Part 1. COMPTROLLER OF PUBLIC ACCOUNTS
Subchapter GG. INSURANCE TAX
The Comptroller of Public Accounts adopts an amendment to §3.834, concerning volunteer fire department assistance fund assessment pursuant to the Insurance Code, Chapter 2007, without changes to the proposed text as published in the January 25, 2008, issue of the Texas Register (33 TexReg 658). Subsection (a) is being amended to clarify the calculation of the assessment, clarify the final assessment date, and delete the definition of assessment date. Subsection (b) now sets out the formula for the calculation of the assessment. Subsection (e) is amended to stipulate that insurers may recoup the assessment from policy holders. Subsections (d), (f), and (g) are amended to correct statutory citations due to the recodification of the Insurance Code. The remaining subsections are being relettered accordingly.
No comments were received regarding adoption of the amendment.
The amendment is adopted under Tax Code, §111.002 and §111.0022, which provide the comptroller with the authority to prescribe, adopt, and enforce rules relating to the administration and enforcement of the provisions of Tax Code, Title 2, and taxes, fees, or other charges which the comptroller administers under other law.
The rule implements Texas Insurance Code, Chapter 2007.
This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority.
Filed with the Office of the Secretary of State on March 10, 2008.
TRD-200801375
Martin Cherry
General Counsel
Comptroller of Public Accounts
Effective date: March 30, 2008
Proposal publication date: January 25, 2008
For further information, please call: (512) 475-0387
Chapter 31. EMPLOYMENT AFTER RETIREMENT
Subchapter C. EMPLOYMENT AFTER DISABILITY RETIREMENT
The Board of Trustees (Board) of the Teacher Retirement System of Texas (TRS) adopts new §§31.35 - 31.37 relating to a disability retiree's report of excess compensation earned for work during retirement and forfeiture of annuity payments due to excess compensation. The new sections are adopted in response to legislation providing for the suspension or reduction of disability retirement annuity benefits received by a TRS disability retiree based on excess compensation earned for work. The new sections are adopted without changes to the proposed text as published in the November 23, 2007, issue of the Texas Register (32 TexReg 8426).
New §§31.35 - 31.37 are adopted in response to House Bill 2427, 80th Legislature, Regular Session (2007) ("H.B. 2427"). H.B. 2427 amended the provisions of the TRS retirement plan to authorize TRS to adopt rules relating to the suspension or reduction of disability retirement annuities based on compensation earned by a disability retiree. H.B. 2427 also requires a disability retiree whose annuity is suspended to pay an additional premium for coverage under the retirees' health benefit plan, TRS-Care, as determined by TRS as the trustee for TRS-Care, up to the total cost of coverage for the retiree and any dependents, during the period of time the annuity is suspended. To implement the payment of any additional TRS-Care premiums because of the forfeiture of disability retirement annuities under adopted new §§31.35 - 31.37, TRS also adopts amended TRS-Care rule 34 TAC §41.5 (relating to Payment of Contributions), as published elsewhere in this issue of the Texas Register.
Adopted new §31.35 concerns a disability retiree's report of excess compensation. The adopted new section would require a new disability retiree to report earned compensation to TRS when the annual compensation exceeds the greater of the disability retiree's highest salary in any school year before retirement or $40,000. Under the adopted rule, a report would not be required for a calendar year in which the retirement annuity payments totaled $2,000 or less. The adopted new rule would also establish administrative requirements relating to the required report, including a description of "compensation," a calendar year schedule for the filing of a report (beginning with the first full calendar year after the retiree's effective date of retirement), and a May 1 annual deadline for the report. Under new §31.35, TRS may audit the compensation report of a disability retiree by requiring the retiree to provide more information and may obtain independent information regarding earnings.
