by the new participating
entity no later than the last day of the next calendar month after
the last date of employment with the former participating entity employer;
and
(3) The individual promptly files an election to continue
coverage with the new participating entity employer with coverage
to be effective in the calendar month in which the individual is first
employed with the new participating entity.
(d) Full-time or part-time employees who initially
waive coverage under TRS-ActiveCare may enroll during any open-enrollment
period as prescribed by the trustee; however, they may not enroll
due to a change in employment from one participating entity to another
during the same plan year unless the change occurs during a concurrent
open enrollment or the employee satisfies the requirements for an
enrollment opportunity provided under Rule 41.36(b) of this title.
|
| Source Note: The provisions of this §41.39 adopted to be effective August 26, 2002, 27 TexReg 7970; amended to be effective March 8, 2007, 32 TexReg 1092; amended to be effective April 9, 2008, 33 TexReg 2825; amended to be effective April 1, 2011, 36 TexReg 2001; amended to be effective September 1, 2011, 36 TexReg 5380; amended to be effective December 22, 2014, 39 TexReg 10029; amended to be effective August 15, 2019, 44 TexReg 4189 |
