PART 3. TEACHER RETIREMENT SYSTEM OF TEXAS
CHAPTER 41. HEALTH CARE AND INSURANCE PROGRAMS
SUBCHAPTER A. RETIREE HEALTH CARE BENEFITS (TRS-CARE)
The Teacher Retirement System of Texas (TRS), as trustee of the health benefits program for TRS retirees (TRS-Care) under the Texas Public School Retired Employees Group Benefits Act (Chapter 1575 of the Insurance Code), proposes amendments to §41.7, relating to the effective date of coverage for an eligible individual who elects to enroll in TRS-Care. One of the proposed amendments addresses the effective date of TRS-Care coverage for an eligible surviving spouse or eligible dependent child of a deceased TRS service or disability retiree or deceased active TRS member (together, a Survivor). The other proposed amendment is a non-substantive change to eliminate a redundant explanatory rule reference.
Under the existing wording of §41.7(d), the effective date of coverage for a Survivor who is not enrolled in TRS-Care immediately preceding the death of the spouse or parent will be the first day of the month following TRS-Care's receipt of a timely submitted enrollment application. As a consequence, a Survivor must submit his or her enrollment application to TRS-Care before the end of the month in which the spouse or parent died in order to enroll in TRS-Care effective on the first day of the immediately following month. There have been a few recent situations in which a Survivor has not been able to submit his or her enrollment application quickly enough to avoid a month's delay in his or her effective date in TRS-Care. For example, if the active TRS member died in the third week of April, the surviving spouse might not have enough time to submit the enrollment application before April 30. Consequently, the submission of an enrollment application during the month of May, even though timely under 34 TAC §41.1, relating to initial enrollment periods for TRS-Care, would result in an effective date of coverage of June 1, not May 1. To avoid a potential month delay in coverage under TRS-Care, TRS proposes an amendment to §41.7.
Subsection (d) of §41.7 is proposed for amendment to provide that, if the Survivor is not enrolled in TRS-Care immediately preceding the death of the spouse or parent, the Survivor will be allowed to choose an effective date of coverage that is either: (1) the first day of the month following TRS-Care's receipt of an application during the initial enrollment period as described in §41.1; or (2) the first day of the month following the month of the retiree's or member's death, provided TRS-Care receives an application for enrollment in TRS-Care within the initial enrollment period as described in §41.1. Applying the proposed amendment to the example described in the preceding paragraph, upon the filing of a timely application for enrollment in TRS-Care, the Survivor may elect to have his or her TRS-Care coverage begin on May 1 or on June 1.
In addition, a non-substantive amendment is proposed for existing subsection (c) of §41.7 to delete a repetitive explanatory reference to another rule that already appears in subsection (a) of §41.7.
Ken Welch, TRS Chief Financial Officer, estimates that, for each year of the first five years that the proposed amended rule will be in effect, there will be no foreseeable implications relating to cost or revenues of the state or local governments as a result of enforcing or administering the amended sections.
For each year of the first five years that the proposed rules will be in effect, Ronnie Jung, TRS Executive Director, has determined that the public benefits expected as a result of the adoption of the proposed amended rule will be to grant to the Survivor greater flexibility in choosing his or her effective date of TRS-Care coverage. For each year of the first five years that the proposed rules will be in effect, Mr. Welch has determined that there will not be any probable economic costs to persons required to comply with the proposed amended rule. Mr. Welch has also determined that there will be no effect on local employment because of the proposal, and therefore no local employment impact statement is required under §2001.022 of the Government Code. In addition, Mr. Welch has determined that the proposed amended rule will have no adverse economic effect on small businesses or micro-businesses, and, therefore, neither an economic impact statement nor a regulatory flexibility analysis is required under §2006.002 of the Government Code.
Comments may be submitted in writing to Ronnie Jung, Executive Director, 1000 Red River Street, Austin, Texas 78701-2698. To be considered, written comments must be received by TRS no later than 30 days after publication of this notice.
Statutory Authority: The amended rule is proposed under §1575.052 of the Insurance Code, which authorizes TRS to adopt rules reasonably necessary to implement the Texas Public School Retired Employees Group Benefits Act (Chapter 1575 of the Insurance Code), including those relating to periods for enrollment and selection of optional coverage and procedures for enrolling and exercising options under TRS-Care.
Cross-reference to Statute: The proposed amended rule affects the following sections of the Insurance Code: §1575.156, relating to TRS-Care coverage for a surviving spouse or dependents of surviving spouse; and §1575.157, relating to TRS-Care coverage for a surviving dependent child.
§41.7.Effective Date of Coverage.
(a) - (b) (No change.)
(c) The effective date of coverage for a surviving
spouse or for a surviving dependent child is the first day of his
or her eligibility if TRS-Care receives an application within the
initial enrollment period as described 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))] and the deceased participant had the surviving
spouse or the surviving dependent child enrolled in TRS-Care before
the participant died.
(d) If the surviving spouse or the surviving dependent child was not enrolled in TRS-Care immediately preceding his or her becoming eligible for coverage, the effective date of coverage will be, at the election of the surviving spouse or the surviving dependent child, either the first day of the month following:
(1) TRS-Care's receipt of an application
during the initial enrollment period as described in §41.1 of
this title; or[.]
(2) the month of the death of the deceased TRS service or disability retiree or deceased active TRS member, provided TRS-Care receives an application during the initial enrollment period as described in §41.1 of this title.
(e) - (m) (No change.)
This agency hereby certifies that the proposal has been reviewed by legal counsel and found to be within the agency's legal authority to adopt.
Filed with the Office of the Secretary of State on December 19, 2008.
TRD-200806626
Ronnie G. Jung
Executive Director
Teacher Retirement System of Texas
Earliest possible date of adoption: February 1, 2009
For further information, please call: (512) 542-6438