Page 22 - Demo

Court-ordered Dependent ChildrenIf the participating employer receives a court order or national medical support notice that directs an employee to provide health coverage for a dependent child, the court-ordered dependent child will be automatically enrolled from the date the participating employer receives notification of the court order or national medical support notice. A court order or national medical support notice that directs anyone other than the employee to provide health coverage for a dependent child does not require TRS-ActiveCare to provide dependent coverage for the dependent child and is not a special enrollment event for the employee or any of the employee%u2019s eligible dependents.The court order or national medical support notice that is directed to the employee is a special enrollment event for an employee and the applicable dependents. Therefore, if an eligible employee is not covered by TRS-ActiveCare at the time the participating employer receives the court order or national medical support notice, the employee, the employee%u2019s spouse, and the employee%u2019s dependent children may be enrolled in TRS-ActiveCare.With regard to any individuals who are not the subject of the court order or national medical support notice, normal eligibility and special enrollment event rules apply (for example, a request, along with supporting documentation, to enroll such individuals must be received within 31 days of the receipt by the participating employer of the court order or national medical support notice). You will need to contact your BA Advocate if you need to enroll an employee%u2019s dependent children for court-ordered coverage when the employee decides not to enroll. If you are enrolling through a ThirdParty Enrollment Portal you can make the update on that portal or notify your Benefits Administrator. If the employee is adding only one child, he or she should submit the child%u2019s information. The child will be set up with a single ID number and the employee-only premium rate will be charged. If the employee is adding more than one child, the eldest child will be set up with an ID number and that child%u2019s information should be submitted. The other children will be listed as dependents and the employee and children premium rate will be charged.If a participating employer receives a court order or national medical support notice to add coverage for an employee%u2019s dependent children, the children may be added to the employee%u2019s current TRS-ActiveCare plan if the employee is already enrolled. The employee may also select a different plan at this time. If the employee is not enrolled in TRS-ActiveCare, the employee may select a plan for the dependent children.If the employee refuses to sign an application, the participating employer should consult with its legal counsel to determine what action should be taken. If the participating employer determines it should enroll the child, the Benefits Administrator should make note of this action for their records. It is the participating employer responsibility to complete any forms required and to update the appropriate eligibility in the enrollment portal.Note: Failure to comply with a court order or national medical support notice may subject the employer to penalties under state law. Consult with your legal counsel if you have questions concerning a particular court order or national medical support notice.Other Court-ordered DependentsA court order or national medical support notice that directs an employee to provide health coverage for a spouse, for an ex-spouse or for other dependents that are not eligible children under TRS-ActiveCare eligibility standards do not require TRS-ActiveCare to provide dependent coverage as a result of the court order or national medical support notice. Additionally, this type of court order or national medical support notice does not qualify as a special enrollment event to make plan changes. An ex-spouse is not eligible for TRSActiveCare coverage unless the ex-spouse is already covered as a COBRA continuation participant.Active Contributing vs. Active WorkingIt is a TRS requirement that employees enter a status of Active Contributing or Active Working on either the bswift Enrollment Portal or the TPA site. It is the Benefits Administrator%u2019s responsibility to review the status to ensure it was entered correctly by the employee. Below is the definition of each status.%u2022 Active Contributing: those who are currently working for TRS-covered employers and are contributing to the TRS retirement plan.%u2022 Active Working: those who fit into one of the three following categories: (1) have at least five years of service credit and are not currently employed in a TRS-covered position, (2) have less than five years of service credit and are currently employed by a TRS-covered employer but not in a membership eligible position, or (3) have less than five years of service credit and have been absent from employment with a TRS-covered employer for less than five years.22 www.bcbstx.com/trsactivecareba