Adopted new §31.36 concerns forfeiture of disability retirement annuity payments due to excess compensation. Under the adopted new section, a disability retiree's monthly annuity payments would be forfeited if the retiree reported earned compensation in excess of the limit established under adopted new §31.35. The new section provides, however, that TRS would resume annuity payments following receipt of a new report showing that compensation had ceased or decreased sufficiently. The adopted new rule also provides for the forfeiture of disability retirement annuities if TRS were to learn that a disability retiree had failed to report compensation in excess of the limit.
Adopted new §31.37 concerns the applicability of excess compensation provisions to employment after retirement in Texas public educational institutions. Under the adopted new section, a disability retiree is subject to the reporting and forfeiture provisions if the retiree earns compensation for employment by a Texas public educational institution, regardless of whether the employment results in forfeiture of an annuity in the month of employment under existing employment after retirement rules.
No comments were received regarding the proposed new sections.
Statutory Authority: The new sections are adopted under the authority of the following sections of the Government Code: §824.310, which authorizes TRS to adopt rules relating to the suspension or reduction of disability retirement annuities based on compensation earned by a disability retiree; §824.301, which authorizes the Board to adopt rules requiring the submission to TRS of additional information about a disability; and §825.102, which authorizes the Board to adopt rules for the administration of the funds of the retirement system.
This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority.
Filed with the Office of the Secretary of State on March 7, 2008.
TRD-200801362
Ronnie G. Jung
Executive Director
Teacher Retirement System of Texas
Effective date: March 27, 2008
Proposal publication date: November 23, 2007
For further information, please call: (512) 542-6438
Subchapter A. RETIREE HEALTH CARE BENEFITS (TRS-CARE)
The Board of Trustees (Board) of the Teacher Retirement System of Texas (TRS) adopts amendments to §41.2 relating to additional enrollment opportunities under TRS-Care, the health benefits program for TRS retirees administered by TRS, as trustee. The substantive amendments, located in a new subsection (b), are adopted mainly to address special enrollment events under TRS-Care. The amended section is adopted with non-substantive changes to the formatting of the proposed text of §41.2(a), (a)(8) and (b)(1) as published in the November 30, 2007, issue of the Texas Register (32 TexReg 8699).
The substantive amendments to §41.2, located in a new subsection (b), as noted above, are adopted mainly to address special enrollment events under TRS-Care, which have been defined by TRS rule. Pursuant to Board authorization granted in February 2007, TRS filed the appropriate documentation with the Centers for Medicare and Medicaid Services (CMS) to elect to exempt (i.e., opt out) TRS-Care from Provisions 2 and 3 of the Health Insurance Portability and Accountability Act of 1996 (HIPAA). Provision 2 of HIPAA addresses special enrollment events. By opting out of this provision of HIPAA, the special enrollment events of TRS-Care are described and defined in new subsection (b) of amended §41.2, through the adoption of HIPAA standards, save and except as to listed exceptions to HIPAA contained therein. New subsection (b) of the amended rule clarifies that individuals who are already enrolled in TRS-Care may not elect a different plan upon the occurrence of a special enrollment event. Also, a TRS pension retiree who is not already enrolled in TRS-Care cannot enroll in TRS-Care as a result of a special enrollment event applicable to his dependent. Finally, in no event, as a result of a special enrollment event applicable to the dependent, may the dependent of a TRS pension retiree enroll in TRS-Care if the TRS pension retiree is not already enrolled in TRS-Care.
The non-substantive amendments to §41.2 relate to a general reorganization of this rule into three distinct and separately addressed additional enrollment opportunities: an Age 65 Additional Enrollment Opportunity addressed in §41.2(a), the above noted special enrollment event opportunity addressed in §41.2(b), and an enrollment opportunity established by TRS addressed in §41.2(c). The remaining proposed non-substantive amendments to §41.2 are proposed for purposes of clarification or to delete subsections that are no longer necessary. The technical, non-substantive change to the formatting of the proposed text as published occurs in §41.2(a): the phrase in subsection (a) referring back to the same subsection, i.e., back to itself -- "as described in subsection (a) of this section" -- is changed to read, "as described in this subsection." The change does not require republication of the amended rule for public comment.
