| (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
contribution for coverage of a dependent or a surviving dependent
child will result in termination of coverage for the dependent or
surviving dependent 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
contribution for coverage of a retiree or a surviving spouse will
result in termination of coverage for the retiree or surviving spouse
at the end of the month for which the last contribution was made.
(f) A disability retiree whose annuity payments are
forfeited under §31.36 of this title (Relating to Forfeiture
of Disability Retirement Annuity Payments Due to Excess Compensation)
shall pay the total monthly cost of coverage, as determined by the
trustee, attributable to the participation of that disability retiree
and the dependents of that disability retiree during the months for
which the disability retiree'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 contribution for coverage attributable to his participation
or that of his dependents, 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 eligible 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 current 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 suspension, 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 disability retiree, all costs of coverage due and owing attributable
to the participation of that disability retiree and the dependents
of that disability 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
disability 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:
(A) TRS-Care coverage for the dependents of that disability
retiree shall be terminated effective the last day of the month in
which the dependents' coverage was suspended under subsection (g)
of this section;
(B) TRS-Care coverage for the disability retiree shall
be terminated effective the last day of the last month in which the
disability retiree's coverage was suspended under subsection (g) of
this section.
|
| Source Note: The provisions of this §41.5 adopted to be effective April 7, 1987, 12 TexReg 1000; amended to be effective November 6, 1987, 12 TexReg 3926; amended to be effective March 12, 2003, 28 TexReg 2112; amended to be effective February 9, 2006, 31 TexReg 709; amended to be effective March 27, 2008, 33 TexReg 2554; amended to be effective January 6, 2013, 37 TexReg 10248; amended to be effective January 4, 2018, 42 TexReg 7720 |
