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If... The employee%u2019s effective date is... The employee%u2019s eligible dependent effective date is%u2026LOSS OF ELIGIBILITYThe employee is enrolled in an approved HMO and loses eligibility because he or she no longer lives, works or resides in that HMO service area. The employee may enroll in another approved HMO (if applicable) or a TRS-ActiveCare plan within 31 days after losing eligibility.The first of the month following the event date.The same date as the employee%u2019s effective date of coverage.In no event will the dependent%u2019s coverage become effective prior to the employee%u2019s effective date.MILITARYThe employee returns from military service and enrolls (or re-enrolls) in TRS-ActiveCare within 31 days after his or her actively-atwork date.If the employee returns to active employment within the same plan year and chooses to re-enroll in TRS-ActiveCare, the employee must select the same plan option in which he or she was previously enrolled.The employee%u2019s choice of:(1) his or her actively at work date, or(2) the first of the month following the employee%u2019s actively at work date.Premium is billed for the full month in which coverage begins.The employee must choose the effective date of coverage within 31 days after the eligibility date.The same date as the employee%u2019s effective date of coverage.In no event will the dependent%u2019s coverage become effective prior to the employee%u2019s effective date.LEAVE WITHOUT PAYThe employee returns from leave- withoutpay status and enrolls (or re-enrolls) for coverage within 31 days after his or her actively-at-work date.If the employee returns to active employment within the same plan year and chooses to re-enroll in TRS-ActiveCare, the employee must select the same plan in which he or she was previously enrolled.The employee%u2019s choice of:(1) his or her actively at work date, or(2) the first of the month following the employee%u2019s actively at work date.Premium is billed for the full month in which coverage begins.The employee must choose the effective date of coverage within 31 days after the eligibility date.The same date as the employee%u2019s effective date of coverage.In no event will the dependent%u2019s coverage become effective prior to the employee%u2019s effective date.www.bcbstx.com/trsactivecareba 31