No comments were received regarding the proposed amended section.
Statutory Authority: The amended section is adopted under the authority of §1575.052, Insurance Code, which authorizes the Board to adopt rules it considers necessary to implement and administer the TRS-Care program.
§41.2.Additional Enrollment Opportunities.
(a) Age 65 Additional Enrollment Opportunity. "Eligible participants," as defined in paragraph (1) of this subsection, have an additional enrollment opportunity in TRS-Care as described in this subsection when they become 65 years old (the "Age 65 Additional Enrollment Opportunity").
(1) For purposes of this subsection, the term "eligible participants" means:
(A) all TRS service retirees who are enrolled in TRS-Care;
(B) dependents, as defined in Insurance Code, §1575.003, who are enrolled in TRS-Care and who are eligible to enroll in TRS-Care in their own right as a TRS service or disability retiree; and
(C) surviving spouses, as defined in Insurance Code, §1575.003 who are enrolled in TRS-Care.
(2) Those eligible participants who are enrolled in TRS-Care on August 31, 2004, and who become 65 years old after that date have the Age 65 Additional Enrollment Opportunity on the date that they become 65 years old.
(3) Those eligible participants who enroll in TRS-Care after August 31, 2004, and who become 65 years old after the date of their enrollment have the Age 65 Additional Enrollment Opportunity on the date that they become 65 years old.
(4) The Age 65 Additional Enrollment Opportunity for those eligible participants who enroll in TRS-Care after August 31, 2004, and who are 65 years old or older when they enroll in TRS-Care runs concurrently with the initial enrollment period as set out in §41.1 of this title (relating to Initial Enrollment Periods for the Health Benefits Program Under the Texas Public School Retired Employees Group Benefits Act (TRS-Care)).
(5) An eligible participant who is not enrolled in Medicare Part A at the time of his or her Age 65 Additional Enrollment Opportunity can enroll in the next-higher TRS-Care coverage tier, as determined by TRS-Care, and add dependent coverage in that same coverage tier.
(6) An eligible participant who is enrolled in Medicare Part A at the time of his or her Age 65 Additional Enrollment Opportunity can enroll in any TRS-Care coverage tier and add dependent coverage in that same coverage tier.
(7) An eligible participant, at the time of his or her Age 65 Additional Enrollment Opportunity, can choose to remain in the same TRS-Care coverage tier and add dependent coverage in that coverage tier.
(8) The period to enroll in TRS-Care pursuant to the Age 65 Additional Enrollment Opportunity for eligible participants described in paragraph (2) or (3) of this subsection expires at the end of the later of:
(A) the 31st day following the last day of the month in which the eligible participant becomes 65 years old; or
(B) the 31st day after the date printed on the notice of the additional enrollment opportunity sent to the eligible participant at the eligible participant's last-known address, as shown in the TRS-Care records.
(b) Special Enrollment Event Opportunity.
(1) Except as provided in the exceptions found in subparagraphs (A) - (C) of this paragraph, an individual who becomes eligible for coverage under the special enrollment provisions of the Health Insurance Portability and Accountability Act of 1996 (Pub. L. No. 104-191, 110 Stat. 1936 (1996)), including a dependent whose coverage under TRS-Care was waived due to the existence of other coverage for the dependent during the Age 65 Additional Enrollment Opportunity described in subsection (a) of this section, may elect to enroll in TRS-Care.
(A) In no event may an individual who is already enrolled in TRS-Care elect a different plan, for himself or any eligible dependents, but may only add eligible dependents for coverage under the individual's existing plan selection upon the occurrence of a special enrollment event.
(B) In no event may a TRS retiree enroll in TRS-Care as a result of a special enrollment event applicable to his dependent.
(C) In no event, as a result of a special enrollment event applicable to the dependent, may the dependent of a TRS retiree enroll in TRS-Care if the TRS retiree is not enrolled in TRS-Care.
