1. (a) Manner, form and effect of election. All elections to opt in or opt out of participation in the uniform group coverage under the Texas School Employees Uniform Group Health Coverage Act (the "Act") (TRS-ActiveCare) pursuant to the provisions of Insurance Code, Article 3.50-7, as added by the 77th Legislature, 2001 in House Bill 3343 and as permitted by the Teacher Retirement System of Texas (TRS), as trustee of the program, shall be in writing, in a form prescribed by TRS and received by TRS no later than 5:00 p.m. on or before the applicable election deadline date specified in this section. A notice of election otherwise valid received by facsimile before the applicable deadline is acceptable if TRS receives the original, signed notice of election within seven calendar days after the applicable deadline. An incomplete or unsigned notice of election will not be deemed received by TRS for purposes of determining whether a valid election has been exercised. A valid election filed with TRS is irrevocable once the election deadline passes, unless TRS is authorized to extend a deadline and does so by resolution of the TRS Board of Trustees. Entities electing to participate in the TRS-ActiveCare program may not discontinue participation unless authorized by Insurance Code, Article 3.50-7, and by appropriate rule or resolution adopted by the TRS Board of Trustees. Entities opting out of participation in the TRS-ActiveCare program have no further opportunity to elect to participate except as authorized by Insurance Code, Article 3.50-7, and by appropriate rule or resolution adopted by the TRS Board of Trustees. If an entity has an option to opt in and thereby participate in the TRS-ActiveCare program, a failure to properly or timely file a notice of election shall have the effect of the entity electing not to participate. Likewise, if an entity has an option to opt out and thereby not participate in the TRS-ActiveCare program, a failure to properly or timely file a notice of election shall have the effect of the entity electing to participate.

2. (b) School districts with 500 or fewer employees. Pursuant to Insurance Code, Article 3.50-7 §5(a), school districts with 500 or fewer employees as of January 1, 2001 are required to participate effective September 1, 2002 in the TRS-ActiveCare program, except that certain of these school districts may delay or opt out of participation by specified election deadlines as provided in paragraphs (1) through (3) of this subsection.

   1. (1) Pursuant to Insurance Code, Article 3.50-7 §5(g), a school district with 500 or fewer employees as of January 1, 2001 that, on January 1, 2001, was individually self-funded for the provision of health care coverage to its employees may elect to opt out of the mandatory participation in the TRS-ActiveCare program effective September 1, 2002, by filing its notice of election with TRS on or before September 1, 2001. Subsection (h) of this section provides the method for a school district to change its election.
   2. (2) Pursuant to Insurance Code, Article 3.50-7 §5(e), a school district with 500 or fewer employees as of January 1, 2001 that was a member on January 1, 2001 of a risk pool established under the authority of Local Government Code, Chapter 172, may opt out of the mandatory participation in the TRS-ActiveCare program effective September 1, 2002 by filing its notice of election with TRS on or before September 1, 2001 and electing thereby to continue in the risk pool that the district participated in on January 1, 2001. Subsection (h) of this section provides the method for a school district to change its election.

   3. (3) Pursuant to Insurance Code, Article 3.50-7 §5(h), a school district with 500 or fewer employees as of January 1, 2001 , other than a qualifying district as defined in subsection (b)(3)(B) of this section, that is a party to a contract for the provision of health insurance coverage to the employees of the district that is in effect on September 1, 2002 may delay mandatory participation in the TRS-ActiveCare program effective September 1, 2002, by filing its notice of election with TRS on or before September 1, 2001.

      1. (A) A qualifying school district, as defined in subsection (b)(3)(B) of this section, may delay mandatory participation in the TRS-ActiveCare program effective September 1, 2002, by filing its notice of election with TRS on or before 5:00 p.m., Central Time, on August 15, 2002.

      2. (B) A qualifying school district is one that meets the following criteria:

         1. (i) had 500 or fewer employees as of January 1, 2001;
         2. (ii) made available to its employees in the 2001-2002 school year one or more plans of comparable coverage as determined by the TRS comparability report for the 2001-2002 school year; and
         3. (iii) reflected in its comparability compliance report to TRS that at least 50% of the district's aggregate employees covered by plans offered by the district in the 2001-2002 school year were participating in the comparable plan(s) made available by the district.
      3. (C) At the time of an election under subsection (b)(3) of this section, such a school district must provide the expiration date of the contract to TRS and shall begin mandatory participation in the TRS-ActiveCare program on the first day of the month immediately following the month in which termination or expiration of the contract occurs.
3. (c) School districts with 501 or more employees but not more than 1000 employees. School districts with 501 or more employees but not more than 1000 employees at any time during the 2001 school year, as reflected on any report received by TRS for a reporting period during that school year may elect to participate in the TRS-ActiveCare program in the manner prescribed in subsection (h) of this section.
4. (d) School districts with 1001 or more employees. A school district with 1001 or more employees at any time during the 2001 school year, as reflected on any report received by TRS for a reporting period during that school year, may elect to participate in the TRS-ActiveCare program, provided that notice of its election shall be in a form prescribed by TRS and shall be received by TRS at its offices on or after November 22, 2002, in which event the school district will become a participating entity on the later of the first day of the month following (6) months after the date on which TRS receives the notice or a preferred date specified by the school district in its notice. Alternatively, the district will become a participating entity effective on the date approved by the Executive Director, if applicable, as described in subsection (i) of this section.
5. (e) Educational districts. Pursuant to Insurance Code, Article 3.50-7 §5(i), educational districts whose employees are members of TRS are required to participate effective September 1, 2002 in the TRS-ActiveCare program, except that educational districts with 500 or fewer employees on January 1, 2001 may opt out of participation. September 1, 2001 is the deadline for such an educational district to file its notice of election with TRS to opt out of participation in the TRS-ActiveCare program. Subsection (h) of this section provides a method for an educational district to change its election.

