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To terminate a split premium arrangement an online Application to Terminate Split Premium Form must be completed. Benefits Administrators must complete the online Application to Terminate Split Premium Form. This form should be submitted online.To access the online Application to Terminate Split Premium Form go to TRS split bill.Termination of employment will terminate an existing split premium arrangement. If either employee is sent via a TPA file or entered on the bswift Enrollment Portal as a termination, the following actions would apply in the absence of an online Application to Terminate Split Premium Form:%u2022 Termination of the primary employee.%u2022 All members on the policy would be terminated with this transaction. The secondary split member would have 31 days from the date of the primary termination to apply for coverage under a special enrollment event.%u2022 Termination of secondary employee (previously declined spouse). %u2022 The secondary employee%u2019s split billing will be terminated. The coverage would continue under the primary insured and a notice sent to the primary insured%u2019s Benefits Administrator to collect full premium.Split premium arrangements will need to be applied for each year during Annual Enrollment. Any split premium arrangement currently in place will terminate on Aug. 31 unless a new online Application to Split Premium Form is received. Applications that are submitted and approved by Aug. 31 will be effective Sept. 1. Any application submitted after Aug. 31 will be effective first of the following month after it is approved. Dual Enrollment ProcessingTRS rules do not allow double coverage under TRS-ActiveCare. If a member is already covered under one TRS-ActiveCare policy, then the member cannot enroll in and maintain coverage under a second policy. This applies to employees and dependents.If bswift receives an enrollment from a member who is currently enrolled in TRS-ActiveCare, the coverage with the newest effective date will remain in force. TRS-ActiveCare coverage with the oldest effective date will be terminated. In the instance that the new coverage begins mid-month (e.g. a new hire has chosen actively-at-work date), then the new coverage date will be adjusted to the first of the following month and the old coverage will be ended at the end of the preceding month to avoid an overlap in coverage.bswift will notify the respective employers with the date the coverage was terminated. If the coverage should have been terminated on any other date, it is the responsibility of the Benefits Administrator at the respective employer to report the correct termination date to bswift. (If a dependent is going directly from dependent coverage to coverage as an employee, the dependent%u2019s effective date of coverage under the new plan will be the first of the month following their actively-at-work date.)In cases where the effective date of coverage at each employer are identical, most commonly seen at Annual Enrollment, the bswift BA Advocate team will work with the two employers and any TPAs to determine which employer maintains the coverage. Until a response is received from the respective BAs, bswift will maintain coverage under the employer who sent coverage most recently.28 www.bcbstx.com/trsactivecareba