Texas Administrative Code › Title 34 - PUBLIC FINANCE › Part 3 - TEACHER RETIREMENT SYSTEM OF TEXAS › Chapter 41 - HEALTH CARE AND INSURANCE PROGRAMS › Subchapter C - TEXAS SCHOOL EMPLOYEES GROUP HEALTH (TRS-ACTIVECARE) › Section 41.33 - Definitions Applicable to the Texas School Employees Uniform Group Health Coverage Program

Current through Reg. 49, No. 28; July 12, 2024
The following words and terms when used in this subchapter
					 or in connection with the administration of Chapter 1579, Insurance Code, shall
					 have the following meanings unless the context clearly indicates
					 otherwise:
(1) Dependent--Only those
				  individuals described by §
										1579.004,
				  Insurance Code, and an individual under 26 years of age ("child") who is
				  described by any one of the following subparagraphs (A), (B), or (C) at all
				  times during which the child is receiving coverage under TRS-ActiveCare.
(A) A child under the legal guardianship of a
				  full-time or part-time employee;
(B) A full-time or part-time employee's
				  grandchild whose primary residence is the household of that full-time or
				  part-time employee if the grandchild is a dependent of the full-time or
				  part-time employee for federal income tax purposes for the reporting year in
				  which coverage of the grandchild is in effect; or
(C) A child in a regular parent-child
				  relationship with a full-time or part-time employee, meaning that the child's
				  primary residence is the household of that full-time or part-time employee, the
				  full-time or part-time employee provides at least 50% of the child's support,
				  neither of the child's natural parents reside in that household, and the
				  full-time or part-time employee has the legal right to make decisions regarding
				  the child's medical care.
(D) For
				  clarification and without intending to identify all persons who are not a
				  Dependent for purposes of coverage, even though the individual may be in a
				  dependent relationship with a full-time or part-time employee, the following
				  are not included in the definition of Dependent in this section:
(i) Other than the spouse of a full-time or
				  part-time employee, a Dependent does not include an individual who is a
				  "participating member" as defined in paragraph (5) of this section.
(ii) A Dependent does not include a parent or
				  grandparent of a full-time or part-time employee.
(iii) A Dependent does not include a brother
				  or a sister of a full-time or part-time employee unless the brother or sister
				  is an unmarried individual under 26 years of age who is either:
(I) under the legal guardianship of a
				  full-time or part-time employee; or
(II) in a regular parent-child relationship
				  with a full-time or part-time employee, meaning that the brother or sister's
				  primary residence is the household of that full-time or part-time employee, the
				  full-time or part-time employee provides at least 50% of the brother or
				  sister's support, neither of the brother or sister's natural parents reside in
				  that household, and the full-time or part-time employee has the legal right to
				  make decisions regarding the brother or sister's medical care.