(a) Employees.
(1) Full-time Employees. Eligibility for GBP health coverage for full-time employees begins on the first day of the calendar month following the employee's completion of the health insurance waiting period. If the employee described in paragraphs (A) or (B) does not enroll in GBP health coverage on or before becoming eligible, he/she will automatically be enrolled in HealthSelect of Texas upon becoming eligible.
(2) Part-time employees.
(b) Retirees.
(1) A retiree who is at least 65 years of age with a minimum of 10 years eligible service credit or a retiree whose age and eligible service credit equals or exceeds 80 with a minimum of 10 years eligible service credit, is eligible for GBP health coverage on the day he/she becomes an annuitant provided the individual retires directly from state service. If the individual does not retire directly from state service as described in §1551.1055(b) of the Act, eligibility for GBP health coverage begins on the first day of the calendar month following 60 days after the date of retirement.
(2) A retiree who is less than 65 years of age with a minimum of 10 years eligible service credit is eligible for GBP health coverage with the applicable state contribution on the first day of the calendar month following the date on which the individual reaches 65 years of age, subject to meeting the required health insurance waiting period, if applicable.
(3) ORP Retirees.
(4) Retirees eligible for interim insurance. A retiree with at least 10 years of eligible service credit who is not eligible for a state contribution for GBP health coverage at the time of retirement is eligible for dental and vision coverage and, except as provided in paragraph (5) of this subsection, optional life insurance and dependent life insurance at the time of retirement. A retiree described by this paragraph and by paragraph (2) of this subsection, is eligible for GBP health coverage under the provisions described in §1551.323 of the Act, upon payment of the total cost, as determined by the Board of Trustees. For purposes of §1551.323, the total cost shall be determined by the Board of Trustees based on an actuarial determination, as recommended by ERS' consulting actuary for insurance, of the estimated total claims costs for individuals eligible for interim insurance pursuant to §1551.323 of the Act. If an individual who is eligible for this interim insurance is also eligible for COBRA coverage, then COBRA coverage should be exhausted, if possible, before the interim insurance begins as described by this subsection.
(5) A retiree is eligible for optional life insurance and dependent life insurance coverage if the retiree was enrolled in such coverage on the day before becoming an annuitant. Except as provided in paragraph (6) of this subsection, a retiree may not increase the amount of life insurance for which the retiree was enrolled on the day before becoming an annuitant, but may cancel life insurance coverage at any time. Canceled life insurance coverage may never be reinstated. A retiree is not eligible for disability or AD&D coverage.
(6) A retiree who is not enrolled in retiree optional life insurance or dependent life insurance coverage is eligible to apply for minimum retiree optional life insurance or dependent life insurance coverage. Submission of evidence of insurability acceptable to ERS shall be required for enrollment in such coverage.
(7) A retiree who was not enrolled in dependent life insurance coverage on the day before becoming an annuitant becomes eligible for dependent life insurance coverage of a newly acquired dependent on the first day of the month following the date on which the individual becomes a dependent of the retiree.
(8) A retiree who returns to work for an employer may continue coverage for which he/she is eligible as a retiree, or, subject to subsection (a) of this section, elect to participate in the GBP as a full-time or part-time employee. Time spent in an eligible position as a return to work retiree may not be used to meet eligibility requirements for retiree health insurance coverage. A return to work retiree who elected active employee coverage will be re-enrolled in retiree coverage for which he/she is eligible and may elect new retiree coverage for which he/she is eligible at the time of separation from active duty.
(9) A retiree whose extended life insurance benefits are terminated for reasons other than termination pursuant to §1551.351 of the Act is eligible for retiree life insurance coverage on the first day of the month following the extended life insurance benefits termination date.
(c) Dependents of employees and retirees.
(1) The dependents of an employee/retiree are eligible for coverage on the same day that the employee/retiree becomes eligible. Except as otherwise provided in this paragraph, a newly acquired dependent is eligible for coverage on the first day of the month following the date on which the individual becomes a dependent of a covered employee/retiree. The employee/retiree must be enrolled for a particular coverage before the employee's/retiree's dependents are eligible for that type of coverage. An eligible child for whom a covered employee/retiree is court-ordered to provide medical support becomes eligible for GBP health coverage upon receipt by the employer of a valid court order. A newborn natural child is eligible automatically on the date of birth. A newly adopted child is eligible automatically on the date of placement for adoption.
(2) Except as otherwise provided in this paragraph, double coverage is not permitted for any participant in the GBP.
(d) Former COBRA unmarried children.
(1) A former COBRA unmarried child is eligible to continue the GBP health, dental and vision insurance coverage in which the child was enrolled upon expiration of the child's continuation coverage under COBRA.
(2) A former COBRA unmarried child continuing health insurance coverage under the provisions of this subsection is eligible for dental and vision insurance coverage if such coverage was not in effect upon the expiration of the child's continuation coverage under COBRA.
(3) A former COBRA unmarried child is eligible to enroll a newly acquired dependent child within 30 days of the child's date of birth or placement for adoption. Otherwise, he/she cannot enroll any other dependents in GBP health coverage.
(e) Surviving dependents.
(1) The surviving spouse of a deceased retiree or an active employee is eligible to continue coverage in the GBP health, dental and vision plans in which the surviving spouse was enrolled on the day of death of the employee/retiree provided, however, the deceased active employee must have had at least 10 years of service credit, including at least 3 years on August 31, 2001 or at least 10 years after August 31, 2001 of service as an eligible employee with an employer, at the time of death. A deceased active employee described by §1551.114 of the Act must have had at least 10 years of eligible service credit, as determined by ERS, before his/her surviving spouse is eligible to continue coverage. A surviving spouse who is also an annuitant or employee shall not be eligible for surviving spouse benefits as long as he/she is eligible for coverage as an employee/retiree. Participants continuing coverage as surviving spouses are not eligible for life insurance coverage.
(2) The dependent child of a deceased retiree or an active employee is eligible to continue coverage in the GBP health, dental and vision plans in which the dependent children were enrolled on the day of death of the employee/retiree provided, however, the deceased active employee must have had, at the time of death, at least 10 years of service credit, including at least 3 years on August 31, 2001 or at least 10 years after August 31, 2001 of service as an eligible employee with an employer, as long as the surviving spouse is eligible and continues to participate in the GBP. A deceased active employee described by §1551.114 of the Act must have had at least 10 years of eligible service credit, as determined by ERS, before his/her dependent children are eligible to continue coverage. Dependent children of deceased employees/retirees will be considered as dependents of the deceased employee's/retiree's surviving spouse for purposes of the GBP. Participants continuing coverage as surviving dependents are not eligible for life insurance coverage.
Cont'd...