34 Tex. Admin. Code § 41.45 - Required Information from School Districts, Other Educational Districts, Charter Schools, and Regional Education Service Centers Electing to Participate in TRS-ActiveCare

(a) An eligible entity that submits a written election to participate in TRS-ActiveCare under §41.30 must include with the notice of election the information listed below for each medical and prescription drug plan that the entity offered to its employees during the designated time period. The entity must include this information for the year to date for the plan year in which the entity submits its notice of election (current year) and for the two complete plan years immediately preceding the current year. The required information is:

(1) Plan type (PPO, POS, HMO, etc.), including the effective date of each plan;

(2) Average number of employees participating in each plan;

(3) Average number of covered lives in each plan;

(4) Description of all medical and prescription drug benefits, including effective dates of any changes in each plan;

(5) Total premium rates by family tier for each insured plan, including effective dates of any changes;

(6) Total COBRA rates by family tier for each self-funded plan, including effective dates of any changes;

(7) Required employee contribution rates by family tier for each plan, including effective dates of any changes;

(8) Funding arrangement (fully insured, self-funded, etc.) for each plan;

(9) Total premiums paid by year for each plan, if insured;

(10) Total claims paid by year for each plan;

(11) Employee counts by age, gender, and participation status;

(12) A high cost claimant report; and

(13) Any other summary health information that TRS may require.

(b) Written notices of election to participate in TRS-ActiveCare under §41.30 without the information required under this section will be considered incomplete and will be denied by TRS. Entitles should reach out to TRS before the election deadline in §41.30 to ask questions and address issues related to the information that is required under this section.

(c) TRS will not deny an entity's request to participate in TRS-ActiveCare based on any information provided to TRS in accordance with the requirements of this section.

(d) TRS may prescribe the form in which entities must submit the information required by this section.

Notes

34 Tex. Admin. Code § 41.45

The provisions of this §41.45 adopted to be effective June 18, 2003, 28 TexReg 4561; amended to be effective April 1, 2011, 36 TexReg 2001; Amended by Texas Register, Volume 46, Number 41, October 8, 2021, TexReg 6944, eff. 10/17/2021