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Disabled DependentsA covered employee%u2019s child, 26 and over, 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 the child meets other requirements as determined by TRS. The employee must complete the Disabled Dependent Authorization Form and the Disabled Dependent Physician Certification Form to provide satisfactory proof of the disability and dependency, and return it to:Blue Cross and Blue Shield of TexasPO Box 660044 Dallas, TX 75266-0044 The forms must be submitted no later than 31 days after the date the child turns 26, or after the event date. To avoid any gap in coverage, the forms should be submitted and approved prior to the end of the month the child turns 26, or prior to the event date. If the participant misses the applicable 31-day deadline for submission of the forms to BCBSTX, the participant may submit the forms for review prior to the Annual Enrollment deadline for an effective date of Sept. 1 (the beginning of the new plan year).Once the forms are approved, BCBSTX will notify bswift and the dependent%u2019s record will then be updated with the disabled flag. Until approval has been determined, the dependent record should not be updated on a Third-Party Enrollment Portal. Coverage will not be updated for dependents until approval has been received from BCBSTX.The Disabled Dependent Authorization Form is available on the BCBSTX TRS-ActiveCare website www.bcbstx.com/trsactivecare/tools-and-resources/forms.Note: A sibling who is over 26 may qualify as a disabled dependent. Parents and grandparents of the covered employee do not meet the definition of an eligible dependent.Special Eligibility Situations%u2022 If an employee and spouse both work for a participating employer, the spouse may be covered as an employee or as a dependent of an eligible employee. Only one parent may enroll dependent children for coverage. If both parents enroll the dependent children, the newest coverage record will be accepted.%u2022 A child (under 26) who is employed by an employer and is a contributing TRS member can be covered as a dependent on his or her parent%u2019s TRS-ActiveCare coverage. However, current law only allows pooling of state and employer funds for %u201cmarried couples.%u201d An employee who is covered as a dependent child will not be entitled to state or employer funding.%u2022 A retiree who returns to work for a participating employer in TRS-ActiveCare is eligible for TRS-ActiveCare coverage if the retiree meets TRS-ActiveCare eligibility requirements, regardless of any prior coverage under TRS-Care.%u2022 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.%u2022 Part-time employees are not entitled to state assistance in the purchase of their TRS-ActiveCare coverage. The participating employer that employs a part-time employee may, but is not required to, provide assistance in the purchase of TRS-ActiveCare coverage for the part-time employee.%u2022 Upon termination of a retiree%u2019s TRS-ActiveCare coverage, the retiree may enroll in TRS-Care if the retiree: leaves active employment with a participating employer, turns 65 or has a special enrollment event. The opportunity to enroll in TRS-Care under these rights is limited in time.%u2022 If a participant has employee and spouse coverage, and the spouse is hired by a participating employer, the employee may drop the spouse (unless restricted by employer%u2019s Section 125 cafeteria plan rules) so that the spouse may enroll as a new hire. (The cancellation reason would be considered voluntary and would not be eligible for COBRA.)%u2022 If a participant has employee-only or employee and child coverage, and the spouse is hired by a participating employer, the employee cannot enroll the spouse because the spouse is a new hire; there must be a loss of other coverage. The employee may enroll the spouse within 31 days of the spouse%u2019s event date for loss of other coverage.www.bcbstx.com/trsactivecareba 21