TITLE 34.PUBLIC FINANCE

Part 3. TEACHER RETIREMENT SYSTEM OF TEXAS

Chapter 41. HEALTH CARE AND INSURANCE PROGRAMS

Subchapter A. RETIREE HEALTH CARE BENEFITS (TRS-CARE)

34 TAC §41.7, §41.11

The Teacher Retirement System of Texas (TRS) proposes amendments to §41.7, relating to effective date of coverage and a new §41.11, relating to years of service credit used to determine premiums, each relative to the Texas Public School Retired Employees Group Insurance Program (TRS-Care). These proposed amendments and the new section implement Senate Bill 1369 and House Bill 3459, 78th Legislature, Regular Session, 2003, and House Bill 7, 78th Legislature, 3rd Called Session, 2003. The proposed amendments to §41.7 implement changes to the effective date of coverage based on the new TRS-Care eligibility criteria set out in House Bill 7 for those TRS members taking a service retirement after September 1, 2004. They also address when TRS-Care coverage begins for those retirees taking advantage of the additional enrollment opportunity provided by the referenced legislation. The proposed new §41.11 addresses which years of service credit will be used in determining premiums for TRS retirees, surviving spouses, and divorced spouses who elect COBRA coverage pursuant to Senate Bill 1369 and House Bill 3459.

Ronnie Jung, Executive Director, has determined that for each year of the first five-year period that the proposed amendments and the new section are in effect, there will be no fiscal implications to state or local governments as a result of enforcing or administering the amendments or the new section. There is no foreseeable effect on local employment or local economies as a result of the proposed amendments or new section.

Mr. Jung has also determined that for each year of the first five years that the proposed amendments to §41.7 are in effect, the public benefit anticipated as a result of the amendments will be that TRS rules will comply with the statutory changes and that those TRS members taking a retirement after September 1, 2004 will have notice of when their coverage will be effective. Mr. Jung has determined that for each year of the first five years that the proposed new §41.11 is in effect, the public benefit anticipated as a result of the new section will be notice to retirees, surviving spouses, and divorced spouses electing COBRA of the years of service credit that will be used to determine their TRS-Care premiums. There is no anticipated adverse economic effect on small businesses or micro-businesses as a result of compliance with the proposed amendments or new section. Mr. Jung has determined that there is no potential economic costs to persons required to comply with the proposed amendments. Mr. Jung has determined that the potential economic costs to persons required to comply with the proposed new section for each year of the first five years the proposal will be in effect may be the difference in the amount of premium paid based on their years of service credit as provided by the new section.

Written comments on the proposal may be submitted to Ronnie Jung, Executive Director, 1000 Red River, Austin, Texas 78701.

These sections are proposed under Insurance Code §1575.052, which gives TRS the authority to adopt rules as necessary to administer and operate the TRS-Care program. The sections are also proposed under Government Code, Chapter 825, §825.102, which authorizes the Board of Trustees of the Teacher Retirement System to adopt rules for the transaction of business of the Board.

There are no other codes affected.

§41.7.Effective Date of Coverage.

(a) The following words and phrases, when used in this section, [ shall ] have the following meanings, unless the context clearly indicates otherwise.

(1) Noncontributory coverage means TRS-Care [ --The ] coverage provided at no cost to eligible TRS retirees and surviving spouses .

(2) Contributory coverage means TRS-Care coverage [ --Coverage ] for which eligible TRS retirees, surviving spouses, and surviving dependent children must pay at least some part of the cost [ a contribution is required ].

(b) For those TRS members who take a service or disability retirement before September 1, 2004, and who enroll or are enrolled in noncontributory coverage during their initial enrollment period as described in §41.1 of this chapter relating to Enrollment Periods for the Texas Public School Retired Employees Group Insurance Program (TRS-Care), the [ The ] effective date of such [ noncontributory ] coverage is [ for a retiree shall be ] the first day of the month following the effective date of retirement unless the retiree has waived coverage in writing.

(c) This subsection applies to the following TRS members: those who take a service or disability retirement after September 1, 2004, and enroll in noncontributory coverage during their initial enrollment period as described in §41.1 of this chapter and those who, regardless of their retirement date, enroll in contributory coverage during their initial enrollment period as described in §41.1. For such members, the [ The ] effective date of [ contributory ] coverage is [ for the retiree shall be ]:

(1) the first day of the month following the effective date of retirement if the application for coverage is received by TRS-Care on or before the effective retirement date; or

(2) the first day of the month following the receipt of the application by TRS-Care if the application is received after the effective retirement date but within the initial [ 31-day ] enrollment period.

