Page 51 - Demo

* For the purposes of dependent eligibility under TRS-ActiveCare, a grandchild is not considered a child. ** This requirement does not apply to dependents age 18 and over.You can cover your eligible dependents including:%u2022 Your spouse, including a common law spouse (a common law spouse is not considered eligible unless a Declaration of Informal Marriage is on file with an authorized government agency)%u2022 A child under age 26 who is:%u2022 a natural child%u2022 an adopted child or child lawfully placed for adoption%u2022 a stepchild%u2022 a foster child%u2022 a child under your legal guardianship%u2022 A grandchild under age 26 whose primary residence is your household and who is your dependent for federal income tax reporting in the year when their coverage is in effect*%u2022 Any %u2018other dependent%u2019 under age 26 in a regular parent-child relationship with you (other than described above), meeting all these requirements:%u2022 the child%u2019s primary residence is your household%u2022 you provide at least 50% of the child%u2019s support%u2022 neither of the child%u2019s natural parents live in your household%u2022 you have the legal right to make decisions about the child%u2019s medical care**%u2022 Your child age 26 or older who is: %u2022 mentally or physically incapacitated %u2022 dependent on you on a regular basis, as determined by TRS %u2022 who meets other requirements, as determined by TRSTo add a mentally or physically incapacitated child, you and your child%u2019s doctor must fill out a Dependent Child Statement of Disability to provide satisfactory proof of the disability and dependency. You must submit the forms no later than 31 days after the date the child turns 26, or after the event date. To avoid gaps in coverage, the forms must be turned in and approved before the end of the month your child turns 26, or after the event date. The form is available at www.bcbstx.com/trsactivecare. A dependent does not include your brother or sister unless they are under age 26 and either: %u2022 under your legal guardianship, or %u2022 in a regular parent-child relationship with you, as defined in the %u2018any other child%u2019 categoryYour parents and grandparents are not eligible dependents. Note: It%u2019s against the law to elect coverage for an ineligible person. Violations may result in prosecution and expulsion from the TRS-ActiveCare program for up to five years.Your Eligible Dependents What is CHIP and is it available to my family?The Children%u2019s Health Insurance Program provides low-cost children%u2019s health insurance. To find out if your family qualifies and to apply, call CHIP at 1-800-647-6558 or 211, or visit www.texaschildrenshealthplan.org. Note: A child can%u2019t get coverage under both TRS-ActiveCare and CHIP.www.bcbstx.com/trsactivecare 51