34 Tex. Admin. Code § 41.40 - Coverage Continuation While on Leave Without Pay

(a) Full-time and part-time employees covered under TRS-ActiveCare who are placed on leave-without-pay-status by a participating entity in accordance with that entity's personnel policies, and their eligible covered dependents, may continue participation in TRS-ActiveCare in accordance with this section under the coverage plan in effect the day before leave without pay begins. For purposes of this section, "leave-without-pay status" includes unpaid leave taken in accordance with the Family and Medical Leave Act of 1993 or other applicable law.

(b) Individuals who were placed on leave-without-pay status by a participating entity in accordance with that employer's personnel policies or applicable law prior to the date the employer became a participating entity may enroll in TRS-ActiveCare in accordance with § 41.36 of this title (relating to Enrollment Periods for TRS-ActiveCare) if they were covered by the participating entity's health coverage plan on the day before the employer became a participating entity and provided they would meet eligibility requirements under § 41.34 of this title (relating to Eligibility for Coverage under the Texas School Employees Uniform Group Health Coverage Program) but for their leave-without-pay status.

(c) Individuals who were placed on leave-without-pay status by a participating entity in accordance with that employer's personnel policies or applicable law prior to the date the employer became a participating entity, but who were not covered by the participating entity's health coverage plan on the day before the employer became a participating entity, may enroll in TRS-ActiveCare in accordance with § 41.36 of this title when they return to work and provided they meet eligibility requirements under § 41.34 of this title.

(d) Unless otherwise required by applicable law, continued coverage for an individual described in subsection (a) or (b) of this section shall terminate the earlier of:

(1) 11:59 p.m. Austin Time on the last calendar day of the month for which premiums are paid;

(2) 11:59 p.m. Austin Time on the last calendar day of the month in which the employment of the covered individual, or the individual under whom a dependent qualified for coverage, terminates as determined by the participating entity, except as otherwise provided under § 41.39 of this title (relating to Coverage for Individuals Changing Employers);

(3) 11:59 p.m. Austin Time on the last calendar day of the month in which a covered individual, or the individual under whom a dependent qualified for coverage, is no longer eligible for coverage under TRS-ActiveCare under § 41.34 of this title due to requirements unrelated to leave-without-pay status; or

(4) 11:59 p.m. Austin Time on the last calendar day of the sixth month following the month in which coverage continuation under this section began for either the covered individual, or for the individual under whom a dependent qualified for coverage.

Notes

34 Tex. Admin. Code § 41.40

The provisions of this §41.40 adopted to be effective December 26, 2002, 27 TexReg 12003; amended to be effective March 8, 2007, 32 TexReg 1092