(d) Retirees who , due to their effective retirement date , have a choice of beginning [ contributory ] coverage in two different months may defer the effective date of coverage to the first day of the latter month if that election is made in writing and is received by TRS-Care before [ in advance of ] the beginning of the first month in which the effective date of coverage could have taken place.

(e) The effective date of coverage for a surviving spouse or for a surviving dependent child is [ shall be ] the first day of his or her [ their ] eligibility if TRS-Care receives an application within the initial enrollment period as described in §41.1 of this chapter and the deceased participant had the surviving spouse or the surviving dependent child enrolled in TRS-Care [ covered under the program ] before the participant [ he or she ] died.

(f) If [ Where ] the surviving spouse or the surviving dependent child was not enrolled in TRS-Care [ covered under the program ] immediately preceding his or her becoming eligible for coverage , the effective date of coverage will be the first day of the month following TRS-Care's receipt of an application during the initial enrollment period as described in §41.1 of this chapter [ by TRS-Care ].

(g) The effective date of coverage for an eligible dependent [ dependents who are eligible to be enrolled and ] who is [ are ] enrolled under a retiree's or surviving spouse's TRS-Care coverage during the initial enrollment period is the same date as the retiree or surviving spouse's effective date of coverage unless the dependent is enrolled after the retiree's effective retirement date and after the retiree has enrolled but within the initial enrollment period, in which case the dependent's effective date of coverage will be the first day of the month following TRS-Care's receipt of the application to enroll the dependent. [ will be: ]

[ (1) the same date as the retiree or surviving spouse if the enrollment is during the initial enrollment period; ]

[ (2) the first day of the month following receipt of the application by TRS-Care if the enrollment of the dependents is after the initial enrollment period; or ]

[ (3) the day on which a child is born, if the participant has coverage for children already in effect under TRS-Care. ]

(h) The effective date of coverage for an eligible dependent who is enrolled under a retiree's or surviving spouse's TRS-Care coverage as a result of a special enrollment event under the Health Insurance Portability and Accountability Act of 1996 (HIPAA) is the date specified by HIPAA.

(i) The effective date of coverage for a retiree, a surviving spouse, and an eligible dependent who have a second initial enrollment period as described in §41.1 of this chapter relating to Enrollment Periods for the Texas Public School Retired Employees Group Insurance Program (TRS-Care) and who enroll during the time period prescribed by §41.1 is:

(1) the first day of the month following the date that the retiree or surviving spouse becomes eligible for TRS-Care under subsections (c)(1), (c)(2), or (c)(3) of §41.10 of this chapter relating to Eligibility to Enroll in the Texas Public School Retired Employees Group Insurance Program if the application for coverage is received by TRS-Care on or before the date of eligibility for TRS-Care under subsections (c)(1), (c)(2), or (c)(3) of §41.10; or

(2) the first day of the month following the receipt of the application by TRS-Care if the application is received after the date on which the retiree or surviving spouse becomes eligible for TRS-Care under subsections (c)(1), (c)(2), or (c)(3) of §41.10 of this chapter but within the enrollment period.

(j) The effective date of coverage for a retiree, a surviving spouse, and an eligible dependent who have an additional enrollment opportunity as described in §41.2(b) of this chapter relating to Additional Enrollment Opportunity and who submit an application within the time period described by §41.2 is:

(1) September 1, 2004, if the application for coverage is received by TRS-Care by August 31, 2004; or

(2) October 1, 2004, if the application is received on or after September 1, 2004 but within the enrollment period.

(k) The effective date of coverage for a retiree, a surviving spouse, and an eligible dependent who have an additional enrollment opportunity as described in §41.2(c) or §41.2(d) of this chapter relating to Additional Enrollment Opportunity and who submit an application within the time period described by §41.2 is:

(1) the first day of the month following the retiree's or surviving spouse's 65th birthday if the application for coverage is received by TRS-Care on or before the retiree's or surviving spouse's 65th birthday; or

(2) the first day of the month following the receipt of the application by TRS-Care if the application is received after the retiree's or surviving spouse's 65th birthday but within the enrollment period.

(l) [ (h) ] Except as provided in subsections (o), (p), and (q) [ (l), (m), and (n) ] of this section, the effective date of changes in coverage due to the acquisition of Medicare is [ shall be on ] the first of the month following the date of TRS-Care's receipt of a copy of the participant's or dependent's Medicare card [ by TRS-Care ].

(m) [ (i) ] Except as provided in subsections (o), (p), and (q) [ (l), (m), and (n) ] of this section, the effective date of reduction in coverage shall be the first day of the month following TRS-Care's receipt of a signed request [ by TRS-Care ] for reduced coverage.