(2) The enrollment period for an individual who becomes eligible for coverage due to a special enrollment event shall be the 31 calendar days immediately after the date of the special enrollment event. To make an effective election, a completed TRS-Care application must be received by TRS within this 31-day period.
(c) Enrollment Opportunity Established by TRS. If an eligible TRS retiree or his eligible dependent does not have either an Age 65 Additional Enrollment Opportunity or a special enrollment event, then he may enroll in TRS-Care only during a subsequent enrollment period established by TRS.
(d) This section does not affect the right of a TRS service retiree or surviving spouse enrolled in a TRS-Care coverage tier to drop coverage, select a lower coverage tier, or drop dependents at any time.
This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority.
Filed with the Office of the Secretary of State on March 5, 2008.
TRD-200801323
Ronnie G. Jung
Executive Director
Teacher Retirement System of Texas
Effective date: March 25, 2008
Proposal publication date: November 30, 2007
For further information, please call: (512) 542-6438
The Board of Trustees (Board) of the Teacher Retirement System of Texas (TRS) adopts amendments to §41.5 concerning a disability retiree's payment of monthly contributions for their own participation and their dependents' participation in the health benefits program for TRS retirees (TRS-Care), administered by TRS as trustee. The amended section is adopted in response to legislation providing for an additional contribution by disability retirees who earn excess compensation for work during retirement. The amended section is adopted without changes to the proposed text as published in the November 23, 2007, issue of the Texas Register (32 TexReg 8428).
House Bill 2427, 80th Legislature, Regular Session (2007) ("H.B. 2427") authorizes TRS to adopt rules requiring TRS disability retirees to report income earned from other employment and to adopt rules providing for suspension of coverage or reduction of disability retirement annuities based on compensation earned by a disability retiree. H.B. 2427 also requires a disability retiree whose annuity is suspended to pay additional TRS-Care premium amounts as determined by the trustee. Amended §41.5, a TRS-Care rule, is adopted in response to H.B. 2427. To implement the related pension provisions concerning the suspension of coverage or reduction of disability retirement annuities based on compensation earned by a disability retiree, the Board also adopts new rules 34 TAC §§31.35 (relating to Disability Retiree Report of Excess Compensation), 31.36 (relating to Forfeiture of Disability Retirement Annuity Payments Due to Excess Compensation), and 31.37 (relating to Applicability of Excess Compensation Provisions to Employment in Texas Public Educational Institutions), as published elsewhere in this issue of the Texas Register
Amended §41.5 requires a disability retiree whose annuity payments have been forfeited pursuant to H.B. 2427 to pay the total cost of TRS-Care coverage, including dependent coverage, during the months of annuity forfeiture. Failure to timely pay such total costs will result in the suspension of TRS-Care coverage for the disability retiree and his dependents. During the suspension of coverage, (i) coverage under TRS-Care will cease and the costs of coverage for TRS-Care will no longer accrue, and (ii) TRS-Care coverage of a dependent shall not be terminated for failure to make the required contribution for coverage, and (iii) TRS-Care 2 or TRS-Care 3 coverage of a disability retiree shall not be dropped to TRS-Care 1 coverage for failure to make any required contribution for coverage.
No later than the last day of the month in which TRS resumes annuity payments to the disability retiree, the amended section requires the disability retiree to pay all costs of TRS-Care coverage due and owing, including past due amounts for coverage prior to the suspension of coverage and the costs of coverage for all months during which the disability retiree's annuity payments are resumed, if any. Failure to timely make such a payment will result in (i) any TRS-Care 2 or TRS-Care 3 coverage held by a disability retiree before the suspension being dropped to TRS-Care 1 coverage, (ii) TRS-Care 1 coverage being resumed for the disability retiree who had TRS-Care 1 coverage before the suspension of coverage, at no cost to the disability retiree, and (iii) TRS-Care coverage for the disability retiree's dependents who were enrolled in TRS-Care 1, 2, or 3 being terminated.
