| (9) A retiree whose extended life insurance benefits
are terminated for reasons other than termination pursuant to §1551.351
of the Act is eligible for retiree life insurance coverage on the
first day of the month following the extended life insurance benefits
termination date.
(c) Dependents of employees and retirees.
(1) The dependents of an employee/retiree are eligible
for coverage on the same day that the employee/retiree becomes eligible.
Except as otherwise provided in this paragraph, a newly acquired dependent
is eligible for coverage on the first day of the month following the
date on which the individual becomes a dependent of a covered employee/retiree.
The employee/retiree must be enrolled for a particular coverage before
the employee's/retiree's dependents are eligible for that type of
coverage. An eligible child for whom a covered employee/retiree is
court-ordered to provide medical support becomes eligible for GBP
health coverage upon receipt by the employer of a valid court order.
A newborn natural child is eligible automatically on the date of birth.
A newly adopted child is eligible automatically on the date of placement
for adoption.
(2) Except as otherwise provided in this paragraph,
double coverage is not permitted for any participant in the GBP.
(A) A participant may not be simultaneously covered
by basic or optional term life insurance as an employee/retiree and
dependent term life insurance as a dependent. A family member who
is covered as an employee/retiree is not eligible to be covered as
a dependent in the GBP. Except as provided in subparagraph (B) of
this paragraph, a dependent may not be covered by more than one employee/retiree
for the same coverage.
(B) A child who is an eligible dependent of two employees/retirees
in the GBP may be enrolled in dependent life insurance coverage and
accidental death and dismemberment coverage by both employees/retirees,
if otherwise eligible.
(d) Former COBRA unmarried children.
(1) A former COBRA unmarried child is eligible to continue
the GBP health, dental and vision insurance coverage in which the
child was enrolled upon expiration of the child's continuation coverage
under COBRA.
(2) A former COBRA unmarried child continuing health
insurance coverage under the provisions of this subsection is eligible
for dental and vision insurance coverage if such coverage was not
in effect upon the expiration of the child's continuation coverage
under COBRA.
(3) A former COBRA unmarried child is eligible to enroll
a newly acquired dependent child within 30 days of the child's date
of birth or placement for adoption. Otherwise, he/she cannot enroll
any other dependents in GBP health coverage.
(e) Surviving dependents.
(1) The surviving spouse of a deceased retiree or an
active employee is eligible to continue coverage in the GBP health,
dental and vision plans in which the surviving spouse was enrolled
on the day of death of the employee/retiree provided, however, the
deceased active employee must have had at least 10 years of service
credit, including at least 3 years on August 31, 2001 or at least
10 years after August 31, 2001 of service as an eligible employee
with an employer, at the time of death. A deceased active employee
described by §1551.114 of the Act must have had at least 10 years
of eligible service credit, as determined by ERS, before his/her surviving
spouse is eligible to continue coverage. A surviving spouse who is
also an annuitant or employee shall not be eligible for surviving
spouse benefits as long as he/she is eligible for coverage as an employee/retiree.
Participants continuing coverage as surviving spouses are not eligible
for life insurance coverage.
(2) The dependent child of a deceased retiree or an
active employee is eligible to continue coverage in the GBP health,
dental and vision plans in which the dependent children were enrolled
on the day of death of the employee/retiree provided, however, the
deceased active employee must have had, at the time of death, at least
10 years of service credit, including at least 3 years on August 31,
2001 or at least 10 years after August 31, 2001 of service as an eligible
employee with an employer, as long as the surviving spouse is eligible
and continues to participate in the GBP. A deceased active employee
described by §1551.114 of the Act must have had at least 10 years
of eligible service credit, as determined by ERS, before his/her dependent
children are eligible to continue coverage. Dependent children of
deceased employees/retirees will be considered as dependents of the
deceased employee's/retiree's surviving spouse for purposes of the
GBP. Participants continuing coverage as surviving dependents are
not eligible for life insurance coverage.
(3) If a retiree or active employee does not have a
spouse covered in the GBP at the time of his/her death, dependent
children of the deceased retiree or active employee are eligible to
continue coverage in the GBP health, dental and vision plans in which
the dependent children were enrolled on the day of death of the employee/retiree
provided, however, the deceased active employee must have had at least
10 years of service credit, including at least 3 years on August 31,
2001 or at least 10 years after August 31, 2001 of service as an eligible
employee with an employer, at the time of death. A deceased retiree
or active employee described by §1551.114 of the Act, must have
had at least 10 years of eligible service credit, as determined by
ERS, before his/her dependent children are eligible to continue coverage.
A surviving dependent child may continue such coverage until the dependent
child becomes ineligible as defined in §81.1 of this chapter
(relating to Definitions). Participants continuing coverage as surviving
dependents are not eligible for life insurance coverage.
(4) A person who is the surviving spouse or dependent
of a member may secure GBP health coverage if the individual was eligible
to participate in the GBP under §§1551.101, 1551.102 or
1551.155(a) of the Act, but was not participating at the time of the
individual's death.
(5) A surviving spouse or dependent seeking group coverage
under paragraphs (1) - (4) of this subsection must apply for coverage
not later than the 30th day after the date on which the individual
who was eligible to participate in the GBP dies; and shall pay for
coverage at the group rate for other participants.
(6) A surviving spouse or an eligible dependent child
of a paid law enforcement officer employed by the state or a custodial
employee of the institutional division of the Texas Department of
Criminal Justice who suffers a death in the line of duty as provided
by Chapter 615, Government Code, shall be eligible for coverage in
the GBP as provided in subparagraphs (A) - (D) of this paragraph.
(A) Coverage for a surviving spouse under this paragraph
shall be at the same rate as the employee-/retiree-only coverage,
and the surviving spouse shall be entitled to the benefit of the state
contribution applied to employee-/retiree-only coverage.
(B) Coverage for a surviving spouse with children shall
be at the same rate as the employee-/retiree-with-children coverage,
and the survivors shall be entitled to receive the benefit of the
state contribution applied to coverage for an employee-/retiree-with-children.
(C) Where there is no surviving spouse, a surviving
child eligible for coverage under this paragraph shall be entitled
to the benefit of the state contribution for employee-/retiree-only
coverage.
(D) In order for a surviving spouse or children to
receive coverage in the GBP under this paragraph, they must pay the
balance, if any, of all contributions due after applying the state
contribution to such coverage. Any out-of-pocket insurance required
contributions due from the survivor may be deducted by ERS from the
survivor's annuity payment, if any, or must be paid to ERS by the
survivor through electronic bank deduction or direct payment. The
applicable state contributions will be paid to ERS by the employer
that employed the deceased law enforcement officer or custodial employee.
(7) A surviving spouse and eligible dependents, and
a surviving dependent child, continuing GBP health coverage under
the provisions of this subsection are eligible for dental and vision
insurance coverage if such coverage was not in effect on the date
of death of the deceased employee/retiree. Any insurance required
contributions are the sole responsibility of the surviving spouse
and dependents.
(f) Disability retiree. An ORP participant who applies
and is approved for disability retirement is entitled to retiree insurance
coverage as provided in §81.7(a)(3) of this chapter. An ORP participant
authorized by the Act with at least 10 years of eligible service credit,
and granted ORP disabled retiree status in the GBP, as established
by ERS, is eligible to participate in the GBP. Initial or continued
eligibility for insurance coverage for an ORP disabled retiree will
be determined by ERS under the following provisions.
Cont'd... |