(n) [ (j) ] A retiree, surviving spouse, or surviving dependent child may cancel any coverage by submitting the appropriate cancellation notice to TRS-Care.

(1) Cancellations will be effective on: [ at midnight on the last day of the month in which the signed notice is received by the program. ]

(A) the first day of the month following the date printed on the notice of cancellation form ("notice date") sent to the retiree at the retiree's last known address, as shown in the TRS-Care records, if TRS-Care receives the completed notice of cancellation within fourteen days of the notice date; or

(B) the first day of the month following TRS-Care's receipt of the retiree's completed notice of cancellation form if the form is received more than fourteen calendar days after the notice date; or

(C) the first day of the month following TRS-Care's receipt of a written request to cancel coverage from a surviving spouse or from or on behalf of a surviving dependent child.

(2) This subsection [ section ] shall also apply to waivers of noncontributory coverage by retirees who take a TRS retirement before September 1, 2004 .

[(k) All participants and dependents shall be entitled to all applicable rights under the Federal Public Health Service Act (COBRA), Title XXII.]

(o) [ (l) ] Where a participant who has Medicare Part A coverage incorrectly enrolls in an insurance coverage option that provides for coverage without corresponding Medicare Part A coverage and [ as a result ] payment is made by Medicare and TRS-Care in a manner that violates the provisions of Chapter 1575, Insurance Code, [ Article 3.50-4, ] which requires TRS-Care to be secondary to Medicare, TRS may [ the Teacher Retirement System of Texas (TRS) is authorized to ] seek the recovery of funds paid in violation of Chapter 1575 [ Article 3.50-4 ] and may [ to ] make the effective date of the correct coverage retroactive to the first day of the earliest month for which recovery of such overpaid funds is possible under Medicare rules.

(p) [ (m) ] Where a participant who has Medicare Part A coverage incorrectly enrolls in a TRS-Care coverage option that provides for coverage without corresponding Medicare Part A and there is no claim made upon TRS-Care or the legitimate claim is less than the amount of overpaid contributions, TRS-Care may [ is authorized to ] refund or credit the amount due to the participant and may [ to ] make the effective date of the correct coverage retroactive to when the participant was first enrolled in both Medicare and TRS-Care to a maximum retroactive period of twelve months, including the month in which proof of Medicare Part A is received by TRS-Care.

(q) [ (n) ] Upon TRS-Care's discovery that [ by TRS-Care of ] a participant [ who ] does not have Medicare Part A coverage and [ who ] is incorrectly enrolled in a TRS-Care coverage option that requires [ provides for corresponding ] Medicare Part A coverage , TRS-Care will contact the participant and advise the participant [ them ] that the cost of coverage and the coverage will be adjusted prospectively effective the first day of the next month unless a copy of a Medicare card showing Part A coverage is received prior to that date. Claims will [ shall ] be paid based upon the coverage in effect at the time the services were provided. Any claims already paid as if Part A were [ was ] in effect will [ shall ] not be adjusted.

§41.11.Years of Service Credit Used to Determine Premiums.

(a) In addition to other criteria that TRS may use to determine premiums, pursuant to section 1575.212, Insurance Code, TRS may use years of service credit to determine applicable premium rates.

(b) To determine the applicable premium for those retirees who take a TRS retirement before September 1, 2004, TRS will use the retiree's years of service credit to which the retiree is entitled under the Chapter 823, Government Code, at the time of the TRS retirement.

(c) To determine the applicable premium for those retirees who take a TRS retirement after September 1, 2004, TRS will use the retiree's years of service credit that can be considered in determining eligibility for TRS-Care benefits at the time of the TRS retirement.

(d) To determine the applicable premium for surviving spouses and divorced spouses who elect COBRA coverage, TRS will use the retiree's years of service credit as determined by either subsection (b) or subsection (c) of this section, as applicable.

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 June 7, 2004.

TRD-200403715

Ronnie G. Jung

Executive Director

Teacher Retirement System of Texas

Proposed date of adoption: July 23, 2004

For further information, please call: (512) 542-6115


Subchapter C. TEXAS SCHOOL EMPLOYEES GROUP HEALTH (TRS-ACTIVECARE)

34 TAC §41.38, §41.50

The Teacher Retirement System of Texas (TRS) proposes amendments to §41.38, relating to termination date of coverage and to §41.50, relating to adjudication of claims, both concerning the Texas School Employees Uniform Group Health Coverage Program known as TRS-ActiveCare. The proposed amendments to §41.38 clarify that coverage for an individual enrolled in a TRS-ActiveCare health maintenance organization (HMO) terminates for the reasons and on the date specified in the individual's evidence of coverage from the HMO. The proposed amendments to §41.38 also add a termination provision for participants whose participating entity fails to make all premium payments for at least 90 days. The proposed amendments to §41.50 clarify that appeals from enrollees participating in a TRS-ActiveCare health maintenance organization (HMO) are not included within this appeal process but follow the HMO's appeal process.

