1. (a) The following individuals have an additional enrollment opportunity in TRS-Care as described in this section when they become 65 years old:

   1. (1) all TRS service retirees who are enrolled in TRS-Care;
   2. (2) dependents, as defined in Insurance Code, §1575.003, who are enrolled in TRS-Care and who are eligible to enroll in TRS-Care in their own right as a TRS service or disability retiree; and
   3. (3) surviving spouses, as defined in Insurance Code, §1575.003 who are enrolled in TRS-Care.
2. (b) The individuals defined in subsection (a) of this section are referred to as "eligible participants" in this section.
3. (c) Those eligible participants who are enrolled in TRS-Care on August 31, 2004, and who are 65 years old or older on that date have an additional enrollment opportunity on September 1, 2004.
4. (d) Those eligible participants who are enrolled in TRS-Care on August 31, 2004, and who become 65 years old after that date have an additional enrollment opportunity on the date that they become 65 years old.
5. (e) Those eligible participants who enroll in TRS-Care after August 31, 2004, and who become 65 years old after that date have an additional enrollment opportunity on the date that they become 65 years old.
6. (f) The additional enrollment opportunity for those eligible participants who enroll in TRS-Care after August 31, 2004, and who are 65 years old or older when they enroll in TRS-Care runs concurrently with the initial enrollment period as set out in §41.1 of this chapter relating to Initial Enrollment Periods for the Health Benefits Program Under the Texas Public School Retired Employees Group Benefits Act (TRS-Care).
7. (g) An eligible participant who is not enrolled in Medicare Part A at the time of his or her additional enrollment opportunity can enroll in the next-higher TRS-Care coverage tier, as determined by TRS-Care, and add dependent coverage in that same coverage tier.
8. (h) An eligible participant who is enrolled in Medicare Part A at the time of his or her additional enrollment opportunity can enroll in any TRS-Care coverage tier and add dependent coverage in that same coverage tier.
9. (i) An eligible participant can choose to remain in the same TRS-Care coverage tier and add dependent coverage in that coverage tier.
10. (j) If an eligible participant waives coverage for a dependent during the additional enrollment opportunity described in this section, the eligible participant will be able to enroll that dependent only as a result of a special enrollment event under the Health Insurance Portability and Accountability Act of 1996 (HIPAA) or during a subsequent enrollment period set by TRS. To enroll a dependent in TRS-Care as a result of a special enrollment event, the eligible participant must submit a TRS-Care application to TRS within 31 days of the date that the person becomes an eligible dependent.
11. (k) The additional enrollment period for eligible participants described in subsection (c) of this section ends on September 30, 2004.

12. (l) The additional enrollment period for eligible participants described in subsection (d) or (e) of this section expires at the end of the later of:

    1. (1) the 31st day following the last day of the month in which the eligible participant becomes 65 years old; or
    2. (2) the 31st day after the date printed on the notice of the additional enrollment opportunity sent to the eligible participant at the eligible participant's last-known address, as shown in the TRS-Care records.
13. (m) This section does not affect the right of a TRS service retiree or surviving spouse enrolled in a TRS-Care coverage tier to drop coverage, select a lower level of coverage, or drop dependents at any time.

Source Note:The provisions of this §41.2 adopted to be effective August 25, 2004, 29 TexReg 8128; amended to be effective February 9, 2006, 31 TexReg 709.