Pursuant to amended §41.5, reinstatement of TRS-Care coverage will be effective the first (1st) day of the earliest month for which the disability retiree's annuity payments are resumed. For example, if in May, the disability retiree's annuity payments are resumed for not only the month of April, but also the month of March, then the disability retiree's TRS-Care coverage is also reinstated effective the first (1st) day of March. As noted above, the amounts then due and owing from the disability retiree would include an amount payable for TRS-Care coverage during the month of March and April in this example.
A disability retiree may not change TRS-Care 1 coverage tier or add dependents unless and until the disability retiree has an additional enrollment opportunity as set out in 34 TAC §41.2 (relating to Additional Enrollment Opportunities) or some other opportunity under §1575.161 of the Insurance Code (relating to Open Enrollment; Additional Enrollment Periods).
The non-substantive amendments to §41.5 are adopted for purposes of clarification.
No comments were received regarding the proposed amended section.
Statutory Authority: The amended section is adopted under the following sections of the Insurance Code: §1575.052, which authorizes TRS as trustee for TRS-Care to adopt rules reasonably necessary to implement and administer TRS-Care, including procedures for contributions and deductions, and §1575.212, which authorizes TRS as trustee for TRS-Care to establish ranges for payment of the share of total costs allocated under §1575.211 to retirees.
This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority.
Filed with the Office of the Secretary of State on March 7, 2008.
TRD-200801363
Ronnie G. Jung
Executive Director
Teacher Retirement System of Texas
Effective date: March 27, 2008
Proposal publication date: November 23, 2007
For further information, please call: (512) 542-6438
The Board of Trustees (Board) of the Teacher Retirement System of Texas (TRS) adopts amendments to §41.7 relating to the effective date of coverage under TRS-Care, the health benefits program for TRS retirees administered by TRS, as trustee. The substantive amendments are adopted mainly to implement recent legislation concerning health benefit coverage during the transition period from active employment to retirement. The amended section is adopted without changes to the proposed text of the rule as published in the November 30, 2007, issue of the Texas Register (32 TexReg 8701).
TRS has in the past facilitated the transition of retiring individuals from their existing health coverage to coverage under TRS-Care by having in place an option to defer the effective date of TRS-Care coverage. Depending upon the date of the individual's retirement and the date TRS received the individual's retirement application, a TRS member could defer the effective date of his TRS-Care coverage for either one or two months.
House Bill 973, 80th Legislature, Regular Session (2007) ("H.B. 973") made changes to §22.004 of the Education Code (relating to Group Health Benefits for School Employees) that entitle an employee of a district, who resigns effective after the last day of an instructional year, to participate or be enrolled in his existing coverage, whether under TRS-ActiveCare or under some other coverage offered by the individual's employer, for an additional period of time beyond his date of resignation. In the usual situation, this additional period of time will extend the individual's existing coverage through the summer months (i.e., June, July, and August). In light of the above, TRS amends §41.7 to expand the existing option to defer TRS-Care coverage to allow TRS members to defer the effective date of TRS-Care coverage for themselves and their eligible dependents for up to three months. This additional month of available deferment will allow individuals greater flexibility to avoid either having to pay premiums for coverage under both their existing health benefits plan and under TRS-Care for the month of August or having to drop their coverage under their existing health benefits plan during the month of August while at the same time starting their TRS-Care coverage.
Accordingly, in relettered subsection (b) of amended §41.7, regardless of the date a TRS member submits her application for retirement, if the TRS member timely submits an application for TRS-Care coverage, she may defer the effective date of coverage for herself and her eligible dependents to the first day of any of the three (3) months immediately following the month after the effective date of retirement. However, in no event may the TRS member choose an effective date for TRS-Care coverage that begins before the first day of the month that immediately follows the month in which the TRS-Care application for coverage is received by TRS-Care.