Ronnie Jung, Executive Director, has determined that for each year of the first five-year period the amendments are in effect, there will be no determinable fiscal implications to state or local governments as a result of enforcing or administering the amended sections. There is no foreseeable effect on local employment or local economies as a result of the proposed amendments.

Mr. Jung has also determined that for each year of the first five years that the proposed amendments are in effect the public benefit anticipated as a result of the amendments to §41.38 will be that the rules are consistent with current HMO practice and that TRS-ActiveCare can limit its financial exposure when participating entities fail to make any premium payments for an extended period of time. Mr. Jung has determined that for each year of the first five years that the proposed amendments are in effect the public benefit anticipated as a result of the amendments to §41.50 will be that those enrolled in a TRS-ActiveCare HMO have clearer notice of what appeal process applies to them. There is no anticipated adverse economic effect on small businesses or micro-businesses as a result of compliance with the proposed amendments.

Mr. Jung has also determined that the anticipated economic costs to persons required to comply with the proposed amendments that address termination for a participating entity's failure to pay all premiums for at least 90 days for each year of the first five years the proposal will be in effect could include an individual whose coverage has been terminated and who does not elect COBRA coverage being required to pay for health care services the individual received after coverage was terminated. Mr. Jung has determined that there are no anticipated economic costs to persons required to comply with the other proposed amendments for each year of the first five years the proposal will be in effect.

Written comments on the proposal may be submitted to Ronnie Jung, Executive Director, 1000 Red River, Austin, Texas 78701.

These amendments are proposed under §1579.052, Insurance Code, which gives TRS authority to adopt rules relating to the TRS-ActiveCare program as necessary. The amendments are also proposed under Government Code, Chapter 825, §825.102, which authorizes the Board of Trustees of the Teacher Retirement System to adopt rules for the administration of the funds of the retirement system and for the transaction of business of the Board.

There are no other codes affected by the proposal.

§41.38.Termination Date of Coverage.

(a) Unless otherwise required by law or this section, coverage shall terminate at the earliest of:

(1) - (2) (No change.)

(3) 11:59 p.m. Central Time on the last calendar day of the month in which a covered individual, or the individual under whom a dependent qualified for coverage, is no longer eligible for coverage under the TRS-ActiveCare program under §41.34 of this title (relating to Eligibility for Coverage under the Texas School Employees Uniform Group Health Coverage Program); [ or ]

(4) 11:59 p.m. Central Time on the date specified by the trustee if the covered individual, or the individual under whom a dependent qualified for coverage, is expelled from the program ; [ . ]

(5) 11:59 p.m. Central Time on the last calendar day of the month immediately preceding the month in which TRS receives a notification from a participating entity, in the form prescribed by TRS, that a covered individual failed to make a required monthly premium payment to the participating entity ; [ . ]

(6) 11:59 p.m. Central Time on the last calendar day of the month in which a covered individual enters into active, full-time military, naval, or air service, except as provided under the Uniformed Services Employment and Reemployment Rights Act of 1994 (USERRA) or other applicable law ; or [ . ]

(7) 11:59 p.m. Central Time on the last day of the month for which TRS-ActiveCare received payment if the participating entity employing the covered individual, or the individual under whom a dependent qualified for coverage, has failed to make all premium payments due for a period of 90 days or longer; or

(8) the termination date that a health maintenance organization participating in the TRS-ActiveCare program provides for in its Evidence of Coverage for the reasons listed in that Evidence of Coverage.

(b) (No change.)

§41.50.Adjudication of Claims.

(a) A person enrolled in the TRS-ActiveCare program , other than a person enrolled in a health maintenance organization (HMO) participating in TRS-ActiveCare, who is denied payment of a claim or other benefit ("Claimant") may submit a written request to the administering firm for reconsideration of the claim. The claimant shall submit a request for reconsideration according to procedures established by the administering firm. All relevant medical information should be submitted to the administering firm prior to a final decision. Persons enrolled in a TRS-ActiveCare HMO follow the appeal procedures set out by the HMO.

(b) - (n) (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 June 7, 2004.

TRD-200403716

Ronnie G. Jung

Executive Director

Teacher Retirement System of Texas

Proposed date of adoption: July 23, 2004

For further information, please call: (512) 542-6115