| (a) An eligible entity that submits a written election
to participate in TRS-ActiveCare under §41.30 must include with
the notice of election the information listed below for each medical
and prescription drug plan that the entity offered to its employees
during the designated time period. The entity must include this information
for the year to date for the plan year in which the entity submits
its notice of election (current year) and for the two complete plan
years immediately preceding the current year. The required information
is:
(1) Plan type (PPO, POS, HMO, etc.), including the
effective date of each plan;
(2) Average number of employees participating in each
plan;
(3) Average number of covered lives in each plan;
(4) Description of all medical and prescription drug
benefits, including effective dates of any changes in each plan;
(5) Total premium rates by family tier for each insured
plan, including effective dates of any changes;
(6) Total COBRA rates by family tier for each self-funded
plan, including effective dates of any changes;
(7) Required employee contribution rates by family
tier for each plan, including effective dates of any changes;
(8) Funding arrangement (fully insured, self-funded,
etc.) for each plan;
(9) Total premiums paid by year for each plan, if insured;
(10) Total claims paid by year for each plan;
(11) Employee counts by age, gender, and participation
status;
(12) A high cost claimant report; and
(13) Any other summary health information that TRS
may require.
(b) Written notices of election to participate in TRS-ActiveCare
under §41.30 without the information required under this section
will be considered incomplete and will be denied by TRS. Entitles
should reach out to TRS before the election deadline in §41.30
to ask questions and address issues related to the information that
is required under this section.
(c) TRS will not deny an entity's request to participate
in TRS-ActiveCare based on any information provided to TRS in accordance
with the requirements of this section.
(d) TRS may prescribe the form in which entities must
submit the information required by this section.
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| Source Note: The provisions of this §41.45 adopted to be effective June 18, 2003, 28 TexReg 4561; amended to be effective April 1, 2011, 36 TexReg 2001; amended to be effective October 17, 2021, 46 TexReg 6944 |
