Page 17 - Demo

Employee EligibilityTo be eligible for TRS-ActiveCare, an individual:%u2022 Must either be (i) a participating member who is currently employed by a participating employer in a position that is eligible for membership in the TRS pension, or (ii) an individual who is currently employed by a participating employer for 10 or more regularly scheduled hours each week in a position that is not eligible for membership; and%u2022 Is not receiving health care coverage as an employee or retiree under (i) the Texas State College and University Employees Uniform Insurance Benefits Act (e.g., coverage offered by The University of Texas System or the Texas A&M University System), (ii) the Texas Employees Uniform Group Insurance Benefits Act (e.g., coverage offered by ERS); or (iii) TRS-CareNOTE: Medicare-eligible retirees ARE eligible to enroll in TRS-ActiveCare.If a current employee was an eligible part-time employee during an enrollment opportunity for the current plan year, and later during the current plan year the employee becomes an eligible full-time employee, the employee will have a 31-day opportunity, beginning on the first day that this employee becomes an eligible full-time employee, to enroll himself or herself, as well as, his or her eligible dependents in TRS-ActiveCare during the current plan year. This enrollment opportunity exists even if enrollment in TRS-ActiveCare during the current plan year was previously declined by this employee.An eligible full-time employee is a participating member of the TRS pension who is:%u2022 currently employed by a participating employer;%u2022 employed in a position that IS eligible for membership in the TRS pension; and%u2022 not receiving coverage as an employee or retiree from TRS-Care or a uniform group insurance or health benefits program offered by ERS, the University of Texas, or Texas A&M University.An eligible part-time employee is an individual who is:%u2022 currently employed by a participating employer;%u2022 employed in a position that IS NOT eligible for membership in the TRS pension or is not eligible for membership in the TRS pension because of a service or disability retirement; and%u2022 not receiving coverage as an employee or retiree from TRS-Care or a uniform group insurance or health benefits program offered by ERS, the University of Texas, or Texas A&M University. NOTE: Medicare-eligible retirees ARE eligible to enroll in TRS-ActiveCare.Accordingly, for purposes of enrollment in TRS-ActiveCare, individuals who are hired in a substitute position or who have retired under the TRS pension will be considered part-time employees, regardless of the number of hours they work for the participating employer.Part-time employees are not entitled to a state contribution toward the purchase of their TRS-ActiveCare coverage. The participating employer that employs a part-time employee may, but is not required to, provide a contribution toward the purchase of TRSActiveCare coverage for the part-time employee.Note: Although under their particular circumstances, a retiree, a higher education employee, or a state employee may not be covered as an employee of a participating reporting employer, he or she may be able to be covered as a dependent of an eligible employee. Employees covered as dependents by a higher education employer or a state program may also be covered under TRS-ActiveCare as an employee.Medicare Secondary Payer for Medicare-Eligible Return-to-Work RetireesUnder the Medicare Secondary Payer Law, Medicare-eligible TRS-Care retirees can enroll in TRS-ActiveCare if they return to work for a TRS-covered employer. Return-to-work retirees enrolled in TRS-Care and eligible for Medicare may enroll in TRS-ActiveCare if they return to a TRS employer and work 10 or more hours per week. www.bcbstx.com/trsactivecareba 17