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Dependent EligibilityAn employee may also cover his or her eligible dependents at the same time he or she enrolls in coverage. No person may be covered under TRS-ActiveCare as both an employee and as a dependent, or as a dependent of more than one employee. Eligible dependents include:%u2022 A spouse, including a common law spouse (A common law spouse is not considered eligible unless there is a Declaration of Informal Marriage filed with an authorized government agency.)%u2022 A child under 26, who is one of the following:%u2022 a natural child%u2022 an adopted child or a child who is lawfully placed for legal adoption%u2022 a stepchild%u2022 a foster child%u2022 a child under the legal guardianship of the employee%u2022 A grandchild* under 26 whose primary residence is the household of the employee and who is a dependent of the employee for federal income tax purposes for the reporting year in which coverage of the grandchild is in effect.*For purposes of dependent eligibility under TRS-ActiveCare, a grandchild that does not fit into the above definition and is not considered a child.%u2022 %u201cAny other dependent%u201d (other than those listed above) under 26 in a regular parent-child relationship with the employee, meeting all four of the following requirements:%u2022 The child%u2019s primary residence is the household of the employee;%u2022 The employee provides at least 50% of the child%u2019s support;%u2022 Neither of the child%u2019s natural parents resides in that household; and%u2022 The employee has the legal right to make decisions regarding the child%u2019s medical care.**This requirement does not apply to dependents 18 and over.%u2022 A child, 26 or over, of a covered employee may be eligible for dependent coverage, provided that the child is either mentally or physically incapacitated to such an extent that they are dependent on the employee on a regular basis as determined by TRS, and meet other requirements as determined by TRS.A dependent does not include a brother or a sister of an employee, unless the brother or sister is an individual under 26 who is either: (1) under the legal guardianship of an employee, or (2) in a regular parent-child relationship with an employee, as defined in the %u201cany other child%u201d category above. Parents and grandparents of the covered employee do not meet the definition of an eligible dependent.Please see the %u201cChanging Employment between Participating Employers and Rehires%u201d section for more details around dual coverage.Note: It is against the law to elect coverage for an ineligible person. Violations may result in prosecution and/or expulsion from the TRS-ActiveCare program for up to five years. TRS-ActiveCare eligibility audits may be conducted periodically. Audit notifications will be mailed to TRS-ActiveCare plan participants when TRS-ActiveCare needs to verify participants, or their covered dependents, meet plan eligibility requirements. During an eligibility audit, participants may be asked to provide satisfactory proof of eligibility to the Benefits Administrator, and if unsatisfactory, he or she will have a limited time to cancel coverage for the ineligible persons without incurring penalties that may include expulsion under TRS rules published in the Texas Administrative Code and recovery of paid claims. It is the responsibility of the Benefits Administrator to obtain and maintain documentation.20 www.bcbstx.com/trsactivecareba

