Page 52 - Demo

Any eligible individual electing to continue TRS-ActiveCare coverage must pay the total TRS cost, excluding supplemental state contributions, plus a 2% administrative fee.* The COBRA participant will receive coupons and remit premiums directly to the COBRA administrator (bswift for the TRS-ActiveCare Primary, TRS-ActiveCare HD, TRS-ActiveCare Primary+ and TRS-ActiveCare 2 plans or the applicable administrator for HMO health plans). The COBRA administrator will send all notifications of premium changes, health care benefit changes and the COBRA coverage termination date to the participant.Premium payments are due the first of each month. Premium payments must be postmarked within 30 days of the premium due date (grace period) or COBRA coverage will be terminated. If premium payments are not received by the 20th of the month, a reminder notice will be sent.Note: If a participant does not make a payment within the grace period, their coverage will be terminated as of the last month of full payment.Benefits for COBRA participants will be the same as those for active employees. COBRA participants must elect the same plan they had at termination. COBRA participants will have the same rights as active employees at the next plan enrollment period.The rate charged for COBRA coverage will be determined as follows:%u2022 Any spouse, dependent child or employee continuing coverage as an individual will be charged the rate for employee-only coverage.%u2022 An employee and spouse continuing coverage will be charged the rate for employee and spouse coverage.%u2022 Any adult continuing coverage with dependent children will be charged the rate for employee and child coverage.%u2022 If the entire family continues coverage, they will be charged the rate for employee and family coverage.%u2022 If more than one child continues coverage (without an adult), the coverage will be set up under the youngest child%u2019s identification number and they will be charged the rate for employee and child coverage.*Disability extension: Qualified medical plan beneficiaries, who have been determined by the SSA to be disabled, and are eligible for the 11-month disability extension of COBRA coverage, will be charged up to 150% of the applicable cost during the additional months of COBRA coverage (up to 11 months) based on Department of Labor rules. Individuals with HMO coverage should consult their HMO%u2019s Evidence of Coverage for information regarding COBRA coverage.When COBRA Coverage EndsCOBRA continuation coverage ends if:%u2022 The benefits continuation period expires (COBRA participants will receive an End of Eligibility Notice 60 days prior to the expiration of their continuation period.)%u2022 Premiums are not postmarked within 30 days of the due date.%u2022 The COBRA participant becomes covered under another group health plan as an employee, spouse or dependent.%u2022 The COBRA participant becomes entitled to Medicare benefits.%u2022 TRS-ActiveCare no longer provides group medical coverage for public school employees.There is no conversion privilege available for any of the TRS-ActiveCare medical or HMO plans. The premiums and coverage are subject to change in accordance with any updates made to the TRS-ActiveCare medical or HMO plans.52 www.bcbstx.com/trsactivecareba