6. (f) Charter schools. Pursuant to Insurance Code, Article 3.50-7 §6, an open-enrollment charter school established under Education Code, Chapter 12, Subchapter D, ("charter school") may elect to participate in the TRS-ActiveCare program. Only an eligible charter school under the Act may elect to participate.

   1. (1) Pursuant to Insurance Code, Article 3.50-7 §6(a), to be eligible, a charter school must agree to inspection of all records of the school relating to its participation in the TRS-ActiveCare program by TRS, by the administering firm as defined in Insurance Code, Article 3.50-7 §2(1), by the commissioner of education, or by a designee of any of those entities, and further must agree to have its accounts relating to participation in the TRS-ActiveCare program annually audited by a certified public accountant at the school's expense. The agreement of the charter school shall be evidenced in writing and shall constitute a part of a notice of election prescribed by TRS pursuant to subsection (a) of this section.
   2. (2) This paragraph applies only to charter schools eligible to participate in the TRS-ActiveCare program that either received state funding in accordance with Education Code, Chapter 12, prior to June 1, 2001, and did not file a notice of election to participate on or before September 1, 2001, or received or will receive state funding in accordance with Education Code, Chapter 12, on or after June 1, 2001, and did not or do not file a notice of election to participate on or before the later of September 1, 2001 or the ninetieth calendar day following the date the Texas Education Agency authorized the Comptroller to issue the first payment of funds to such charter school, so long as the ninetieth calendar day is no later than June 30, 2003. Those eligible charter schools may elect to opt into and participate in the TRS-ActiveCare program by filing a notice of election in a form prescribed by TRS and received by TRS in its offices no later than 5:00 p.m., Central Time, on July 1, 2003, in which event the charter school will become a participating entity no later than the first day of the month following sixty (60) days after the date on which TRS receives the notice.
   3. (3) Eligible charter schools that do not elect to participate in the TRS-ActiveCare program pursuant to subsection (f)(2) of this section may opt into and participate in the TRS-ActiveCare program by filing a notice of election in a form prescribed by TRS and received by TRS in its offices at any time or date after 5:00 p.m., Central Time, on July 1, 2003, in which event the charter school will become a participating entity on the later of the first day of the month following six (6) months from the date on which TRS receives the notice or a preferred date specified by the charter school. Alternatively, the eligible charter school will become a participating entity effective on the date approved by the Executive Director, if applicable, as described in subsection (i) of this section.
7. (g) Regional education service centers. Pursuant to Insurance Code, Article 3.50-7 §5(a), each regional education service center established under Education Code, Chapter 8, is required to participate effective September 1, 2002 in the TRS-ActiveCare program.

8. (h) School districts described in subsection (b)(1), (b)(2), or (c) of this section, and educational districts described in subsection (e) of this section may opt into and participate in the TRS-ActiveCare program as follows:

   1. (1) By filing a notice of election in a form prescribed by TRS and received by TRS in its offices no later than 5:00 p.m., Central Time, on July 1, 2003, in which event the district will become a participating entity no later than the first day of the month following sixty (60) days from the date that TRS receives the notice; or
   2. (2) By filing a notice of election in a form prescribed by TRS and received by TRS in its offices at any time or date after 5:00 p.m., Central Time, on July 1, 2003, in which event the district will become a participating entity on the later of the first day of the month following six (6) months from the date on which TRS receives the notice or a preferred date specified by the school district; or
   3. (3) By complying with subsection (i) of this section.

9. (i) An entity that will become a participating entity in the TRS-ActiveCare program on the first day of the month following six (6) months after the date on which TRS receives the entity's notice of election but desires to become a participating entity on an earlier date may include in its notice a request that the Executive Director consider an exception to the notice requirement. The notice must include the earlier date on which the entity desires its coverage to begin. The Executive Director will grant the exception if, in his or her sole discretion, upon considering the following criteria, he or she finds that an exception is in the best interest of the TRS-ActiveCare program:

   1. (1) the impact on the requesting entity's employees and dependents;
   2. (2) the impact on the TRS-ActiveCare program's third-party administrator;
   3. (3) the impact on the TRS-ActiveCare program's provider network;
   4. (4) the number of potential enrollees that would be coming into the TRS-ActiveCare program for the first time on the same date; and
   5. (5) the impact on the TRS-ActiveCare program as a whole, taking into account any recommendations and observations of TRS's health care consultant.

Source Note:The provisions of this §41.30 adopted to be effective January 1, 2002, 26 TexReg 11035; amended to be effective March 12, 2003, 28 TexReg 2114; amended to be effective June 18, 2003, 28 TexReg 4560.