For example, consider an individual who chooses a retirement date of May 31st. Assume that this individual submits his application for TRS-Care coverage before his retirement date of May 31st. Normally, this individual's TRS-Care coverage will begin on June 1st. However, this individual may choose to have his TRS-Care coverage begin on July 1st, August 1st, or September 1st (i.e., the first day of any of the three (3) months immediately following the month after the effective date of his retirement). However, if this same individual does not submit his application for TRS-Care coverage until July, then this individual's TRS-Care coverage will normally begin on August 1st. Assuming this individual still chooses a May 31st retirement date, this individual can defer the effective date of his TRS-Care coverage to September 1st. This retiree cannot choose to have TRS-Care coverage begin June 1st or July 1st, nor can he defer the effective date of his coverage to October 1st or November 1st.
The non-substantive amendments to §41.7 are adopted for purposes of clarification (for example, see relettered §41.7(f) concerning special enrollment events) or to delete subsections that are no longer necessary.
No comments were received regarding the proposed amended section.
Statutory Authority: The amended section is adopted under the authority of §1575.052, Insurance Code, which authorizes the Board to adopt rules it considers necessary to implement and administer the TRS-Care program.
This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority.
Filed with the Office of the Secretary of State on March 5, 2008.
TRD-200801324
Ronnie G. Jung
Executive Director
Teacher Retirement System of Texas
Effective date: March 25, 2008
Proposal publication date: November 30, 2007
For further information, please call: (512) 542-6438
The Board of Trustees (Board) of the Teacher Retirement System of Texas (TRS) adopts amendments to the following rules for the health benefits program for active public education employees (TRS-ActiveCare) administered by TRS, as trustee: §41.50 concerning administrative appeals relating to claims and §41.51 concerning administrative appeals relating to eligibility. The amended sections are adopted without changes to the proposed text as published in the December 7, 2007, issue of the Texas Register (32 TexReg 9097).
Amended §41.50 and §41.51 respectively address the process that participants in TRS-ActiveCare can use to appeal a denial of a claim or a denial of a request to enroll in TRS-ActiveCare. Before the merits of an appeal are reviewed by the TRS Appeal Committee (the "Committee"), a determination is made as to whether or not the appeal has been timely filed. If the Committee determines that the appeal was not timely made, this finding becomes the final decision of TRS.
Section 41.50 concerns appeals relating to claims and other benefits under TRS-ActiveCare that are made to the Committee and possibly thereafter to the Executive Director. The most significant adopted change to the section is to delete current subsection (f) and replace it with adopted new subsection (o). The adopted change under new subsection (o) provides that the Committee shall review appeals made at any stage of the appeal process for timeliness and not just the appeal initially made within the appeal process. The remaining changes adopted for §41.50 are for clarification and renumbering purposes only.
Section 41.51 concerns appeals relating to eligibility under TRS-ActiveCare. The rule addresses appeals relating to eligibility that are made to the Committee and possibly thereafter to the Executive Director. The most significant adopted change to §41.51 is to delete current subsection (e) and replace it with adopted new subsection (i). As with the adopted amendments to §41.50(o), the adopted change under new subsection (i) to §41.51 provides that the Committee shall review appeals made at any stage of the appeal process for timeliness and not just the appeal initially made within the appeal process. The remaining changes adopted for §41.51 are for clarification and renumbering purposes only.
No comments were received regarding the proposed amended sections.
Statutory Authority: The amended sections are adopted under the authority of §1579.052, Insurance Code, which authorizes the Board to adopt rules it considers necessary to implement and administer the TRS-ActiveCare program; and §1579.101, Insurance Code, which requires TRS to establish by rule plans for group coverages under the TRS-ActiveCare program and to define by rule the requirements of each coverage plan and tier of coverage.
This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority.
Filed with the Office of the Secretary of State on March 5, 2008.
TRD-200801325
Ronnie G. Jung
Executive Director
Teacher Retirement System of Texas
Effective date: March 25, 2008
Proposal publication date: December 7, 2007
For further information, please call: (512) 542-6438